Ankle-brachial index (ABI) and Toe brachial index (TBI) can easily detect peripheral arterial disease (PAD) in people with type 2 diabetes (T2DM). We aimed to explore the association between ABI-TBI and micro-and macro-vascular complications of diabetes including carotid intima-media thickness (CIMT) in people with T2DM. This cross-sectional study was conducted on 277 patients with T2DM. The association between PAD and retinopathy, neuropathy, nephropathy, cardiovascular disease (CVD) was assessed in all participants. Moreover, the association of ABI-TBI and CIMT was investigated in 180 participants using regression models. CIMT of more than 0.82 mm was detected in 21.2

Objective: Papillary thyroid cancer (PTC) is the most prevalent endocrine cancer. Activation of platelet-derived growth factor receptors (PDGFRs) is involved in the development of thyroid cancers. This systematic review aims to evaluate the molecular and clinical significance of PDGFRs in PTC. Method: A comprehensive literature search was performed in PubMed, Scopus, and Web of Science databases up to August 2024, focusing on studies evaluating PDGFRα/β variants, expression levels, and clinical outcomes in PTC. Eligible studies were selected according to PRISMA guideline. Studies including unknown histology, insufficient data, case reports, non-human experiments, and review article were excluded. The REMARK criteria were applied for quality assessment of the included studies. Results: A total of twelve studies were included. Genetic alterations in the promoter of PDGFRα (rs6554162 and rs1800812) showed a significant association with increased risk of PTC, while synonymous variants were more frequently detected in benign tumors. In contrast, noncoding variants in PDGFRβ showed no association with PTC. Overexpression of PDGFRα was significantly associated with lymph node metastasis, larger tumor size, poorer disease-free survival (DFS) with some inconsistency and poor response to radioactive iodine therapy. Findings on PDGFRβ expression were inconsistent. However, one study reported its upregulation in metastatic PTC and its association with shorter overall survival in patients with BRAFV600E. Conclusion: PDGFRα may serve as a potential biomarker associated with aggressive tumor behavior and treatment failure in people with PTC. Further experimental studies are needed to validate the results. Targeting PDGFRα may represent a therapeutic approach, but evidence is still insufficient.

First-degree relatives (FDRs) of people with type 2 diabetes mellitus (T2DM) are considered as a high-risk group to develop T2DM. This study aimed to determine the prevalence of prediabetes and diabetes and assess the agreement among three standard diagnostic criteria in this population. A cross-sectional study of 1,029 FDRs of people with T2DM was conducted. Anthropometric, blood pressure, and biochemical assessments, including fasting plasma glucose (FPG), HbA1c, lipid profile, and a 2-hour oral glucose tolerance test (OGTT), were performed. Agreement between diagnostic criteria was assessed using kappa statistics, and multivariable logistic regression identified the factors associated with dysglycemia. According to a single diagnostic criterion, the prevalence of diabetes and prediabetes in FDRs with undiagnosed diabetes was 9.2

Background:Mobile applications can enhance diabetes self-management by visualizing glucose trends and promoting engagement. However, evidence on their behavioral and clinical effectiveness in environments with constrained resources remains limited. This study evaluated the impact of the Iranian Asan-Chek mobile app on glycemic outcomes and user experiences among adults with type 1 diabetes mellitus (T1DM). Methods:In a 12-week quasi-experimental mixed-methods study, 148 adults with T1DM were recruited. Seventy-four participants used the Bluetooth-enabled Asan-Chek app (intervention group) and 74 performed structured self-monitoring of blood glucose (control group). Primary outcomes included changes in HbA1c and qualitative insights into user engagement and experience. Semi-structured interviews with 15 purposively selected participants (13 app users, 2 controls, varied in age and diabetes duration) explored attitudes, perceived benefits, and barriers. Transcripts were analyzed thematically. Results:HbA1c decreased by 0.62% in the app group and by 0.41% in the control group (both P < 0.001), without any notable divergence between the intervention and control participants (P = 0.202). Changes in BMI, insulin requirements, and glycemic variability during the course of the study exhibited no statistical disparity between the two groups. Qualitative analysis uncovered three motifs: (i) heightened self efficacy and perceived control arising from instant feedback; (ii) stronger motivation prompted by color coded trend charts and reminders and (iii) usability and economic barriers: interface complexity, data driven anxiety, test strip cost, and finger prick fatigue. Conclusion:Over twelve weeks, qualitative results highlighted that the Asan-Chek app provided motivational and behavioral advantages for individuals with T1DM but did not outperform structured SMBG in attaining HbA1c targets. Addressing challenges through optimized app interface, comprehensive user training, affordable supplies via reimbursement, and AI-driven feedback may help convert these behavioral gains into lasting glycemic improvement.

