Background/Objectives: The prognostic nutritional index (PNI) and Glasgow Prognostic Score (GPS) are associated with patients’ nutritional and immune statuses. One important factor in the pathophysiology of type 2 diabetes mellitus (T2DM) is inflammation. Being present in insulin-target tissues, chronic tissue inflammation has become recognized as a crucial aspect of obesity and type 2 diabetes. This study aimed to compare the PNI and GPS levels of the subjects with T2DM to those of prediabetes (preDM) individuals. Furthermore, the goal was to investigate how these inflammatory markers relate to different types of obesity and whether the combination of PNI, GPS, and obesity-related indices was associated with any particular prognostic variables. Methods: In this study, we enrolled one-hundred patients with newly diagnosed T2DM and one-hundred patients with preDM. Results: Four findings emerged from this observational study. As a first observation, 28% of patients with preDM and 15% of patients with T2DM had a normal weight, while up to 43% of patients with preDM and 60% of patients with T2DM were obese. The second important observation was that the PNI of the T2DM patients was significantly lower than the PNI of the patients with preDM (p < 0.0001). The PNI showed that patients with T2DM had a moderate-to-severe malnutrition status (median value of 38.00). Patients with preDM had a mild-to-moderate malnutrition status (median value of 61.00) at diagnosis. Third, observed in the current study, preDM patients with PNI < 61.00 and T2DM patients with a PNI < 38.00 were associated with significantly higher median values of the waist-to-height ratio (WHtR) (p = 0.041, and p = 0.034, respectively) and body mass index (BMI) (p = 0.016, and p = 0.041, respectively). Fourth, this study also revealed, in the T2DM group, a moderate and statistically significant negative correlation between PNI and weight (rho = −0.322, p = 0.035), waist circumference (WC) (rho = −0.308, p = 0.042), hip circumference (HC) (rho = −0.338, p = 0.039), WHtR (rho = −0.341, p = 0.022), body adiposity index (BAI) (rho = −0.312, p = 0.032), and fasting plasma glucose (FPG) (rho = −0.318, p = 0.029). Additionally, the PNI values expressed a weak negative correlation with BMI (rho = −0.279, p = 0.015), and glycated hemoglobin A1c (HbA1c) (rho = −0.245, p = 0.025). The PNI levels exhibited a single positive correlation, weak but statistically significant, with estimated glomerular filtration rate (eGFR-CKD-EPI) values (rho = 0.263, p = 0.018). Conclusions: The findings of this study regarding the correlations between PNI, GPS, and different obesity-related indices in people with diabetes or prediabetes suggest that these indices, which assess nutritional and inflammatory status, can be used as independent predictor factors associated with the four pillars of DM management (glucose, blood pressure, lipids, and weight control) recommended by the American Diabetes Association (ADA).

Systemic inflammation has an important role in the prognosis and progression of many chronic diseases, including diabetes (T2DM). This retrospective study aimed to evaluate inflammatory status by determining the serum inflammatory biomarkers (PTX3, hs-CRP, TNF-α, and IL-6) and new indices, like the mean corpuscular volume (MCV) to lymphocyte ratio (MCVL) and cumulative inflammatory index (IIC), in a cohort of patients with prediabetes (PreDM) and newly diagnosed T2DM. We also wanted to assess the association with clinical parameters and different obesity-related indices, to identify possible correlations and to evaluate the diagnostic accuracy of the biomarkers using ROC curve analysis. In this study, we included 60 patients diagnosed with T2DM and 30 patients with PreDM. The ELISA method was applied. Elevated PTX3, hs-CRP, TNF-α, and IL-6 levels were found in T2DM patients compared to preDM patients. An independent relationship was found between PTX3, hs-CRP, and different obesity-related indices in patients with preDM and T2DM. The MCVL index exhibited an inverse trend proportional to the rising levels of HbA1c in the T2DM group. Spearman’s analysis revealed in the T2DM group that the PTX3 values correlated much better with IIC (rho = 0.445, p-value = 0.014) and MCVL (rho = 0.338, p-value = 0.048). Hs-CRP values expressed moderate-to-weak correlations with IIC and MCVL in both groups. Additionally, ROC analysis showed that the PTX3 (AUC was 0.720; p = 0.003; cut-off value 1888.00 pg/mL, with 67.60% sensitivity and 73.30% specificity) and MCVL index (AUC was 0.677; p = 0.047; cut-off value 39.60, with 63.30% sensitivity and 66.70% specificity) have a good, accurate diagnosis compared with IL-6 (AUC was 0.866; p < 0.0001; cut-off value 40.30 pg/mL, with 100.00% sensitivity and 60.00% specificity). IIC showed 61.70% sensitivity and 60.00% specificity, with an AUC of 0.572, p = 0.027 and a cut-off value of 2.35. PTX3 and MCVL can serve as independent predictor factors in the inflammatory status in preDM and T2DM patients, supporting their potential as biomarkers for T2DM management and future research.

