Background: Type 2 diabetes (T2D) is correlated to amnestic mild cognitive impairment (aMCI) and to non-amnestic mild cognitive impairment (naMCI). This study evaluated whether the T2D variable characterizes a peculiar cognitive profile in elderly patients. Moreover, it explores the association between glycated hemoglobin levels (HbA1c), T2D duration, insulin and oral hypoglycemic agent treatment, and cognition in elderly diabetic patients. Methods: Detailed neuropsychological battery was used to diagnose MCI subtypes. A total of 39 MCI subjects with T2D (T2D-MCI) and 37 MCI subjects without T2D (ND-MCI), matched for age, educational level, and Mini-Mental State Examination score, were included. Results: ND-MCI performed worse in memory and language domains than T2D-MCI. The amnestic subtype is more frequent among ND-MCI and non-amnestic subtype in T2D-MCI. In T2D-MCI, high HbA1c levels correlate with episodic memory (immediate recall) and T2D duration. Some indexes of episodic memory (immediate recall), attention, and visual-spatial ability correlate with insulin treatment. Conclusions: An association between T2D and non-amnestic MCI is suggested. In the T2D-MCI group, significant associations between insulin treatment and memory (immediate recall), complex figure copy, and attention were found.

Disorders of lipoprotein metabolism are among the major risk factors for cardiovascular disease (CVD) development. Single nucleotide polymorphisms (SNPs) have been associated with the individual variability in blood lipid profile and response to lipid-lowering treatments. Here, we genotyped 34 selected SNPs located in coding genes related to lipid metabolism, inflammation, coagulation, and a polymorphism in the MIR499 gene—a microRNA previously linked to CVD—to evaluate the association with lipid trait in subjects with moderate dyslipidemia not on lipid-lowering treatment (Treatment-naïve (TN) cohort, n = 125) and in patients treated with statins (STAT cohort, n = 302). We also explored the association between SNPs and the effect of a novel phytochemical lipid-lowering treatment in the TN cohort. We found that 6 SNPs (in the MIR499, TNFA, CETP, SOD2, and VEGFA genes) were associated with lipid traits in the TN cohort, while no association was found with the response to twelve-week phytochemical treatment. In the STAT cohort, nine SNPs (in the MIR499, CETP, CYP2C9, IL6, ABCC2, PON1, IL10, and VEGFA genes) were associated with lipid traits, three of which were in common with the TN cohort. Interestingly, in both cohorts, the presence of the rs3746444 MIR499 SNP was associated with a more favorable blood lipid profile. Our findings could add information to better understand the individual genetic variability in maintaining a low atherogenic lipid profile and the response to different lipid-lowering therapies.

Background: Distinguishing between Charcot Neuroarthropathy (CN), osteomyelitis (OM), and CN complicated with superimposed OM in diabetic patients is crucial for the treatment choice. Given that current diagnostic methods lack specificity, advanced techniques, e.g., magnetic resonance imaging (MRI) and 99mTc-HMPAO–WBC Single Photon Emission Computed Tomography (SPECT/CT), are needed. This study addresses the challenges in distinguishing OM and CN. Methods: We included diabetic patients with CN and soft tissue ulceration. MRI and 99mTc-HMPAO–WBC SPECT/CT were used for the diagnosis. The patients were classified into three probability levels for OM (i.e., Definite, Probable, and Unlikely) according to the Consensus Criteria for Diabetic Foot Osteomyelitis (CC-DFO). Results: Eight patients met the eligibility criteria. MRI, supported by SPECT-CT and CC-DFO, showed consistency with the OM diagnosis in three cases. The key diagnostic features included the location of signal abnormalities and secondary features such as skin ulcers, sinus tracts, and abscesses. Notably, cases with inconclusive MRI were clarified by SPECT/CT, emphasizing its efficacy in challenging scenarios. Conclusions: The primary objective of this study was to compare the results of MRI and 99mTc-HMPAO–WBC SPECT/CT with the CC-DFO score in the diabetic foot with CN and suspected OM. Advanced imaging offers a complementary approach to distinguish between CN and OM. This can help delineate the limits of the disease for presurgical planning. While MRI is valuable, 99mTc-HMPAO–WBC SPECT/CT provides additional clarity, especially in challenging cases or when metallic implants affect MRI accuracy.

