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Article ; Online: Response to Chia Siang Kow and colleagues.

Avogaro, Angelo / Bonora, Benedetta Maria / Fadini, Gian Paolo

2022 Volume 59, Issue 2, Page(s) 287

MeSH term(s)	Humans ; Seeds
Language	English
Publishing date	2022-01-13
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	1097676-0
ISSN	1432-5233 ; 0940-5429
ISSN (online)	1432-5233
ISSN	0940-5429
DOI	10.1007/s00592-021-01811-w
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Article ; Online: Ketosis-prone Diabetes and Hypogonadism: A New Clinical Association to be Aware of ?

Graziani, Andrea / Pollis, Riccardo Maria / Bonora, Benedetta Maria / Scaroni, Carla / Sabbadin, Chiara

Endocrine, metabolic & immune disorders drug targets

2023 Volume 23, Issue 12, Page(s) 1552–1556

Abstract: Background: Ketosis-prone diabetes (KPD) is an emerging entity, sharing features of both type 1 diabetes mellitus and type 2 diabetes mellitus. Patients with KPD usually present with diabetic ketoacidosis without the classic phenotype of autoimmune type ...

Abstract	Background: Ketosis-prone diabetes (KPD) is an emerging entity, sharing features of both type 1 diabetes mellitus and type 2 diabetes mellitus. Patients with KPD usually present with diabetic ketoacidosis without the classic phenotype of autoimmune type 1 diabetes. In most cases, they are Afro-American adults, who require insulin therapy for the management of acute decompensation, then usually encountering insulin-free remission for prolonged periods of time with diet or with non-insulin agents. Meanwhile, hypogonadism is a known condition that could be associated with higher risk of developing both type 1 and type 2 diabetes and could be a risk factor for decompensated diabetes. The association of KPD and hypogonadism is reported for the first time in literature. Case presentation: Here we report two peculiar cases of young African patients, affected by KPD and hypergonadotropic hypogonadism, respectively Klinefelter's syndrome and primary ovarian failure. Both patients were treated promptly for the ketoacidosis with intravenous fluids combined with continuous insulin infusion, and then switched to subcutaneous regimen. After the correct clinical evaluation, oral antidiabetic drugs were added. Conclusion: KPD remains an under-recognized and under-diagnosed type of diabetes. As hypogonadism is strongly linked to dysmetabolic disorders, the evaluation of sex hormones should be performed at the onset of diabetes. Further studies should investigate the hypothalamic-pituitary-gonadal axis and its role in the development of KDP and its manifestations and complications.
MeSH term(s)	Adult ; Humans ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetic Ketoacidosis/complications ; Diabetic Ketoacidosis/diagnosis ; Diabetic Ketoacidosis/drug therapy ; Insulin/therapeutic use ; Ketosis/complications ; Ketosis/drug therapy ; Hypogonadism/complications ; Hypogonadism/diagnosis ; Hypogonadism/drug therapy
Chemical Substances	Insulin
Language	English
Publishing date	2023-08-09
Publishing country	United Arab Emirates
Document type	Case Reports
ZDB-ID	2228325-0
ISSN	2212-3873 ; 1871-5303
ISSN (online)	2212-3873
ISSN	1871-5303
DOI	10.2174/1871530323666230621114503
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Article ; Online: Improved prediction of long-term kidney outcomes in people with type 2 diabetes by levels of circulating haematopoietic stem/progenitor cells.

Bonora, Benedetta Maria / Morieri, Mario Luca / Marassi, Marella / Cappellari, Roberta / Avogaro, Angelo / Fadini, Gian Paolo

Diabetologia

2023 Volume 66, Issue 12, Page(s) 2346–2355

Abstract: Aim/hypothesis: We examined whether prediction of long-term kidney outcomes in individuals with type 2 diabetes can be improved by measuring circulating levels of haematopoietic stem/progenitor cells (HSPCs), which are reduced in diabetes and are ... ...

