Gabriele Angelo Vassallo1 · Tommaso Dionisi2,3 · Vittorio De Vita4 · Giuseppe Augello1 ·Antonio Gasbarrini3,5 · Dario Pitocco6 · Giovanni Addolorato2,3
Received: 25 January 2025 / Accepted: 29 March 2025 / Published online: 19 April 2025 © The Author(s) 2025
Abstract
Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic strategy for modulating gut dysbiosis in diabetes mellitus. This review critically evaluates preclinical and clinical evidence on FMT in type 1 (T1D) and type 2 dia-betes (T2D). Studies suggest that FMT can restore microbial diversity, improve glycemic control, and modulate immune responses, with varying effects across diabetes subtypes. In T1D, preclinical models demonstrate that FMT influences regulatory T-cell expansion and β-cell preservation, though clinical translation remains limited. In T2D, FMT has shown transient improvements in insulin sensitivity, with sustained effects observed only in patients with specific microbiome signatures. However, heterogeneity in patient responses, donor variability, and methodological limitations complicate its clinical application. This review highlights the interplay between FMT, immune modulation, and microbial metabolism, advocating for phenotype-stratified trials and multi-omics integration to enhance therapeutic precision.
Keywords Fecal microbiota transplantation · Intestinal Microbiome · Diabetes · Insulin sensitivity · Metabolic syndrome · Beta-cell
Abbreviations
FMT Fecal microbiota transplantation TUDCA Tauroursodeoxycholic acid VEGF Vascular endothelial growth factor SCFAs Short-chain fatty acids MMTT Mixed meal tolerance test FVT Fecal virome transplantation OGTT Oral glucose tolerance test SRB Sulfate-reducing bacteria LSI Lifestyle intervention
Huanjia Qu1 · Lingling Zhou1 · Dong Tang2 · Qiuling Zhang1 · Pu Yang3 · Boyi Yang3 · Junping Shi4
Received: 25 December 2024 / Accepted: 22 March 2025 / Published online: 19 April 2025 © The Author(s) 2025
Purpose Type 2 diabetes mellitus (T2DM) is associated with ectopic fat deposition, especially in the liver and pancreas.Therefore, this study aimed to evaluate the relationship between liver fat fraction (LFF), pancreatic fat fraction (PFF), and new-onset T2DM in metabolic dysfunction-associated fatty liver disease (MAFLD) by magnetic resonance imaging (MRI).
Methods This is a retrospective study of patients with MAFLD who underwent abdominal MRI between 2022 and July 2024. LFF and PFF were measured using an axial multi-echo Dixon-based sequence. All participants underwent routine medical history, anthropometric measurements, and laboratory tests. Multivariable stepwise selection models were con-structed to predict PFF and T2DM status based on variables of clinical interest.
Results This study included 80 MAFLD patients with 40 untreated new-onset T2DM and 40 non-T2DM controls. LFF, PFF, and homeostasis model assessment of insulin resistance (HOMA-IR) index were higher in the T2DM group than in the control group. In the new-onset T2DM group, PFF was linearly positively correlated with LFF (rs=0.321, P=0.04) and HOMA-IR (rs=0.350, P=0.03). After adjustment for several metabolic variables, PFF remained an independent risk factor for incident T2DM in MAFLD patients (all P<0.05). The area under the receiver operating characteristic curve for PFF and LFF to predict T2DM was 0.889 and 0.633 (P<0.001 and P=0.03), respectively.
Conclusion In MAFLD patients, PFF, and LFF play a prominent role in new-onset T2DM with high predictive and diag-nostic value.
Keywords Metabolic dysfunction-associated fatty liver disease · Type 2 diabetes mellitus · Liver fat fraction ·Pancreatic fat fraction · Ectopic fat deposition · MRI
原创:十六点五 中山二院糖尿病足中心
很多糖尿病人得了糖尿病足后,有很多后悔,其中一个就是“早知道有这么一个疾病,我就不应该吸烟”,“我要是早点戒烟就好了,免得受这种痛苦”。
糖尿病真是一种痛苦的疾病,不能吃、不能喝、常要动、老吃药等等,尤其是不能喝酒,对于一些病人真的的非常痛苦,而且在网上或者公众号还有很多关于糖尿病与喝酒的关系文章,其中有个重要的观点:喝酒可以降血糖?
糖尿病足患者是否应该运动、什么时候运动、做什么运动,目前在临床上有非常大的争议。
糖尿病足的病人临床上有一个显著的特点就是“低蛋白”血症。之前认为低蛋白血症的发病率非常高,经过对于我们医院及合作医院所有能够统计的病人进行分析,发现100%的糖尿病足(wagner分级2级以上),都会有不同程度的低蛋白血症。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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