Type 2 diabetes mellitus is associated with asymptomatic acute abdomen among elderly patients admitted to acute tertiary care hospital wards

Andrea Tumminia1  · Raffaella Romano2  · Francesco Frasca1,3  · Francesco Galeano3  · Roberto Baratta1  · Vittorio Oteri3  · Alessia Longo3  · Lucia Frittitta3,4  · Rosario Le Moli5  · Tommaso Piticchio6  · Antonino Di Pino7  · Maurizio Di Marco7  · Luigi Piazza8  · Maria Carolina Picardo9  · Paola Magnano San Lio10 · Filippo Luca Fimognari11  · Marcello Romano2

Received: 13 November 2025 / Accepted: 5 February 2026 © The Author(s) 2026

Abstract

Background Pain may be absent in a substantial proportion of elderly patients with acute abdominal conditions. This study explored the association between type 2 diabetes mellitus (T2DM) and asymptomatic presentation.

Methods We conducted a cross-sectional analysis of 215 patients aged≥65 years admitted with acute abdominal conditions. Demographic, clinical, and laboratory data were extracted from medical records. Descriptive statistics and multivariable logistic regression were used to identify associative predictors of asymptomatic acute abdomen (AAA).

Results The median age was 82 years [77–86]; 54.4% (n=117) were female; 31.2% (n=67) had T2DM. Overall, 33.5% (n=72) presented without abdominal pain. T2DM prevalence was higher in AAA than symptomatic patients (44.4% vs. 24.5%, p<0.01). In multivariable analysis, T2DM (OR 1.95, 95% CI 1.10–3.45, p=0.02), lower heart rate (OR 0.83, 95% CI 0.71–0.96, p=0.01), and absence of fever (OR 0.50, 95% CI 0.26–0.95, p=0.03) were associated with AAA. Among patients with T2DM, longer diabetes duration (12.5 years [10.5–14.5] vs. 8.8 years [5.0–11.0]; p<0.01) and higher HbA1c (8.2% [7.2–8.7] vs. 7.5% [6.8–7.6]; p=0.02) were associated with asymptomatic presentation.

Conclusions Asymptomatic acute abdomen is common among elderly patients. Long-standing and poorly controlled T2DM is associated with absent pain. Prospective studies are needed to clarify causal mechanisms, and early glyco-metabolic assessment may aid recognition of at-risk patients.

Keywords Type 2 diabetes · Acute abdomen · Elderly · Pain perception · Emergency medicine · Predictors

Medical nutrition therapy in physiological pregnancy and in pregnancy complicated by obesity and/or diabetes: SID-AMD recommendations

Annunziata Lapolla1  · Maria Grazia Dalfrà1  · Giuseppe Marelli2  · Mario Parrillo3  · Laura Sciacca4  · Maria Angela Sculli5  · Elena Succurro6  · Elisabetta Torlone7  · Ester Vitacolonna8

Received: 18 September 2024 / Accepted: 27 December 2024 / Published online: 22 January 2025 © Springer-Verlag Italia S.r.l., part of Springer Nature 2025

Abstract

Proper nutrition is essential during pregnancy to ensure an adequate supply of nutrients to the foetus and adequate maternal weight gain. In pregnancy complicated by diabetes (both gestational and pre-gestational), diet in terms of both the intake and quality of carbohydrates is an essential factor in glycaemic control. Maternal BMI at conception defines the correct weight increase during gestation in order to reduce maternal-foetal complications related to hypo- or hyper-nutrition. The recommendations presented here, which are based on national and international guidelines and the most recently published data on nutrition in physiological pregnancy and pregnancy complicated by hyperglycaemia and/or obesity, are designed to help healthcare professionals prescribe suitable eating patterns to safeguard the health of the mother and the foetus.

Communicated by Massimo Federici, M.D.

