Diabetes & Metabolism Journal

Review

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Differences between Type 2 Diabetes Mellitus and Obesity Management: Medical, Social, and Public Health Perspectives: Soo Lim, Ga Eun Nam, Arya M. Sharma; Diabetes Metab J. 2025;49(4):565-579. Published online June 11, 2025; DOI: https://doi.org/10.4093/dmj.2025.0278

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Obesity and type 2 diabetes mellitus (T2DM) are among the most urgent global public health challenges, yet differ markedly in recognition and management across medical, social, infrastructure, and policy domains. T2DM is supported by clear diagnostic criteria, defined treatment targets, and broad acceptance as a chronic disease. In contrast, obesity is assessed using imprecise metrics like body mass index, lacks standardized treatment goals, and is often misunderstood as a lifestyle issue rather than a chronic, relapsing disease. This misconception contributes to stigma, discrimination, and unrealistic patient expectations. T2DM receives substantial research funding, comprehensive clinical guidelines, and structured medical education, with strong support from large professional societies and multidisciplinary care models. Obesity care remains underfunded, inconsistently delivered, and underrepresented in medical training. Public health and policy efforts strongly favor T2DM, providing coordinated programs, insurance coverage, and regulatory oversight. Conversely, obesity is marginalized, with limited policy influence and a largely unregulated commercial weight-loss industry. Bridging these disparities requires adopting lessons from T2DM management—such as evidence-based guidelines, improved provider training, expanded insurance coverage, and public health strategies—to enhance obesity care and recognize it as a chronic disease requiring long-term, structured management.

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GLP-1 Receptor Agonists: Advances in Mechanism, Therapeutic Applications, and Future Perspectives
Megha Pawar, Chandrashekhar Patil, Zubershaha Fakir, Durgesh Pagar, Sunil Mahajan
BioMed Target Journal.2025; : 2. CrossRef

Sulwon Lecture 2022

Others
Opening the Precision Diabetes Care through Digital Healthcare: Joonyub Lee, Jin Yu, Kun-Ho Yoon; Diabetes Metab J. 2023;47(3):307-314. Published online March 29, 2023; DOI: https://doi.org/10.4093/dmj.2022.0386

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The national healthcare systems of every country in the world cannot sustain the rise in healthcare expenditure caused by chronic diseases and their complications. To sustain the national healthcare system, a novel system should be developed to improve the quality of care and minimize healthcare costs. For 20 years, our team developed patient-communicating digital healthcare platforms and proved their efficacy. National scale randomized control trials are underway to systematically measure the efficacy and economic benefits of this digital health care system. Precision medicine aims to maximize effectiveness of disease management by considering individual variability. Digital health technologies enable precision medicine at a reasonable cost that was not available before. The government launched the “National Integrated Bio-big Data Project” which will collect diverse health data from the participants. Individuals will share their health information to physicians or researchers at their will by gateway named “My-Healthway.’ Taken together, now we stand in front of the evolution of medical care, so-called “Precision medicine.” led by various kinds of technologies and a huge amount of health information exchange. We should lead these new trends as pioneers, not as followers, to establish and implement the best care for our patients that can help them to withstand their devastating diseases.

Citations

Citations to this article as recorded by

Social determinants of health and type 2 diabetes in Asia
Kyunghun Sung, Seung‐Hwan Lee
Journal of Diabetes Investigation.2025; 16(6): 971. CrossRef
Digital health: current applications, challenges, and future directions for enhancing healthcare quality and safety
Saidi Hu, Danyang Song, Siran Wan, Shunhong Zhang, Chenchen Luo, Nian Li, Guangyue Liu, Jailson da Graça Espírito Santo Vasconcelos, Leonilde Lavres Ceita de Carvalho, Eveline Neobísi, Monazeri Lima Bragança da Costa, José Etchu Takounjou, Karem Maimite D
Frontiers in Public Health.2025;[Epub] CrossRef
A New Era in Islet Transplantation: Stem Cell-Derived and Gene-Edited Islet Therapies
Joonyub Lee, Seung-Hwan Lee
Diabetes & Metabolism Journal.2025; 49(6): 1201. CrossRef
Bridging the digital divide: student-led literacy initiatives in diabetes management
Pedro Almeida Moyano, Mohammed Raddaoui, Andrea de Barros Coscelli Ferraz, Gustavo José Martiniano Porfírio, Luciana Aparecida Campos, Ovidiu Constantin Baltatu
Frontiers in Clinical Diabetes and Healthcare.2025;[Epub] CrossRef
Technological Innovations Transforming Diabetes Care in Practice
Shinae Kang
The Journal of Korean Diabetes.2024; 25(2): 57. CrossRef
Islet transplantation in Korea
Joonyub Lee, Kun‐Ho Yoon
Journal of Diabetes Investigation.2024; 15(9): 1165. CrossRef

