Volume 17 · Issue 11 · 2025

With continuous changes in diabetes technologies such as continuous glucose monitoring and artificial pancreas, blood glucose control and quality of life of patients with type 1 diabetes mellitus (T1DM) have gradually improved. However, according to glycosylated hemoglobin<With a control target of 7.0%, the compliance rate of T1DM patients in my country is less than 30%, highlighting the necessity and urgency of standardized prevention and control of T1DM. This article reviews the management methods of T1DM, and proposes an integrated management framework of "Team, Technology, Education and Peer Support (GLITTER)", aiming to achieve the synchronous improvement of metabolic control level and mental health status of T1DM patients, and provide implementable clinical practice plans for optimizing T1DM management.

Obesity is a complex, multifactorial and progressive chronic disease, which is prevalent worldwide. The traditional view attributes obesity to the imbalance of energy intake and consumption, and in recent years there has been more and more evidence about the role of environmental pollutants in the pathogenesis of obesity. Environmental pollutants, especially endocrine disrupting chemicals (EDCs), are a class of exogenous compounds that disrupt the endocrine system, disrupt the hormone balance and can lead to metabolic disorders, eventually leading to obesity. They play a key role in the obesity epidemic. Such substances are defined as "obesogens". Obesogen promotes the occurrence and development of obesity through various mechanisms, and obesogen exposure is an important environmental driver of obesity epidemic. Not only do these compounds disrupt the hormonal system, but they may also alter metabolic pathways that regulate the energy balance in the body. In this paper, the concept, categories, possible mechanisms and epidemiological research progress of obesity agents are expounded, in order to provide reference for curbing the epidemic of obesity and its related metabolic diseases. Further studies, particularly epidemiological studies, are needed in the future to fully elucidate their hazards.

Obesity is a public health problem that seriously endangers health. In order to standardize the construction of multidisciplinary joint diagnosis and treatment of obesity centers and promote the rational allocation of medical resources, Guangdong Society of Precision Medicine Application took the lead, and in conjunction with Guangdong Provincial Center for Disease Control and Prevention and related medical institutions, formulated the "Guidelines for the Construction of Multidisciplinary Joint Diagnosis and Treatment of Obesity Centers in Hospitals" group standard (hereinafter referred to as "group standard"). The group standard aims to provide standardized and standardized guidance for the construction of multidisciplinary joint diagnosis and treatment of obesity centers in hospitals. It is applicable to tertiary hospitals, secondary hospitals that have established weight loss centers or independent units that plan to build obesity diagnosis and treatment institutions, and provides construction, operation, management and supervision specifications. This article intends to interpret the background significance, main content, clinical application and other key contents of group standard formulation.

Many hypoglycemic drugs have been proved to have multiple benefits besides lowering glucose, and the evidence-based evidence for their application in non-adapted witness groups is gradually increasing. However, the addition of new indications is restricted by many factors, and the update of drug instructions often lags. Article 29 of the "Physician Law of the People's Republic of China" proposes that doctors should adhere to the principle of safe, effective, economical and rational drug use, and follow the guidelines for clinical application of drugs, clinical diagnosis and treatment guidelines, and drug instructions and other rational drug use. In special circumstances such as the absence of effective or better treatment, after obtaining the explicit informed consent of the patient, the doctor can use the drug usage that is not specified in the drug instructions but has evidence-based medical evidence to carry out treatment. In daily diagnosis and treatment practice, the use of super-indicated drugs is a relatively difficult problem, facing many challenges, such as inaccurate clinical efficacy, potential unknown risks of patients, medical insurance reimbursement, etc. It is urgent to give unified industry standards in professional fields. Based on this, the Diabetes Specialist Branch of Shanghai Medical Association took the lead and invited a number of endocrinology and pharmacy experts to, according to domestic and foreign guidelines, consensus and the latest evidence-based evidence, combined with the actual situation in China, give 30 recommendations for 9 types of hypoglycemic drugs that are more common in clinical super-indications, aiming at providing reference for relevant practitioners to promote rational drug use and ensure patient safety.

