Romanian Journal of Diabetes Nutrition and Metabolic Diseases

Elevated surfactant protein A (SP-A) and reduced lung function status in poorly-controlled diabetes mellitus (DM) subjects

2026-04-01T23:03:04+03:00

This study assessed lung function status of DM subjects. Materials and methods: 64 females consisting of 32 control and 32 DM subjects participated in this study. Spirometry and blood analysis were used to assess lung function status. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percentage of forced expiratory volume in one second (FEV1%), oxygen saturation (SPO2), fasting blood sugar (FBS), glycaeted haemoglobin (HbA1c), oxygen content of blood (O2), haemoglobin concentration (Hb) and SP-A were measured. Results: Results obtained showed that the mean FEV1 and FEV1% were significantly decreased (P<0.05) in DM subjects when compared to control. However, the mean FEV1% of DM subjects was not significantly below 80%. SPO2, O2 content and Hb concentration were significantly reduced (P<0.05) in DM subjects when compared to control. BHBA, HbA1c, SP-A were all significantly higher (P<0.05) in DM subjects when compared to control. Most DM subjects were poorly controlled as seen in their HbA1c values above 6.8%. The results of this study strongly indicate that poorly controlled DM patients are at risk of restrictive lung disease. There is therefore the need for regular monitoring of lung function status of diabetic patients, especially the poorly controlled.

The mediators and predictors of higher values of thyroid-stimulating hormone in type 2 diabetes mellitus: a cross-sectional study

2026-04-01T23:03:04+03:00

Subclinical hypothyroidism associated with a higher level of thyroid-stimulating hormone (TSH) is commonly reported in type 2 diabetes mellitus (T2DM). Multiple causes, rather than a specific cause, have been reported for this association. This study aims to investigate some biomarkers as mediators or predictors of the higher levels of TSH in T2DM. This cross-sectional study included 150 diabetic patients. The patients were grouped according to their TSH levels into Group I (0–4 μIU), Group II (4.1–8.0 μIU), and Group III (>8.0 μIU). Anthropometric measurements, glycemic and lipid indices, thyroid hormones, and inflammatory biomarkers (including C-reactive protein and interleukin 6) were determined. The mediation (indirect effect) was assessed using the Sobel test, and prediction was evaluated using logistic regression and Receiver Operating Characteristic tests. Groups II and III showed significantly higher values of these biomarkers. None of these biomarkers has an indirect (mediation) effect on the high levels of TSH. Duration of the disease, triglyceride-glucose index, interleukin-6, and stress hyperglycemia ratio are significant predictors. These predictors have areas under the curves of 0.810, 0.805, 0.869, and 0.562, respectively. We conclude that specific biomarkers can predict higher TSH levels, but they do not act as mediators.

Renal mechanisms of calcium and phosphates homeostasis in rats at the early stages of alloxan-induced experimental diabetes mellitus under conditions of pharmacological blockade of the renin–angiotensin–aldosterone system

2026-04-01T23:03:04+03:00

The objectives of the research were to study the peculiarities of the intrarenal mechanisms of calcium and phosphates homeostasis regulation against the background of pharmacological blockade of the intrarenal renin-angiotensin system at the early stages of alloxan-induced experimental diabetes mellitus. The experiments were carried out on 26 white non-linear mature male rats – 16 animals with 11-day long alloxan-induced experimental diabetes mellitus and 10 intact animals of the control. Pharmacological blockade of renin–angiotensin–aldosterone system was induced by captopril administration to 8 diabetic rats. The results of the present experimental study evidence that in addition to its well-known effects on intrarenal hemodynamics, the renin–angiotensin–aldosterone system plays an important role in the modulation of sodium-dependent tubular transport processes of calcium and phosphates. The increase of sodium-dependent excretion of calcium and phosphates in rats with 11-day alloxan-induced experimental diabetes mellitus is predominantly of a hyperdynamic–hyperperfusion nature. Limitation of sodium ions reabsorption is accompanied by a decrease in the intensity of sodium-dependent calcium and phosphates reabsorption processes. Despite the inability of pharmacological RAAS blockade to eliminate the hemodynamic-hyperperfusion consequences of hyperfiltration, compensatory-functional renal mechanisms of calcium and phosphates metabolism remain preserved at this stage of experimental alloxan-induced diabetes mellitus, ensuring effective maintenance of their homeostasis.

