Publications by authors named "Koufakis T"

Objectives: SGLT-2 inhibitors have been shown to exert cardio- and renoprotective actions. We aimed to investigate the underlying mechanisms using H-NMR based metabolomics in patients with type-2 diabetes mellitus who received dapagliflozin.

Methods: 50 patients with type 2 diabetes mellitus, inadequately controlled on metformin monotherapy (HbA1c > 7%) received dapagliflozin for 3 months and 30 matched patients received insulin degludec for 3 months.

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  • Obstructive sleep apnea (OSA) is a common condition linked to higher cardiovascular risks, especially in people with obesity and type 2 diabetes (T2D), and although continuous positive airway pressure (CPAP) is often used for treatment, many patients struggle to stick with it.
  • New focus is on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors, which may offer benefits for OSA patients by helping with weight loss, lowering blood pressure, and improving heart health.
  • Emerging evidence suggests that these medications can reduce OSA severity and enhance daytime alertness, highlighting the need for more research to confirm their
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As the incidence of type 2 diabetes mellitus (T2DM) continues to increase globally, researchers are keen to investigate various interventions to mitigate its impact. Among these, vitamin D supplementation has attracted significant attention due to its influence on insulin secretion from the pancreas and insulin receptors in body cells. A substantial body of evidence indicates that vitamin D supplementation can reduce low-grade inflammation, a critical factor in developing insulin resistance.

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Tobacco use represents the leading preventable risk factor for premature deaths worldwide. A meta-analysis of 74 epidemiological studies, including 3.2 million individuals with type 2 diabetes mellitus (T2DM) from 33 countries, reported a pooled prevalence of smoking of 20.

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The growing prevalence of overweight/obesity, the persistence of inadequate glycemic control among the majority of affected individuals, and the still unacceptably high risk of cardiovascular morbidity and mortality among population with type 1 diabetes mellitus (T1D), impose an urgent need for the introduction of non-insulin glucose-lowering agents in the therapeutic armamentarium. Given that their antihyperglycemic mechanism of action is independent of endogenous insulin secretion and that the observed cardio-renal benefits are unrelated to their glucose-lowering properties, one can speculate that the use of sodium-glucose co-transporter-2 inhibitors (SGLT2is) could provide benefits in T1D, similar to the ones observed among individuals with type 2 diabetes mellitus, chronic kidney disease (CKD), and heart failure. Available evidence from randomized controlled trials suggests that treatment with SGLT2is as adjunct to insulin in T1D results in modest reductions in glycated hemoglobin and body weight.

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  • - The study aimed to determine the rates of overweight and obesity among patients admitted to an internal medicine department and to see if there's a link between body mass index (BMI) and reasons for hospitalization.
  • - Over a 30-day period, 118 patients were analyzed, revealing that 53.25% of them had overweight or obesity, with a mean BMI of 26.85 kg/m² and an average age of 71.84 years.
  • - A significant finding was that patients hospitalized for hepatobiliary diseases had a higher BMI compared to those admitted for other gastrointestinal issues, suggesting that the reason for hospitalization may influence BMI.
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  • - The study aimed to analyze the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on blood sugar control in adults with type 1 diabetes when added to insulin therapy.
  • - A systematic search found six randomized controlled trials with 378 participants, revealing a slight reduction in HbA1c levels but no significant improvement in other glucose monitoring metrics.
  • - The results indicated that while GLP-1RA therapy reduced time spent above the target glucose range and increased time spent below it, overall benefits on continuous glucose monitoring were minimal.
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Obesity is a significant predisposing factor for heart failure with preserved ejection fraction (HFpEF). Although a substantial proportion of individuals with HFpEF also have obesity, those with obesity are under-represented in clinical trials for heart failure. In turn, current guidelines provided limited recommendations for the medical management of this patient population.

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  • * A study with 75 individuals highlighted that the duration of diabetes affected presepsin levels, with type 1 diabetes patients showing higher levels compared to type 2 diabetes patients, especially in well-controlled groups.
  • * After considering other factors like age and body mass index, the difference in presepsin levels remained significant, indicating its possible role as a marker for inflammation in diabetes management.
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  • * For nearly 20 years, treatments targeting the renin-angiotensin system (RAS) were the primary option for protecting heart and kidney health in these patients, but new therapies have emerged in the last five years.
  • * Recent clinical trials have shown that combining various medications, like SGLT-2 inhibitors and GLP-1 receptor agonists, can enhance cardiorenal protection, though more research is needed to confirm the benefits of these combination therapies.
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  • * Many people who are obese find it hard to lose weight just by eating healthy and exercising.
  • * New medications like semaglutide, liraglutide, and tirzepatide are helping many people lose weight, and researchers are studying how well they work and how much they cost to help fight obesity.
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Vasdeki, Dimitra, Georgios Tsamos, Kleoniki I. Athanasiadou, Vasiliki Michou, Evangelos Botsarakos, Michael Doumas, Kalliopi Kotsa, and Theocharis Koufakis. Above the clouds with diabetes: From pathophysiological considerations to practical recommendations for safe flights.

