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Oxidative stress and protein nonenzymatic glycation are key factors in diabetic-foot syndrome pathogenesis. Type 2 diabetes (T2DM) progression involves excessive gluconolactone (GDL) production, linked to endothelial injury and diabetic arteriosclerosis. This study explored GDL's role in diabetic-foot syndrome using high-performance liquid chromatography-tandem mass spectrometry to analyze sera from 75 T2DM patients (including 32 with diabetic-foot) and 36 healthy controls. GDL levels were significantly higher in T2DM patients and correlated with increased hemoglobin A1c glycation and reactive oxygen species production in endothelial cells, suggesting GDL's role in accelerating macrovascular arteriosclerosis and diabetic-foot syndrome. These findings highlight GDL's potential as a diagnostic biomarker and therapeutic target for diabetic macrovascular complications.
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http://dx.doi.org/10.1007/s12265-025-10622-1 | DOI Listing |
Acta Diabetol
September 2025
Department of Systems of Medicine, University of Tor Vergata, Rome, 00133, Italy.
Aim: The study aimed to evaluate the rate and causes of major amputation in patients with diabetic foot syndrome.
Methods: The current study is a retrospective observational study including consecutive patients referred to a tertiary-level diabetic foot service from January 2020 to November 2023 due to a new diabetic foot problem requiring hospital admission. All patients had been managed by a multi-disciplinary diabetic foot team (MDFT) through a pre-set limb salvage protocol including the management of peripheral arterial disease, infection, foot offloading, and comorbidities.
Diabetes Metab J
August 2025
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Diabetes mellitus predisposes individuals to a broad spectrum of infections. People with diabetes face a 1.5- to 4-fold increased risk of both common and severe infections, and infections remain the leading cause of morbidity and mortality.
View Article and Find Full Text PDFObjective: Aim: To study the effect of TLR4 gene polymorphisms (rs1927911, rs2149356 and rs4986790) on the risk of developing DFS in T2DM.
Patients And Methods: Materials and Methods: The study included 58 patients with T2DM who had CVD (case group) and 60 patients with T2DM who did not have CVD (control group). Genetic polymorphisms of the TLR4 gene were determined by real-time polymerase chain reaction using the Gene AmpR PCR System 7500 amplifier (Applied Biosystems, USA) and TaqMan Mutation Detection Assays Life-Technology (USA).
Acta Diabetol
August 2025
Department of Endocrinology and Metabolism, Azienda Ospedaliera Santa Maria Della Misericordia, Perugia Hospital, Piazzale Gambuli 3, 06541, Perugia, Italy.
Background And Aims: Dual pathway inhibition (DPI) with aspirin and low-dose rivaroxaban (LDR) has shown benefits in reducing major adverse cardiovascular (MACEs) and limb (MALEs) events in patients with lower extremity peripheral artery disease (LE-PAD). This study aimed to determine whether DPI is preferable to anti-platelet therapy alone in reducing adverse outcomes in diabetic patients with "symptomatic" LE-PAD and to assess the safety of DPI, specifically bleeding risks. The findings aim to support development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome.
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