Gestational diabetes mellitus (GDM) has recently been associated with abnormal profiles of inflammatory cells and cytokines, though the findings remain inconsistent and unclear.

To elucidate the peripheral immune status in GDM.

We systematically screened databases including Web of Science, PubMed, and EMBASE for eligible studies. Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data. The pooled mean difference (MD) with 95% confidence interval (CI) was analyzed as the outcome measure. The Newcastle-Ottawa scale was employed to assess study quality.

A total of 19 studies involving various immune cell subgroups were included in our analysis. Specifically, total CD4+ T cells (WMD = 3.08; 95%CI: 0.81-5.35) were significantly increased in GDM groups. In contrast, total lymphocytes (SMD = 0.05; 95%CI: -0.16 to 0.26), CD3+ T cells (SMD = -0.34; 95%CI: -1.01 to 0.32), CD8+ T cells (SMD = 0.21; 95%CI: -0.31 to 0.73), and natural killer T (NKT) Cells (SMD = 0.83; 95%CI: -1.10 to 2.75) showed no significant changes in GDM. Activation markers (HLA-DR+ or CD69+) on CD4+ T cells (WMD = 0.20; 95%CI: 0.06-0.34) were increased in GDM patients. Treg cells, a classical subgroup of CD4+ T cells, showed a decreasing trend in GDM compared to controls (SMD = -0.83; 95%CI: -1.31 to -0.34). These results indicate an abnormal immune status in the peripheral profiles of GDM.

GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles, including higher levels of CD4+ T cells and a reduced population of Treg cells. Treating immune dysregulation could be a new direction for GDM management, although further research is needed to understand the precise mechanisms of immune overactivation in GDM.

Diabetes mellitus (DM) comprises distinct subtypes-including type 1 DM, type 2 DM, and gestational DM - all characterized by chronic hyperglycemia and substantial morbidity. Conventional diagnostic and therapeutic strategies often fall short in addressing the complex, multifactorial nature of DM. This review explores how multi-omics integration enhances our mechanistic understanding of DM and informs emerging personalized therapeutic approaches. We consolidated genomic, transcriptomic, proteomic, metabolomic, and microbiomic data from major databases and peer-reviewed publications (2015-2025), with an emphasis on clinical relevance. Multi-omics investigations have identified convergent molecular networks underlying β-cell dysfunction, insulin resistance, and diabetic complications. The combination of metabolomics and microbiomics highlights critical interactions between metabolic intermediates and gut dysbiosis. Novel biomarkers facilitate early detection of DM and its complications, while single-cell multi-omics and machine learning further refine risk stratification. By dissecting DM heterogeneity more precisely, multi-omics integration enables targeted interventions and preventive strategies. Future efforts should focus on data harmonization, ethical considerations, and real-world validation to fully leverage multi-omics in addressing the global DM burden.

The primary complication associated with gestational diabetes mellitus (GDM) is delivery of an infant that is large for gestational age (LGA). Epidemiological findings have demonstrated that irregular lipid metabolism significantly contributes to insulin resistance, a key pathophysiological mechanism in GDM. However, the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.

To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.

Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95% confidence intervals for LGA according to five lipid indices. Restricted cubic spline models were applied to investigate dose-response relationships. The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups. Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.

Across crude and adjusted models, females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category. Conversely, high-density lipoprotein cholesterol levels demonstrated the contrary trend. Restricted cubic spline analyses revealed linear associations between the five lipid indices, except triglyceride levels, and the prevalence of LGA. The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent. The five lipid indices presented significant diagnostic efficacy, as indicated by receiver operating characteristic curve areas.

Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.

Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion (CSII) require a lower dose of insulin than those treated with multiple daily injections (MDIs). However, it is unclear whether this is also the case for patients with type 2 diabetes mellitus (T2DM).

To compare insulin dosage requirements between CSII and MDI in T2DM, identifying influencing factors associated with both therapeutic modalities.

A total of 954 patients with T2DM were divided into two groups: CSII and MDI groups. The total daily insulin dose (TDD), TDD per kilogram per day (TDD/kg), and ratio of total basal insulin dose to TDD (%TBa) required to achieve the target blood glucose levels were compared between the two groups. In addition, factors affecting insulin dosage were analyzed in both groups of patients.

