Nanomedicine could improve the treatment of diabetes by exploiting various therapeutic mechanisms through the use of suitable nanoformulations. For example, glucose-sensitive nanoparticles can release insulin in response to high glucose levels, mimicking the physiological release of insulin. Oral nanoformulations for insulin uptake via the gut represent a long-sought alternative to subcutaneous injections, which cause pain, discomfort, and possible local infection. Nanoparticles containing oligonucleotides can be used in gene therapy and cell therapy to stimulate insulin production in β-cells or β-like cells and modulate the responses of T1DM-associated immune cells. In contrast, viral vectors do not induce immunogenicity. Finally, in diabetic wound healing, local delivery of nanoformulations containing regenerative molecules can stimulate tissue repair and thus provide a valuable tool to treat this diabetic complication. Here, we describe these different approaches to diabetes treatment with nanoformulations and their potential for clinical application.

The association between acne and insulin resistance has not been investigated as thoroughly in males as it has been in women, despite the fact that in adult men, acne prevalence has grown. On the face, sebaceous glands produce and secrete sebum, which lubricates the skin and protects it from friction. Metformin, an insulin-sensitizing medication, may modify the association between acne vulgaris and insulin resistance (IR). Individuals with IR, metabolic syndrome or with impaired glucose tolerance are sometimes treated ‘off label’ with Metformin. In these conditions, IR may be a leading factor in the pathogenesis of acne, and in men, Metformin treatment may reduce the Global Acne Grading System (GAGS) score by enhancing insulin sensitivity. However, additional clinical studies are required to corroborate these assumptions.

Objectives: To evaluate the impact of heart failure (HF) on one-year outcomes in patients hospitalized for diabetic foot ulcers (DFUs). Methods: A retrospective observational study including consecutive patients admitted in 2024 to a tertiary multidisciplinary diabetic foot service for DFUs. Patients were stratified according to the presence of HF (HF+ vs. HF−). One-year outcomes included wound healing, major amputation, non-fatal major adverse limb events (NF-MALCE), including myocardial infarction, stroke, recurrent chronic limb-threatening ischaemia (CLTI) requiring revascularization, and mortality. Results: Overall, 270 patients were included (104 HF+ [38.5%] vs. 166 HF− [61.5%]). Patients with HF exhibited a more severe cardiorenal phenotype, with worse cardiac and renal biomarkers. At one-year follow-up, patients with HF showed lower wound healing rates than patients without HF (58.6% vs. 71.7%, p = 0.03), higher incidence of NF-MALCE (43.3% vs. 18.7%, p < 0.001), mainly driven by recurrent CLTI requiring revascularization (48.9% vs. 27.0%, p < 0.001), and higher mortality (21.1% vs. 7.2%, p = 0.001). Conversely, no differences were observed in major amputation, myocardial infarction, or stroke. After multivariable adjustment for age, sex, ischaemic heart disease, atrial fibrillation, dialysis, haemoglobin, albumin, foot infection and peripheral arterial disease (PAD), HF remained independently associated with NF-MALCE (adjusted odds ratio (aOR) 2.90, 95% confidence interval (CI) 1.38–6.09, p = 0.005) and recurrent CLTI requiring revascularization (aOR 2.43, 95% CI 1.11–5.32, p = 0.026); the association remained consistent in the subgroup with PAD. Conclusions: HF identifies a high-risk cardio-renal phenotype and is independently associated with increased limb-related adverse events in patients hospitalized for DFUs, supporting closer vascular surveillance and integrated multidisciplinary cardio-renal-foot care.