Insulin is an indispensable drug in the treatment of diabetes. With the advancement of technology, new insulin preparations are constantly emerging and applied in clinical practice. In order to promote primary doctors to use insulin more standardized and reasonable for patients with type 2 diabetes (T2DM) and improve their prognosis, the Diabetology Professional Committee of Xinjiang Medical Association took the lead in organizing relevant experts. Based on evidence-based medical evidence, according to the latest research progress at home and abroad, and combined with primary clinical practice, the Expert Consensus on Insulin Application in Primary Physicians with Type 2 Diabetes Patients (2025 Edition) was written. The consensus includes blood glucose control goals, indications for insulin therapy, classification and characteristics of insulin, initial insulin therapy regimen, optimization and adjustment of regimen after initial therapy, referral of patients with T2DM treated with insulin at the primary level, application of insulin under special circumstances, and precautions in insulin therapy. Primary doctors should strengthen their cognition and application ability of insulin, and improve the quality of life of diabetic patients through individualized treatment and effective patient education.

Diabetes mellitus, kidney disease and cardiovascular disease are closely related and promote each other. Numerous studies have confirmed that combined with a novel nonsteroidal mineralocorticoid receptor antagonist (ns-MRA) fenelidone on the basis of routine blood pressure and blood glucose control can significantly reduce type 2 diabetes mellitus (T2DM) -related chronic kidney disease (CKD), heart failure with mild decrease in ejection fraction/heart failure with preserved ejection fraction (HFmrEF/HFpEF), and non-diabetes-related chronic kidney disease (nd-CKD). In order to help the clinical application of feneridone more rational and standardized, experts in the fields of endocrine diseases, cardiovascular diseases and kidney diseases, based on the Chinese Expert Consensus on the Application of Feneridone in Diabetic Patients with Chronic Kidney Disease (2023 Edition), from the perspective of multidisciplinary clinical application, based on the latest evidence-based evidence and combined with clinical practice experience, wrote the Multidisciplinary Expert Consensus on the Clinical Application of Feneridone (2025 Edition), and put forward 19 recommendations, aiming to provide a reference for the rational use of this drug in multidisciplinary clinical practice.

To assess the relationship between the severity of hepatic steatosis and pancreatic α-cell dysfunction in patients with type 2 diabetes mellitus (T2DM).

This was a cross-sectional study. A cohort of 508 T2DM patients were recruited through convenience sampling from the outpatient Department of Endocrinology at Nantong First People′s Hospital between September 2023 and October 2024. Hepatic steatosis was evaluated via the transient elastography-derived controlled attenuation parameter (TE-CAP) in all participants, while 190 patients additionally underwent magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) assessment. Data on height, weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TC), glucagon area under the curve (AUC_gla), and glycated hemoglobin A_1c (HbA_1c) were collected. Body mass index (BMI) was calculated based on the recorded height and weight. The cohort of 508 patients was stratified into three subgroups according to the tertiles of TE-CAP levels: the CAP₁ group (95-245 dB/m), the CAP₂ group (246-292 dB/m), and the CAP₃ group (293-403 dB/m). Within this cohort, 190 patients were further categorized into three subgroups according to the tertiles of MRI-PDFF levels: the PDFF₁ group (0.86%-4.22%), the PDFF₂ group (4.23%-10.29%), and the PDFF₃ group (10.30%-40.85%). To assess trends in clinical data as the tertiles of TE-CAP or MRI-PDFF levels increased, one-way analysis of variance with linear polynomial contrasts, the Jonckheere-Terpstra test, and the chi-square test with linear-by-linear associations were employed. Pearson′s correlation analysis was used to analyze the relationships between the TE-CAP or MRI-PDFF and relevant clinical variables, and multivariate linear regression analysis was used to analyze whether the AUC_gla was an independent factor for the TE-CAP or MRI-PDFF.

