Iskanje po repozitoriju

A+ | A- | | SLO | ENG

Povzetek: Type 2 diabetes is a chronic and progressive metabolic disease, with a steadily increasing global incidence and prevalence, representing a major public health concern due to its substantial impact on morbidity and mortality. Type 2 diabetes is characterized by defective insulin secretion and peripheral insulin resistance, resulting in dysregulated glucose homeostasis. Optimal disease management is critical due to its association with multiple systemic complications, including diabetic retinopathy, nephropathy, neuropathy, foot ulcers, cardiomyopathy, and diabetes-related cognitive impairment. The involvement of exosomes in the initiation and progression of type 2 diabetes has recently gained considerable attention. These nanosized vesicles, secreted by virtually all cell types, play a pivotal role in mediating intercellular communication. This review highlights the potential of exosomes and their molecular cargo, particularly microRNAs, as endogenous biomarkers for the detection and monitoring of type 2 diabetes and its associated complications, while also exploring their emerging therapeutic applications.
Ključne besede: type 2 diabetes, diabetic complications, obesity, insulin resistance, extracellular vesicles, exosomes, MiRNAs, biomarkers, therapy
Objavljeno v DiRROS: 08.09.2026; Ogledov: 65; Prenosov: 38
Celotno besedilo (1,90 MB)
Gradivo ima več datotek! Več...

Povzetek: Introduction: Type 1 diabetes (T1D) is associated with an increased risk of cardiovascular and autonomic complications. Although cardiopulmonary exercise testing (CPET) is a valuable tool for assessing cardiorespiratory function, data on physiological response to maximal exertion in adolescents with T1D remain limited and inconsistent. This study aimed to compare cardiovascular, respiratory, metabolic, and microvascular responses to CPET in adolescents with T1D and healthy peers.Methods: Sixteen participants aged 11–16 years (eight with T1D and eight healthy controls), matched for anthropometric characteristics, underwent CPET on a cycle ergometer. Respiratory gas exchange, heart rate, heart rate variability, blood pressure, blood glucose, lactate concentration, skin blood flow, skin temperature, and cutaneous vascular conductance were measured at predefined time points during rest, exercise, and recovery. Blood glucose, lactate concentration, and skin microvascular variables were assessed at rest and during recovery.Results: Adolescents with T1D demonstrated a significantly lower V̇O2/power output slope and a higher ventilatory equivalent for oxygen at maximal effort, suggesting altered oxygen uptake efficiency. Maximal power output and maximal oxygen consumption did not differ between groups. Heart rate responses and heart rate variability were similar throughout testing. However, finger skin blood flow and cutaneous vascular conductance were significantly lower in the T1D group at rest and during recovery.Conclusion: Adolescents with T1D showed preserved cardiovascular function and comparable overall exercise capacity to healthy peers, despite subtle impairments in oxygen utilization and reduced skin microvascular function. These findings indicate that even at a young age, T1D is associated with altered metabolic, respiratory, and microvascular responses to maximal exercise. The results suggest that peripheral, rather than central mechanisms may underlie these differences, potentially involving glucose levels or synthetic insulin effects on vascular endothelium.
Ključne besede: autonomic nervous system, cardiovascular system, exercise testing, microcirculation, oxygen uptake, type 1 diabetes
Objavljeno v DiRROS: 07.09.2026; Ogledov: 61; Prenosov: 43
Celotno besedilo (909,18 KB)
Gradivo ima več datotek! Več...