Background:To evaluate the efficacy and safety of collagen-based dressings in the management of diabetic foot ulcers (DFUs), compared to standard wound care (SWC), human amniotic membrane allografts (hAMA), and decellularized extracellular matrix (dECM) products. Methods:A systematic review of randomized controlled trials (RCTs) and cohort studies published between December 2013 and March 2025 was conducted using PubMed, Scopus, and Web of Science. Eligible studies assessed collagen-based dressings for DFUs, with primary outcomes including wound area reduction, closure rates, and healing time. Adverse events were considered secondary outcomes. Due to heterogeneity, findings were narratively synthesized by dressing type. Results:Twenty-two studies (15 RCTs, 7 cohort studies) were included. Collagen-based dressings consistently outperformed SWC, achieving greater wound reduction (54.5--88.2%), higher closure rates (22.2--82.4%), and shorter healing times (21--83.5 days), with no serious treatment-related adverse events. Helicoll showed superior performance (wound reduction: 84--86.5%; closure: 50--71.4%). Comparisons with hAMA and dECM yielded mixed and heterogeneous results, without consistent evidence of superiority. RCTs favored hAMA over Apligraf, while some real-world studies reported the opposite. Findings on collagen/ORC/silver dressings versus dECM were also inconsistent. Conclusions:Collagen-based dressings are safe and effective for improving DFU healing when compared with standard wound care. However, current evidence is insufficient and heterogeneous to establish superiority over other advanced biologic therapies. Further head-to-head randomized trials are warranted.

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) offer cardioprotection in type 2 diabetes mellitus (T2DM). We evaluated their monotherapy versus their combined use for prevention of myocardial infarction (MI) and stroke. Conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, five databases were systematically searched through November 2025 for studies evaluating use of SGLT2i and GLP-1RA in combination versus their monotherapy in adults with T2DM. Hazard ratios (HRs) for MI and stroke were pooled utilizing random-effects models. Subgroup interaction testing and grading of recommendations assessment, development, and evaluation (GRADE) certainty assessments were performed. Of the studies, eight comprising ten comparisons were included. Combination therapy was associated with a lower overall risk of MI (HR 0.79, 95 https://www.crd.york.ac.uk/PROSPERO/view/CRD420261320374 .

[This corrects the article DOI: 10.1007/s40200-026-02045-9.].

Unlike neuropathy, there is no universal agreement for screening of peripheral artery disease (PAD) among high risk diabetic patients. Considering the fact that screening of neuropathy is easier and more available, it is important to find if diabetic patients with neuropathy should be considered for screening of PAD. The study aims to explore the association between diabetic peripheral neuropathy, defined as loss of protective sensation (LOPS), and peripheral artery disease (PAD), and whether LOPS can be used as an indicator of PAD among patients with type 2 diabetes mellitus (T2DM). A cross-sectional study was conducted between 2017 and 2023 on adult patients with T2DM referred for PAD and LOPS screening. Clinical, demographic, and laboratory data were collected from electronic medical records. All participants underwent comprehensive foot examinations for LOPS and assessments of ankle-brachial index (ABI) and toe-brachial index (TBI). PAD was defined as ABI ≤ 0.9 or TBI ≤ 0.7 for cases with ABI > 1.3. A total of 1,136 patients were included, of whom 611 (53

Background:Type 2 diabetes mellitus (T2DM) is one of the most serious public health problems all over the world. Development of local consensus on management of T2DM, providing clinicians, researchers, and policymakers with updated and valid evidence in consideration of practical issues, is crucial. Therefore, we aimed to develop a consensus report on management of T2DM in Iran. Methods:A task force group comprised of experts in diabetes management reviewed published literature. The task force members reached the majority agreement on all recommendations after participating in several group meeting discussions. Results:The consensus provided recommendations on diverse aspects on management of people with T2DM in Iran. The recommendations covered the following topics: first-line treatment, diabetes management in people with obesity, combination therapy in people with T2DM, injectable therapy, and non-alcoholic fatty liver in people with T2DM. Conclusion:Considering evidence-based guidelines, the task force group developed a consensus to address important clinical issues in the management of people with T2DM in Iran.