Reviews

Drug/Regimen
Evaluating the Evidence behind the Novel Strategy of Early Combination from Vision to Implementation: Päivi Maria Paldánius; Diabetes Metab J. 2020;44(6):785-801. Published online September 15, 2020; DOI: https://doi.org/10.4093/dmj.2020.0179

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Type 2 diabetes mellitus (T2DM) is a complex and progressive chronic disease characterised by elevating hyperglycaemia and associated need to gradually intensify therapy in order to achieve and maintain glycaemic control. Treating hyperglycaemia with sequential therapy is proposed to allow holistic assessment of the efficacy and risk-to-benefit ratio of each added component. However, there is an array of evidence supporting the scientific rationale for using synergistic, earlier, modern drug combinations to achieve glycaemic goals, delay the deterioration of glycaemic control, and, therefore, potentially preserve or slow down the declining β-cell function. Additionally, implementation of early combination(s) may lead to opportunities to combat clinical inertia and other hurdles to optimised disease management outcomes. This review aims to discuss the latest empirical evidence for long-term clinical benefits of this novel strategy of early combination in people with newly diagnosed T2DM versus the current widely-implemented treatment paradigm, which focuses on control of hyperglycaemia using lifestyle interventions followed by sequentially intensified (mostly metformin-based) monotherapy. The recent reported Vildagliptin Efficacy in combination with metfoRmin For earlY treatment of T2DM (VERIFY) study results have provided significant new evidence confirming long-term glycaemic durability and tolerability of a specific early combination in the management of newly diagnosed, treatment-naïve patients worldwide. These results have also contributed to changes in clinical treatment guidelines and standards of care while clinical implementation and individualised treatment decisions based on VERIFY results might face barriers beyond the existing scientific evidence.

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A retrospective cohort study of a community-based primary care program’s effects on pharmacotherapy quality in low-income Peruvians with type 2 diabetes and hypertension
John E. Deaver, Gabriela M. Uchuya, Wayne R. Cohen, Janet A. Foote, Harry H. X. Wang
PLOS Global Public Health.2024; 4(8): e0003512. CrossRef

Basic Research
Histone Deacetylase 9: Its Role in the Pathogenesis of Diabetes and Other Chronic Diseases: Siqi Hu, Eun-Hee Cho, Ji-Young Lee; Diabetes Metab J. 2020;44(2):234-244. Published online March 24, 2020; DOI: https://doi.org/10.4093/dmj.2019.0243

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As a member of the class IIa histone deacetylases (HDACs), HDAC9 catalyzes the deacetylation of histones and transcription factors, commonly leading to the suppression of gene transcription. The activity of HDAC9 is regulated transcriptionally and post-translationally. HDAC9 is known to play an essential role in regulating myocyte and adipocyte differentiation and cardiac muscle development. Also, recent studies have suggested that HDAC9 is involved in the pathogenesis of chronic diseases, including cardiovascular diseases, osteoporosis, autoimmune disease, cancer, obesity, insulin resistance, and liver fibrosis. HDAC9 modulates the expression of genes related to the pathogenesis of chronic diseases by altering chromatin structure in their promotor region or reducing the transcriptional activity of their respective transcription factors. This review summarizes the current knowledge of the regulation of HDAC9 expression and activity. Also, the roles of HDAC9 in the pathogenesis of chronic diseases are discussed, along with potential underlying mechanisms.

