Diabetes & Metabolism Journal

Reviews

Complications
Diabetes Mellitus and Infectious Diseases: Current Evidence and Clinical Implications: Taeeun Kim, Sang-Ho Choi; Diabetes Metab J. 2025;49(5):915-933. Published online August 27, 2025; DOI: https://doi.org/10.4093/dmj.2025.0508

12,371 View
499 Download
23 Web of Science
26 Crossref

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. Chronic hyperglycemia impairs neutrophil chemotaxis, oxidative burst, and complement activation, while vascular insufficiency and neuropathy compromise tissue perfusion and barrier integrity. These defects, together with altered skin, mucosal, and gut microbiota, influence the marked susceptibility to urinary tract infections (especially renal abscess and emphysematous pyelonephritis), osteomyelitis, diabetic foot infections, pneumonia (including influenza), tuberculosis, skin and soft tissue infections, and lifethreatening syndromes such as emphysematous cholecystitis and rhino-orbital mucormycosis that are almost exclusive to people with diabetes. Outcomes from infections are worse in diabetes. Although the core therapeutic principles align with those for patients without diabetes, management should be individualized. Glycemic control should balance infection risk and hypoglycemia; antimicrobial dosing should account for renal function and drug interactions; and strict antimicrobial stewardship is required. If needed, prompt debridement and multidisciplinary intervention are necessary to mitigate complications and reduce mortality. Preventive care relies on comprehensive vaccination (influenza, pneumococcus, severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], hepatitis B, herpes zoster, and Tdap/Td) and regular foot surveillance with offloading to avert ulceration.

