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Objectives: Type 2 diabetes (T2D) has been increasingly associated with a heightened risk of various gastrointestinal (GI) cancers. This narrative review aims to synthesise current evidence on the link between newly diagnosed T2D and GI malignancies, and to propose a clinical framework for risk-adapted cancer vigilance. Methods: We conducted a narrative review of the literature focusing on the association between T2D and GI cancers, including colorectal, pancreatic, liver, gastric, and biliary malignancies. We examined shared risk factors, underlying biological mechanisms, and emerging insights into pathophysiology. Results: Epidemiological and mechanistic studies suggest that chronic hyperglycaemia, hyperinsulinemia, insulin resistance, inflammation, and gut microbiota alterations contribute to cancer development in patients with T2D. Despite these findings, current screening guidelines do not provide T2D-specific recommendations for GI cancer surveillance. Conclusions: T2D is an emerging risk factor for several GI malignancies. Clinicians should be aware of this association and consider individualised assessment in newly diagnosed patients. The proposed algorithm is intended to stimulate further discussion and guide future research. Prospective studies are needed to evaluate the effectiveness and feasibility of targeted screening strategies in this high-risk population.

Galectin-3 (Gal-3) secreted by activated macrophages is involved in inflammation, fibrosis, and tumorigenesis. It is considered a potential biomarker and therapeutic target. This study assessed the association between serum Gal-3, type 2 diabetes (T2D), and colorectal polyps (CRPs). In this cross-sectional study, 80 non-cancer patients undergoing colonoscopy were divided into four subgroups based on T2D and CRP status. Serum Gal-3 and metabolic parameters were measured. All patients’ mean serum Gal-3 level was 13.63 ng/mL. Gal-3 levels were significantly higher in T2D+ than in the T2D− group (14.93 ng/mL, p = 0.02). Gal-3 concentration correlated significantly with age (rho = 0.281; p = 0.012), gender (rho = 0.220; p = 0.049), serum peptide C levels (rho = 0.957; p = 0.006), and serum IGF-1 levels (rho = −0.417; p < 0.001) in all patients, and for patients T2D-, it also correlated significantly with fasting plasma glucose levels (rho = −0.406; p = 0.009). A logistic regression analysis of the risk of polyps was conducted (CRP+ vs. CRP−) considering factors such as gender, age, body weight, waist circumference, T2D, HOMA-IR, insulin, API, IGF-1, total cholesterol, and Gal-3. Gal-3 serum was shown to be a strong independent predictor of CRPs regardless of the presence of T2D+ (p = 0.031). Gal-3 may correlate with the development of CRPs and might be a candidate biomarker of CRPs/cancer development.

Introduction: Obesity is a systemic disease leading to many complications. One of the causes of obesity is excessive energy intake in relation to its expenditure. Assessing portion sizes and estimating caloric intake is crucial in maintaining a healthy body weight and combating obesity. Objectives: To evaluate the impact of BMI on the perception of portion sizes and their estimated caloric content. Patients and methods: The anonymous survey was filled out by 205 patients. The survey contained questions regarding different meals. Pictures of main meals were presented and individually assessed by the study participants. Next, they were divided into groups, individuals with normal weight (BMI < 25 kg/m2), who were overweight (BMI 25–29.9 kg/m2), and with obesity (BMI ≥ 30 kg/m2), to analyze the differences in food perception and caloric estimation. Results: The study did not demonstrate significant differences in the subgroups’ estimated portion sizes of most main meals. No statistical significance was found in the estimated caloric content of the indicated main meal portions across the studied groups. Obese, overweight, and normal-weighted patients assess food portion size similarly. Conclusions: BMI has no significant impact on caloric estimation. The majority of the population estimate the caloric value of the meals inappropriately. Nevertheless, patients with excessive body weight (overweight and obesity) have a tendency (but not statistically significant) to underestimate the caloric value of full meals compared with people with normal BMI. Incorrect calorie estimation may lead to consuming bigger meal portions in patients with overweight and obesity.