Among the 508 patients who underwent TE-CAP assessment, the CAP₁, CAP₂ and CAP₃ groups included 169, 171 and 168 patients, respectively. From the CAP₁ group to the CAP₂ and CAP₃ groups, BMI, ALT, AST, TG, TC, and AUC_gla increased progressively (P for trend <0.05). Among the 190 patients for whom the MRI-PDFF was detected, the PDFF₁, PDFF₂ and PDFF₃ groups included 63, 64 and 63 patients, respectively. From the PDFF₁ group to the PDFF₂ and PDFF₃ group, BMI, ALT, AST, TG, TC, and AUC_gla also increased progressively (P for trend <0.001). The results of Pearson correlation analysis revealed strong positive correlations between AUC_gla and both TE-CAP (r=0.292, P<0.001) and MRI-PDFF (r=0.368, P<0.001). Multivariate linear regression adjusted for BMI, ALT, AST, TG, TC, and HbA_1c confirmed that elevated AUC_gla independently predicted increased TE-CAP (β=0.129, t=3.493, P=0.001) and MRI-PDFF (β=0.186, t=3.055, P=0.003).

Elevated total glucagon levels (AUC_gla) in patients with T2DM are strongly associated with the increased hepatic steatosis severity, as quantified by TE-CAP and MRI-PDFF. Dysfunction of pancreatic α-cells constitutes an independent risk factor for hepatic steatosis in this population.

To investigate the prevalence of chronic kidney disease (CKD)-related complications in patients with different subtypes of diabetic kidney disease (DKD), including CKD-mineral and bone disorder (CKD-MBD), anemia, metabolic acidosis, electrolyte disturbances, and cardiovascular and cerebrovascular diseases.

This was a cross-sectional study. We consecutively enrolled patients diagnosed with diabetes mellitus and hospitalized at the Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University from January to December 2021. Data on CKD-related complications were collected, and prevalence rates were calculated. Clinical parameters including age, serum creatinine, urinary microalbumin, and estimate glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were calculated. Based on eGFR and UACR, participants were stratified into four subgroups: non-DKD (nDKD), non-albuminuria DKD with reduced eGFR (NA-DKD), albuminuria DKD with preserved eGFR (A-DKD), and mixed subtype (albuminuria with reduced eGFR, Mixed). Intergroup comparisons were performed using one-way analysis of variances (ANOVA), Kruskal-Wallis H test, or chi-square test. Multivariate logistic regression was applied to identify risk factors for cardiovascular and cerebrovascular complications in patients with DKD.

The study included 1 184 diabetic patients (nDKD=711, NA-DKD=39, A-DKD=281, Mixed=153). Among 473 DKD patients, the prevalence rates were: 68.1% (154/226) for abnormal CKD-MBD biomarkers, 37.6% (178/473) for anemia, 33.4% (158/473) for metabolic acidosis, 9.1% (43/473) for hypokalemia, 3.4% (16/473) for hyperkalemia, and 25.4% (120/473) for cardiovascular and cerebrovascular diseases. Compared with other subgroups, the Mixed group exhibited a significantly higher prevalence of all complications except hypokalemia (P<0.05). Multivariate logistic regression analysis identified carotid plaque (OR=2.088, 95%CI 1.562-6.748) and age (OR=1.614, 95%CI 1.299-2.006) as independent risk factors for cardiovascular and cerebrovascular events in patients with DKD.

DKD patients demonstrate a high prevalence of CKD-related complications, with the highest burden observed in those exhibiting both elevated UACR and reduced eGFR (Mixed subtype), with the exception of hypokalemia.

To analyze the epidemiological characteristics and influencing factors of different stages of cardiovascular-kidney-metabolic (CKM) syndrome among adults in Beijing-Tianjin-Hebei region.

Based on baseline data from the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) collected between 2017 and 2019, a total of 33 077 participants aged 18 to 90 years were included in this cross-sectional study. CKM syndrome was categorized into five stages (0 to 4). The intermediate stage (CKM-Intermediate) comprised stages 1 and 2, representing individuals without cardiovascular disease (CVD) or not at high risk of CVD. The advanced stage (CKM-advanced) comprised stages 3 and 4, representing individuals with confirmed CVD or at high risk for CVD. Age-standardized prevalence was calculated using the direct standardization method. Differences in prevalence between groups were compared using log-binomial models. The multinomial logistic regression models were employed to identify influencing factors.

