November 14 marks World Diabetes Day, a global initiative to raise awareness, share knowledge, and support people living with diabetes. Diabetes is a growing public health challenge, affecting millions worldwide and leading to serious health complications if not managed effectively. This year's theme, ‘Diabetes and well-being,’ focuses on the relationship between diabetes and the workplace and highlights the need for integrated care throughout a person's life, from childhood to older adulthood.

World Diabetes Day is a reminder of the role each of us can play in spreading awareness, improving understanding, and supporting people living with diabetes globally.

As part of a cross-BMC collaboration, we’re highlighting research from BMC Endocrine Disorders and Cardiovascular Diabetology. These studies explore how diabetes affects people’s lives and the progress being made to improve care, self-management, and overall well-being, helping individuals better manage their health and thrive every day. These contributions reflect our commitment to supporting Sustainable Development Goals, with particular focus on SDG 3: "Ensure healthy lives and promote well-being for all ages".

BMC Endocrine Disorders - Evaluating cloudcare, a population health management system, in persons with type 1 diabetes: an observational study

A study published in BMC Endocrine Disorders evaluated CloudCare, a population health management system designed for people with diabetes (PWDs) based on remote monitoring. The authors noted that as diabetes technology advances, the large amount of glucose data generated can challenge healthcare professionals (HCPs) in terms of workflow and timely interpretation. This study aimed to assess how integrating CloudCare into existing care pathways might influence treatment satisfaction, healthcare workload, diabetes-related distress, and glycaemic outcomes among adults with type 1 diabetes. 

The study involved a single-centre, prospective observational cohort of adults (n = 119) with type 1 diabetes who had been diagnosed for at least six months before inclusion and were using insulin. Participants were followed for six months after starting CloudCare, with outcomes including treatment satisfaction, contact frequency between PWDs and HCPs, diabetes-related distress, and glycaemic metrics such as time in range (TIR) and glucose management indicator (GMI). 

The findings showed that application of CloudCare increased treatment satisfaction, maintained excellent glycaemic control, and decreased face-to-face contacts between PWDs and HCPs. Diabetes-related distress also improved and remained lower at six months. Overall, the findings suggest that CloudCare may help  improve treatment satisfaction, reduce HCP workload and maintain glycemic control, supporting its potential role in modern diabetes care.

Cardiovascular Diabetology - Mitochondrial ultrastructural pathology in diabetic cardiomyopathy: integrated analysis via scanning electron microscopy and 3D visualization imaging

Mitochondrial dysfunction is a key contributor to cardiac impairment in diabetes. A study published in Cardiovascular Diabetology aimed to characterise alterations in mitochondrial ultrastructure (shape, size, cristae integrity), mitochondrial dynamics, and energy‑metabolism impairments in diabetic cardiomyopathy (DCM). 

The research used both high-glucose-treated cardiomyocyte models (H9c2 cells) and DCM model mice. Scanning electron microscopy (SEM) and 3D reconstructions quantified mitochondrial length, surface roughness, cristae structure, and mitochondria-associated membrane (MAM) contacts. Molecular analyses measured fusion and fission proteins, mitophagy markers, mitochondrial DNA copy number, ATP content, membrane potential, and respiratory chain complex activity.

The study showed that mitochondria in DCM hearts were fragmented, and showed disrupted cristae and increased MAM contacts. This was accompanied by a lower DNA copy number, reduced ATP production, decreased membrane potential, impaired respiratory chain activity, and elevated oxidative stress. Molecular analysis revealed decreased expression of fusion proteins whereas the fission protein p-Drp1^ser616 and autophagy markers PINK1 and Parkin were significantly increased. The authors conclude that ultrastructural remodelling, molecular dysregulation, and bioenergetic failure together form a ‘3D morphology - molecular regulation - metabolic dysfunction’ cascade driving DCM progression.

BMC Endocrine Disorders - Recurrent education: A promising strategy for enhancing diabetes management and reducing hypoglycemia in children with type 1 diabetes

Recurrent individualized education may play a key role in improving diabetes management among children and adolescents with type 1 diabetes (T1D). A study published in BMC Endocrine Disorders by Güneş Kaya and colleagues explored how repeated educational sessions could reduce hypoglycemia unawareness - particularly in those with impaired hypoglycemia awareness (IHA) - and improve overall metabolic control.

