Gabriele Angelo Vassallo1 · Tommaso Dionisi2,3 · Vittorio De Vita4 · Giuseppe Augello1 ·Antonio Gasbarrini3,5 · Dario Pitocco6 · Giovanni Addolorato2,3
Received: 25 January 2025 / Accepted: 29 March 2025 / Published online: 19 April 2025 © The Author(s) 2025
Abstract
Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic strategy for modulating gut dysbiosis in diabetes mellitus. This review critically evaluates preclinical and clinical evidence on FMT in type 1 (T1D) and type 2 dia-betes (T2D). Studies suggest that FMT can restore microbial diversity, improve glycemic control, and modulate immune responses, with varying effects across diabetes subtypes. In T1D, preclinical models demonstrate that FMT influences regulatory T-cell expansion and β-cell preservation, though clinical translation remains limited. In T2D, FMT has shown transient improvements in insulin sensitivity, with sustained effects observed only in patients with specific microbiome signatures. However, heterogeneity in patient responses, donor variability, and methodological limitations complicate its clinical application. This review highlights the interplay between FMT, immune modulation, and microbial metabolism, advocating for phenotype-stratified trials and multi-omics integration to enhance therapeutic precision.
Keywords Fecal microbiota transplantation · Intestinal Microbiome · Diabetes · Insulin sensitivity · Metabolic syndrome · Beta-cell
Abbreviations
FMT Fecal microbiota transplantation TUDCA Tauroursodeoxycholic acid VEGF Vascular endothelial growth factor SCFAs Short-chain fatty acids MMTT Mixed meal tolerance test FVT Fecal virome transplantation OGTT Oral glucose tolerance test SRB Sulfate-reducing bacteria LSI Lifestyle intervention
Huanjia Qu1 · Lingling Zhou1 · Dong Tang2 · Qiuling Zhang1 · Pu Yang3 · Boyi Yang3 · Junping Shi4
Received: 25 December 2024 / Accepted: 22 March 2025 / Published online: 19 April 2025 © The Author(s) 2025
Purpose Type 2 diabetes mellitus (T2DM) is associated with ectopic fat deposition, especially in the liver and pancreas.Therefore, this study aimed to evaluate the relationship between liver fat fraction (LFF), pancreatic fat fraction (PFF), and new-onset T2DM in metabolic dysfunction-associated fatty liver disease (MAFLD) by magnetic resonance imaging (MRI).
Methods This is a retrospective study of patients with MAFLD who underwent abdominal MRI between 2022 and July 2024. LFF and PFF were measured using an axial multi-echo Dixon-based sequence. All participants underwent routine medical history, anthropometric measurements, and laboratory tests. Multivariable stepwise selection models were con-structed to predict PFF and T2DM status based on variables of clinical interest.
Results This study included 80 MAFLD patients with 40 untreated new-onset T2DM and 40 non-T2DM controls. LFF, PFF, and homeostasis model assessment of insulin resistance (HOMA-IR) index were higher in the T2DM group than in the control group. In the new-onset T2DM group, PFF was linearly positively correlated with LFF (rs=0.321, P=0.04) and HOMA-IR (rs=0.350, P=0.03). After adjustment for several metabolic variables, PFF remained an independent risk factor for incident T2DM in MAFLD patients (all P<0.05). The area under the receiver operating characteristic curve for PFF and LFF to predict T2DM was 0.889 and 0.633 (P<0.001 and P=0.03), respectively.
Conclusion In MAFLD patients, PFF, and LFF play a prominent role in new-onset T2DM with high predictive and diag-nostic value.
Keywords Metabolic dysfunction-associated fatty liver disease · Type 2 diabetes mellitus · Liver fat fraction ·Pancreatic fat fraction · Ectopic fat deposition · MRI
刘晗 负压引流与创面修复
是不是 瘘了？
原创： 十六点五 中山二院糖尿病足中心
男性，24岁，3年前外院诊断“下丘脑生殖细胞瘤”，进行γ刀治疗后，长期应用“氢化可的松”早晚各2片维持，半年前不慎损伤左小腿下部外侧皮肤，之后长期不愈合，收入院。
含银的敷料是目前治疗糖尿病足的主流敷料，有各种剂型，包括泡沫状、胶冻态、液态、粉末态、膏态等等，生产的厂家的非常多，其中的质量良莠不齐，很难鉴别。
进一步的清创就到了骨骼，对于骨髓炎最彻底的治疗方法就是去除被细菌侵袭的骨，正常的骨骼一般是浅黄色，如果发白或者变黑，往往就提示这段骨头可能活性比较差，另外，还有一种是面积比较大的骨暴露，一般的肉芽组织很难爬上去，因此，对于坏死的骨头及较大面积的骨暴露，一般需要清除。
皮下组织中的脂肪组织在足部分布广泛，而皮下脂肪中血管分布非常少，在相对或绝对缺血的糖尿病足中，脂肪组织边缘的是否出血不是其是否存活的可靠指标。
这是一个我们在《糖尿病足切开设计（1）》中提到过，这次从不同角度谈谈足趾的保全。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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