Abstract	Aim/hypothesis: We examined whether prediction of long-term kidney outcomes in individuals with type 2 diabetes can be improved by measuring circulating levels of haematopoietic stem/progenitor cells (HSPCs), which are reduced in diabetes and are associated with cardiovascular risk. Methods: We included individuals with type 2 diabetes who had a baseline determination of circulating HSPCs in 2004-2019 at the diabetes centre of the University Hospital of Padua and divided them into two groups based on their median value per ml of blood. We collected updated data on eGFR and albuminuria up to December 2022. The primary endpoint was a composite of new-onset macroalbuminuria, sustained ≥40% eGFR decline, end-stage kidney disease or death from any cause. The analyses were adjusted for known predictors of kidney disease in the population with diabetes. Results: We analysed 342 participants (67.8% men) with a mean age of 65.6 years. Those with low HSPC counts (n=171) were significantly older and had a greater prevalence of hypertension, heart failure and nephropathy (45.0% vs 33.9%; p=0.036), as evidenced by lower eGFR and higher albuminuria at baseline. During a median follow-up of 6.7 years, participants with high vs low HSPC counts had lower rates of the composite kidney outcome (adjusted HR 0.69 [95% CI 0.49, 0.97]), slower decline in eGFR and a similar increase in albuminuria. Adding the HSPC information to the risk score of the CKD Prognosis Consortium significantly improved discrimination of individuals with future adverse kidney outcomes. Conclusions/interpretation: HSPC levels predict worsening of kidney function and improve the identification of individuals with type 2 diabetes and adverse kidney outcomes over and beyond a clinical risk score.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Diabetes Mellitus, Type 2/complications ; Albuminuria ; Glomerular Filtration Rate ; Kidney Diseases/etiology ; Kidney ; Stem Cells ; Renal Insufficiency, Chronic
Language	English
Publishing date	2023-09-15
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1694-9
ISSN	1432-0428 ; 0012-186X
ISSN (online)	1432-0428
ISSN	0012-186X
DOI	10.1007/s00125-023-06002-6
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Zs.A 279: Show issues

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Article ; Online: The Toll of Lockdown Against COVID-19 on Diabetes Outpatient Care: Analysis From an Outbreak Area in Northeast Italy.

Bonora, Benedetta Maria / Morieri, Mario Luca / Avogaro, Angelo / Fadini, Gian Paolo

Diabetes care

2020 Volume 44, Issue 1, Page(s) e18–e21

Keywords	covid19
Language	English
Publishing date	2020-10-30
Publishing country	United States
Document type	Letter
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc20-1872
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Article: Extraglycemic Effects of SGLT2 Inhibitors: A Review of the Evidence.

Bonora, Benedetta Maria / Avogaro, Angelo / Fadini, Gian Paolo

Diabetes, metabolic syndrome and obesity : targets and therapy

2020 Volume 13, Page(s) 161–174

Abstract: Patients with type 2 diabetes (T2D) are often overweight/obese and affected by arterial hypertension, dyslipidaemia, and have high serum levels of uric acid. Moreover, T2D patient have a higher risk of developing cardiovascular or renal complications, ... ...

Abstract	Patients with type 2 diabetes (T2D) are often overweight/obese and affected by arterial hypertension, dyslipidaemia, and have high serum levels of uric acid. Moreover, T2D patient have a higher risk of developing cardiovascular or renal complications, which are leading causes of morbidity and mortality in this population. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a new class of glucose-lowering medications that block the reabsorption of glucose in the kidney, thereby increasing urinary glucose excretion, and lowering blood glucose levels. The beneficial effects of SGLT2 inhibition extend beyond glycaemic control, and include improvement in blood pressure, body weight, uric acid concentrations, liver steatosis, oxidative stress, and inflammation. In dedicated cardiovascular outcome trials, SGLT2i treatment was associated with a significant reduction in the rate of cardiovascular events and renal endpoints. In this review, we summarize the evidence for extra-glycemic effects of SGLT2i and the potential mechanisms driving cardiorenal protection exerted by this class of medications.
Language	English
Publishing date	2020-01-21
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2494854-8
ISSN	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSO.S233538
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Article ; Online: Diabetes pharmacotherapy and circulating stem/progenitor cells. State of the art and evidence gaps.

Albiero, Mattia / Bonora, Benedetta Maria / Fadini, Gian Paolo

Current opinion in pharmacology

2020 Volume 55, Page(s) 151–156

Abstract: Diabetes is burdened with the development of several end-organ complications leading to excess mortality. Though the causes of such organ damage are far from being clarified, diabetes has been redefined as a disease of impaired damage control, wherein ... ...