In this prospective study, 47 participants aged 8-18 years with T1D were recruited. Three weekly educational sessions covered the hypoglycemia treatment algorithm, symptom recognition, insulin therapy, hyperglycemia, carbohydrate use, glucose monitoring, the exercise- hypoglycemia relationship, and prevention strategies. Continuous glucose monitoring and questionnaire assessments were repeated six weeks after the sessions.

Results showed significant improvements after education, including increased time in range (TIR), better hypoglycemia awareness and self-treatment, reduced hypoglycemia duration, and improved hypoglycemia fear scores. The authors concluded that recurrent diabetes education can enhance glycaemic outcomes and self-management in young people with T1D, supporting its use to reduce severe hypoglycemic events.

Cardiovascular Diabetology - Improving 10-year cardiovascular risk prediction in patients with type 2 diabetes with metabolomics

Cardiovascular disease is a leading cause of mortality in type 2 diabetes in Europe. A study published in Cardiovascular Diabetology by Schöttker and colleagues evaluated whether adding metabolomic biomarkers could improve 10-year prediction of major adverse cardiovascular events (MACE) in adults with type 2 diabetes.

The research used data from the UK Biobank (n = 10,257) and the German ESTHER study (n = 1,039). They measured 249 metabolites using Nuclear Magnetic Resonance (NMR) spectroscopy in blood samples and used sex-specific LASSO regression with bootstrapping to select the metabolites most strongly predictive of MACE.

Seven metabolites were selected as adding predictive value to the baseline model. Key contributors included albumin and omega-3 fatty acids for males and lactate for females. Integration of these metabolites improved the model’s predictive performance. In internal validation with the UK Biobank, the C-index increased from 0.660 to 0.678 (P = 0.037), while in external validation with ESTHER, the increase was +0.043 (P = 0.011). 

The authors conclude that adding these metabolomic biomarkers can enhance an established MACE prediction model for patients with type 2 diabetes and that NMR metabolomics may have potential for clinical translation in cardiovascular routine risk assessment.

BMC Endocrine Disorders - Age at type 1 diabetes onset does not influence attained brain volume

A study conducted in Finland by Thorn and colleagues and published in BMC Endocrine Disorders investigated whether the age at which a person develops Type 1 diabetes is associated with their attained brain volume in adulthood. 

Adult participants with Type 1 diabetes were recruited from the nationwide Finnish Diabetic Nephropathy (FinnDiane) Study. About two-thirds of the 180 participants had been diagnosed before turning 18. Participants underwent MRI scans to measure their intracranial volume. For gray and white matter analyses, 113 participants were included. They applied fractional polynomial regression to examine the impact of age at disease onset. Models included covariates such as sex, age, height, HbA1c.

The study found that the range of age at diabetes onset was 1.2–39.0 years. There was no statistically significant association between age at T1D onset and intracranial volume (p = 0.85), cerebral white (p = 0.10), and gray matter volumes (p = 0.12). These findings suggest that the age of onset does not appear to influence overall brain growth in a significant way.

Cardiovascular Diabetology - Evaluation of glycemic status and subclinical atherosclerosis in familial hypercholesterolemia subjects with or without LDL receptor mutation

Familial hypercholesterolemia (FH) is a genetic condition characterised by elevated LDL-C levels. A recent study published in Cardiovascular Diabetology by Piro and colleagues examined the impact of genotype on glycemic status and on atherosclerotic injury in FH subjects.

The study involved a cross-sectional analysis of 322 adults (ages 18–70) with a clinical diagnosis of FH, who were not on lipid-lowering therapy and had no prior cardiovascular disease. Participants were classified into two groups according to genotype: LDL receptor (LDLR) group and non-LDLR (NLDLR) group.

The results showed that among people with FH, subjects with NLDLR mutations exhibited a worse glycaemic profile than those in the LDLR group, while subjects with null LDLR mutations had the strongest inverse association with high glycaemic status. Overall, the study highlights that the genetic background of FH influences both metabolic profile and the atherosclerosis distribution, underscoring the importance of combining genetic, lipid, and glucose data.