Electronic cigarette (e-cigarette) use has grown rapidly worldwide, yet metabolic health consequences, particularly glycaemic outcomes, remain poorly understood. This systematic review and meta-analysis synthesises the available epidemiological evidence on the association between e-cigarette use and diabetes mellitus, prediabetes, and insulin resistance. We conducted a systematic search of PubMed, Scopus and Embase from inception through December 2025, following PRISMA 2020 guidelines. Studies reporting effect estimates for the association between e-cigarette use and diabetes, prediabetes, or insulin resistance in adult populations were eligible. Random-effects meta-analyses were performed, stratified by outcome and exposure category (current exclusive e-cigarette users, dual users, and former e-cigarette users versus never users). Heterogeneity was assessed using I2 statistics and Cochran’s Q test. Ten studies (9 cross-sectional, 1 prospective cohort; combined participants exceeding 2.8 million) met inclusion criteria; 8 cross-sectional studies contributed to quantitative pooling, while one cross-sectional study and the prospective cohort were narratively synthesised. For prediabetes, pooled ORs versus never users were 1.34 (95
Introduction and Objective: The emergence of open-source automated insulin delivery (AID) systems, often developed and supported by patient communities, has introduced a transformative approach to diabetes management. These systems integrate continuous glucose monitoring (CGM), insulin pumps, and algorithm-driven smartphone applications to automate insulin delivery. This study aimed to explore the usage patterns, glycemic outcomes, and user perceptions of DIY AID systems (DIYAPS), specifically focusing on their effectiveness and impact on quality of life (QOL) in individuals with type 1 diabetes (T1D). Methods: A cross-sectional study was conducted using a structured questionnaire distributed among members of the Loopers Community WhatsApp group from May to August 2024. The survey collected data on demographics, computer literacy, DIYAPS components, duration of use, CGM metrics before and after adoption, and user feedback on system usability. One of the coauthors, who is a DIYAPS user, also contributed a detailed user perspective, providing firsthand insights to enrich the study findings. Responses were anonymized, and ethical research protocols were adhered to throughout the study. Results: A total of 10 participants (50% male, 50% female) from different parts of the country completed the survey. The average time in range improved significantly from 63% ±10% to 80% ±12%, while time above range and time below range decreased from 28% ±12% to 17% ±14% and 13% ±11% to 7% ±6%, respectively. Mean hemoglobin A1C levels dropped from 8.02% to 6.75%. Participants reported reduced fear of hypoglycemia, better sleep quality, and greater flexibility in daily routines. The coauthor’s user perspective highlighted additional benefits, such as improved overnight glycemic control and reduced dependence on manual adjustments, alongside practical challenges like device maintenance. Conclusion: DIYAPS demonstrates significant potential in improving glycemic control and enhancing QOL for individuals with T1D. Despite technical challenges, the systems provide a cost-effective and customizable alternative to commercial AID options. The findings support further integration of open-source AID systems into clinical practice while advocating for collaborative care and longitudinal studies to assess long-term outcomes and safety.
Introduction: The fixed-dose combination (FDC) of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors offers an effective, non-metformin based option for patients with type-2 diabetes mellitus (T2DM) who cannot tolerate metformin. The objective of the study was to address the existing gaps in knowledge about FDC of SGLT-2 inhibitors and DPP-4 inhibitors particularly, the combination of dapagliflozin and sitagliptin FDC and to provide evidence to address these issues. Methods: This cross-sectional, observational, questionnaire-based study was conducted at five round table meetings, which included clinicians from India. A validated questionnaire (of 9 questions) was used to assess clinical views on dapagliflozin and sitagliptin FDC therapy for T2DM management. The opinions and suggestions from all the meetings were compiled and analyzed, to derive the consensus statement. Results: A strong consensus (89.47%) identified efficacy as the key factor for the early initiation of combination therapies for glycemic control. Experts (90.91%) agreed that combining SGLT-2 inhibitors and DPP-4 inhibitors enhances insulin sensitivity. A consensus (55.56%) supported early initiation of dapagliflozin and sitagliptin FDC to reduce hypoglycemia risk. Experts also noted the regimen’s simplicity (59.26%) and, with a majority (78.57%), agreed that it reduces major cardiovascular (CV) events, weight, blood pressure, and heart failure risk while improving the lipid profile. Most experts (80.56%) supported the early use of dapagliflozin and sitagliptin FDC in T2DM patients with CV risk. Conclusion: The consensus strongly indicates that early initiation of dapagliflozin and sitagliptin FDC therapy improves glycemic control, reduces CV events, and enhances patient outcomes.
The increasing prevalence of type 2 diabetes mellitus (T2DM) and the associated challenges in treatment are a cause of concern worldwide. Gliclazide is an oral antidiabetes drug used in the treatment of T2DM. It is a second-generation sulphonylurea (SU) which controls blood glucose levels and offers additional benefits. It is distinct from other SUs in terms of its molecular and structural properties. Early aggressive management of blood glucose in diabetes has been shown to provide advantages for micro- and macrovascular complications. Hence, this review is intended to discuss the glycemic and extraglycemic effects of gliclazide.
ABSTRACT A preliminary knowledge of the gut-thyroid axis based on the studies in the last few years suggests that the intestinal microbiota and its metabolites may affect the thyroid either directly or indirectly by affecting the conversion and storage of iodothyronine, the absorption of thyroid-related micronutrients and playing a crucial role in the onset and progression of thyroid organ-specific autoimmunity. These findings may offer new insights into the pathogenesis of thyroid disorders and their clinical management. The research on thyroid and gut microbiota has however, just touched the surface. Here, in the present review, we have summarized the current scientific evidence related to the gut microbiota and thyroid disorders as well as the studies of probiotic supplementation in thyroid disorders and pave the way for future research on the gut-thyroid axis.