The prevalence rates of CKM stages 0 to 4 were 14.0% (95%CI 13.4%-14.6%), 19.0% (95%CI 18.3%-19.7%), 45.1% (95%CI 44.2%-46.0%), 16.0% (95%CI 15.3%-16.6%) and 5.9% (95%CI 5.5%-6.4%), respectively. The overall age-standardized prevalence of CKM-advanced was 21.9% (95%CI 21.2%-22.7%). The prevalence of CKM-advanced increased with age, reaching 18.5% in individuals under 45 years, 23.7% in those aged 45-64 years, and 44.7% in those aged 65 years old and over. The prevalence was higher among males than females (24.1% vs. 19.4%), ethnic minorities than the Han population (28.9% vs. 21.1%), and rural residents than urban residents (26.7% vs. 20.0%). All group differences were statistically significant (P<0.01). The results of the multinomial logistic regression analysis showed that age (OR=2.45, 95%CI 2.24-2.67), male sex (OR=1.76, 95%CI 1.59-1.94), ethnic minority status (OR=1.66, 95%CI 1.45-1.91), smoking (OR=1.24, 95%CI 1.11-1.38), family history of hypertension (OR=1.25, 95%CI 1.16-1.35), and family history of diabetes (OR=1.27, 95%CI 1.16-1.38) were all significantly associated with progression across different CKM stages (P<0.05).

The prevalence of CKM-advanced among Chinese adults is relatively high, with notable differences in epidemiological characteristics across population subgroups. Targeted screening and early interventions should be implemented for populations with distinct characteristics.

To summarize current literature on the application of spinal cord electrical stimulation (SCS) in patients with diabetic foot (DF).

A systematic search was performed across 11 databases from inception to February 15, 2025, including PubMed, Embase, Web of Science Core Collection, Medline, CINAHL, Google Scholar, Open Grey, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, Wanfang, and SinoMed. Studies on SCS in patients with DF were retrieved. Extracted data included study objective, design, participants, sample size, electrode placement site, current parameters, evaluation time, evaluation tools, and treatment outcomes.

A total of 14 studies were included, most of which were prospective cohort studies published within the last five years. The most common site for electrode implantation was the T₁₀-T₁₂ spinal level, and all implants used conventional SCS (frequency <500 Hz). The core efficacy outcomes included pain scores, skin healing status, lower limb or foot skin temperature, and quality of life. Eleven studies consistently reported that SCS significantly reduced pain levels in patients with DF. Ten studies demonstrated that SCS improved parameters of peripheral blood perfusion. Eight studies indicated that SCS therapy enhanced the quality of life. Six studies indicated that SCS significantly enhances the healing of ulcers. One study also suggested a reduction in amputation rates among patients receiving SCS therapy.

SCS provides a promising treatment option for patients with DF who do not respond to conventional therapy. It has the potential to significantly alleviate pain, improve lower limb blood perfusion, enhance quality of life, promote ulcer healing, and reduce the risk of amputation.

To investigate whether the sodium-glucose cotransporter-2 inhibitor henagliflozin (HENA) can ameliorate the progression of diabetic kidney disease (DKD) by regulating angiopoietin-like protein 8 (ANGPTL8), and to explore its underlying mechanisms.

Six-week-old male C57BL/6J mice were randomly divided into control group (CON group), DKD group, and DKD+HENA group (HENA group) according to the random numder table methord, with 6 mice in each group. Post-modeling assessments included serum creatinine, urinary protein quantification, and renal histopathological evaluation via PAS, Masson staining and Sirus red staning. Renal cortex tissue and serum levels of inflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], fibrosis markers [α-smooth muscle actin (α-SMA), transforming growth factor-β1 (TGF-β1), fibronectin (FN)], and ANGPTL8 were measured using quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and enzyme linked immunosorbent assay (ELISA). In vitro, primary mouse renal proximal tubular epithelial cells (PTEC) cultured under normal glucose (NG group), high glucose (HG group), or HG+HENA (HENA group) conditions and ANGPTL8-overexpressing human kidney-2 (HK-2) cells were cultured with different concentrations, 3 parallel groups in each group, then the inflammatory factors, fibrotic markers and ANGPTL8 were assessed via qRT-PCR and Western blotting. Network pharmacology and molecular docking were used to identify potential targets of HENA in DKD, mainly involving the renal phosphoinositid 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway. The activity of this pathway and its effects on cellular metabolism under HENA treatment were further examined via qRT-PCR and Western blotting. One-way analysis of variance (ANOVA) was used for comparisons among multiple groups.