Social media addiction and its association with eating disorder risk among first-year students at a private Peruvian university

2026-04-01T23:03:05+03:00

University students face increasing exposure to social media platforms that often promote idealized body standards, raising concerns about their potential impact on eating behaviors. This study explored whether social media addiction and body image dissatisfaction are associated with the risk of eating disorders (EDs) among first-year students at a private Peruvian university. A cross-sectional study was conducted with 403 participants who completed three validated instruments: the Social Media Addiction Questionnaire, the Body Dissatisfaction Scale, and the EAT-26. Data were analyzed using bivariate and multivariate models to estimate prevalence ratios (PR). Overall, 13.6% of students were at risk of EDs, with women showing higher prevalence (15%) than men (10%). WhatsApp, Instagram, and TikTok were the most commonly used platforms. High social media addiction was significantly associated with EDs risk (adjusted PR=3.03; 95% CI: 1.33–6.91; p=0.02), whereas body dissatisfaction showed no significant association. These findings point to a possible link between social media engagement patterns and EDs risk in this population, though further research is needed to better understand this relationship. Considering social media consumption habits could be a useful element in eating disorder prevention efforts among young university populations.

Lifestyle-related cardiometabolic targets in romanian patients with type 2 diabetes: a cross-sectional analysis

2026-04-01T23:03:05+03:00

Patients with type 2 diabetes (T2D) face an increased risk of cardiovascular disease (CVD), with risk factor burden, comorbidities, and poor disease control significantly influencing cardiovascular (CV) risk. A strategy that focuses on the simultaneous control of multiple cardiometabolic and lifestyle-related factors has demonstrated benefits in reducing adverse CV outcomes in this population. This study aims to assess the simultaneous attainment of lifestyle-related and cardiometabolic targets in a real-world cohort of adult patients with T2D from Romania. In this cross-sectional analysis, we evaluated the simultaneous attainment of lifestyle-related and cardiometabolic targets in 174 patients with T2D by using the 2023 ESC Guidelines as a reference for current best-practice recommendations. Simultaneous control of both lifestyle-related targets, namely non-smoking status and normal weight, was observed in only 12 patients (6.9%). Strict extended multifactorial control, defined as attainment of at least 4 of the 6 assessed targets, decreased significantly across higher risk categories (57.1% in the moderate-risk group, 28.0% in the high-risk group, 16.2% in the very-high-risk group, p=0.015). Smoking status was strongly associated with the probability of achieving simultaneous risk factor control, with none of the current smokers achieving four or more of the six targets, whereas 34 nonsmokers (27.9%) did so (p<0.001). Although strict extended control (≥4/6 targets) was numerically more frequent in normal-weight patients than in those with obesity (35.0% vs. 16.5%), this difference did not reach statistical significance in the unadjusted categorical comparison (p=0.152). Simultaneous attainment of lifestyle-related cardiometabolic targets was low in patients with T2D. A multidisciplinary approach emphasizing lifestyle changes and optimal risk factor management is urgently needed in these patients.

Morphometric and structural changes in the rectus abdominis muscle of rats under conditions of experimental obesity and diabetes mellitus

2026-04-01T23:03:05+03:00

The modern metabolic paradigm considers skeletal muscles not only as an organ of locomotion but as a key metabolic unit responsible for the regulation of glucose homeostasis in the body. The aim of the work is to establish the morphofunctional features of changes in the rectus abdominis muscle of rats under conditions of 8-month modeling of alimentary obesity caused by a high-fat diet and subsequent induction of diabetes mellitus. The study was conducted on 30 sexually mature Wistar rats, divided into three groups of 10 individuals: a control group, a group with a high-fat diet, and a group with a diet and induced diabetes mellitus. Histological examination of the muscles of rats in the high-fat diet and diet with diabetes mellitus groups revealed pronounced signs of diabetic myopathy. In the alimentary obesity group, initial changes were observed in the form of unevenness in the caliber of muscle fibers and signs of intracellular lipid accumulation. In the diet and diabetes group, structural disorders became degenerative in nature, areas with pronounced myocyte atrophy, areas of fiber architectonics disturbance, sarcolemma fragmentation, and focal infiltration were visualized. The nuclear apparatus of myocytes in these groups showed signs of chromatin condensation and pyknosis, which indicates the activation of destructive processes. Additionally, a significant decrease in the density of the capillary network in the endomysium was recorded, which was accompanied by signs of endothelial dysfunction, creating conditions for chronic local energy deficiency of the tissue. The study allowed us to establish the complex nature of structural and functional changes in the rectus abdominis muscle under conditions of metabolic stress induced by a combination of a high-fat diet and type 2 diabetes.