Compared to the CSII group, the MDI group required a higher TDD [median (interquartile)]: 30.00 (24.00, 38.00) U/day vs 26.40 (21.60, 32.40) U/day; P < 0.01, TDD/kg and %TBa. In the MDI group and CSII groups, an increase in TDD was independently associated with an increase in body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c).

Patients with T2DM receiving CSII treatment require a lower dose of insulin to achieve good glycemic control. BMI, WC, FPG, and HbA1c are the main factors affecting insulin dosage.

Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences. Hence, clinicians have focused on early diagnosis and treatment.

To investigate the effectiveness of the combination of doppler ultrasonography (DUS), three-dimensional dynamic contrast-enhanced magnetic resonance angiography (CE-MRA), and CT angiography (CTA) in assessing lower extremity arterial disease in diabetes mellitus (DM).

This study retrospectively analyzed the imaging and clinical data of 116 patients diagnosed with DM complicated with lower extremity vascular diseases from January 2021 to June 2023. All patients underwent unilateral or bilateral DUS, CTA, and CE-MRA as well as invasive digital subtraction angiography (DSA). The application values of DUS, CE-MRA, and CTA were compared.

A total of 152 lower extremity arteries in the 116 patients were graded following the classification of vascular branches. The Kappa values between DUS and DSA were 0.780, 0.755, and 0.806 for diagnosing moderate stenosis and 0.484, 0.699, and 0.449 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CE-MRA and DSA were 0.784, 0.814, and 0.835 for diagnosing moderate stenosis and 0.694, 0.748, and 0.606 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CTA and DSA were 0.900, 0.858, and 0.878 for diagnosing moderate stenosis and 0.882, 0.823, and 0.756 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively.

DUS, CE-MRA, and CTA demonstrated comparable accuracy in diagnosing lower extremity arterial disease in DM, and the consistency between CTA and DSA diagnoses was higher than the other two imaging methods.

Metformin-induced vitamin B12 deficiency is a prevalent condition among patients with type 2 diabetes mellitus. In recent years, a growing body of evidence has demonstrated the association between vitamin B12 deficiency and the onset, progression, and worsening of diabetic neuropathy (DNP) as well as its improvement with supplementation in cases of deficiency. Major clinical guidelines for diabetes and DNP remain vague in their recommendations for B12 measurement and supplementation, and some guidelines do not address it at all. Given that vitamin B12 therapy is an economical, safe, and widely available treatment in most countries and supported by emerging evidence of its potential benefits, greater efforts should be made to promote systematic screening for vitamin B12 deficiency in all patients with DNP before establishing a definitive diagnosis as well as in patients with diabetes with risk factors for deficiency. Vitamin B12 deficiency should be treated in all affected patients, and supplementation should be considered in those with borderline levels when confirmatory diagnostic tests for deficiency are unavailable. Clinical guidelines should place greater emphasis on the recommendations for measuring and supplementing vitamin B12 in these patients.

Diabetes mellitus, a global epidemic, represents a major public health threat. Stem cell therapy, with its regenerative capacity, has emerged as a promising approach for diabetes mellitus management. This paper reviews recent advancements, prospects, and challenges in stem cell-based treatments for diabetes mellitus, focusing on the applications of induced pluripotent stem cells and mesenchymal stem cells, the development of pancreatic islet organoids, and the potential for personalized medicine. The review critically assesses the efficacy and safety of stem cell therapies in clinical trials and examines their applications in both type 1 and type 2 diabetes mellitus. Despite the promising potential, challenges such as safety concerns, transplantation efficiency, ethical considerations, and immune rejection remain prevalent. Lastly, the paper discusses future directions, including the integration of stem cell therapy with other treatments and the advancement of personalized therapeutic strategies, offering new perspectives and hope for diabetes mellitus management.

Cognitive decline in type 2 diabetes mellitus (T2DM) occurs years before the onset of clinical symptoms. Early detection of this incipient cognitive decline stage, which is T2DM without mild cognitive impairment, is critical for clinical intervention, yet it remains elusive and challenging to identify.

To identify structural changes in the brains of T2DM patients without cognitive impairment to gain insights into the early-stage cognitive decline.

Using diffusion tensor imaging (DTI), we constructed structural brain networks in 47 T2DM patients and 47 age-/sex-matched healthy controls. Machine learning models incorporating connectivity features were developed to classify T2DM brains and predict disease duration.

