Welcome to the latest episode (October 2026) of DOC Updates, where every month Neil Skolnik, MD and John Russell, MD review the most important articles on diabetes, obesity, and cardiometabolic disease. This month on DOC Updates: Zoungas et al; Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults. New England Journal of Medicine, 28 August […]
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Islet-Targeted ZnT8 Antibodies Protect Pancreatic β-Cells From Inflammatory Stress
β-Cell maladaptive unfolded protein response is a shared pathogenic feature of type 1 and type 2 diabetes, yet therapeutic strategies that selectively restore β-cell proteostasis remain limited. Zinc transporter 8 (ZnT8) is an islet-restricted endoplasmic reticulum (ER)–resident membrane protein whose folding burden is amplified under inflammatory stress. Here, we show that cell surface–directed ZnT8 antibodies […]
Read MoreGIP Acutely Blunts Insulin- and GLP-1–Induced Muscle Microvascular Perfusion
Glucose-dependent insulinotropic polypeptide (GIP) promotes nutrient storage, but its vascular actions in skeletal muscle remain unclear. To determine whether GIP regulates muscle microvascular perfusion, a key determinant of substrate use, we examined GIP receptor (GIPR) expression in vascular endothelium and assessed GIP effects in vivo in chow-fed and high-fat diet (HFD)–fed rats. Overnight-fasted rats received 120-min […]
Read MoreSIRT6 Deficiency Impairs Endothelial Integrity to Exacerbate Diabetic Atherosclerosis via Inhibiting Deacetylation-Dependent ZEB1 Degradation
Endothelial dysfunction contributes to the pathogenesis and progression of diabetes and atherosclerotic cardiovascular diseases (ASCVDs) with sirtuin-6 (SIRT6) downregulation in vascular endothelial cells (ECs). Here, the effects and underlying mechanisms of SIRT6 as a deacetylase were investigated in maintaining EC integrity against diabetes-exacerbated atherogenesis. SIRT6 downregulation was exacerbated in carotid artery ECs of Apoe−/− mice […]
Read MoreDual Modulation of Prostaglandin E 2 Receptors EP3 and EP4 Protects β-Cell Mass in a Model of Aggressive Autoimmune Inflammation
Type 1 diabetes is driven by both β-cell dysfunction and an autoreactive immune system, resulting in β-cell destruction and hyperglycemia. We previously showed that pharmacological modulation of prostaglandin E2 (PGE2) receptor (EP) signaling protects β-cells from cytokine-mediated death ex vivo and relieves oxidative stress and maintains β-cell identity in a mouse model of type 2 […]
Read MoreMyeloid-Specific Heparanase Aggravates Insulitis in Type 1 Diabetes via Heparan Sulfate Fragment-Dependent Amplification of Macrophage Polarization
The intraislet heparan sulfate (HS) barrier is essential for β-cell survival, yet its role in type 1 diabetes (T1D) remains incompletely understood. We investigated the expression pattern, pathogenic function, and therapeutic potential of the heparanase (HPSE)-HS axis in T1D by integrating single-cell RNA sequencing data sets from human and mouse islets and peripheral immune cells, […]
Read MoreA Selective Cullin 3 RING E3 Ligase Inhibitor Attenuates Hyperglycemia via Dual Insulin Sensitizing and Insulinotropic Action
Hyperglycemia is a hallmark of type 2 diabetes and a key pathogenic driver of diabetes complications. Cullin RING E3 ligases (CRLs) are multisubunit E3 ubiquitin ligases that mediate cellular protein turnover. The activity of CRLs requires cullin neddylation, a posttranslational modification that can be pharmacologically targeted with therapeutic potentials. By using hyperinsulinemic-euglycemic clamp analysis, we […]
Read MoreMetabolic Blockade of Glycolysis Diminishes Autoreactive CD4 T-Cell Effector Responses in Type 1 Diabetes
Proinflammatory T helper 1 (Th1) CD4 T cells orchestrate β-cell destruction in type 1 diabetes (T1D) by using glycolysis for effector responses. By targeting T-cell metabolism, we may identify novel mechanisms and therapies to effectively delay T cell–mediated autoimmune diseases like T1D. We hypothesized that treatment of prediabetic mice with the glycolysis inhibitor, 2-deoxyglucose (2-DG), […]
Read MoreAdipose Tissue Palmitoylation Cycling Mediates Insulin Resistance and Preservation of β-Cell Function in Mice
Excess adiposity is associated with insulin resistance and pancreatic β-cell dysfunction. We show that palmitoylation cycling in white adipose tissue (WAT) balances insulin sensitivity and insulin secretion. WAT and brown adipose tissue (BAT) ablation of acyl-protein thioesterase 1 (APT1) in APT1-deficient (knockout) mice (APT1-AdipoKO) resulted in increased body weight and exacerbated insulin resistance when the […]
Read MoreThe Intersection of Immunosenescence, Cellular Senescence, and Type 1 Diabetes: Paving the Way for Future Interventions
Immunosenescence, characterized by functional decline and altered phenotypes of immune cells with age, can disturb immune tolerance and promote autoreactive responses. Type 1 diabetes (T1D) has traditionally been viewed as a disease of immune dysregulation that leads to the autoimmune destruction of pancreatic β-cells. Emerging evidence suggests that senescence contributes to both the onset and […]
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