Prediabetes and early type 2 diabetes mellitus (T2D) are increasingly recognized as states of both metabolic and neurochemical dysregulation. This narrative review synthesizes emerging evidence of alterations in key neurotransmitter systems—dopamine, serotonin, norepinephrine, gamma-aminobutyric acid, and glutamate—in individuals with prediabetes and diabetes. Beyond peripheral insulin resistance and β-cell dysfunction, disturbances in the central nervous system, especially related to neurotransmitter signaling, may play a role in disease onset and progression. Neuroimaging studies reveal early imbalances in excitatory and inhibitory neurotransmitters, while biochemical and histological findings demonstrate altered receptor expression in both the brain and pancreatic islets. These changes affect metabolic control and are implicated in mood, cognition, and feeding behavior. We investigate the mechanistic links between neurotransmitter dysfunction and glucose metabolism, including the roles of brain insulin resistance, inflammation, mitochondrial stress, and gut–brain axis signaling. Finally, we discuss therapeutic strategies that target neurochemical pathways and highlight the need for longitudinal, sex-aware, and multi-omics studies to refine early interventions. Understanding the neurobiological roots of early T2D could revolutionize risk assessment and open doors for new neuro-metabolic treatments.

Neuroendocrine tumors are uncommon in the gastrointestinal system but can develop in the majority of the body’s epithelial organs. Our goal was to examine the presence and clinical application of serum dopamine (DA), serotonin (ST), norepinephrine (NE), and epinephrine (EPI), in addition to determining the significance of the Prognostic Nutritional Index (PNI), Glasgow Prognostic Score (GPS), and systemic inflammatory response (SIR) markers as a prognostic factor for patients with colorectal neuroendocrine tumors (CR-NETs), in various tumor–node–metastasis (TNM) stages. We also wanted to identify the possible connection between them. This study included 25 consecutive patients who were diagnosed with CR-NETs and a control group consisting of 60 patients with newly diagnosed colorectal cancer (CRC). We used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. This study revealed that CR-NET patients showed significantly higher serum levels of DA compared to CRC patients. We showed that serum DA was present in the early stages of CR-NETs, with increasing levels as we advanced through the TNM stages. Moreover, we found a close relationship between the levels of DA and the inflammation and nutritional status of the CR-NET patients in this study. CR-NET patients from the PNI < 47.00 subgroup had a higher level of DA than those from the PNI ≥ 47.00 subgroup. Pearson’s correlation analysis revealed correlations between DA, PNI, and the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR). Both hematological indices were negatively correlated with albumin (ALB). Our investigation’s findings relating to the PNI, GPS, SIR, and DA indicate that these tools can be markers of nutritional and systemic inflammatory status, are simple to use, and are repeatable. Further research on this topic could provide valuable insights into which biomarkers to incorporate into clinical practice for the management of CR-NET patients.