Background: Diabetes affects over 460 million people worldwide and represents a growing public health challenge driven largely by dietary and lifestyle factors. While Type 2 diabetes (T2D) is more prevalent, Type 1 diabetes (T1D) presents unique therapeutic challenges, particularly in younger individuals. Advances in diabetes management, such as continuous glucose monitoring (CGM), insulin pumps (IP), and, more recently, smart multiple dose injection (MDI) pens, have significantly enhanced glycemic control and improved patients’ quality of life. Aim: This study aims to evaluate the baseline characteristics of patients switching from MDI therapy to the Medtronic Smart MDI system [composed of a smart insulin pen (InPenTM) and a connected CGM Medtronic SimpleraTM sensor] and to assess its impact on glycemic outcomes over different time periods (14, 30, and 90 days). Methods: A retrospective observational study was conducted among adults with T1D who initiated Medtronic Smart MDI therapy. Participants were enrolled voluntarily at the Diabetes and Nutrition Clinic in Ast Fermo, Marche Region, Italy. Glycemic parameters were monitored using CGM data and analyzed with descriptive statistics, including mean, standard deviation (SD), and interquartile range (IQR). Comparisons across time periods were performed using the Wilcoxon signed-rank test, with statistical significance set at p < 0.05. Results: This study included 21 participants with a mean age of 51.5 years, a mean BMI of 24.7, and a mean duration of T1D of 21.9 years. The transition from a traditional MDI system to the Smart MDI system resulted in significant improvements in key glycemic parameters: mean Sensor Glucose (SG) decreased from 171.0 mg/dL to 153.5 mg/dL (p = 0.035), Time In Range (TIR) increased from 58.0% to 64.4% (p = 0.005), and time above range (TAR; >180 mg/dL) decreased from 39.0% to 34.2% (p = 0.015). No significant differences were observed in the time below range (TBR). Conclusions: The transition to the Medtronic Smart MDI system significantly enhanced glycemic control by lowering mean glucose levels and increasing TIR. These findings highlight its efficacy in improving hyperglycemia management while maintaining a stable risk of hypoglycemia.

Il diabete rappresenta una patologia in costante aumento: familiarità, età e stili di vita rappresentano i principali fattori di rischio per questa malattia e per le complicanze ad essa correlate. Considerando l'importanza del regime alimentare per la prevenzione e il trattamento di questa patologia, scopo del presente studio è stato quello di valutare le conoscenze alimentari di pazienti al primo accesso presso un centro di Diabetologia e di indagare sulla loro eventuale influenza su alcuni parametri ematici. È stato somministrato il questionario di Moynihan. La relazione tra i punteggi ottenuti e le variabili emoglobina glicata, BMI, glicemia a digiuno, è stata analizzata attraverso regressione multipla basata sul metodo dei minimi quadrati ordinari (modello OLS). Il response rate è stato del 73,3%. Il punteggio medio totale ottenuto dal questionario è stato di 23,61 ed è stata osservata una correlazione statisticamente significativa (p<0,0473) tra i migliori punteggi del questionario e i valori di Hb1Ac. Questo studio è il primo passo di un'indagine più ampia che verrà condotta nell'ottica di promuovere una formazione del paziente volta a verificare nel tempo le ricadute positive sulle scelte alimentari e sui parametri clinici.

Patients with diabetes mellitus have been reported to be at a high risk of complications from SARS-CoV2 virus infection (COVID-19). In type 2 diabetes, there is a change in immune system cells, which shift from an anti-inflammatory to a predominantly pro-inflammatory pattern. This altered immune profile may induce important clinical consequences, including increased susceptibility to lung infections; and enhanced local inflammatory response. Furthermore, dipeptidyl peptidase 4 (DPP4) enzyme is highly expressed in the lung, and that it may have additional actions besides its effects on glucose metabolism, which might exert profound pro-inflammatory effects. We briefly review the impact on the inflammatory system of DPP4 for its possible detrimental effect on COVID-19 syndrome, and of DPP4 inhibitors (gliptins), currently used as glucose lowering agents, which may have the potential to exert positive pleiotropic effect on inflammatory diseases, in addition to their effects on glucose metabolism. Thanks to these ancillary effects, gliptins could potentially be “repurposed” as salutary drugs against COVID-19 syndrome, even in non-diabetic subjects. Clinical studies should be designed to investigate this possibility.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a novel class of incretin mimetics for treating type 2 diabetes (T2D). This study evaluated the impact of semaglutide, the first oral GLP-1RA, on glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body composition and anthropometric parameters. Additionally, the effects on cardiovascular risk factors and quality of life (QoL) in T2D patients were assessed. Methods: A prospective observational study with a six-month follow-up was conducted. Clinical parameters, including HbA1c, FPG, anthropometric measurements, blood pressure, cardiovascular risk factors, Diabetes Treatment Satisfaction Questionnaire (DTSQ) responses, and Short Form (36) Health Survey (SF-36) responses, were collected at baseline (T0) and at six months (T1). Results: Sixty-one subjects were enrolled, with there being an average T2D duration of 4.67 ± 3.93 years. Significant decreases were observed in HbA1c (µ = −1.24; SD = 1.33; p < 0.05), FPG (µ = −31.01 mg/dL; SD = 41.71; p < 0.05), body composition and anthropometric parameters (p < 0.05), and cardiovascular risk factors (p < 0.05), with an increase in DTSQ scores (p < 0.05). Conclusions: The administration of 14 mg/day oral semaglutide improved several clinical parameters after six months of treatment. These findings suggest semaglutide is effective in improving glycemic control, weight management, and some cardiovascular risk factors in T2D patients.