T2DM patients exhibited reduced global/local efficiency and small-worldness, alongside weakened connectivity in cortical regions but enhanced subcortical-frontal connections, suggesting compensatory mechanisms. A classification model leveraging 18 connectivity features achieved 92.5% accuracy in distinguishing T2DM brains. Structural connectivity patterns further predicted disease onset with an error of ± 1.9 years.

Our findings reveal early-stage brain network reorganization in T2DM, highlighting subcortical-frontal connectivity as a compensatory biomarker. The high-accuracy models demonstrate the potential of DTI-based biomarkers for preclinical cognitive decline detection.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder linked to high blood glucose and gut dysbiosis. Probiotics like Lactobacillus rhamnosus LRa05 may improve glycemic control and gut microbiota.

To explore the impact of LRa05 with hypoglycemic medications on glycemic control and intestinal flora in T2DM patients with gut dysbiosis.

Seventy-six participants were randomly assigned to receive either LRa05 (0.1 g 2 × 10¹⁰ CFU) (n = 38) or a placebo (n = 38) for 12 weeks. Baseline characteristics were recorded, and changes in glycated hemoglobin, fasting blood glucose, and other biochemical indices were assessed using repeated measures one-way analysis of variance. Additionally, gut microbiota diversity was analyzed through species accumulation and alpha and beta diversity metrics.

The intervention group showed statistically significant improvements in lipid profiles, particularly in high-density lipoprotein cholesterol levels, which increased significantly over time (P < 0.001). Additionally, fasting blood glucose was significantly reduced in the LRa05 group compared with the placebo group (P < 0.001). No significant changes were observed in glycated hemoglobin, insulin sensitivity, or systemic inflammatory markers such as C-reactive protein. Furthermore, gut microbiota analysis revealed significant shifts in composition following the intervention, particularly an increase in Bifidobacterium and a decrease in Bacillota, indicating beneficial effects on gut health.

This study demonstrated that the combination of Lactobacillus rhamnosus LRa05 and hypoglycemic medications positively impacted glycemic control, specifically reflected in improved levels of high-density lipoprotein and fasting blood glucose. Additionally, significant alterations in gut microbiota composition were observed in patients with T2DM, indicating a potential synergistic effect between gut health and blood glucose regulation.

Prediabetes mellitus (PDM) is receiving increasing attention as a precursor to type 2 diabetes mellitus. Lifestyle and traditional Chinese medicine (TCM) interventions are effective for PDM prevention and treatment. Therefore, we conducted a preliminary investigation and an exploratory randomised controlled trial to assess the effects of a combined lifestyle and TCM intervention on PDM indicators.

To study the effectiveness of Xiaokeqing granules (XQG) and lifestyle interventions in PDM participants while using metabolomics to identify potential markers.

Forty PDM participants with yin deficiency syndrome with excessive heat were recruited and randomly allocated to the control (Con) group or the XQG group (20 per group). The Con group underwent lifestyle interventions, whereas the XQG group underwent lifestyle and XQG interventions. The follow-up duration was 2 months. Fasting blood glucose, 2-hour postprandial glucose (2hPG), glycated haemoglobin A1c, fasting insulin, homeostasis model assessment-insulin resistance levels, and serum metabolomics characteristics were compared via liquid chromatography-tandem mass spectrometry analysis.

There were significant differences in 2hPG between the two groups (P < 0.05) in the intention-to-treat analysis and per-protocol analysis. The intervention method used in this study was safe (P > 0.05). Groenlandicine, kaempferol, isomangiferin, etc., are the XQG constituents absorbed in the blood. N-Nervonoyl methionine and 5-hydroxy-L-tryptophan are core potential metabolomic biomarkers for the effectiveness of XQG and lifestyle interventions. HTR1A, HTR2C, SLC6A4, etc., are the core targets of XQG and lifestyle interventions, as well as the reason for their clinical efficacy. Possible mechanistic pathways include tryptophan metabolism, pantothenate and certificate of analysis biosynthesis, lysine degradation and biosynthesis of cofactors.

This pilot study provides evidence that a combined XQG and lifestyle intervention can improve 2hPG in participants with PDM. The mechanism of action is related to multiple constituents, targets and pathways.