Citations

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Palmitic acid alters enhancers/super-enhancers near inflammatory and efferocytosis-associated genes in human monocytes
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Downregulation of HDAC9 Alleviates Autophagy Dysfunction by Inducing Acetylation of ATG4B in Metabolic Dysfunction‐Associated Steatotic Liver Disease
Xiao‐Han Ma, Guang‐Peng Liu, Le Liu, Zi‐yue Dou, Xue He, Xi Chen
The FASEB Journal.2025;[Epub] CrossRef
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Zheng Yan, Qin Xu, Xin He, Ying Yao, Dingzhen Liu, Hairui Wang
BMC Genomics.2025;[Epub] CrossRef
The multifactorial role of HDAC9 at the maternal–fetal interface in the pathogenesis of preeclampsia
Megan A. Opichka, Jennifer J. McIntosh, Justin L. Grobe
Clinical Science.2025; 139(24): 1769. CrossRef
Impact of housing temperature on adipose tissue HDAC9 expression and adipogenic differentiation in high fat‐fed mice
Samah Ahmadieh, Brandee Goo, Abdalrahman Zarzour, David Kim, Hong Shi, Praneet Veerapaneni, Ronnie Chouhaita, Nicole K. H. Yiew, Carla Dominguez Gonzalez, Akash Chakravartty, James Pennoyer, Nazeera Hassan, Tyler W. Benson, Mourad Ogbi, David J. Fulton, R
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HDAC9 inhibition reduces skeletal muscle atrophy and enhances regeneration in mice with cigarette smoke-induced COPD
Guixian Zheng, Chao Li, Xiaoli Chen, Zhaohui Deng, Ting Xie, Zengyu Huo, Xinyan Wei, Yanbing Huang, Xia Zeng, Yu Luo, Jing Bai
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2024; 1870(4): 167023. CrossRef
Identification of HDAC9 and ARRDC4 as potential biomarkers and targets for treatment of type 2 diabetes
Jing Liu, Lingzhen Meng, Zhihong Liu, Ming Lu, Ruiying Wang
Scientific Reports.2024;[Epub] CrossRef
HDAC9 as a Privileged Target: Reviewing its Role in Different Diseases and Structure-activity Relationships (SARs) of its Inhibitors
Totan Das, Samima Khatun, Tarun Jha, Shovanlal Gayen
Mini-Reviews in Medicinal Chemistry.2024; 24(7): 767. CrossRef
The role of histone deacetylases in inflammatory respiratory diseases: an update
Sicen Pan, Xiangdong Wang, Jian Jiao, Luo Zhang
Expert Review of Clinical Immunology.2024; 20(10): 1193. CrossRef
The Human Genetic Differences in the Outcomes of mRNA Vaccination against COVID-19: A Prospective Cohort Study
Ha-Eun Ryu, Jihyun Yoon, Ja-Eun Choi, Seok-Jae Heo, Kyung-Won Hong, Dong-Hyuk Jung
Vaccines.2024; 12(6): 626. CrossRef
Targeting histone deacetylases for cancer therapy: Trends and challenges
Tao Liang, Fengli Wang, Reham M. Elhassan, Yongmei Cheng, Xiaolei Tang, Wengang Chen, Hao Fang, Xuben Hou
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Therapeutic approach of natural products that treat osteoporosis by targeting epigenetic modulation
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Frontiers in Genetics.2023;[Epub] CrossRef
Research Progress on Histone Deacetylase Inhibitors
玉姜汤
Hans Journal of Medicinal Chemistry.2023; 11(02): 116. CrossRef
HDAC9 Inhibition as a Novel Treatment for Stroke
Hugh S. Markus
Stroke.2023; 54(12): 3182. CrossRef
Histone deacetylase 9 exacerbates podocyte injury in hyperhomocysteinemia through epigenetic repression of Klotho
Min Liu, Yang Zhang, Ping Zhan, Wenjuan Sun, Chuanqiao Dong, Xiaohan Liu, Yujie Yang, Xiaojie Wang, Yusheng Xie, Chengjiang Gao, Huili Hu, Benkang Shi, Ziying Wang, Chun Guo, Fan Yi
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Molecular mechanism and therapeutic potential of HDAC9 in intervertebral disc degeneration
Ming Lei, Hui Lin, Deyao Shi, Pan Hong, Hui Song, Bomansaan Herman, Zhiwei Liao, Cao Yang
Cellular & Molecular Biology Letters.2023;[Epub] CrossRef
Interindividual variability in transgene mRNA and protein production following adeno-associated virus gene therapy for hemophilia A
Sylvia Fong, Bridget Yates, Choong-Ryoul Sihn, Aras N. Mattis, Nina Mitchell, Su Liu, Chris B. Russell, Benjamin Kim, Adebayo Lawal, Savita Rangarajan, Will Lester, Stuart Bunting, Glenn F. Pierce, K. John Pasi, Wing Yen Wong
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Active RhoA Exerts an Inhibitory Effect on the Homeostasis and Angiogenic Capacity of Human Endothelial Cells
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HDAC9 Contributes to Serous Ovarian Cancer Progression through Regulating Epithelial–Mesenchymal Transition
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