ABSTRACT Aim To estimate the efficacy and safety of the basal‐bolus and premixed insulin as intensification regimens in patients with type 2 diabetes mellitus (T2DM). Methods A comprehensive search of online databases was performed until December 2022 to identify randomized controlled trials (RCTs) comparing premixed insulin versus basal‐bolus regimen with treat‐to‐target intention. The Cochrane ROB‐2 tool and GRADE approach were used for quality assessment and certainty of the evidence, respectively. Pooled weighted mean difference (WMD) and odds ratio (OR) were calculated using random‐effects meta‐analysis models. Results Eighteen RCTs were included in the meta‐analysis, and 66% had a low risk of bias. We found no significant difference between the two regimens regarding HbA1c reduction (WMD: 0.03% [−0.05%, 0.10%]). The basal‐bolus regimen improved fasting plasma glucose (FPG) more than the premixed regimen (WMD: 6.35 mg/dL [0.31, 12.39]). Both had similar effects on weight gain. The odds of developing overall, nocturnal, and severe hypoglycemia were comparable (pooled OR: 0.9, 1.02, and 1.00, respectively) with no heterogeneity. Findings of the model were robust. The certainty of the evidence was moderate to high for all outcomes except FPG. Conclusions Two regimens are clinically comparable. Patient preference should be considered when adopting an individualized approach in a real‐world setting.

Somatostatin receptor analogs (SRAs) and dopamine agonists (DAs) are the main medical treatments for patients with acromegaly who fail to achieve remission after surgery. We aimed to explore the potential role of select clinical, biochemical, and radiological factors in predicting biochemical and structural responses to medical therapy in a real-world setting. This retrospective cohort study included 58 patients with active acromegaly following surgery treated with Octreotide long-acting release (LAR) (± Cabergoline). Biochemical outcomes were defined as the tight biochemical response (TBR; normal insulin-like growth factor-1(IGF-1)) and biochemical control (BC; IGF-1 ≤ 1.2 upper limit of normal (ULN)). The structural response was defined as > 25

Background: Thyroid cancer is the most common type of cancer affecting the endocrine system. The main treatment approaches consist of surgical procedures and radioiodine therapy. Recently, there has been a heightened interest in investigating alternative treatment options, including probiotics, which could potentially minimize toxicity. Consequently, there is a growing imperative for research aimed at investigating the potential role of probiotics in the management of cancer. Methods: The B-CPAP cell line was maintained in culture and tested with different dilutions of two bacterial strains. Toxicity evaluations were performed using the MTT assay to identify appropriate concentrations. mRNA was extracted and analyzed via real-time PCR to measure the expression levels of the Bcl-2, Bax, and P53 genes. Furthermore, changes in the cell cycle and the induction of apoptosis were examined using flow cytometry. Results: The supernatant derived from Lacticaseibacillus casei (L. casei) – ATCC-393 and Lacticaseibacillus rhamnosus (L. rhamnosus)-GG demonstrated a significant inhibitory effect on the growth of B-CPAP cancer cells. The findings indicated that the combination produced a more pronounced anti-cancer effect by enhancing the expression of pro-apoptotic genes while reducing Bcl-2 gene expression in B-CPAP cells. Conclusion: The findings indicated a notable change in the expression of genes associated with apoptosis and modifications in the cell cycle. This implies that probiotics may enhance the efficacy of chemotherapy in treating thyroid cancer. In particular, L. rhamnosus and L. casei may play a beneficial role in the therapeutic process. Further research is required to investigate the direct impact of probiotics on thyroid function.