Introduction: The major cause of obesity is excessive calorie intake. Inappropriate dietary habits, like increased meal frequency, portion sizes, or amount of snacks consumed contribute to obesity development. Potential differences in the perception of snacks by people with different BMIs may be one of the causes of obesity. Assessment of the perception of snacks by people with excessive and normal body weight will allow us to check whether this parameter actually has an impact on the development of obesity. Materials and Methods: A survey study was conducted to check differences in assessing different snacks and beverages by individuals with varied BMIs. Participants analyzed snacks on presented photographs and assessed portion sizes, estimated caloric content, assessed whether the meal was healthy, and determined whether the indicated portion would be sufficient to satisfy their hunger. The study population was divided according to body mass index (BMI) into individuals with normal weight, overweight, and obesity. Additionally, the study group was divided according to gender and age. Results: There were no statistically significant differences in the majority of the studied parameters concerning BMI; however, the study revealed relatively low education level regarding caloric assessment. Conclusions: BMI seems not to have an influence on calorie and portion size perception of snacks. The majority of the population wrongly assessed the calorific value of snacks, which might contribute to obesity development. People have a tendency to overestimate the caloric value of snacks. Women assess the portion size of highly processed snacks as larger than men do.

Patients with Covid-19 place new challenges on the management of type 2 diabetes, including the questions of whether glucose-lowering therapy should be adjusted during infection and how to manage a return to normal care after resolution of Covid-19 symptoms. Due to the sudden onset of the pandemic, physicians have by necessity made such important clinical decisions in the absence of robust evidence or consistent guidelines. The risk to patients is compounded by the prevalence of cardiovascular disease in this population, which alongside diabetes is a major risk factor for severe disease and mortality in Covid-19. We convened as experts from the Central and Eastern European region to consider what advice we can provide in the setting of type 2 diabetes and Covid-19, considering the evidence before, during and after infection. We review recommendations that have been published to date, and consider the best available—but currently limited—evidence from large observational studies and the DARE-19 randomized control trial. Notably, we find a lack of guidance on restarting patients on optimal antidiabetic therapy after recovering from Covid-19, and suggest that this may provide an opportunity to optimize treatment and counter clinical inertia that predates the pandemic. Furthermore, we emphasize that optimization applies not only to glycaemic control, but other factors such as cardiorenal protection. While we look forward to the emergence of new evidence that we hope will address these gaps, in the interim we provide a perspective, based on our collective clinical experience, on how best to manage glucose-lowering therapy as patients with Covid-19 recover from their disease and return to normal care.

Obesity is a disease which is currently one of the most serious problems affecting approximately 650 million people worldwide. Improper lifestyle is considered the primary cause of the disease; however, many other factors contribute to the problem. In recent years, attention has been drawn to the role of gut microbiota in developing and controlling obesity and overweight. Microorganisms in the gastrointestinal tract are responsible for the fermentation of certain nutrients, causing efficient digestion, stimulation of intestinal transit, vitamin production, and modulation of the host’s immune system. Numerous studies have demonstrated that gut microbiota composition differs between obese individuals and those with a normal body mass index (BMI). It has also been shown that altering gut microbiota can influence the phenotype of the host organism, promoting metabolic changes, including BMI reduction. Recent studies aimed at using probiotics to modify gut microbiota composition to reduce body weight are still inconclusive.

Background The risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancer – difficult within regular outpatient diabetes care - is of utmost importance for patients’ survival. The aim of this multicenter, retrospective (years 1998–2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting. Methods In the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified. The control group consisted of 203 strictly age- and gender matched subjects with type 2 diabetes without cancer. Factors associated with diabetes: disease duration, antidiabetic medications use and metabolic control of diabetes were analyzed. Also other variables: BMI (body mass index), smoking habits, place of residence and comorbidities were included into analysis. Results The most prevalent malignancies in men and women together were breast cancer (20.7 %) and colorectal cancer (16.3 %). HbA 1c (hemoglobin A 1c ) level ≥8.5 %, obesity and insulin treatment in dose-dependent and time-varying manner demonstrated significant association with increased risk of malignancy, while metformin use was associated with a lower risk of cancer. Diabetes duration, comorbidities, smoking habits, place of residence and aspirin use did not show significant association with risk of malignancy. Conclusions In the outpatient setting the obese patients with poorly controlled insulin treated type 2 diabetes mellitus should be rigorously assessed towards malignancies, particularly breast cancer in women and colorectal cancer in men.

