Marianna Blyumin-Karasik1 | Jessica Colon2 | Sophie Gaer1 | Isabella Vigil1 | Sylvie Nguyen2 | Jordan Rosen1

1 Precision Skin & Body Institute, Davie, Florida, USA | 2Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida, USA

Correspondence: Marianna Blyumin-Karasik (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Received: 12 May 2025 | Revised: 7 August 2025 | Accepted: 12 August 2025

Funding: The authors received no specific funding for this work.

Keywords: aesthetic | cosmeceuticals | hypochlorous acid | integrated skincare | laser treatment | photoaging | resurfacing laser

Carmine Piccolo1  · Sara de Candia1  · Annalisa Natalicchio1  · Sergio Di Molfetta1  · Irene Caruso1  · Luigi Laviola1  · Francesco Giorgino1  · Gian Pio Sorice

Received: 16 December 2025 / Accepted: 11 March 2026 © The Author(s) 2026

Abstract

Aims Phenylketonuria and type 1 diabetes are lifelong metabolic disorders requiring complex and potentially conflicting nutritional strategies. Their coexistence is rare, yet management may become particularly challenging during transition from pediatric to adult care. We describe the case of a young adult with phenylketonuria who developed type 1 diabetes.

Methods A 27-year-old man with longstanding phenylketonuria was referred to an adult metabolic-diabetes center after the diagnosis of type 1 diabetes. Clinical, biochemical, nutritional, and continuous glucose monitoring data were reviewed. The intervention included structured therapeutic education, transition from fixed insulin doses to a dynamic regimen based on carbohydrate counting, and revision of medical nutrition therapy using phenylketonuria-adapted low-protein foods and sugar-free phenylalanine-free amino acid supplements.

Results At diagnosis, HbA1c was 11.5%, with markedly reduced C-peptide levels and high titer anti-GAD antibodies. Ini-tial diabetes management was associated with poor adherence to the phenylketonuria diet, increased intake of conventional protein sources, and elevated phenylalanine levels. After individualized insulin titration and nutritional intervention, HbA1c improved from 11.5% to 7.8%, phenylalanine levels decreased from 842 to 705 μmol/L, insulin requirement declined from 0.55 to 0.3 IU/kg/day, and continuous glucose monitoring showed improved glycemic control without increased hypoglyce-mia. The Glycemia Risk Index improved from high-risk Zone E to low-intermediate-risk Zone B.

Conclusions This case highlights the need for personalized multidisciplinary care integrating continuous glucose monitor-ing, carbohydrate counting, and phenylketonuria specific nutrition to optimize both metabolic conditions.

Keywords Phenylketonuria · Type 1 diabetes · CGM · multidisciplinary approach

Nicolò Diego Borella1  · Antonio Ferramosca2  · Giona Castagna1  · Silvia Ippolito1  · Sara Ceresoli2  · Antonio Taverna1  · Beatrice Sonzogni2  · Roberto Trevisan1,3 · Giuseppe Lepore1

Received: 6 March 2024 / Accepted: 15 October 2024 / Published online: 22 November 2024 © The Author(s) 2024

Abstract

Context Advanced hybrid closed loop (AHCL) systems currently represent the most advanced modality of insulin therapy.

Aim To compare the night-time (from 00 to 07 a.m.) effectiveness in achieving recommended glycemic targets of three dif-ferent AHCL systems in adults with type 1 diabetes (T1D).

Methods We retrospectively evaluated 55 adults with T1D (mean age 41±16 years, male 40%, diabetes duration 19.4±11.4 years, BMI 24.1±4.1 kg/m2 ) with similar glycemic control (GMI 7.0–7.4%). Twenty-two participants were using the Minimed 780G system, 18 the Tandem t:slim X2 with Control-IQ system and 15 the DBLG1 system. Continuous glucose monitoring derived metrics and insulin requirement of 14 consecutive nights were

Results All three groups achieved the recommended mean TIR>70%, mean TBR<4%, and mean CV<36% with a similar insulin requirement (Minimed 780G system: TIR 73.9±11.2%, TBR 0.9±1.2%, CV 29±6.7%; Tandem t:slim X2 with Con-trol-IQ system: TIR 74.1±11.1%, TBR 1.1±1.0%, CV 34.5±6.6%; DBLG1 System TIR 71.7±11.3%, TBR 1.4±3.7%, CV 32.4±7.1%). Tight TIR% (70–140 mg/dl) was significantly higher (p<0.01) in the Tandem t:slim X2 with Control-IQ group (51.5±9.8%) when compared to Minimed 780G group (42.1±13.7%) and DBLG1 System (40.1±10.5%). In all three groups the insulin infusion similarly decreased from midnight to 05.00 am and then increased.

Conclusions All the three AHCL systems achieved the recommended TIR, TBR and CV without difference in insulin requirement. The Tandem Control-IQ system obtained a higher tight TIR.

Oliver Kuss1,2,3  · Michael Roden3,4,5  · Sabrina Schlesinger1,3  · Annika Hoyer6

Received: 27 May 2024 / Accepted: 23 November 2024 / Published online: 12 December 2024 © The Author(s) 2024

Abstract

Aims Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.

Methods We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.

Results The adjusted difference in log(SD) values of time to death between the verum and placebo arms was −0.036 (95%- CI: −0.059; −0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.

Conclusions This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.

Keywords Dipeptidyl peptidase-4 inhibitors · Glucagon-like peptide 1 · HbA1c · Meta-regression · Precision medicine · Sodium–glucose transporter 2 inhibitors · Type 2 diabetes mellitus