Thyroid cancer (TC) ranks among the most prevalent cancers globally. The incidence rate of thyroid cancer has significantly risen in the past few decades. Most patients with differentiated thyroid cancer can be effectively treated with thyroidectomy and radioiodine adjuvant therapy. However, the management of locally advanced or distant metastatic TC remains challenging, especially in radioactive iodine-resistant tumors. Targeted therapy is the use of drugs designed to target overexpressed molecules in cancer cells. Epidermal growth factor receptor (EGFR) is a cell surface protein that plays a crucial role in cell proliferation, differentiation, and migration. Several studies have indicated that EGFR is overexpressed in thyroid cancer, making it a promising target in cancer treatment. In this review, we aimed to provide the functional significance of EGFR signaling pathway in TC. In addition, current strategies using anti-EGFR monoclonal antibodies and EGFR tyrosine kinase inhibitors for treating thyroid cancer are explored.

Type 2 diabetes mellitus (T2DM) is a global health crisis, with cardiovascular disease (CVD) accounting for 75

This study aimed to investigate the association between maternal exposure to ambient air pollution and intrapartum fetal distress. The retrospective data were obtained for 150 parturients, ages 19-45, referred to Kamali Teaching Hospital, Karaj, Iran, in 2016. To assess the impact of the 2, 4, and 8 weeks exposure windows before the delivery of particulate matter ≤ 10 micrometers (PM10) and sulfur dioxide (SO2) on fetal distress incidence, logistic regression models were fitted, crudely and adjusted for maternal covariates. The parturients' ages owned a mean (standard deviation) of 30.4 (5.4). Moreover, 17 fetal distress cases were detected (11.3 %), demonstrating higher proportions of cousin marriage and family history of diabetes than the non-fetal distress group. Adjusted for body mass index, cousin marriage, abortion, and family history of diabetes, and over the eight weeks exposure window, a five µg/m3 increase of SO2 and PM10 provided odds ratios of 2.12 (95 % CI: 1.04-4.30) and 1.61 (95 % CI: 1.08-2.40), respectively, for fetal distress incidence. To conclude, we found the long-term impacts of SO2 and PM10 on the incidence of fetal distress based on the exposure level during the last eight weeks of pregnancy.

The effect of statin use on hepatocellular carcinoma (HCC) in patients with metabolic dysfunction–associated steatotic liver disease (MASLD) or type two diabetes mellitus (T2DM) is still unclear. In this umbrella review, we aimed to assess the available evidence for the association of statin use and HCC risk in the target population. We carried out an umbrella review of previous systematic reviews/meta-analyses indexed in Cochrane, Embase, Scopus, and PubMed databases and published between Jan 1st, 2013, and Oct 22, 2024. We used random effects models to recalculate summary risk estimates for HCC incidence. Using A Measurement Tool to Assess methodological quality of systematic Review (AMSTAR2) tool, two independent reviewers evaluated each article for eligibility and methodologic quality and gathered data from the included studies. Of the initially identified 1,038 systematic reviews/meta-analyses, three non-overlapping studies with medium/high quality were included for qualitative synthesis. Statin use in people with T2DM was reported in six studies belonging to two meta-analyses. The results showed that statins were associated with a decreased risk of HCC (RR: 0.16, 95

Pharmacogenetics studies suggest that genetic variants have a possible influence on the inter-individual differences in therapeutic response to glucagon-like peptide 1 receptor agonists (GLP-1 RAs). We aimed to examine the potential role of genetic variability of glucagon-like peptide 1 receptor (GLP-1R) on glycemic response to GLP-1 RAs in a population of Iranian people with type 2 diabetes mellitus (T2DM). In this study, we analyzed the data from participants in a non-inferiority randomized clinical trial between 2019 and 2020. Patients received liraglutide 1.8 mg/day subcutaneously for 24 weeks. They were stratified by the baseline hemoglobin A1c (HbA1c) into four categories: 7–7.99, 8–8.99, 9–9.99, and ≥ 10