Citations

Citations to this article as recorded by

Risk of Acute Cholecystitis Based on Combination of Patient Age, Patient Sex, Leukocytosis, and Sonographic Murphy Sign
Hideaki Ishida, Hiroko Naganuma
Journal of Ultrasound in Medicine.2026; 45(5): 1117. CrossRef
Review on the Gut‐Kidney Axis Mechanism and Therapeutic Strategies in Diabetic Nephropathy
Qing Li, Mingrong Cheng, Xiaoyan Zhang
Diabetes/Metabolism Research and Reviews.2026;[Epub] CrossRef
Prim-O-glucosylcimifugin targets Staphylococcus aureus caseinolytic protease P to inhibit α-hemolysin expression and promote healing of MRSA-induced diabetic skin infections
Yan Wang, Shanshan Luo, Xinping Guo, Mengli Jin, Xingye Wang, Mingran Li, Shuang Jiang, Lin Wei, Mingjun Liu, Wu Song
Microbial Pathogenesis.2026; 212: 108296. CrossRef
Preoperative triglyceride–glucose index as a metabolic predictor of surgical site infection after posterior lumbar fusion
Yu Hua, Shaoxing Li, Yuan Jiang, Jinwang Liu
Journal of Orthopaedic Surgery.2026;[Epub] CrossRef
Development and validation of a risk nomogram model for predicting superficial fungal infections in patients with type 2 diabetes mellitus : a cross-sectional study
Yu Li, Guozhong Zhou, Feifei Yang, Rong long, Wei Shi, Yan Dong, Yuanyuan Zhou, Nan Chen, Ying Yang
BMC Infectious Diseases.2026;[Epub] CrossRef
Transcending risk factors: the implications of redefining diabetes as an immunometabolic disease for infectious disease studies
Xiujun Zhang, Fan Zhang, Wenjian Li
Frontiers in Immunology.2026;[Epub] CrossRef
Atypical Spread of Head and Neck Phlegmon: Case Series Requiring Multidisciplinary Management
Monika Warlewska, Daria Wziątek-Kuczmik, Jakub Fiegler-Rudol, Iwona Niedzielska
Journal of Maxillofacial and Oral Surgery.2026;[Epub] CrossRef
A study on metabolic differences between infectious and non-infectious stones in patients with urine culture positive for Proteus mirabilis
Endi Zhang, Zhichao Chi, Xuming Zhang, Jianxing Li, Chaoyue Ji, Weiguo Hu
BMC Urology.2026;[Epub] CrossRef
Long-Term Hyperglycemia Affects the Expression of Diaph1 and Its Cytoskeleton Ligands in the Epidermis of Diabetic Patients—A Quantitative Study
Bernard Kordas, Wojciech Matuszewski, Robert Modzelewski, Jarosław Szuszkiewicz, Michał Załęcki, Joanna Wojtkiewicz, Judyta Juranek
Diabetology.2026; 7(4): 78. CrossRef
Predictive Factors for Progression to Severe Pulmonary Tuberculosis in Patients with Concurrent HIV/AIDS and Type 2 Diabetes Mellitus: A Single-Center Retrospective Study
Bennan Zhao, Jun Kang, Qing Du, Dafeng Liu
Infection and Drug Resistance.2026; Volume 19: 1. CrossRef
Posterior migration of an Ahmed glaucoma valve: A case report of a rare postoperative complication
Alyssa Stathopoulos, Catherine Seeger, Catherine Johnson, Mohit Jethi, Sandra Fernando Sieminski, Jamie Schaefer
American Journal of Ophthalmology Case Reports.2026; 42: 102590. CrossRef
Hyperglycemia- induced innate immune tolerance involves the metabolic and epigenetic rewiring in human alveolar macrophages
Jiang Wang, Na Yuan, Bin Wang, YongHui Qiu, Bo Wang, LiXin Xie
Frontiers in Immunology.2026;[Epub] CrossRef
Risk prediction of pneumocystis jirovecii pneumonia in kidney transplant recipients using a clinical nomogram
Qu Liu, Zhenghui Wang, Yujiao Song, Lanlan Liu, Shuang Qiu, Xinxin Niu, Jie Liu, Hailong Jin, Qing Zhang
Frontiers in Cellular and Infection Microbiology.2026;[Epub] CrossRef
Rethinking bronchiectasis through a metabolic lens
Laura Garriga-Grimau
The Lancet Respiratory Medicine.2026; 14(7): 573. CrossRef
Case Report: Moxibustion-induced burns leading to disseminated methicillin-resistant Staphylococcus aureus infection in a patient with type 2 diabetes mellitus
Hong Liang, Zhen-Fang Mao, Jin-Yu Huang, Yang Yang, Xue-Mei Li, Jie-Feng Mao, Qi Li, Yun-Bo Zhang, Wu-Xiao Wei
Frontiers in Endocrinology.2026;[Epub] CrossRef
Janus nanofiber membrane integrates exudate management and immunomodulation for enhanced diabetic wound healing
Qian Ren, Chenlei Gong, Shuai Zhang, Xiaolei Song, Dali Wang, Weidong Le
Colloids and Surfaces B: Biointerfaces.2026; 266: 115873. CrossRef
Prolonged Suppression of Bacterial Growth in Urine Culture Following Fluoroquinolone Therapy in an Elderly Diabetic Patient: A Diagnostic Pitfall
Mehdi Roshdi Maleki
Infection and Drug Resistance.2026; Volume 19: 1. CrossRef
Keratinizing Penile Squamous Cell Carcinoma Arising from Chronic Balanoposthitis in an Uncircumcised Diabetic Man: A Case Report from a Rural Tertiary Hospital in Uganda
Hans Chris-Uchendu, Tumwesige Charles, Arthur Nek, Gerald Olwit, Stanley Okecho, Kwikiriza Rhonah, Sean Kaheru
International Medical Case Reports Journal.2026; Volume 19: 1. CrossRef
Delayed Radiological Resolution: A Comparative Longitudinal Study of Viral Pneumonia Evolution in Diabetic vs. Non-Diabetic Patients
Ana Maria Mihai, Ovidiu Rosca, Florina Lucaciu, Alexandra Herlo, Talida Georgiana Cut, Ioana-Melinda Luput-Andrica, Radu Gheorghe Dan, Matilda Radulescu, Andreea Cristina Floruncut, Adelina Marinescu, Alexandra Sima
Diseases.2026; 14(6): 210. CrossRef
Chirality-dependent catalytic activity of nanozymes for accelerated healing of infected wounds
Ying Lu, Shuaishuai Cui, Yang Zhang, Li Wu, Yujian He
Chemical Engineering Journal.2026; 543: 178513. CrossRef
Early prediction of severe acute cholecystitis using routine admission parameters: a study of 1,330 patients
Alparslan Ertenlice, Hikmet Pehlevan Özel, Zeynep Nur Yurdakul, Mehmet Sefa Çamöz, Gözde İğdeci Tut, Şule Bal, İbrahim Kılınç, Sadettin Er
Updates in Surgery.2026;[Epub] CrossRef
Antimicrobial treatment pattern and Medications Adherence among Iraqi T2DM patients with recurrent urinary tract infection in Wasit province
Maher Kadhum Abed, Manal Khalid Abdulridha, Hussein Adnan
Al Mustansiriyah Journal of Pharmaceutical Sciences.2026; 26(2): 162. CrossRef
A Plant Photoregulator‐Inspired S‐Type Heterojunction System for Diabetic Keratopathy via Tri‐Modal Light‐Driven Immunometabolic Reprogramming, Tissue Repair, and Antibacterial Activity
Mengzhen Zhao, Zhibin Zhou, Yuxuan Wei, Xiangfan Huang, Zhiyong Zhou, Jiaheng Chen, Haoxin Cheng, Xiaotian Hu, Xiaolei Wang
Advanced Science.2026;[Epub] CrossRef
Determinants of COVID-19 and Influenza Vaccination Among People with Diabetes Mellitus in Primary Health Care
Mariana Rodrigues Fernandes Alves Lemos, Stela de Azevedo Camtamos, Maria Eduarda Perpétuo Vilano, Silmara Nunes Andrade, Michael Jackson Oliveira de Andrade, Camila Fernanda Cunha Brandão, Ana Paula Sayuri Sato, Eliete Albano de Azevedo Guimarães, Valéri
Vaccines.2026; 14(7): 576. CrossRef
Immunometabolic reprogramming in diabetic osteomyelitis: from mechanisms to therapeutics
Hui Zhang, Zi-Shan Fu, Ying Zhou, Song-Nan Wang, Si-Ying Ye, An-Na Wang, Jun-Tong Liu
Frontiers in Cellular and Infection Microbiology.2025;[Epub] CrossRef
Chronic Infections and Diabetes in Africa: A Narrative Review of Pathogen-Associated Metabolic Risk
Olabisi P Lawal, Fortune I Ebiala, Modinat Abayomi, Obiageri Ihuarulam Okeoma, Nana Ama Aduma Amankwah, John O Patrick, Queeneth Eguakun, Aliyu O Olaniyi
Cureus.2025;[Epub] CrossRef