Introduction: Health-Related Quality of Life (HRQOL) is a key indicator of how chronic conditions such as type 2 diabetes (T2D) affect an individual’s overall well-being. This study explored the relationship between HRQOL and health-related data in older T2D participants. Methods: This retrospective study analyzed data from 987 participants with T2D who underwent checkups at the IRCCS INRCA Hospital, Ancona, Italy. Participants with an EQ-5D-3L index score of 1 were classified as having “no problems” in any dimension, and those with a value less than 1 were categorized as having “any problems”. Results: The mean age was 76.5 years (SD ± 4.5), and 46.5% were male. The “any problems” group (n = 795) was older and had longer diabetes duration, lower educational attainment, higher total cholesterol, higher triglycerides, and a higher Body Mass Index (BMI) with respect to the “no problems” group (n = 195). Multivariate logistic regression identified female sex (OR 2.14, 95% CI: 1.24–3.70), higher BMI (OR 1.07, 95% CI: 1.01–1.14), and depressive symptoms by the 5-item mini-Geriatric Depression Scale (mini GDS 5) (OR 2.43, 95% CI: 1.84–3.21) as significantly associated with lower HRQOL. Conversely, higher scores of the Instrumental Activities of Daily Living (IADL) (OR 0.77, 95% CI: 0.65–0.91) were related to better HRQOL. Conclusions: Female sex, overweight status, depressive symptoms, and lower physical performance are associated with impaired HRQOL in older Italian T2D outpatients. In particular, the EQ-5D-3L index provides a comprehensive index associated with depressive symptoms and low mobility.

Background: Physical activity is an important predictor of quality of life in older adults with type 2 diabetes (T2D). Unfortunately, most T2D adults adopt a sedentary lifestyle. The randomized, controlled TRIPL-A trial aims to verify the effect of a personalized, discontinuous exercise program on a sedentary lifestyle of T2D older adults. Methods: A total of 305 T2D patients (mean age ± SD: 68.8 ± 3.3 years) were divided into a control arm receiving only behavioral counseling and an intervention arm of an 18-month supervised discontinuous exercise program (ERS). The primary outcomes were the changes in sitting time (ST) and metabolic equivalent (MET) values, both evaluated by the International Physical Activity Questionnaire short form. A repeated measures ANOVA with Bonferroni correction for multiple comparisons was used to compare study outcomes. Results: The ST and MET differed significantly during the study compared to the control group (p = 0.028 and p = 0.004, respectively). In the intervention group, a decrease from baseline in ST at 6 months (p = 0.01) and an increase in MET values at 6 months (p = 0.01) up to 12 months (p < 0.01) were found. No significant differences were found for the other variables. Conclusions: Beneficial lifestyle changes were found within the first year of intervention. These results align with the theory of change.

Background: Type 2 diabetes is a prevalent chronic condition, particularly among older adults, and is associated with significant morbidity, mortality, and health care costs. Effective disease self-management is crucial for achieving glycemic control and preventing complications. Objective: This pilot study aims to evaluate the effectiveness of a structured, 5-week training program in improving eHealth literacy among older adults with type 2 diabetes and to assess its impact on health literacy, self-efficacy, psychological well-being, and clinical outcomes. Methods: In total, 200 community-dwelling adults aged ≥60 years with type 2 diabetes, a Mini-Mental State Examination score ≥24, a Geriatric Depression Scale score <9, and a low eHealth Literacy Scale score (≤29) will be recruited. Participants will attend five 90-minute weekly training sessions combining didactic and interactive modules focused on health literacy, diabetes self-management, and the use of digital tools. Assessments will be performed at baseline (T0), post intervention (T1), and at 1-month (T2) and 6-month (T3) follow-up. The primary outcome will be the change in eHealth literacy, as measured by the eHealth Literacy Scale, from baseline to post intervention. In addition, a wide range of secondary outcomes will be examined to capture the program’s multidimensional impact: improvements in general health literacy, self-efficacy in diabetes management, psychological well-being, and quality of life; reductions in diabetes-related emotional distress, body weight, and BMI; and better metabolic control, as measured by hemoglobin A _1c and lipid profiles. Finally, participants’ experiences, satisfaction, and perceived benefits will be explored to inform the future scalability and refinement of the program. A prestudy will be conducted, involving stakeholders, older adults, and caregivers, to refine the training content using co-design techniques. Descriptive statistics will be used to summarize sample characteristics. Preintervention and postintervention changes will be evaluated using 2-tailed paired t tests or their nonparametric equivalents, with repeated-measures models applied to follow-up data. A P value <.05 will indicate statistical significance. Results: The prestudy phase began in April 2025. Improvements in both health literacy and eHealth literacy are expected to be observed among participants, as assessed through validated instruments administered before and after the intervention. Conclusions: The Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) study provides a structured and participatory approach to addressing the digital divide in chronic disease management among older adults. By focusing on personalized, evidence-based training, the study offers a promising model for empowering patients and improving health outcomes through enhanced digital and self-management competencies.