Compared to CON group, mice in DKD group exhibited significant renal dysfunction, pathological alterations including glomerular basement membrane thickening, mesangial matrix expansion, tubular hypertrophy with vacuolization, and elevated renal serum inflammatory factors (IL-1β, IL-6, TNF-α), fibrotic markers (α-SMA, TGF-β1, FN) and ANGPTL8 levels (P<0.05). HENA treatment improved renal function and pathological changes, while reducing above biomarkers and ANGPTL8 elevations (P<0.05). In vitro, HG stimulation upregulated inflammatory factors, fibrotic markers and ANGPTL8 in PTEC, effects reversed by HENA (P<0.05). HENA dose-dependently suppressed inflammation and fibrosis in ANGPTL8-overexpressing HK-2 cells (P<0.05). Network pharmacology and molecular docking identified AKT1 as a key target for HENA in the treatment of DKD. HENA inhibited PI3K/AKT activation and reduced ANGPTL8 production in DKD group in vivo and in HG group in vitro (P<0.05), while PI3K/AKT agonist 740Y-P abrogated HENA-mediated ANGPTL8 suppression in HG environment (P<0.05).

HENA can attenuate renal inflammation and fibrosis in DKD by downregulating tubular ANGPTL8 expression through suppression of the PI3K/AKT signaling pathway.

Analysis of 6 casesKCNJ11ATP-sensitive potassium channel type congenital hyperinsulinemia caused by gene mutation (K_ATP-HI) clinical characteristics and genetic analysis. Selected from January 2014 to December 2022 to be diagnosed and treated by Beijing Children's Hospital affiliated to Capital Medical UniversityKCNJ11Six cases of K with gene mutation_ATP-The families of children with HI were studied, and the clinical characteristics, pathogenic gene carriage and later follow-up data of 6 children were retrospectively analyzed. The results showed that of the 6 children, 4 were macrosomia, 1 was normal birth weight, and 1 was very low birth weight premature infant; Three cases started immediately after birth, and three cases started within 1 to 6 months after birth. All 6 children carriedKCNJ11Gene mutations, mutation types included 5 missense mutations and 1 deletion mutation. All 6 children had been treated with diazoxide without effect; Five cases were treated with octreotide, and 4 cases were effective. After long-term follow-up, the hypoglycemic symptoms resolved spontaneously in 4 cases after withdrawal of octreotide, and 2 cases were lost to follow-up. The above tips, carryKCNJ11Most children with gene mutations are macrosomia, and the disease starts within six months after birth. Most children with this type are insensitive to diazoxide treatment, and some are effective to octreotide treatment. China K_ATP-HI Children'sKCNJ11The main types of gene mutations are missense mutations. As the course of the disease progresses, some children can obtain spontaneous remission.

The diagnosis and treatment of a patient with autoimmune polyendocrine adenopathy syndrome type 1 (APS-1) containing type 1 diabetes mellitus (T1DM) was reported. The patient was a young man who saw a doctor because he "found that his blood sugar had increased for more than 4 years". The patient was diagnosed with chronic cutaneous and mucosal candidiasis at the age of 5, and T1DM was diagnosed after diabetic ketoacidosis at the age of 17. No hypoparathyroidism or adrenocortical hypofunction was found in the relevant examination results. Genetic testing found autoimmune regulatory gene Exon2-4 homozygous deletion mutation, no family history of APS, and the final diagnosis was APS-1. During the course of the disease, the patient's blood sugar control was not good, and hypoglycemia occurred repeatedly. Finally, during the hospitalization in our hospital, the hypoglycemic regimen was adjusted to continuous infusion of insulin aspart, with a basal rate of 17.8 U. The large dose before meals was 4, 5, and 6 U in the morning, noon, and evening, combined with 0.5 g of metformin sustained-release tablets, 3 times/d. The blood sugar control was well monitored, and there was no further hypoglycemia.