Objective Activating mutation in Ubiquitin-specific peptidase (USP8) is identified to enhance cell proliferation and adrenocorticotropic hormone (ACTH) secretion from corticotroph pituitary adenoma. We investigated the USP8 variant status in a population of Iranian people with functional corticotroph pituitary adenoma (FCPA). Moreover, a systematic review was conducted to thoroughly explore the role of USP8 variants and the related pathways in corticotroph adenomas, genotype-phenotype correlation in USP8-mutated individuals with FCPA, and the potential role of USP8 and epidermal growth factor receptor (EGFR) as targeted therapies in PFCAs. Methods Genetic analysis of 20 tissue samples from 19 patients with PFCAs was performed using Sanger sequencing. Moreover, a systematic literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, web of Sciences, and Cochrane databases were searched. The last search was performed on 20 September 2023 for all databases. Results In our series, we found two somatic mutations including a 7-bp deletion variant: c.2151_2157delCTCCTCC, p. Ser718GlnfsTer3, and a missense variant: c.2159 C > G, p. Pro720Arg (rs672601311) in exon 14. The Systematic review indicated USP8 variant in 35% of corticotroph adenomas, with the highest frequency (25%) in 720 code regions, p. Pro720Arg. Data regarding the impact of USP8 mutational status on clinical characteristics and outcomes in FCPAs are inconsistent. Moreover, Pasireotide as well as inhibitors of EGFR such as Gefitinib and Lapatinib, as well as USP8 inhibitors including -ehtyloxyimino9H-indeno (1, 2-b) pyrazine-2, 3-dicarbonitrile, DUBs-IN-2, and RA-9 indicated promising results in treatment of corticotroph adenomas. Conclusion Although the USP8-EGFR system has been identified as the main trigger and target of corticotroph tumorigenesis, more precise multicenter studies are required to yield more consistent information regarding the phenotype-genotype correlation and to develop effective targeted therapies.

Thyroid eye disease (TED) is the foremost extrathyroidal manifestation of Graves’ disease (GD). Currently, available treatments do not entirely prevent the long-term consequences of TED and have distinct disadvantages. Therefore, this systematic review explored available evidence regarding the efficacy of statins in preventing and treating TED. Relevant studies investigating statin usage in patients with GD or TED were identified by searching Medline (Pubmed and Ovid), Scopus, Web of Science, ProQuest, and Cochrane Library databases (from the database inception to September 2023). The review was done according to the PRISMA statement. Web searching was done independently by two investigators. Two researchers independently extracted the data, and any disagreement was adjudicated by consensus. Based on the study design, the studies’ quality appraisal was done using the Newcastle-Ottawa Scale (NOS) and Version 2 of the Cochrane risk-of-bias tool (RoB2). The literature search identified 145 publications, of which four met the inclusion criteria (Three retrospective cohort studies and one randomized clinical trial) and were reviewed in full text. The two retrospective cohort studies demonstrated the beneficial effects of statins on TED in newly diagnosed GD Stein et al. showed that statins, regardless of the type, prevent or delay TED (HR: 0.74 (0.65–0.84)), especially in men or treatment duration of more than one year. Nilsson et al. fascinatingly revealed that at least 60 days of statin usage in the preceding year could decrease the risk of TED development by around 40

Radioactive iodine (RAI) therapy is the standard treatment approach after total thyroidectomy in patients with papillary thyroid carcinoma (PTC). We aimed to identify predictive factors of response to the treatment in intermediate and high-risk patients with PTC. In addition, the impact of multiple RAI treatments was explored. In a 3-year retrospective study, data from intermediate and high-risk patients with PTC who received RAI therapy following total thyroidectomy, were analyzed by the end of year-one and year-three. Demographic data, tumor size, capsular/vascular invasion, extrathyroidal extension, local or distant metastasis, initial dose and cumulative dose of RAI, serum thyroglobulin(Tg), antithyroglobulin antibody(TgAb), and imaging findings were investigated. Patients with an excellent response to a single dose of RAI treatment, after three years of follow-up were classified as the “Responder group”. Excellent response was defined as stimulated serum Tg less than 1 ng/ml, or unstimulated serum Tg less than 0.2 ng/ml in TgAb-negative patients with negative imaging scans. 333 patient records with a complete data set were analyzed in this study. After three years of initial treatment, 271 patients were non-responders (NR) and 62 were responders (R). At baseline, the median pre-ablation serum Tg level was 5.7 ng/ml in the NR group, and 1.25 ng/ml in the R group (P < 0.001). TSH-Stimulated serum Tg greater than 15.7 ng/ml, was associated with response failure even after multiple RAI therapy, AUC: 0.717(0.660–0.774), sensitivity: 52.5