Annunziata Lapolla 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。

1 UO Diabetologia, DIMED, Università di Padova, Padova, Italy

2 Ordine Ospedaliero San Giovanni di Dio Fatebenefratelli, Erba, CO, Italy

3 UOSD Endocrinologia e Malattie del Ricambio, AO Sant’Anna e San Sebastiano, Caserta, Italy

4 Dipartimento Medicina Clinica e Sperimentale, Università degli Studi di Catania, Catania, Italy

5 UOC Diabetologia e Endocrinologia, GOM Bianchi-Melacrino-Morelli, Reggio Calabria, Italy

6 DPT Scienze Mediche Chirurgiche, Università Magna Grecia, Catanzaro, Italy

7 AOS Maria della Misericordia SC Endocrinologia e Metabolismo, Università di Perugia, Perugia, Italy

8 Dipartimento di Medicina e Scienza dell’Invecchiamento, Università di Chieti, Chieti, Italy

Exploring metabolomic clues in diabetic retinopathy: a pilot study

Matthew Simonson1  · Yanliang Li2  · J. Jason McAnany2  · Jason C. Park2  · Felix Y. Chau2  · Bharati Prasad3,4 · Silvana Pannain5  · Erin C. Hanlon5  · Eve Van Cauter5  · Kirstie K. Danielson6  · Brian T. Layden6  · Hui Chen7  · George E. Chlipala8  · Carlos Martinez8  · Stephanie J. Crowley9  · Sirimon Reutrakul6

Received: 23 August 2025 / Accepted: 23 February 2026 © The Author(s) 2026

Keywords Metabolomics · Diabetic retinopathy · Diabetes Mellitus · Retina

Communicated by Massimo Federici, M.D Matthew Simonson 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。

1 College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA

2 Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Chicago, IL, USA

3 Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

4 Jesse Brown Department of Veterans Affairs Hospital, Chicago, IL, USA

5 Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA

6 Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

7 Mass Spectrometry Core, Research Resource Center, Office of Vice Chancellor for Research, University of Illinois at Chicago, Chicago, IL, USA

8 Research Informatics Core, Research Resources Center, University of Illinois at Chicago, Chicago, IL, USA

9 Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA

The close relationship between inflammation and insulin resistance: a comparative perspective from a new angle

Xiaoyan Wang1  · Run Yang1  · Jingxiang Li1  · Yongqi Liang2  · Chenxi Jin1  · Yining Xu1  · Xianbo Wu2  · Mengchen Zou1

Received: 4 July 2025 / Accepted: 30 September 2025 / Published online: 15 October 2025 © The Author(s) 2025

Abstract

    Background Excess weight is a progressive metabolic epidemic, and inflammation plays an important role in the progres-sion of disease. Insulin resistance (IR) is an important feature of obesity, but it does not reflect systemic inflammation. Cur-rently, there is a lack of effective clinical tools for early risk stratification and intervention in physically active people.

    Methods This was a prospective cohort of 72,262 overweight but physically active persons in the UK Biobank. The TyG was combined with hsCRP, waist circumference (WC), or body mass index (BMI) as indices of IR. Adjusted Cox regression, interaction tests, restricted cubic splines (RCS) analysis, Kaplan-Meier analysis, and Harrell’s C-index were used to examine the relations and time-dependent predictive power.

    Results During 12.7 years of follow-up, 1,477 participants developed metabolic dysfunction-associated fatty liver disease (MAFLD). RCS analysis suggested TyG-hsCRP had a nonlinear positive correlations with all-cause mortality. Compared to the lowest quartile group, the corrected hazard ratio (HR) (95% confidence interval [CI]) of new-onset MAFLD in maximum quartile groups for TyG-hsCRP was 1.94(1.62–2.32), for TyG-WC was 1.78(1.44–2.18), for TyG-BMI was 1.36(1.12–1.65), and for TyG was 1.41(1.15–1.72). The relation between C-index of TyG-hsCRP and MAFLD was higher than that of other TyG indices. Similar results were observed in all-cause mortality.

    Conclusion TyG-hsCRP is superior to other indices for identifying risk of MAFLD and all-cause mortality in overweight but physically active people. Our findings suggest the importance of inflammatory metabolism and provide evidence for effectively early anti-inflammatory treatments.

    Keywords Excess weight · Inflammation · Insulin resistance · Physically active

Communicated by Salvatore Corrao, M.D

    Mengchen Zou

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    Xianbo Wu

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1 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road North, Guangzhou 510515, China

2 Department of Occupational Health and Medicine, School of Public Health, Southern Medical University, Guangzhou, China

How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective

Chunhai Tao1 , Xi Chen2*, Wenji Zheng1*, Zehao Zhang1 , Ruoyan Tao3 , Rui Deng1 and Qizhe Xiong1

1School of Statistics, Jiangxi University of Finance and Economics, Nanchang, China, 2School of Economics and Management, Nanchang University, Nanchang, China, 3School of Liberal Arts, Macau University of Science and Technology, Taipa, Macau SAR, China

OPEN ACCESS

EDITED BY

Kui Yi, East China Jiaotong University, China

REVIEWED BY

Yong Wang, Dongbei University of Finance and Economics, China Gang Peng, Southwestern University of Finance and Economics, China

*CORRESPONDENCE

Xi Chen 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。 Wenji Zheng 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。