The refractory diarrhea and delayed malnutrition after Roux-en-Y gastric bypass (RYGB) is a chronic adverse reaction of bariatric surgery, which leads to excessive weight loss and is a difficult clinical treatment problem. This article reports a patient who underwent revision surgery for refractory diarrhea and delayed malnutrition 10 years after RYGB. The patient was a middle-aged and elderly male who was obese due to body size 10 years ago (body mass index 28.2 kg/m²), laparoscopic RYGB was performed after poor glycemic control, and the patient developed intractable diarrhea immediately after the operation, persistent iron deficiency anemia 3 years later, minimum hemoglobin 102 g/L, persistent hypoalbuminemia 6 years later, body mass index 20.5 kg/m²Laparoscopic RYGB restorative surgery was performed in accordance with the indications for revised surgery. The patient did not have any further diarrhea after surgery and gained weight after 3 months with a body mass index of 23.1 kg/m.²Iron deficiency anemia and hypoalbuminemia were significantly improved compared with the previous, and hemoglobin was 116 g/L. This case report aims to emphasize long-term nutritional monitoring after metabolic surgery, initiate multidisciplinary interventions in time, and balance metabolic benefits and nutritional risks through precision surgical techniques and individualized management strategies. Laparoscopic RYGB restorative correction surgery is an effective intervention measure.

Rabson-Mendenhall syndrome is a rare condition caused by insulin receptors (INSR) Severe insulin resistance syndrome caused by gene mutation, patients respond poorly to high-dose insulin, metformin, thiazolidinedione and other hypoglycemic drugs, have poor prognosis and short life span, and often die from diabetic ketoacidosis or secondary severe infection at the age of 20 to 30. At present, there are still great challenges in clinical glycemic control for patients with Rabson-Mendenhall syndrome. This article reports a 13-year-old boy with Rabson-Mendenhall syndrome who was treated with high-dose insulin combined with sufficient doses of metformin and thiazolidinediones for 2 weeks and was treated with dapagliflozin 5 mg/d._1c) decreased from 9.7% to 8.6%. Diabetic ketosis induced by pulmonary infection improved after suspension of dapagliflozin, anti-infection, fluid rehydration combined with intravenous insulin treatment. Dapagliflozin 2.5 mg/d was added again and urinary ketone bodies were reviewed regularly, all fluctuated from 1.5 to 3.9 mmol/L, and ketoacidosis did not occur again. After more than 2 months of treatment, HbA_1cIt was further reduced to 7.6%, without hypoglycemia, and gained weight compared with before. For refractory hyperglycemia in Rabson-Mendenhall syndrome, sodium-glucose cotransporter 2 inhibitors may provide a new adjuvant drug option for glycemic control, but their long-term hypoglycemic benefits and safety still need to be further studied.

Late dumping syndrome is a common complication after weight loss surgery, which often manifests as severe hypoglycemia 2~3 h after meal, which is a difficult problem in clinical treatment. This article reports the diagnosis and treatment of a young female patient with "repeated hypoglycemia after weight loss surgery, and the effect of nutritional intervention, acarbose, metformin and other drugs was not good. After subcutaneous injection of glucagon-like peptide-1 receptor agonist (GLP-1RA) weekly preparation of semaglutide 0.25 mg/week, the efficacy was good, the hypoglycemia disappeared, and the severe hyperinsulinemia was significantly improved". It is expected that the report of this patient will provide a new way of thinking for the treatment of hypoglycemia in dumping syndrome.

