Chronic limb-threatening ischemia (CLTI) compounded by diabetic foot ulceration remains a leading precursor to major lower-extremity amputation. Transverse tibial transport (TTT) can improve perfusion but requires corticotomy and bulky external fixation. We report what is, to our knowledge, the first application of fully automated tibial periosteal distraction (PD) for limb preservation. A 65-year-old man with recurrent forefoot gangrene underwent tibial PD using a miniaturised, programmable motor to gradually elevate the periosteum. Through a 1 cm incision, a low-profile subperiosteal plate was implanted and linked to the motor, which advanced 0.031 mm hourly (0.75 mm/day) up to 10 mm. Distraction was completed uneventfully over 13 days, and the device was removed at the bedside on Day 21. Skin temperature increased by 2°C, and digital systolic (toe) pressure rose from 22 to 50 mmHg. The wound progressed to healing without complication. Automated PD may offer a minimally invasive, biologically driven alternative for high-risk CLTI patients, eliminating the need for patient-adjusted screws and standardising adherence. Prospective studies are required to validate its safety, durability, optimal distraction parameters and cost-effectiveness.

This study aimed to assess the prevalence of glucagon-like peptide-1 (GLP-1) receptor agonist use and interest in using medications for weight loss among adults (≥ 18 years) in Great Britain.

Nationally representative household survey, January-March 2025 (n = 5893). Participants were asked whether they had used medication in the past year to manage type 2 diabetes (excluding insulin), reduce the risk of heart disease, or support weight loss and, if so, whether they had used any of five specific GLP-1 or dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Those who had not used medication to support weight loss in the past year were asked how likely they would be to consider doing so in the next year. Estimates were reported stratified by participant characteristics and extrapolated to the national population.

Overall, 2.9% [2.4-3.4%]- approximately 1.6 million adults-reported using a GLP-1 or GLP-1/GIP medication to support weight loss in the past year, with 1.7% [1.4-2.1%] (~ 910,000 adults) using them exclusively for this purpose. Of those who used them exclusively for weight loss, the majority (91.4% [85.6-97.2%]) reported using medications licensed for this purpose in Great Britain, most commonly Mounjaro (tirzepatide; 80.2% [71.9-88.6%]). Of those who had not used weight-loss medication in the past year, 6.5% [5.7-7.3%] (~ 3.3 million adults) expressed an interest in doing so in the next year. Use and interest were more prevalent among women, people in mid-life, and those reporting past-month psychological distress. Interest was also higher among people facing greater socioeconomic disadvantage.

In the first quarter of 2025, an estimated 4.9 million adults in Great Britain-nearly one in ten-either had recently used a GLP-1 or GLP-1/GIP medication to support weight loss or were interested in doing so in the near future. A substantial minority reported using a type of GLP-1 medication that was not licensed for weight management, suggesting off-label use. Interest was particularly high among less advantaged socioeconomic groups, while use was similar across groups, highlighting the importance of addressing equity in access. These findings underscore the need to monitor who is accessing these medications and to ensure their safe, appropriate, and equitable provision.

This study focuses on determining the relationships between gestational weight gain(GWG) that falls within, below, or exceeds the Institute of Medicine(IOM) guidelines and negative perinatal outcomes. We additionally evaluated if insufficient GWG is linked to negative outcomes in pregnant women with gestational diabete mellitus(GDM).

A Population-based retrospective cohort was conducted using data from the Sina Health Information System (SINAEHR) between 05/01/2018 and 28/12/2024 on the 18,575 Iranian women with GDM from Mashhad University affiliated centers. GWG assigned categories based on IOM guidelines according to pre pregnancy BMI. Multivariable logistic regression was employed to examine the association between gestational weight gain (GWG) categories and adverse pregnancy outcomes.

A total of 18,575 pregnant patients participated in the study. After adjusting for confounders, analysis revealed that excessive GWG was associated with increased odds of cesarean delivery (adjusted OR 1.62, 95% CI 1.49-1.77), NICU admission (adjusted OR 1.86, 95% CI 1.67-2.06) and macrosomia (adjusted OR 1.98, 95% CI 1.75-2.24) and insufficient GWG, was also correlated with increased risks of preterm birth (adjusted OR 2.32, 95% CI 2.05-2.63), NICU admission (adjusted OR 1.69, 95% CI 1.53-1.88) and lower odds of macrosomia. Additionally, inadequate GWG was associated with lower odds of hypertension disorders of pregnancy whereas excessive GWG significantly increased its risk (adjusted OR 2.23, 95% CI 1.94-2.57). These findings underscore the importance of optimal GWG for favorable pregnancy outcomes and highlight the differential risks associated with deviations from IOM guidelines.