SPECIALTY SECTION

This article was submitted to Organizational Psychology, a section of the journal Frontiers in Psychology

RECEIVED 27 October 2022 ACCEPTED 05 December 2022 PUBLISHED 05 January 2023

CITATION

Tao C, Chen X, Zheng W, Zhang Z, Tao R, Deng R and Xiong Q (2023) How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective Frint Psychol. 13:1081562.

doi: 10.3389/fpsyg.2022.1081562

COPYRIGHT

© 2023 Tao, Chen, Zheng, Zhang, Tao, Deng and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the  origina publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

  Due to the disorderly access to medical care and inefficient use of health resources, the advancement of the hierarchical diagnosis and treatment is more valued in promoting health system reform. Hence, this article integrates prospect theory into an evolutionary game model of the local government health departments, the medical institutions, and the patients in the system promotion of the hierarchical diagnosis and treatment. The simulation shows the specific influencing mechanism of the psychological perceived value of game subjects. Then by introducing the stochastic evolutionary game model, the system promotion under different medical cultures is also discussed in detail. The results indicate that for local government health departments, the amount and duration of financial subsidies are the key factors influencing the game system’s evolution. For medical institutions, participating in the hierarchical diagnosis and treatment system is relatively beneficial. For patients, the recovery rate in primary hospitals matters more than the cost of treatment. Changes in the risk sensitivity coefficient will cause the equilibrium of the game system to change. However, changes in the loss avoidance factor do not change the equilibrium and only have an impact on the speed of convergence. With the health departments’ intervention, patients in rural medical culture are more inclined to support the hierarchical diagnosis and treatment system than those in urban or town medical culture. Therefore, in order to promote the hierarchical diagnosis and treatment system, this article recommends that more attention should be paid to the regulatory role of health departments and the participation improvement of medical institutions and patients.

KEYWORDS

hierarchical diagnosis and treatment, evolutionary game theory, prospect theory, stochastic disturbance, medical cultures

Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases

Esra Küpeli Akkol 1 *, Irem Tatlı Çankaya2 , Gökçe S¸ eker Karatoprak 3 , Elif Carpar 4 , Eduardo Sobarzo-Sánchez 5,6 and Raffaele Capasso7

  Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara, Turkey, 2 Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey, 3 Department of Pharmacognosy, Faculty of Pharmacy, Erciyes University, Kayseri, Turkey, 4 Department of Psychiatry, Private French La Paix Hospital, Istanbul, Turkey, 5 Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile, 6 Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain, 7 Department of Agricultural Sciences, University of Naples Federico II, Potici, Italy

OPEN ACCESS

Edited by:Anca Oana Docea, University of Medicine and Pharmacy of Craiova, Romania

Reviewed by: Luigia Trabace, University of Foggia, Italy Vasileios Siokas, University of Thessaly, Greece

*Correspondence: Esra Küpeli Akkol 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。

Specialty section: This article was submitted to Neuropharmacology, a section of the journal Frontiers in Pharmacolog

Received: 22 February 2021

Accepted: 16 April 2021

Published: 13 May 2021

Citation: Küpeli Akkol E, Tatlı Çankaya I, S¸ eker Karatoprak Gç, Carpar E, Sobarzo-Sánchez E and Capasso R (2021) Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases. Front. Pharmacol. 12:669638. doi: 10.3389/fphar.2021.669638

  Psychiatric disorders are frequently encountered in many neurological disorders, such as Alzheimer’s and Parkinson diseases along with epilepsy, migraine, essential tremors, and stroke. The most common comorbid diagnoses in neurological diseases are depression and anxiety disorders along with cognitive impairment. Whether the underlying reason is due to common neurochemical mechanisms or loss of previous functioning level, comorbidities are often overlooked. Various treatment options are available, such as pharmacological treatments, cognitive-behavioral therapy, somatic interventions, or electroconvulsive therapy. However oral antidepressant therapy may have some disadvantages, such as interaction with other medications, low tolerability due to side effects, and low efficiency. Natural compounds of plant origin are extensively researched to find a better and safer alternative treatment. Experimental studies have shown that phytochemicals such as alkaloids, terpenes, flavonoids, phenolic acids as well as lipids have significant potential in in vitro and in vivo models of psychiatric disorders. In this review, various efficacy of natural products in in vitro and in vivo studies on neuroprotective and their roles in psychiatric disorders are examined and their neuro-therapeutic potentials are shed light.

Keywords: Alzheimer’s diseases, anxiety, depression, Parkinson’s disease, natural compound