The age of onset of diabetes is significantly younger, and the global burden of early-onset diabetes, usually defined as diabetes diagnosed before the age of 40, is increasing. Adolescent-onset adult diabetes mellitus (MODY), as the most common type of monogenic diabetes, accounts for a considerable proportion of early-onset diabetic patients. Because of its unique genetic mechanism and individualized treatment needs, early identification and correct typing are crucial to improving patients' blood glucose control and clinical prognosis. However, MODY is often misdiagnosed as type 1 or type 2 diabetes in clinic, resulting in improper treatment. This article aims to review the research on the prevalence of MODY in early-onset diabetes at home and abroad, in order to improve clinicians' understanding, and provide a scientific basis for promoting accurate screening and individualized treatment of this group of people, and improving clinical outcomes.

Type 2 diabetes is a chronic metabolic disease in which environment interacts with genetic factors and is closely related to inflammation. Lifestyle, as an important part of environmental factors, largely explains the disease burden of diabetes and becomes the cornerstone of its prevention and intervention. The mechanism of lifestyle and T2DM still needs to be explored and there is a lack of effective warning indicators in clinic. The mechanism of inflammation is closely related to the occurrence and development of diabetes and its complications, and research has found that a healthy lifestyle can improve inflammation and bring long-term benefits. This review discusses how exercise, smoking, sleep, weight management, and social connections act on type 2 diabetes and its complications through inflammation.

Diabetic neuropathy (DN) is the most common complication of diabetes, and its incidence continues to rise with increasing prevalence of diabetes. The pathogenesis of DN involves a variety of pathophysiological processes mediated by long-term hyperglycemia, and the clinical manifestations of DN are diverse depending on the type of nerve involved. This paper systematically reviews the latest research progress of DN, focusing on the innovative exploration of new pathogenesis and corresponding treatment strategies, and discusses the key roles of immune microenvironment remodeling, glial cell damage, intestinal flora dysbalance and amino acid metabolism disorders in the development of DN, as well as new therapeutic modalities such as immunomodulators, neurotrophic drugs, flora intervention and metabolic reprogramming aimed at these pathogenesis.

Particulate matter (PM) pollution is closely related to glucose metabolism diseases. Epidemiological evidence at home and abroad confirms that PM exposure can increase the incidence of diabetes and the risk of complications. The main biological mechanisms include activation of inflammatory response, hypothalamic-pituitary-adrenal axis dysregulation, intestinal flora metabolism dysregulation, multi-factor synergy and exposure time-dose-effect relationship. Multifaceted interventions (policy level, drug level, individual protection, etc.) are of great significance to reduce the risk of glucose metabolism diseases caused by PM contamination. This paper reviews the epidemiological evidence, biological mechanisms and prevention and control strategies of the effects of PM contamination on glucose metabolism.

Transplantation is an effective treatment for type 1 diabetes mellitus and advanced insulin-dependent type 2 diabetes mellitus, but immune rejection after transplantation seriously affects its long-term efficacy. Single-cell RNA sequencing (scRNA-seq) technology provides a new perspective for clarifying the rejection mechanism and developing precise intervention strategies by analyzing the heterogeneity, dynamic changes and molecular interaction networks of immune cells in the transplanted microenvironment with high resolution. Studies have shown that scRNA-seq can accurately recognize effector T cells (Teff), regulatory T cells (Treg), macrophage subsets (M₁/M₂) and other key immune cells, revealing core regulatory pathways such as interferon signaling, chemokine recruitment and metabolic reprogramming. Based on this, intervention strategies targeting the CXCL10-CXCR3 axis, Treg/Teff balance, and macrophage-β cell interaction significantly improved graft survival. In the future, it is necessary to further integrate multi-omics data, optimize dynamic monitoring technology and promote clinical translation to achieve precise immunoengineering treatment of islet transplantation.

Glucose metabolism is closely related to bone metabolism, and the risk of fracture in diabetic patients is significantly higher than that in non-diabetic patients. Therefore, it is particularly important to identify the high risk of diabetic fracture early and take personalized intervention measures to reduce the risk of diabetic fracture. This paper reviews the risk factors of fracture in diabetic patients, the main types of risk prediction models, construction methods and prediction performance, aiming to provide reference for the development and clinical application of fracture risk prediction models in diabetic patients.