Publications by authors named "Benedetta Bonora"
Article Synopsis
- The study aimed to compare the effectiveness of injectable versus oral semaglutide in managing type 2 diabetes by examining real-world clinical outcomes, including changes in HbA1c and body weight.
- Researchers analyzed data from two matched groups of 107 participants each, finding that both formulations led to similar reductions in HbA1c and comparable weight loss after 18 months, although injectable users showed greater persistence with the medication.
- The findings suggest that, in practical settings, both forms of semaglutide are effective for T2D management, but results may not apply universally to all patient populations due to specific characteristics of the cohorts studied.
Background And Aims: An acute depletion of circulating haematopoietic stem/progenitor cells (HSPCs) occurs during COVID-19, especially among patients with a poorer disease course. We herein examined whether HSPCs levels at hospital admission for COVID-19 predict 1-year mortality and the long-COVID syndrome.
Materials And Methods: Patients hospitalized for COVID-19 in an infectious disease ward were consecutively enrolled.
Aim/hypothesis: We examined whether prediction of long-term kidney outcomes in individuals with type 2 diabetes can be improved by measuring circulating levels of haematopoietic stem/progenitor cells (HSPCs), which are reduced in diabetes and are associated with cardiovascular risk.
Methods: We included individuals with type 2 diabetes who had a baseline determination of circulating HSPCs in 2004-2019 at the diabetes centre of the University Hospital of Padua and divided them into two groups based on their median value per ml of blood. We collected updated data on eGFR and albuminuria up to December 2022.
In recent years, GLP-1 receptor agonists (GLP-1RA), and SGLT-2 inhibitors (SGLT-2i) have become available, which have become valuable additions to therapy for type 2 diabetes as they are associated with low risk for hypoglycemia and cardiovascular benefits. Indeed, SGLT-2i have emerged as a promising class of agents to treat heart failure (HF). By inhibiting SGLT-2, these agents lead to excretion of glucose in urine with subsequent lowering of plasma glucose, although it is becoming clear that the observed benefits in HF cannot be explained by glucose-lowering alone.
View Article and Find Full Text PDFKetosis-prone Diabetes and Hypogonadism: A New Clinical Association to be Aware of ?
Endocr Metab Immune Disord Drug Targets
September 2023
Article Synopsis
- Ketosis-prone diabetes (KPD) is a new form of diabetes that shares characteristics of both type 1 and type 2 diabetes, commonly seen in African American adults who experience diabetic ketoacidosis but may later achieve insulin-free remission.
- The text presents two cases of young African patients with KPD, one affected by Klinefelter's syndrome and the other by primary ovarian failure, both managed effectively with insulin and oral medications.
- The study emphasizes the need for better recognition of KPD and suggests that evaluating sex hormones at diabetes onset could provide insights into its associations with conditions like hypogonadism, warranting further exploration of hormonal influences on KPD.*
Article Synopsis
- Diabetes lowers the levels of endothelial progenitor cells (EPCs), which are important for maintaining blood vessel health, and low levels of EPCs are linked to worsening diabetes complications.
- This study focused on patients with decompensated diabetes who received intensive insulin therapy, measuring EPC levels at admission, discharge, and two months post-discharge.
- Results showed a significant increase in EPC levels after treatment, especially in newly-diagnosed cases and those with type 1 diabetes, suggesting that rapid glucose management could help improve vascular repair capabilities early in the disease.
Frailty affects the physical, cognitive, and social domains exposing older adults to an increased risk of cardiovascular disease and death. The mechanisms linking frailty and cardiovascular outcomes are mostly unknown. Here, we studied the association of abundance (flow cytometry) and gene expression profile (RNAseq) of stem/progenitor cells (HSPCs) and molecular markers of inflammaging (ELISA) with the cardiorespiratory phenotype and prospective adverse events of individuals classified according to levels of frailty.
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- Admission hyperglycemia is linked to worse outcomes in COVID-19, with a notable 45% of hospitalized patients exhibiting elevated blood sugar levels.
- Patients with elevated hyperglycemia showed a 50-60% reduction in hematopoietic stem/progenitor cells (HSPCs), which is crucial for immune response and has been shown to predict negative health complications.
- Lower levels of HSPCs significantly increase the risk of severe COVID-19 results, and about 28% of the impact from hyperglycemia on patient outcomes can be attributed to the reduction of HSPCs.
Aims: To conduct a pooled analysis to assess the performance of intermittently scanned continuous glucose monitoring (isCGM) in association with the rate of change in sensor glucose in a cohort of children, adolescents, and adults with type 1 diabetes.
Material And Methods: In this pooled analysis, isCGM system accuracy was assessed depending on the rate of change in sensor glucose. Clinical studies that have been investigating isCGM accuracy against blood glucose, accompanied with collection time points were included in this analysis.
Peripheral artery disease (PAD) is a severe complication of diabetes, characterized by defective traffic of hematopoietic stem/progenitor cells (HSPCs). We examined the hematopoietic nonhematopoietic role of p66Shc in regulating HSPC traffic and blood flow recovery after ischemia in diabetic mice. Using streptozotocin-induced diabetes, chimeric mice with green fluorescent protein (GFP) bone marrow (BM), and the hind limb ischemia model, we found that the physiologic mobilization and homing of HSPCs were abolished by diabetes, along with impaired vascular recovery.
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- The study aimed to compare cardiovascular outcomes between type 2 diabetes patients using SGLT2 inhibitors and DPP4 inhibitors in routine care settings.