Pathophysiology
Regulation of Systemic Glucose Homeostasis by T Helper Type 2 Cytokines: Yea Eun Kang, Hyun Jin Kim, Minho Shong; Diabetes Metab J. 2019;43(5):549-559. Published online October 24, 2019; DOI: https://doi.org/10.4093/dmj.2019.0157

13,348 View
130 Download
12 Web of Science
13 Crossref

Abstract PDF PubReader ePub

Obesity results in an inflammatory microenvironment in adipose tissue, leading to the deterioration of tissue protective mechanisms. Although recent studies suggested the importance of type 2 immunity in an anti-inflammatory microenvironment in adipose tissue, the regulatory effects of T helper 2 (Th2) cytokines on systemic metabolic regulation are not fully understood. Recently, we identified the roles of the Th2 cytokine (interleukin 4 [IL-4] and IL-13)-induced adipokine, growth differentiation factor 15 (GDF15), in adipose tissue in regulating systemic glucose metabolism via signal transducer and activator of transcription 6 (STAT6) activation. Moreover, we showed that mitochondrial oxidative phosphorylation is required to maintain these macrophage-regulating autocrine and paracrine signaling pathways via Th2 cytokine-induced secretion of GDF15. In this review, we discuss how the type 2 immune response and Th2 cytokines regulate metabolism in adipose tissue. Specifically, we review the systemic regulatory roles of Th2 cytokines in metabolic disease and the role of mitochondria in maintenance of type 2 responses in adipose tissue homeostasis.

