Metabolic diseases are based on a dysregulated crosstalk between various cells such as adipocytes, hepatocytes and immune cells. Generally, hormones and metabolites mediate this crosstalk that becomes alterated in metabolic syndrome including obesity and diabetes. Recently, Extracellular Vesicles (EVs) are emerging as a novel way of cell-to-cell communication and represent an attractive strategy to transfer fundamental informations between the cells through the transport of proteins and nucleic acids. EVs, released in the extracellular space, circulate via the various body fluids and modulate the cellular responses following their interaction with the near and far target cells. Clinical and experimental data support their role as biomarkers and bioeffectors in several diseases includimg also the metabolic syndrome. Despite numerous studies on the role of macrophages in the development of metabolic diseases, to date, there are little informations about the influence of metabolic stress on the EVs produced by macrophages and about the role of the released vesicles in the organism. Here, we review current understanding about the role of EVs in metabolic diseases, mainly in inflammation status burst. This knowledge may play a relevant role in health monitoring, medical diagnosis and personalized medicine.
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http://dx.doi.org/10.1016/j.cytogfr.2019.12.008 | DOI Listing |
Am J Manag Care
January 2025
McGovern Medical School at UTHealth Houston, 4513 Teas St, Bellaire, TX 77401.
Objective: To examine the effect of physiologic insulin resensitization (PIR) on the cost of treating patients with diabetes and chronic kidney disease (CKD).
Study Design: The mean 1-year cost of treating 66 Medicare Advantage patients with diabetes and CKD who were receiving PIR was compared with that of treating 1301 Medicare Advantage patients with diabetes and CKD not receiving PIR. Differences in disease severity were compared using mean risk adjustment factor scores.
Am J Manag Care
January 2025
Ascension Borgess Hospital, 345 Naomi St, Plainwell, MI 49080. Email:
Objective: To describe the outcomes of a partnership between a drug plan and pharmacists to switch patients from brand name dipeptidyl-peptidase-4 inhibitors to the generic alogliptin.
Study Design: Single-center, retrospective chart review.
Methods: Clinical pharmacists contacted patients with primary care providers within the health system affiliated with the drug plan to facilitate the switch.
Health Syst Reform
December 2025
Independent Consultant, Alexandria, VA, USA.
For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease.
View Article and Find Full Text PDFN Z Med J
January 2025
Department of Public Health, University of Otago, Wellington, Aotearoa New Zealand.
Background: The prevalence of diabetes has been increasing in Aotearoa New Zealand by approximately 7% per year, and is three times higher among Māori and Pacific peoples than in Europeans. The depth of the diabetes epidemic, and the expansive breadth of services required for its management, elevate the need for high-quality evidence on the projected future burden of this complex disease.
Methods: In this manuscript we have projected the prevalence of diabetes (type 1 and type 2 combined) out to 2040-2044 using age-period-cohort modelling.
N Z Med J
January 2025
Department of Medicine, HeartOtago, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Cardiology, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand.
Aim: There are limited data on the prevalence of calcific aortic valve disease (CAVD) in Māori and known inequities in outcomes after aortic valve intervention. Our study aimed to investigate the prevalence of CAVD in Māori.
Methods: Data from initial clinically indicated echocardiograms performed between 2010 to 2018 in patients aged ≥18 years were linked to nationally collected outcome data.
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