In diabetes, pancreatic β-cells gradually lose their ability to secrete insulin with disease progression. β-cell dysfunction is a contributing factor to diabetes severity. Recently, islet cell heterogeneity, exemplified by β-cell dedifferentiation and identified in diabetic animals, has attracted attention as an underlying molecular mechanism of β-cell dysfunction. Previously, we reported β-cell dedifferentiation suppression by calorie restriction, not by reducing hyperglycemia using hypoglycemic agents (including sodium-glucose cotransporter inhibitors), in an obese diabetic mice model (db/db). Here, to explore further mechanisms of the effects of food intake on β-cell function, db/db mice were fed either a high-carbohydrate/low-fat diet (db-HC) or a low-carbohydrate/high-fat diet (db-HF) using similar calorie restriction regimens. After one month of intervention, body weight reduced, and glucose intolerance improved to a similar extent in the db-HC and db-HF groups. However, β-cell dedifferentiation did not improve in the db-HC group, and β-cell mass compensatory increase occurred in this group. More prominent fat accumulation occurred in the db-HC group livers. The expression levels of genes related to lipid metabolism, mainly regulated by peroxisome proliferator-activated receptor α and γ, differed significantly between groups. In conclusion, the fat/carbohydrate ratio in food during calorie restriction in obese mice affected both liver lipid metabolism and β-cell dedifferentiation.

The escalating prevalence of diabetes mellitus underscores the need for a comprehensive understanding of pancreatic beta cell function. Interest in glucose effectiveness has prompted the exploration of novel regulatory factors. The myeloid/lymphoid or mixed-lineage leukaemia gene (MLL) is widely recognised for its role in leukemogenesis and nuclear regulatory mechanisms through its histone methyltransferase activity in active chromatin. However, its function within pancreatic endocrine tissues remains elusive. Herein, we unveil a novel role of MLL in glucose metabolism and insulin secretion. MLL knockdown in βHC-9 pancreatic beta cells diminished insulin secretion in response to glucose loading, paralleled by the downregulation of the glucose-sensitive genes SLC2a1 and SLC2a2. Similar observations were made in MLL heterozygous knockout mice (MLL+/−), which exhibited impaired glucose tolerance and reduced insulin secretion without morphological anomalies in pancreatic endocrine cells. The reduction in insulin secretion was independent of changes in beta cell mass or insulin granule morphology, suggesting the regulatory role of MLL in glucose-sensitive gene expression. The current results suggest that MLL interacts with circadian-related complexes to modulate the expression of glucose transporter genes, thereby regulating glucose sensing and insulin secretion. Our findings shed light on insulin secretion control, providing potential avenues for therapeutics against diabetes.

Hyperthyroidism is known to increase basal metabolism and glucose uptake in the skeletal muscles while promoting gluconeogenesis in the liver. However, the specific mechanism underlying thyroid hormone-induced postprandial hyperglycemia remains unclear. This study explored the influence of thyroid hormones on sodium/glucose cotransporter 1 (SGLT1) expression in the small intestine and their impact on postprandial glucose metabolism. Specifically, we examined the distribution of thyroid hormone receptors in the small intestine and the subsequent effect of thyroid hormones on SGLT1 expression using rat and genetically modified mouse models. Our results demonstrated a significant upregulation of SGLT1 in the distal small intestine following T4 treatment, which corresponded with the enhanced postprandial glucose levels after oral glucose administration but not intraperitoneal administration. Furthermore, in TRβΔ337T knock-in mice that exhibited resistance to thyroid hormones, we observed increased SGLT1 expression and postprandial hyperglycemia, reinforcing our findings in rats. These findings suggest that thyroid hormones enhance glucose absorption in the small intestine via SGLT1, contributing to postprandial hyperglycemia. This study elucidates a previously unexplored aspect of thyroid hormone physiology and highlights the regulatory role of thyroid hormones in SGLT1 expression, offering potential therapeutic avenues for managing postprandial hyperglycemia in patients with diabetes.

Tani Y, et al. Korean Circ J. 2027 ;57:e57. https://doi.org/10.4070/kcj.2026.0041

To evaluate retrospectively the satisfaction of continuous subcutaneous insulin infusion (CSII) compared to multiple daily infusions in Japanese women with diabetes mellitus (DM) during pregnancy, we examined 27 women with type 1 (n = 20) or type 2 (n = 6) diabetes mellitus or gestational diabetes (n = 1) who previously used CSII. Among these patients, 19 had used CSII during pregnancy, which accounted for 30 births. Questionnaires were retrospectively administered. The mean age of patients was 36.5 ± 7.0 years. The average birth weight was 3.1 ± 0.6 kg, with 62% of babies exhibiting complications. The satisfaction level of CSII for patients during pregnancy was 3.95 ± 0.26, whereas it was 1.84 ± 0.26 for multiple daily infusions (P < 0.001).CSII was generally viewed favorably by women with diabetes mellitus for glycemic management during pregnancy.