Inadequate or excessive gestational weight gain relative to IOM guidelines is associated with significant adverse pregnancy outcomes, including preterm birth, NICU admission, macrosomia, cesarean delivery and hypertension disorders of pregnancy. These findings highlight the necessity for careful monitoring and management of weight gain during pregnancy to optimize maternal and neonatal health. Implementing targeted counseling and interventions can help ensure women achieve recommended GWG, ultimately improving pregnancy outcomes.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used in patients with type 2 diabetes mellitus (T2DM), but their influence on post-fracture outcomes remains unclear. This study aimed to evaluate the association between SGLT2 inhibitor use and the risk of vertebral augmentation after an initial osteoporotic vertebral compression fracture (VCF) in patients with T2DM and osteoporosis.

This retrospective cohort study used data from the TriNetX Global Collaborative Network. Adults with T2DM, osteoporosis, and a first documented VCF were identified. Patients who received SGLT2 inhibitors within 6 months prior to the fracture were compared with non-users. Individuals with prior vertebral augmentation, vertebral malignancy, or inflammatory spondylopathies were excluded. Propensity score matching (1:1) was performed based on demographics, comorbidities, and concurrent medications. The primary outcome was vertebral augmentation within 6 months following the index fracture.

After matching, 1757 patients were included in each cohort with well-balanced baseline characteristics. Within 6 months after the initial VCF, vertebral augmentation was performed in 12.5% of SGLT2 inhibitor users and 9.3% of non-users. SGLT2 inhibitor use was associated with a higher likelihood of vertebral augmentation (odds ratio 1.40; 95% confidence interval 1.13-1.73; p = 0.002).

In patients with T2DM and osteoporosis, SGLT2 inhibitor use was associated with an increased likelihood of vertebral augmentation following an initial osteoporotic vertebral fracture, suggesting potential differences in post-fracture clinical course or management intensity.

Gestational diabetes mellitus (GDM) is a common metabolic disorder that affects maternal and fetal health. O-GlcNAcylation is increased in GDM and disrupts placental homeostasis. This study aimed to explore the role of O-GlcNAcylation in GDM progression and the underlying mechanism. Trophoblast cell line (HTR-8/SVneo) was treated with high glucose (HG) to assess a cell model. Ferroptosis was evaluated by lipid reactive oxygen species (ROS), malondialdehyde, Fe2+, and glutathione concentrations. The GDM mouse model was established, and blood glucose and blood lipid were measured. The effect of OGT on ELP3 O-GlcNAcylation was measured using immunoprecipitation and western blotting. The results showed that ferroptosis was involved in HG-induced cell injury, and OGT expression was increased in these cells (over 3-fold). Knockdown of OGT inhibited HG-induced ferroptosis in vitro (P < 0.01), and reduced blood glucose (P < 0.01), blood lipid (P < 0.01), and ferroptosis (P < 0.01) in GDM mice. Moreover, silencing of OGT reduced ELP3 protein stability (P < 0.01) via inhibiting ELP3 O-GlcNAcylation at Ser408 site. Overexpression of ELP3 abrogated the inhibition of ferroptosis in HG-induced cells caused by OGT knockdown (P < 0.01). In conclusion, silencing of OGT inhibits trophoblast ferroptosis by suppressing O-GlcNAcylation of ELP3, thereby ameliorating GDM. The findings suggest that targeting OGT-mediated O-GlcNAcylation may be a promising strategy for GDM treatment.

This study aimed to evaluate female sexual dysfunction (FSD) in postmenopausal women with and without type 2 diabetes (T2D) and its relationship with clinical, laboratory and socioeconomic parameters and quality of life (QoL).

This cross-sectional study enrolled postmenopausal women with and without T2D not taking hormone replacement. Clinical and laboratory factors were assessed, and participants answered cardiovascular risk, socioeconomic, Short Form Health Survey 36 (SF-36) and Female Sexual Function Index (FSFI) questionnaires.

Postmenopausal women without diabetes (n = 105) and with a previous T2D diagnosis (n = 110) were similar in age, marital status, race/ethnicity, employment status, alcohol use and body mass index. Women with T2D showed higher glycemia, glycated hemoglobin, cholesterol, thyroid-stimulating hormone and cardiovascular risk factors. SF-36 scores were significantly lower in women with T2D and sexual dysfunction compared to those without diabetes. FSFI scores below 26.55 were associated with higher odds of FSD with increasing age, whereas vitality showed an inverse association.