Obstructive sleep apnea (OSA) is a recognized independent risk factor for metabolic disorders, type 2 diabetes mellites (DM2) in particular. Therefore, the study aimed to assess the influence of nocturnal oxygen saturation parameters on the onset of DM2 among OSA patients. The study consisted of 549 participants, who underwent polysomnography examination. Based on apnea hypopnea index (AHI), 465 patients were diagnosed with OSA. One hundred and seven individuals had comorbid DM2. Cox regression models were used to assess the effect of oxygen saturation parameters on the onset of DM2. Classification and regression trees (CART) analysis was used to assess the onset of the DM2 in the study group in context of oxygen saturation variables. One-way Cox regression showed higher risk of earlier DM2 for increased values of BMI, AHI, decreased basal O2 and O2 nadir value, while lowered mean O2 desaturation has not shown statistical significance. In the CART analysis, the following cut-off points 92.2%, 81.7%, 87.1% were determined for basal O2, O2 nadir and mean O2 desaturation, respectively, with the first two parameters being statistically significant. Therefore, basal O2 is independent from AHI, BMI and age is a risk factor of DM2 among OSA patients.

Standard markers of glycaemic control, such as glycated haemoglobin (HbA1c) and self-measurement of blood glucose (SMBG), have proven insufficient. HbAc1 is an averaged measurement that does not give information about glucose variability. SMBG provides limited, intermittent blood glucose (BG) values over the day and is associated with poor compliance because of invasiveness of the method and social discomfort. In contrast to glucometers, continuous glucose monitoring (CGM) devices do not require finger-stick blood samples, but instead measure BG via percutaneous or subcutaneous sensors. The immediate benefits of CGM include prevention of hypoglycaemia or hyperglycaemia, and automated analysis of long-term glycaemic data enables reliable treatment adjustments. This review describes the principles of CGM and how CGM data have changed diabetes treatment standards by introducing new glycaemic control parameters. It also compares different CGM devices and examines how the convenience of sharing CGM data in telehealth applies to the current coronavirus-19 pandemic.

The loss of cardioprotection observed in premenopausal, diabetic women may result from the interplay between epigenetic, metabolic, and immunological factors. The aim of this study was to evaluate the concentration of sirtuin 1, visfatin, and IL-27 in relation to cardiovascular parameters and Hashimoto’s disease (HD) in young, asymptomatic women with type 1 diabetes mellitus (T1DM). Thyroid ultrasound, carotid intima-media thickness (cIMT) measurement, electrocardiography, and echocardiography were performed in 50 euthyroid females with T1DM (28 with HD and 22 without concomitant diseases) and 30 controls. The concentrations of serum sirtuin 1, visfatin and IL-27 were assessed using ELISA. The T1DM and HD group had higher cIMT (p = 0.018) and lower left ventricular global longitudinal strain (p = 0.025) compared to females with T1DM exclusively. In women with a double diagnosis, the sirtuin 1 and IL-27 concentrations were non-significantly higher than in other groups and significantly positively correlated with each other (r = 0.445, p = 0.018) and thyroid volume (r = 0.511, p = 0.005; r = 0.482, p = 0.009, respectively) and negatively correlated with relative wall thickness (r = –0.451, p = 0.016; r = –0.387, p = 0.041, respectively). These relationships were not observed in the control group nor for the visfatin concentration. These results suggest that sirtuin 1 and IL-27 contribute to the pathogenesis of early cardiac dysfunction in women with T1DM and HD.