Managing type 1 diabetes mellitus in algerian children: the positive impact of diet and physical activity

2026-04-01T23:03:05+03:00

Nutritionists recommend that people with type 1 diabetes mellitus (T1DM) should engage in physical activity alongside healthy dietary habits. This study was designed to determine the effect of diet and physical activity on T1DM progression in children aged 8 to 15. Young patients with T1DM were enrolled in this quasi-experimental descriptive study at Sebdou and Maghnia hospitals (Tlemcen wilaya, north-west Algeria). The study involved a questionnaire and the prescription of dietary measures and physical exercises. Anthropometric (BMI) and biological (glycaemia and HbA1c) parameters were measured at baseline and after three months of follow-up. Statistical software was used to perform comparison tests at a significance level of p<0.05. Thirty T1DM patients were recruited. The sex ratio was 0.76, with an average age of 12.83±1.98 years. BMI, which was 22.36±5.16 kg/m² at baseline, improved to 21.72±3.71 kg/m² after the experiment. Glycated haemoglobin and glycaemia levels decreased from 9.02%±0.80% and 1.51 g/L±1.007, respectively, at baseline to 7.72%±1.01% and 1.57 g/L±0.41, respectively, at the end of the experiment. Combining drug treatment with a healthy lifestyle and regular monitoring of biological parameters improves the quality of life of diabetic children.

Evaluation of pentosidine as an Advanced Glycation End product (AGE) and its association with microalbumin in Diabetic Nephropathy (DN)

2026-04-01T23:03:05+03:00

Diabetic nephropathy is a major end stage kidney disorder, and its timely diagnosis enables in preventing the morbidity and mortality related to it, thereby enhancing the quality of the patients suffering from the condition. Advanced glycated end-products (AGEs) which include pentosidine, are produced by covalent binding of amino groups with glucose or different saccharide derivatives during the non-enzymatic Millard reaction and might make a contribution to Cardiovascular Disease and other long-time complications in Chronic Kidney Disease. Microalbumin is a marker of diabetic nephropathy. To estimate levels of AGE serum pentosidine and microalbumin in diabetic nephropathy cases, diabetic controls and healthy controls. To study the association between serum pentosidine and urinary microalbumin in diabetic nephropathy. A case control study was conducted among 30 diabetic nephropathy patients and 30 diabetic patients and 30 healthy controls. Serum Pentosidine was analyzed by ELISA, microalbumin by turbidimetric method. ANOVA and Pearson’s correlation and multiple regression analysis was done. Serum pentosidine and urine microalbumin were elevated in cases compared to other two groups. Statistically significant positive association was found between Pentosidine and microalbumin in diabetic nephropathy cases. Multiple regression analysis of Pentosidine and microalbumin with different independent variables was statistically not significant. Uncontrolled blood glucose increases the formation of advanced glycation end products, and it is positively correlated with the urine microalbumin level. Hence evaluation of plasma pentosidine, urine microalbumin may play a vital role in predicting the diagnosis and prognosis of prediabetic nephropathy and severe forms of microvascular and macro vascular complications in diabetes mellitus.

Restoring the sleep-wake cycle helps overcome insulin resistance in rats

2026-04-01T23:03:05+03:00

Our goal was to establish the possibility of increasing insulin sensitivity as a result of restoring the sleep-wake cycle in rats after the formation of insulin resistance under conditions of circadian rhythm disruption due to weekly 24-hour light exposure. Rats were kept under different circumstances: natural day-night change for a week, then – in conditions of 24-hour lighting (>30 lux white 460–480 nm) during one more week, and then rats were transferred to a natural day-night change for another seven days. Animals were subjected to blood sampling from the tail vein on the eighth, fifteenth and twenty second days of the experiment. In the blood samples were determined: fasting glucose level, insulin level, HOMA-IR index, total triglycerides, glucose tolerance test. Statistical processing of the obtained results was carried out using the Student’s t-test and the Mann-Whitney method. The value of p≤0.05 was considered reliable. Changing the regime from natural day and night to 24-hour lighting led to disturbances at the level of dysregulation of metabolic processes in experimental rats. Under these conditions, we observed an increase in the levels of glucose, an increase of insulin concentration and the HOMA-IR index as well as total triglycerides. The restoration of normal living conditions allowed the restoration of indicators. In conclusion, a change in the sleep-wake cycle was manifested in some chages. The return to a normal sleep-wake cycle was marked by the restoration of blood glucose and insulin levels, indicating the overcoming of insulin resistance.