In postmenopausal women with T2D, reduced FSFI scores along with hypertension, hypothyroidism and elevated cardiometabolic risk were linked to poorer QoL. Age increased the odds of FSD, while vitality decreased them. These results underscore the multifactorial interaction of T2D, comorbidities and menopause in women's sexual health and well-being.

Hypertension increases cardiovascular risk in type 2 diabetes mellitus (T2DM) patients. Magnesium is an important nutrient that promotes vascular function and insulin sensitivity, yet its potential role in managing blood pressure (BP) in patients with T2DM remains unclear. This study evaluates the impact of a magnesium-focused nutrition education intervention on dietary magnesium intake and BP control in patients with T2DM.

Thirty patients with T2DM (25 women; mean age, 55.7 ± 9.8 years; body mass index, 33.44 ± 7.17 kg/m²) participated in two clinical visits for data collection and BP measurement and received 12 weeks of magnesium-focused nutrition education to promote dietary magnesium intake.

The education intervention significantly increased dietary magnesium intake by 81.81 mg (p < 0.001). However, there were no significant changes in systolic or diastolic BP. Analysis showed no significant correlation between dietary magnesium intake and systolic or diastolic BP (p ≥ 0.56).

While the intervention successfully increased dietary magnesium intake, it did not affect BP. These findings suggest that increasing dietary magnesium intake through nutrition education may not significantly impact BP in individuals with T2DM. However, further research is needed to confirm these results and explore other factors that may influence BP management in this population.

Syzygium jambolanum has long been used to treat diabetes mellitus in herbal therapy. Scientists are interested in confirming its effectiveness in reducing blood glucose and enhancing metabolic parameters through clinical and biochemical evaluations.

Groups of people with diabetes who were receiving treatment and those who were not were separated. Supplementation with Syzygium jambolanum was given to the treatment group. Fasting Blood Glucose (FBG), HbA1c, SGPT, SGOT, serum urea, Blood Urea Nitrogen (BUN), uric acid, alkaline phosphatase, total cholesterol, HDL cholesterol, and creatinine were among the biochemical markers that were evaluated.

When compared to the untreated group, the treated group's fasting blood glucose levels were significantly lower. Indicating improved glycaemic control and organ function, the treated group also showed notable improvements in other indicators, including HbA1c, SGPT, SGOT, serum urea, BUN, uric acid, alkaline phosphatase, total cholesterol, HDL cholesterol, and creatinine.

Syzygium jambolanum extracts show strong antidiabetic effects by lowering blood glu-cose and enhancing insulin activity. Their rich antioxidant content protects pancreatic β-cells from oxidative stress. Overall, the extracts help improve glycemic control and metabolic health in diabetic conditions.

Syzygium jambolanum exhibits a potent antidiabetic action, markedly lowering blood sugar levels and biochemical indicators linked to problems from diabetes. It might work well as a natural supplement to help control diabetes.

Instant blood-mediated inflammatory reaction (IBMIR) is a major obstacle in clinical islet transplantation, leading to islet apoptosis and dysfunction due to inflammatory reaction. Xuebijing (XBJ), a traditional Chinese medicine, has been extensively used in the treatment of systemic inflammatory conditions and achieved remarkable effect. Giving these properties, XBJ holds promise in improving the outcomes of intrahepatic islet transplantation through inhibiting IBMIR.

The xenogeneic islet transplantation model was employed to evaluate the inhibitory effects of XBJ on IBMIR, while the syngeneic transplantation model was used to confirm that XBJ improves the long-term outcomes of intrahepatic islet transplantation through IBMIR suppression. In addition, studies were conducted under inflammatory conditions to demonstrate the protective effects of XBJ on islets in vitro, specifically its ability to preserve islet viability and function in an inflammatory environment.

In vivo IBMIR model, XBJ significantly inhibited leukocyte infiltration, leading to reduced islet damage. In vitro, XBJ provided direct protection to islets in inflammatory stimulation, preventing apoptosis and preserving islet function. These protective effects were further demonstrated in the syngeneic islet transplantation model, where XBJ markedly improved the outcomes of intrahepatic islet transplantation.

This study provides the evidence that XBJ improves islet transplantation outcomes through dual mechanisms targeting the IBMIR. As an already approved drug, XBJ presents a promising and readily translatable adjunctive therapy for clinical intrahepatic islet transplantation.