Citations

Citations to this article as recorded by

Role of the Th2-like Immune Response in Obesity: IL-4 as a Metabolic Regulator and IL-13 as an Effector of Muscle Energy Metabolism
Lucía A. Méndez-García, Helena Solleiro-Villavicencio, Nallely Bueno-Hernández, Arturo Cérbulo-Vázquez, Galileo Escobedo, Marcela Esquivel-Velázquez, Miguel A. Fonseca-Sánchez
Biomedicines.2025; 13(9): 2208. CrossRef
Interconnected Mechanistic Pathways, Molecular Biomarkers, and Therapeutic Approach of Oral Cancer in Patients with Diabetes Mellitus
Viviana Elian, Violeta Popovici, Mihnea Ioan Nicolescu, Alexandra Maria Nicolescu, Sorina Maria Aurelian, Emma Adriana Ozon
Current Issues in Molecular Biology.2025; 47(11): 929. CrossRef
Macrophage Phenotypic Switch and Obesity‐Associated Metabolic Risk: Mechanisms and Targets
K. F. Hinojosa Vera, C. Hemakumar, R. S. Bilachi, D. C. Ramirez, S. E. Gomez Mejiba, Phull Abdul Rehman
Oxidative Medicine and Cellular Longevity.2025;[Epub] CrossRef
Orchestration of the Adipose Tissue Immune Landscape by Adipocytes
David Bradley, Tuo Deng, Dharti Shantaram, Willa A. Hsueh
Annual Review of Physiology.2024; 86(1): 199. CrossRef
Growth and differentiation factor-15: A link between inflammaging and cardiovascular disease
Balázs Bence Nyárády, Loretta Zsuzsa Kiss, Zsolt Bagyura, Béla Merkely, Edit Dósa, Orsolya Láng, László Kőhidai, Éva Pállinger
Biomedicine & Pharmacotherapy.2024; 174: 116475. CrossRef
Evaluation of Mitochondrial Function in Blood Samples Shows Distinct Patterns in Subjects with Thyroid Carcinoma from Those with Hyperplasia
Julia Bernal-Tirapo, María Teresa Bayo Jiménez, Pedro Yuste-García, Isabel Cordova, Ana Peñas, Francisco-Javier García-Borda, Cesar Quintela, Ignacio Prieto, Cristina Sánchez-Ramos, Eduardo Ferrero-Herrero, María Monsalve
International Journal of Molecular Sciences.2023; 24(7): 6453. CrossRef
A Supportive Role of Mesenchymal Stem Cells on Insulin-Producing Langerhans Islets with a Specific Emphasis on The Secretome
Ronit Vogt Sionov, Ronit Ahdut-HaCohen
Biomedicines.2023; 11(9): 2558. CrossRef
Gdf15 deletion exacerbates acute lung injuries induced by intratracheal inoculation of aerosolized ricin in mice
Mengyun Deng, Duo Su, Nan Xiao, Zhipeng Zhang, Yifeng Wang, Fuliang Zong, Sha Li, Jinglin Wang, Dongsheng Zhou, Yuee Zhao, Huiying Yang
Toxicology.2022; 469: 153135. CrossRef
Role of PPAR Receptor and Ligands in the Pathogenesis and Therapy of Hematologic Malignancies
Jian Wu, Min Zhang, Allison Faircloth
Hemato.2022; 3(3): 422. CrossRef
Macrophage and Adipocyte Mitochondrial Dysfunction in Obesity-Induced Metabolic Diseases
Liwen Wang, Jie Hu, Haiyan Zhou
The World Journal of Men's Health.2021; 39(4): 606. CrossRef
Th2 Cytokines Increase the Expression of Fibroblast Growth Factor 21 in the Liver
Seul-Gi Kang, Seong-Eun Lee, Min-Jeong Choi, Joon-Young Chang, Jung-Tae Kim, Ben-Yuan Zhang, Yea-Eun Kang, Ju-Hee Lee, Hyon-Seung Yi, Minho Shong
Cells.2021; 10(6): 1298. CrossRef
Growth/Differentiation Factor-15 (GDF-15): From Biomarker to Novel Targetable Immune Checkpoint
Jörg Wischhusen, Ignacio Melero, Wolf Herman Fridman
Frontiers in Immunology.2020;[Epub] CrossRef
Transcriptional, Epigenetic and Metabolic Programming of Tumor-Associated Macrophages
Irina Larionova, Elena Kazakova, Marina Patysheva, Julia Kzhyshkowska
Cancers.2020; 12(6): 1411. CrossRef