Evaluation of lipid accumulation product in relation to thyroid hormone levels in hypothyroid patients: a cardiovascular risk perspective

2026-04-01T23:03:05+03:00

Hypothyroidism, a prevalent endocrine disorder leads to complications such as hypertension, bradycardia, dyslipidemia and increased cardiovascular risks. Lipid Accumulation Product (LAP) index, which combines waist circumference (WC) and triglycerides (TG), has been under researched in context to hypothyroidism. This study aims to evaluate LAP levels across euthyroid, subclinical and overt hypothyroid individuals and analyze their correlation with Thyroid stimulating hormone (TSH) levels to determine LAP’s effectiveness in predicting cardiovascular risk related to hypothyroidism. A cross-sectional descriptive study was conducted at Tertiary Care Centre, India. It involved 150 participants in three groups, 50 individuals in each (Euthyroid, subclinical and overt hypothyroid). Age, weight, thyroid parameters, TG, WC and LAP were assessed. The TG, WC and LAP values showed significant increase across all the three study groups (p<0.001). Highest LAP values found in overt hypothyroid patients while lowest found in euthyroid controls. Pearson’s correlation analysis showed a significant positive correlation between LAP and TSH levels. Our study showed an association between LAP and TSH levels indicating hypothyroidism is associated with elevated lipid accumulation, reflecting early metabolic disturbances and increased cardiometabolic risk. LAP may serve as a practical screening tool for cardiovascular risks in hypothyroid patients.

Relationship between diet quality and fasting blood glucose levels in type II diabetes mellitus patients

2026-04-01T23:03:05+03:00

Maintaining good diet quality is important for controlling blood glucose levels in patients with type 2 diabetes mellitus (DM). At Cepiring Community Health Center in 2025, 93.6% of Chronic Disease Management Program (CDMP) participants had impaired fasting blood glucose. Poor diet quality may contribute to higher fasting blood glucose levels. This study aims to examine the relationship between diet quality and fasting blood glucose levels in type 2 DM patients who are part of the Chronic Disease Management Program (CDMP) at Cepiring Community Health Center. This cross-sectional study was conducted in February 2025 and involved 38 respondents. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI) based on a 24-hour dietary recall. Fasting blood glucose data were obtained from medical records. Spearman and Pearson correlation tests were used to analyze the relationship between diet quality and fasting blood glucose. The results showed that most respondents were aged 60 years or older (55.3%), female (86.8%), unemployed (44.7%), and had low education levels (47.4%). Most had low physical activity (76.3%), no family history of DM (63.2%), and obese (42.1%). The highest AHEI component scores were found in alcohol, grains, sodium, red meat, sweetened beverages, PUFA, nuts, omega-3, trans fats, vegetables, and fruits. Bivariate analysis showed that low fruit scores (p=0.003; r=-0.471) and low total AHEI scores (p=0.004; r=-0.453) were associated with higher fasting blood glucose levels. Improving diet quality, especially increasing fruit intake, may help control fasting blood glucose in patients with type 2 DM.

Prevalence of tongue disorders and tongue coating colours among patients with type II diabetes mellitus

2026-04-01T23:03:05+03:00

A coated tongue represents a clinically relevant parameter in the visual diagnosis of systemic conditions. Given that Diabetes Mellitus is among the most prevalent metabolic disorders worldwide, with an especially high burden in India, the early identification of such clinical markers is of substantial importance for timely screening and intervention. The oral cavity mirrors systemic illness, and oral manifestations are associated with diabetes. This study evaluated the prevalence of tongue coating colours and location in type II diabetic patients. Tongue colours were classified according to six categories (Liyan Chen et al.), and coating location assessed using Kojima Parameters. Common tongue abnormalities were also recorded. The study found that pink-coloured coating was most prevalent, followed by yellow and white. Nearly half of the patients showed a thin coating on less than one-third of the back of the tongue. Glossitis and candidiasis were the most frequent abnormalities. These findings highlight the role of tongue examination as a non-invasive method for suspecting diabetes in undiagnosed patients, thereby supporting early screening and treatment.