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Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) are prevalent conditions that have been correlated with infertility through overlapped pathophysiological mechanisms. MASLD is associated with metabolic syndrome and is considered among the major causes of chronic liver disease, while PCOS, which is characterized by ovulatory dysfunction and hyperandrogenism, is one of the leading causes of female infertility. The pathophysiological links between PCOS and MASLD have not yet been fully elucidated, with insulin resistance, hyperandrogenemia, obesity, and dyslipidemia being among the key pathways that contribute to liver lipid accumulation, inflammation, and fibrosis, aggravating liver dysfunction.

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  • Hepatocellular carcinoma (HCC) is the leading type of primary liver cancer, with increasing incidence and high mortality rates, and there are currently limited curative treatment options available despite advances in diagnosis and therapy.
  • Recent advances in understanding the tumor microenvironment have brought attention to immunotherapy as a promising approach for treating advanced HCC, although only a small number of patients benefit from existing solutions.
  • The glucocorticoid-induced TNFR-related protein (GITR) shows potential as a therapeutic target for HCC due to its role in enhancing T-cell function and inhibiting regulatory T-cells, along with evidence suggesting it may aid in anti-tumor effects and liver regeneration.
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Chronic liver disease is one of the main causes of morbidity and mortality in people living with HIV (PLWH). The increasing life expectancy of PLWH, effective treatment for viral hepatitis, and Western dietary patterns as well as the adverse effects of antiretroviral therapy (ART) have rendered metabolic dysfunction-associated steatotic liver disease (MASLD) the most common chronic liver disease in PLWH. The risk factors for MASLD in PLWH include traditional MASLD risk factors and additional virus-specific factors, including the adverse effects of ART.

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Atherosclerotic Cardiovascular Disease (ASCVD) is still one of the leading causes of death globally, with Coronary Artery Disease (CAD) being the most prevalent form of ASCVD. Patients with type 2 Diabetes Mellitus (DM) experience an increased risk for ASCVD during the disease course, with CAD being the most common cause of death among affected individuals, resulting in shorter life expectancy and increased morbidity among survivors. Recently, 2 novel classes of anti-diabetic drugs, namely Sodium-Glucose Co-Transporter- 2 (SGLT-2) inhibitors and Glucagon-Like Peptide-1 (GLP-1) receptor agonists, have shown impressive cardio-renal benefits for patients with type 2 DM, while they might decrease cardio-renal risk even in the absence of baseline DM.

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We sought to determine whether treatment with tirzepatide in type 2 diabetes mellitus (T2DM) patients can increase the odds for achieving normoglycemia, compatible with glycated hemoglobin levels lower than 5.7 %. We demonstrated that treatment with tirzepatide versus control increased the odds for achievement of normoglycemia by >16 times.

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Background: This study aimed to investigate the association between clinical and laboratory parameters and response to therapy with sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2D).

Research Design And Methods: We retrospectively analyzed the medical records of people with T2D in whom SGLT2i was started. Clinical and laboratory parameters were recorded before, 3 and 6 months after starting treatment.

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In this editorial, we comment on the article by Zeng published in the recent issue of the in 2024. We focus on the epidemiological, pathophysiological, and clinical interplay between obesity and type 1 diabetes mellitus (T1DM). Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.

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Sodium-glucose cotransporters 2 (SGLT2) are high-capacity, low-affinity transporters, expressed mainly in the early portion of the proximal renal tube, mediating up to 90% of renal glucose uptake, while SGLT1 receptors are found mainly in the small intestine, facilitating glucose absorption. SGLT2 inhibitors (SGLT2i) originally emerged as agents for the treatment of type 2 diabetes mellitus; however, they soon demonstrated remarkable cardio- and renoprotective actions that led to their licensed use for the treatment of heart failure and chronic kidney disease, regardless of the diabetic status. Cardiovascular remodelling represents an umbrella term that encompasses changes that occur in the cardiovascular system, from the molecular and cellular level, to tissue and organs after local injury, chronic stress, or pressure.

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