Double Diabetes.: Sang Youl Rhee, Young Seol Kim; Korean Diabetes J. 2009;33(1):1-8. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.1

3,480 View
48 Download

Abstract PDF: Generally, most cases of diabetes mellitus (DM) are classified as either type 1 DM or type 2 DM based on their pathophysiolgic features. However, it is not always possible to classify this disease clearly according to current diagnostic criteria. Recently, the existence of non-typical diabetes has been found in patients with simultaneous features of both type 1 and type 2 DM. In these patients, obvious evidence of insulin resistance, positivity of islet autoantibody, and progressive beta cell loss are observed concurrently. Moreover, this non-typical diabetes that usually occurs among children and adolescents has been defined as 'double diabetes', and its worldwide incidence has been on the increase as of late. Thus, there has been heightened interest among researchers about this ambiguous condition.

Original Article

Five Year Follow-up of ICA and GADA in Childhood onset Type 1 DM.: Si Hyung Lee, Ji Sung Yoon, Mi Jung Eun, Jin Ho Kim, Yong Ho Park, Kyu Chang Won, Ihn Ho Jo, Hyoung Woo Lee; Korean Diabetes J. 2003;27(5):395-404. Published online October 1, 2003

2,096 View
27 Download

Abstract PDF: BACKGROUND
Type 1 diabetes develops due to the destruction of insulin-secreting beta-cells by an autoimmune process, in which both genetic and environmental factors are involved. In children with newly diagnosed type 1 DM, the prevalence of ICA (Islet cell cytoplasmic antibody) is 60~86% and is highest at the time of onset after which it decreases. But, GADA (glutamic acid decarboxylase anti- bodies) are characterized by substantial fluctuations in the humoral immune response over a long period after clinical manifestation. This study was performed to evaluate the persistence of type 1 DM associated autoantibodies, including ICA and GADA, and their relation to clinical characteristics of the disease after clinical manifestation. METHODS: Eighteen childhood onset type 1 diabetes patients (mean age 13.7 years; duration 3.9 years) were included in this study. ICA was measured by indirect immunofluorescence using conventional ICA-IgG and positive samples were titered by serial dilutions. Also the sera were screened for GADA by radioimmuno-assay. RESULTS: The positivities of ICA and GADA at the time of study were 55.6% and 61%, falling to 44.4% and 41.2% 5 years later, respectively. There was no case of an ICA negative patient becoming positive or whose ICA titer was increased later. One case of a GADA negative patient became positive later. Initial c-peptide levels didn't have any correlation with initial ICA titers or ICA prevalence, but did with initial GADA titer. There were significant correlations between initial GADA titer and ICA prevalence (p<0.001), and between initial GADA titer or ICA titer and later ICA persistence (p<0.05). CONCLUSION: ICA and GADA persisted long after the clinical diagnosis of type 1 diabetes. And the persistence of autoantibody positivity showed a weak relation with endogenous insulin secretion and clinical characteristics, both at and after diagnosis of overt type 1 diabetes.

First
Prev
Page of 1
Next
Last

Search