Association between HbA1c levels and mean body weight in type 2 diabetes: a five-year self-monitored case report

2026-04-01T23:03:05+03:00

This study proposes a novel method to predict HbA1c levels in individuals with type 2 diabetes using the mean body weight averaged over a three-month period. Weekly weight measurements and daily step counts were collected from a patient over five years, with quarterly blood samples analyzed for HbA1c levels. The analysis identified a statistically significant linear correlation between mean body weight and HbA1c levels, supported by a regression model with a high coefficient of determination. This approach offers a simple and effective means to monitor glycemic control in clinical practice, determining the optimal average weight for each patient to maintain recommended blood sugar levels, as advised by their specialist. Physical activity, specifically daily walking, has been found to positively impact HbA1c control. This report describes findings from a single-patient longitudinal observation and should be interpreted as exploratory. Further validation and broader application of this approach across diverse patient populations are recommended.

From plate to pancreas: exploring the link between food and type 2 diabetes

2026-04-01T23:03:04+03:00

Diabetes mellitus is a prevalent chronic condition marked by persistent hyperglycemia due to impaired insulin production or utilization. Dietary factors significantly contribute to the development and progression of type 2 diabetes. This review critically examines current literature to explore the relationship between specific dietary components and diabetes risk. Foods implicated in diabetes pathophysiology, such as processed meats, refined carbohydrates, sugar-sweetened beverages, and ultra-processed foods, were analyzed for their biochemical and metabolic impacts. Processed meats containing nitrite-nitrates and N-nitrosamines were found to elevate advanced glycation end products (AGEs), increasing diabetes risk. Refined carbohydrates and sugar-sweetened beverages exacerbate hyperglycemia and insulin resistance by raising calorie density and reducing dietary fiber. Ultra-processed foods, rich in hydrogenated fats and synthetic additives, promote insulin resistance and obesity. High salt intake induces leptin resistance, while excessive sugar consumption triggers hyperinsulinemia and weight gain. Conversely, reducing these dietary risks and promoting balanced diets with whole grains, fiber-rich foods, and unsaturated fats can lower diabetes risk. Targeted dietary modifications, including limiting processed and ultra-processed foods, and adopting healthy dietary patterns, play a pivotal role in preventing and managing type 2 diabetes. These findings underscore the critical importance of dietary interventions in mitigating diabetes prevalence and complications.

Cellular therapy in the management of diabetes mellitus: a meta-analysis

2026-04-01T23:03:04+03:00

Diabetes mellitus can be considered a modern-day epidemic that is treatable but not curable with current therapeutic approaches. This study aimed to evaluate whether stem cell transplantation could represent an alternative treatment strategy with curative potential. In March 2025, a comprehensive literature review was conducted across 10 databases. Relevant studies were selected and their results were synthesized through meta-analysis. Outcomes were categorized into two domains: metabolic and secretory. The metabolic outcome showed a mean decrease in glycated hemoglobin of 0.937, while the secretory outcome demonstrated a mean increase in C-peptide secretion of 0.649; however, the latter did not reach statistical significance. These findings suggest that stem cell therapy exerts a therapeutic effect in patients with diabetes, although the magnitude of this effect is insufficient to support its role as a curative therapy. The observed benefits are most likely mediated by paracrine mechanisms rather than by the differentiation of stem cells into insulin-secreting cells.

Gamma-aminobutyric acid in endocrine and metabolic regulation: implications for diabetes mellitus

2026-04-01T23:03:04+03:00

Gamma-aminobutyric acid (GABA), traditionally recognized as the main inhibitory neurotransmitter in the central nervous system, has a wide range of extraneuronal effects, including regulatory roles in endocrine functions and metabolic processes, as demonstrated by increasingly new data. This review summarizes the molecular mechanisms of GABA biosynthesis and metabolism, the classification and tissue distribution of its receptors, and the functional properties of the GABAergic system in the pancreas, adrenal glands, gonads, thyroid gland, gastrointestinal tract, and vascular system. Particular attention is placed on the involvement of GABA in the pathogenesis of type 1 and type 2 diabetes mellitus, emphasizing its immunomodulatory, regenerative, and metabolic effects. These include effects on insulin secretion, insulin resistance, gluconeogenesis, and lipogenesis. The cytoprotective effects of GABA on pancreatic β-cells, its participation in PI3K/Akt signaling pathways, and the modulation of transcription factor expression are discussed. Moreover, the role of the gut microbiota as an exogenous source of GABA, and its potential involvement in the gut-brain axis, is under consideration. Available evidence suggests that GABA has significant therapeutic potential in diabetes mellitus and metabolic disorders, warranting further investigation.