Abstract	Diabetes is burdened with the development of several end-organ complications leading to excess mortality. Though the causes of such organ damage are far from being clarified, diabetes has been redefined as a disease of impaired damage control, wherein ongoing damage is not adequately compensated by activation of repair processes. Bone marrow-derived hematopoietic stem/progenitor cells (HSPCs) and their descendants endothelial progenitor cells (EPCs) have been extensively studied as major players in tissue homeostasis as well as biomarkers of diabetic complication risk. Thus, strategies to raise the levels of circulating HSPCs/EPCs have attracted interest for their potential to modify the future risk of complications. We herein discuss state-of-the-art of the effects exerted by diabetes pharmacotherapy on such cell populations. Further, we highlight which outstanding questions remain to be addressed for a more comprehensive understanding of this topic.
MeSH term(s)	Animals ; Diabetes Mellitus/drug therapy ; Endothelial Progenitor Cells/drug effects ; Hematopoietic Stem Cells/drug effects ; Humans ; Hypoglycemic Agents/pharmacology ; Hypoglycemic Agents/therapeutic use
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2020-11-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2037057-X
ISSN	1471-4973 ; 1471-4892
ISSN (online)	1471-4973
ISSN	1471-4892
DOI	10.1016/j.coph.2020.10.019
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Zs.A 5608: Show issues

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Article ; Online: Euglycemic Ketoacidosis.

Bonora, Benedetta Maria / Avogaro, Angelo / Fadini, Gian Paolo

Current diabetes reports

2020 Volume 20, Issue 7, Page(s) 25

Abstract: Purpose of review: Diabetic ketoacidosis is a life-threatening complication of diabetes characterized by hyperglycemia, acidosis, and ketosis. Ketoacidosis may occur with blood glucose level < 200 mg/dl (improperly defined as euglycemic ketoacidosis, ... ...

Abstract	Purpose of review: Diabetic ketoacidosis is a life-threatening complication of diabetes characterized by hyperglycemia, acidosis, and ketosis. Ketoacidosis may occur with blood glucose level < 200 mg/dl (improperly defined as euglycemic ketoacidosis, euKA) and also in people without diabetes. The absence of marked hyperglycemia can delay diagnosis and treatment, resulting in potential serious adverse outcomes. Recent findings: Recently, with the wide clinical use of sodium glucose co-transporter 2 inhibitors (SGLT2i), euKA has come back into the spotlight. Use of SGLT2i use can predispose to the development of ketoacidosis with relatively low or normal levels of blood glucose. This condition, however, can occur, in the absence of diabetes, in settings such as pregnancy, restriction on caloric intake, glycogen storage diseases or defective gluconeogenesis (alcohol abuse or chronic liver disease), and cocaine abuse. euKA is a challenging diagnosis for most physicians who may be misled by the presence of normal glycemia or mild hyperglycemia. In this article, we review pathophysiology, etiologies, clinical presentation and the management of euKA.
MeSH term(s)	Blood Glucose ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis/diagnosis ; Diabetic Ketoacidosis/drug therapy ; Female ; Humans ; Hyperglycemia ; Pregnancy ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects
Chemical Substances	Blood Glucose ; Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2065167-3
ISSN	1539-0829 ; 1534-4827
ISSN (online)	1539-0829
ISSN	1534-4827
DOI	10.1007/s11892-020-01307-x
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Zs.A 5628: Show issues

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Article ; Online: SGLT-2 inhibitors and atrial fibrillation in the Food and Drug Administration adverse event reporting system.

Bonora, Benedetta Maria / Raschi, Emanuel / Avogaro, Angelo / Fadini, Gian Paolo

Cardiovascular diabetology

2021 Volume 20, Issue 1, Page(s) 39

Abstract: Background: Sodium glucose cotransporter-2 inhibitors (SGLT2i) reduce the risk of heart failure and new data show they can prevent atrial fibrillation (AF). We examined the association between SGLT2i and AF in the Food and Drug Administration adverse ... ...