Povzetek: Background and aims: Although familial hypercholesterolemia (FH) is common and associated with significant cardiovascular morbidity, screening programs are scarce. Furthermore, the effectiveness of nutritional advice for parents on children’s LDL cholesterol (LDL-C) levels is unclear, especially in FH versus non-FH hypercholesterolemia. Methods: In the Fr1dolin study, 367 of 14,513 children in Lower Saxony and Hamburg were positively screened for LDL hypercholesterolemia with an LDL-C>135 mg/dl (>3.5 mmol/l). The screening was considered positive if the first finding of hypercholesterolemia was confirmed in a second sample. These 367 children were invited to a follow-up examination including an extended lipid status, nutritional counseling and genetic analysis. Results: 289 out of 367 screen-positive children (57.4% girls) were followed up for 12 months; 191 (66.1%) underwent genetic testing. Children with a FH-causing pathogenic or likely pathogenic variant (n=40, 20.9%) had significantly higher LDL-C levels than children without a variant or with a variant of uncertain significance (p<0.001). After the nutritional counselling and after 6 and 12 months of follow-up, LDL-C levels did not improve significantly (median LDL-C at baseline 142 mg/dl, and 140 mg/dl at 6 and 12 months follow-up, respectively). Conclusions: A population-based screening program detects LDL-hypercholesterolemia in up to 2.5% of children, with a significant proportion of them having FH genetic variants, supporting early detection. One-time nutritional advice had little effect on LDL-C in general, but particularly in FH, highlighting on the one hand need for structured lifestyle programs and on the other hand early genetic testing in population based FH screening.
Ključne besede: familial hypercholesterolemia, FH, screening, children, LDL-C, nutritional advice, lifestyle intervention, follow-up study
Objavljeno v DiRROS: 04.09.2026; Ogledov: 96; Prenosov: 50
Celotno besedilo (1,51 MB)
Gradivo ima več datotek! Več...

Povzetek: International guidelines define standards of care for type 2 diabetes (T2D), obesity, cardiovascular disease (CVD), metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic kidney disease (CKD). Yet implementation at the national level remains inconsistent, leading to persistent gaps between evidence-based recommendations and real-world practice. Key barriers include linguistic and cultural adaptation, limited communication to clinicians, and siloed regulatory and reimbursement processes. Addressing these challenges requires coordinated strategies, such as concise translations, digital platforms and decision-support tools, integration into medical education, and structured monitoring and evaluation frameworks with feedback and incentives. Equitable and sustainable access further depends on coordination between medical societies, governmental authorities, payers, and patient representatives. Evidence from existing initiatives shows that systematic, context-sensitive approaches can measurably improve care. Building on these lessons, this Commentary recommends priorities for national implementation to ensure that guidelines move more effectively from publication to practice and realise their full potential to improve patient outcomes.
Ključne besede: clinical practice guideline implementation, diabetes, obesity, cardiovascular disease, chronic kidney disease
Objavljeno v DiRROS: 04.09.2026; Ogledov: 103; Prenosov: 51
Celotno besedilo (1,32 MB)
Gradivo ima več datotek! Več...

Povzetek: Background: Type 1 diabetes is an autoimmune disease with significant long-term complications. Variability in the decline of insulin secretion after diagnosis complicates both the development of treatments and disease management. We previously reported that gene expression changes within the first year post-diagnosis were associated with C-peptide decline at two years in the first INNODIA cohort of patients with newly diagnosed type 1 diabetes. Here, we aimed to validate these findings in an independent follow-up cohort and to increase statistical power by combining the data from both cohorts. Methods: We analysed transcriptomic data from a follow-up INNODIA cohort of 168 individuals with newly diagnosed type 1 diabetes to assess whether previously identified associations with disease progression could be replicated. We then combined data from the original and follow-up cohorts for integrated analysis. Longitudinal gene expression changes during the first year after diagnosis were examined in relation to disease progression, alongside age and estimated immune cell abundances. Findings: Analysis of the follow-up cohort validated the previously observed longitudinal changes in gene expression during the first year after diagnosis. In the combined dataset, transcriptomic analysis identified a large number of genes that were differentially expressed during the first year after disease onset. More rapid disease progression was associated with younger age and a relative decrease in neutrophil abundance. In addition, changes in the expression of several genes were associated with the rate of disease progression. Interpretation: These findings support the existence of biological heterogeneity in disease progression after diagnosis of type 1 diabetes and contribute to an improved understanding of the molecular dynamics associated with disease progression. These findings may help future studies aiming to enable patient stratification and design of more targeted and personalised therapeutic approaches in type 1 diabetes.
Ključne besede: type 1 diabetes, transcriptomics, beta cell decline, C-peptide, disease progression
Objavljeno v DiRROS: 04.09.2026; Ogledov: 100; Prenosov: 61
Celotno besedilo (2,26 MB)
Gradivo ima več datotek! Več...