- Researchers analyzed data from over 5.2 million people to identify those starting these medications from 2014 to 2018 and focused on major cardiovascular events.
- Results indicated that SGLT2i users had significantly lower rates of major cardiovascular events, heart attacks, heart failure hospitalizations, and all-cause mortality compared to DPP4i users, suggesting better overall health outcomes for SGLT2i.
Article Synopsis
- Two large randomized controlled trials (RCTs) found that fenofibrate can slow down diabetic retinopathy progression, and this study aims to see if it boosts circulating hematopoietic stem/progenitor cells (HSPCs) which may help protect against retinopathy.
- A 12-week RCT was conducted with diabetic retinopathy patients, comparing fenofibrate to a placebo to determine its effect on HSPC levels, specifically those marked by CD34 and/or CD133.
- Results showed that fenofibrate significantly increased CD34+ HSPCs compared to the placebo group, suggesting a potential protective effect against the progression of diabetic retinopathy.
Aims: COVID-19 has and still is sweeping away the national health systems worldwide. In this review, we sought to determine the evidence base proofs on the antidiabetic treatment capable to reduce the risk of COVID-19-related mortality.
Methods: We have performed a systematic search of published articles using PubMed, and EMBASE from March 2020 to March 31st, 2021.
Article Synopsis
- * A study analyzed adverse event reports from the FDA (2014-2019) to compare AF incidents between SGLT2i and other glucose-lowering medications, finding that AF was reported less frequently with SGLT2i (4.8 per 1000) than with other drugs (8.7 per 1000).
- * The results indicate a consistent protective effect of SGLT2i against AF, reinforcing evidence from clinical trials regarding their benefits.
Article Synopsis
- A study was conducted in North-East Italy to evaluate how patients with Type 2 Diabetes (T2D) could reduce their basal-bolus insulin (BBI) after starting a GLP-1 receptor agonist (GLP-1RA) treatment.
- Out of 425 patients analyzed, about 58.6% were able to de-intensify their insulin therapy, particularly those who were younger, had less severe diabetes, and had better initial blood sugar levels.
- The findings suggest that starting GLP-1RA can lead to a significant reduction in insulin use, with improved HbA1c levels in patients who successfully de-intensified their BBI.
Diabetes is burdened with the development of several end-organ complications leading to excess mortality. Though the causes of such organ damage are far from being clarified, diabetes has been redefined as a disease of impaired damage control, wherein ongoing damage is not adequately compensated by activation of repair processes. Bone marrow-derived hematopoietic stem/progenitor cells (HSPCs) and their descendants endothelial progenitor cells (EPCs) have been extensively studied as major players in tissue homeostasis as well as biomarkers of diabetic complication risk.
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- The study aimed to determine how pre-existing diabetes, newly-diagnosed diabetes, and high blood sugar at admission impacted the severity of COVID-19 in hospitalized patients.
- Researchers reviewed the medical records of 413 COVID-19 patients from an outbreak hospital in Italy, finding that those with diabetes had a significantly higher chance of serious outcomes like ICU admission or death.
- Newly-diagnosed diabetes and high glucose levels at admission were found to be particularly strong predictors of worsening COVID-19, primarily due to rapid deterioration in respiratory function.
Aim: Concerns have been raised that dipeptidyl-peptidase 4 inhibitors (DPP-4i) may increase the risk of pneumonia. We analysed observational data and clinical trials to explore whether use of DPP-4i modifies the risk of pneumonia.
Methods: We identified patients with diabetes in the Veneto region administrative database and performed propensity score matching between new users of DPP-4 inhibitors and new users of other oral glucose-lowering medications (OGLMs).
Bone marrow-derived cells contribute to tissue repair, but traffic of hematopoietic stem/progenitor cells (HSPCs) is impaired in diabetes. We therefore tested whether HSPC mobilization with the CXCR4 antagonist plerixafor improved healing of ischemic diabetic wounds. This was a pilot, phase IIa, double-blind, randomized, placebo-controlled trial (NCT02790957).
View Article and Find Full Text PDFBecause other coronaviruses enter the cells by binding to dipeptidyl-peptidase-4 (DPP-4), it has been speculated that DPP-4 inhibitors (DPP-4is) may exert an activity against severe acute respiratory syndrome coronavirus 2. In the absence of clinical trial results, we analysed epidemiological data to support or discard such a hypothesis. We retrieved information on exposure to DPP-4is among patients with type 2 diabetes (T2D) hospitalized for COVID-19 at an outbreak hospital in Italy.
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- Diabetic ketoacidosis (DKA) is a severe diabetes complication marked by high blood sugar, acidosis, and ketosis, but can also occur with normal or low blood sugar levels, known as euglycemic ketoacidosis (euKA).
- The rise in euglycemic ketoacidosis cases is linked to the use of sodium glucose co-transporter 2 inhibitors (SGLT2i), which can lead to ketoacidosis even when blood glucose isn't high.
- EuKA can also occur in individuals without diabetes under various conditions, making its diagnosis tricky for physicians who may misinterpret normal or slightly elevated blood sugar levels.
Article Synopsis
- In late February 2020, Italy implemented strict lockdown measures due to the COVID-19 pandemic, impacting educational and sports activities and leading to the study of its effects on glucose control in people with type 1 diabetes (T1D).
- Data from 33 T1D individuals showed improved glycaemic control in those who ceased work during the first week of lockdown, with average glucose levels decreasing and time in both hypoglycaemia and hyperglycaemia improving.
- The findings suggest that reduced daily activities, despite challenges like restricted exercise and heightened stress, can positively affect glucose management in patients with T1D.