Abstract	Background: Sodium glucose cotransporter-2 inhibitors (SGLT2i) reduce the risk of heart failure and new data show they can prevent atrial fibrillation (AF). We examined the association between SGLT2i and AF in the Food and Drug Administration adverse event reporting system (FAERS). Methods: We mined the FAERS from 2014q1 to 2019q4 to compare AF reporting for SGLT-2 i versus reports for other glucose lowering medications (ATC10 class). Several exclusions were sequentially applied for: concomitant medications; diabetes, cardiovascular or renal disease indication; reports for competing adverse events (genitourinary tract infections, ketoacidosis, Fournier's gangrene, amputation). We provide descriptive statistics and calculated proportional reporting ratios (PRR). Results: There were 62,098 adverse event reports for SGLT2i and 642,031 reports for other ATC10 drugs. The reporting of AF was significantly lower with SGLT2i than with other ATC10 drugs (4.8 versus 8.7/1000; p < 0.001) with a PRR of 0.55 (0.49-0.62). Results did not change substantially after excluding reports listing insulin (PRR 0.49) or anti-arrhythmics (PRR 0.59) as suspect or concomitant drugs, excluding reports with indications for cardiovascular disease (PRR 0.49) or renal disease (PRR 0.55), and those filed for competing adverse events (PRR 0.63). Results were always statistically significant whether the diabetes indication was specified. Negative and positive controls confirmed internal validity of the database. Conclusions: In a large pharmacovigilance database, AF was robustly and consistently reported more frequently for diabetes medications other than SGLT2i. This finding complements available evidence from trials supporting a protective role of SGLT2i against the occurrence of AF.
MeSH term(s)	Adverse Drug Reaction Reporting Systems ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/prevention & control ; Databases, Factual ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Humans ; Pharmacovigilance ; Protective Factors ; Risk Assessment ; Risk Factors ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Time Factors ; Treatment Outcome ; United States ; United States Food and Drug Administration
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2021-02-11
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1475-2840
ISSN (online)	1475-2840
DOI	10.1186/s12933-021-01243-4
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Article ; Online: Oral or injectable semaglutide for the management of type 2 diabetes in routine care: A multicentre observational study comparing matched cohorts.

Fadini, Gian Paolo / Bonora, Benedetta Maria / Ghiani, Mariangela / Anichini, Roberto / Melchionda, Elena / Fattor, Bruno / Fazion, Stefano / Meregalli, Giancarla / Giaccari, Andrea / Avogaro, Angelo / Consoli, Agostino

Diabetes, obesity & metabolism

2024

Abstract: Aim: To investigate the real-world utilization and comparative clinical outcomes of injectable and oral semaglutide in individuals with type 2 diabetes (T2D) with the aim of enhancing understanding of the practical implications associated with choosing ... ...

Abstract	Aim: To investigate the real-world utilization and comparative clinical outcomes of injectable and oral semaglutide in individuals with type 2 diabetes (T2D) with the aim of enhancing understanding of the practical implications associated with choosing between these formulations. Methods: New users of oral or injectable semaglutide were selected from a cohort of 14 079 initiators of glucagon-like peptide-1 receptor agonists. Propensity-score matching (PSM) was employed to create balanced groups, ensuring comparability. The analysis encompassed dose exposure, drug persistence, and clinical outcomes, including changes in glycated haemoglobin (HbA1c) and body weight, with up to 18 months' follow-up. Results: We analysed two matched groups of 107 participants each, who comprised on average 63.6% men, aged 64 years, with diabetes duration of approximately 10 years, body mass index of 29 kg/m Conclusion: In a real-world setting, improvements in HbA1c and body weight were similar after initiation of oral or injectable semaglutide. These results may be specific to the features of the matched cohorts under investigation, with limited generalizability to populations with different characteristics.
Language	English
Publishing date	2024-03-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1454944-x
ISSN	1463-1326 ; 1462-8902
ISSN (online)	1463-1326
ISSN	1462-8902
DOI	10.1111/dom.15554
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Article ; Online: Hematopoietic and Nonhematopoietic

Albiero, Mattia / D'Anna, Marianna / Bonora, Benedetta Maria / Zuccolotto, Gaia / Rosato, Antonio / Giorgio, Marco / Iori, Elisabetta / Avogaro, Angelo / Fadini, Gian Paolo

Antioxidants & redox signaling

2022 Volume 36, Issue 10-12, Page(s) 593–607

Abstract: Aims: ...

Abstract	Aims:
MeSH term(s)	Animals ; Diabetes Mellitus, Experimental/metabolism ; Hematopoietic Stem Cells/metabolism ; Humans ; Ischemia/metabolism ; Mice ; Mice, Inbred C57BL ; Src Homology 2 Domain-Containing, Transforming Protein 1/genetics ; Src Homology 2 Domain-Containing, Transforming Protein 1/metabolism ; Vascular Endothelial Growth Factor A/metabolism
Chemical Substances	SHC1 protein, human ; Src Homology 2 Domain-Containing, Transforming Protein 1 ; Vascular Endothelial Growth Factor A
Language	English
Publishing date	2022-01-04
Publishing country	United States
Document type	Clinical Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1483836-9
ISSN	1557-7716 ; 1523-0864
ISSN (online)	1557-7716
ISSN	1523-0864
DOI	10.1089/ars.2021.0097
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