Liver cirrhosis and type 2 diabetes mellitus (T2DM) mutually reinforce each other, creating a vicious cycle that accelerates disease progression. This study aimed to evaluate the efficacy and safety of ultrasound-guided targeted infusion of autologous bone marrow-derived platelet-rich plasma (BMPRP) in patients with cirrhosis complicated by T2DM.
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia and a low-grade inflammatory state. The Neutrophil-to-Lymphocyte Ratio (NLR), calculated from routine complete blood count parameters, is an inexpensive and readily available inflammatory index that has been investigated as a marker of disease severity and complications.
Obesity, especially central obesity, is a well-recognized major modifiable risk factor for the development of type 2 diabetes mellitus (T2DM), and the comorbidity of obesity and T2DM has become a global public health crisis with rapidly increasing prevalence. The relationship between obesity and T2DM is not a simple causal association but a complex bidirectional interplay: excessive adiposity, particularly visceral adipose tissue accumulation, triggers a cascade of metabolic and inflammatory abnormalities that lead to insulin resistance (IR) and pancreatic β-cell dysfunction, the core pathological features of T2DM; conversely, T2DM-induced metabolic disorders further exacerbate adipose tissue dysfunction, abnormal fat distribution and weight gain, forming a vicious cycle. This review systematically elaborates the bidirectional pathological link between obesity and T2DM, clarifies the key underlying mechanisms including chronic low-grade inflammation, adipose tissue dysfunction, gut micro biota dysbiosis, mitochondrial dysfunction and genetic epigenetic regulation. We further summarize the current clinical strategies for the comprehensive management of obesity-related T2DM, covering lifestyle intervention, pharmacotherapy and bariatric surgery, and prospect the emerging research directions such as targeted therapy for adipose tissue inflammation, gut micro biota modulation and precision medicine. This review aims to provide a comprehensive understanding of the intimate association between obesity and T2DM, and offer a reference for the optimized clinical management and novel therapeutic development for patients with obesity and T2DM comorbidity.
Obesity is a growing global health challenge, contributing to increased risk of type 2 diabetes, cardiovascular disease, and premature mortality. Injectable pharmacotherapies, including GLP-1 receptor agonists and dual incretin receptor agonists, have become key interventions for weight management. This systematic literature review evaluates the efficacy and safety of semaglutide, tirzepatide, and liraglutide in adults with overweight or obesity. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar from 2015 to 2024 was conducted following PRISMA 2020 guidelines and Cochrane methodology. Twenty-three studies (18 randomized controlled trials, 5 observational studies) were included. Tirzepatide demonstrated the highest mean weight loss (20.1 kg), followed by semaglutide (14.9 kg) and liraglutide (8.4 kg). Gastrointestinal adverse events were the most common, generally mild to moderate, while serious adverse events were uncommon (<5%). Injectable therapies are effective and generally safe, with treatment decisions requiring consideration of individual patient factors and tolerability.
Introduction: T2DM is a global health concern requiring effective glycaemic management to reduce complications. While DPP-4 inhibitors like vildagliptin and sitagliptin are widely used in combination with metformin, limited studies have compared their efficacy in lowering plasma glucose levels. This study aims to address this gap by evaluating the effectiveness of these combinations in glycaemic control. This study aims to address this gap by evaluating the effectiveness of these combinations in glycemic control. Objective: To compare the glycemic outcomes of vildagliptin with metformin versus sitagliptin with metformin in patients with T2DM, focusing on HbA1c reduction as the primary indicator. Methods: A comparative observational study on 172 T2DM patients (≥ 30 years) was done with comorbidities like hypertension, dyslipidemia, and obesity. Inclusion required lab data (FBG, PLBS, HbA1c, Cr, TG) and consent, while exclusions included T1DM, gestational diabetes, insulin therapy, alcohol use, and emergencies. Outcomes assessed were primary (HbA1c), secondary (Cr, TG). Hypothesis: Null (H0): There is no difference in the efficacy of Vildagliptin + Metformin versus Sitagliptin + Metformin. Alternative (Ha): There is a significant difference in the efficacy of Vildagliptin + Metformin versus Sitagliptin + Metformin. Results and conclusion: The study showed that adding vildagliptin or sitagliptin to metformin significantly improved glycaemic control in T2DM over six months. Both combinations effectively reduced FBS, PLBS, HbA1c, and TG without affecting renal function. Vildagliptin achieved slightly better glycaemic reductions compared to sitagliptin with add-on metformin. Both treatments were well-tolerated, with no significant side effects including renal dysfunction or hyperlipidemia. These findings confirm the safety and efficacy of both therapies, with vildagliptin having a slight edge.
