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
糖尿病足到底痛不痛,是一个很痛苦的问题。如果不痛,患者觉得“脚都不痛了,肯定死完全了,还能保吗?”。
根据我们的统计
wagner分级3-4级的糖尿病足中位数愈合时间
是6个月
很多患者甚至需要1年-1年半才能完全愈合
而50%以上的患者在2年左右就会复发或再发
糖尿病足的伤口变化多端好像很难找到其中的规律但经过大量的临床实践我们似乎也找到了一些规律尤其是一个特殊部位有特殊规律的伤口其发病及治疗都有其一定固有的规律由于第一个给我们深刻印象的患者叫“卢红斌”。
糖尿病足是一种可怕的疾病,但和所有的疾病一样,并不是一开始就这么可怕,也是从早期(比较轻的状态)发展成严重的情况,而为了引起大家的注意,网上可以看到的病例往往都是严重的状态的病人,或者是晚期的病人。
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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