Diabetes & Metabolism Journal

Reviews

Basic and Translational Research
Redefining β-Cell Function in Type 2 Diabetes Mellitus: From Comprehensive Assessment to Precision Medicine: YongKyung Kim, Joon Ha, Jun Sung Moon; Diabetes Metab J. 2026;50(2):235-252. Published online March 1, 2026; DOI: https://doi.org/10.4093/dmj.2026.0034

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The global surge in type 2 diabetes mellitus (T2DM) requires a thorough understanding of pancreatic β-cell dysfunction, which remains a central determinant of the disease. However, the evaluation of β-cell insulin secretory capacity is often challenging in clinical practice due to its inherent complexity. This review presents a comprehensive technical overview of diverse assessment methodologies, ranging from conventional fasting-based indices and glucose tolerance tests to advanced mathematical modeling and artificial intelligence-driven approaches. A detailed examination of the methodological strengths and limitations of these various tools is provided to guide their appropriate clinical application. Furthermore, we explore the clinical implications of these assessments in enhancing diagnostic accuracy and tailoring therapeutic strategies. Particular emphasis is placed on the pivotal role of β-cell function evaluation in predicting and achieving diabetes remission—an emerging clinical priority. By integrating the technical landscape of β-cell assessment with practical applications, this review provide a structured framework for optimizing T2DM management and improving long-term patient outcomes.

Citations

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Beyond Glycemic Control: Real-World 12-Month Effects of Insulin Glargine/Lixisenatide on Weight, Endogenous Insulin Secretion, and Albuminuria
Sadettin Ozturk, Elif Melis Baloğlu Akyol
Journal of Clinical Medicine.2026; 15(13): 5049. CrossRef
Short-Term Intensive Insulin Therapy as a Remission Induction Strategy in Newly Diagnosed Type 2 Diabetes Mellitus: A Systematic Review
Tahira Nasreen, Noor ul huda Awan, Mohammad Uzair, Sunita Kumawat, FNU Vanshika, Esha Sharma, Daniel E Cook, Ghazanfar Ali, Ahmad Sattar
Cureus.2026;[Epub] CrossRef

Complications
Clinical Phenotypes of Diabetic Peripheral Neuropathy: Implications for Phenotypic-Based Therapeutics Strategies: Jie-Eun Lee, Jong Chul Won; Diabetes Metab J. 2025;49(4):542-564. Published online July 1, 2025; DOI: https://doi.org/10.4093/dmj.2025.0299

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Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus that encompasses a heterogeneous group of conditions with diverse clinical manifestations. Despite its prevalence, no universally established classification or treatment approach is currently available. Recent findings have underscored the role of systemic inflammation, oxidative stress, and neurochemical imbalances in shaping DPN phenotypes, emphasizing the need for phenotype-specific diagnostic and therapeutic approaches. Advanced diagnostic techniques, including magnetic resonance imaging-based neuroimaging and quantitative sensory testing, are emerging as tools for phenotypic characterization. Therapeutic interventions are moving toward precision medicine, with targeted pharmacological and non-pharmacological strategies tailored to specific clinical presentations. Innovations such as digital health platforms, regenerative therapies, and combinatorial pharmacotherapy are promising for addressing primary neuropathic pain and its associated complications. This review synthesizes the current evidence on DPN phenotypes (painful, painless, and mixed forms), their underlying pathophysiological mechanisms, and the efficacy of treatment approaches. A framework for optimizing management strategies is also proposed. By leveraging novel insights into sensory phenotypes and treatment responsiveness, clinicians can adopt DPN phenotype-based treatment models to optimize patient care, improve treatment outcomes, reduce the substantial disease burden, and enhance patient quality of life.

Citations

Citations to this article as recorded by

Why are we still missing the pain? Rethinking diabetic neuropathy in primary care – lessons from the REGENERAR study
Antonio Alcántara Montero
Future Science OA.2026;[Epub] CrossRef
Plasma Mucin-1 as a Potential Biomarker for Diabetic Peripheral Neuropathy in Type 2 Diabetes
Jae-Hyung Park, Thi Nhi Nguyen, Hye Min Shim, Gyeong Im Yu, Junho Kang, Eun Yeong Ha, Hochan Cho
Biomolecules.2026; 16(1): 128. CrossRef
The association between Apolipoprotein A1, Apolipoprotein B and their ratio with diabetes‐related neuropathy in elderly patients
Iskandar R. Budianto, Ervina Gosal, Tena Djuartina, Alfred Sutrisno
Diabetic Medicine.2026;[Epub] CrossRef
Microglial activation in diabetic neuropathic pain: Molecular trigger mechanisms, neuroimmune crosstalk, and emerging therapeutic targets
Jilin Wang, Huamao Zhou
Neuropeptides.2026; 117: 102612. CrossRef
Arterial stenosis and electrophysiological nerve dysfunction in type 2 diabetes: clinical evidence from GEE models and transcriptomic pathway analysis
Xiu-qin Zhao, Lei-jun Huang, Kai Yao, Wei-chen Zeng, Heng-bing Zu, Jun-feng Wu, Jian-feng Zhang
Frontiers in Endocrinology.2026;[Epub] CrossRef
Preclinical Evidence of Extracellular Vesicle-derived MicroRNAs in Relieving Diabetic Peripheral Neuropathy: A Systematic Review
Amir Reza Ghafourian, Atefeh Soltan Mohseni, Reyhaneh Ghasemi, Maryam Davoudi, Hamid Choobineh, Sheila Jafari, Fariba Nabatchian, Reza Afrisham
Journal of Molecular Neuroscience.2026;[Epub] CrossRef
Association between physical activity and peripheral neuropathy among patients with diabetes mellitus: A cross-sectional study
Raed AlRuwaili, Rakan Nasser Abdullah Alruwaili, Aljawharah Mohammad H. Alshammari, Norah Khalid M. Alanazi, Yusra R. Alruwaili, Mozon H. Alenzi, Bushra Aied H. Alenezi, Kadi Fahad Alfehaid, Baraah Abu Alsel, Safya E. Esmaeel, Shereen Mohamed Olama, Eslam
Orthopedic Reviews.2026;[Epub] CrossRef
Identification of Gene Variations Associated with Diabetic Neuropathy Using Bioinformatics Approach
Siti Fatimah Sultan, Adisti Putri Novriyanti, Siti Rohmah, Lalu Muhammad Irham, Nanik Sulistyani, Muhammad Ma'ruf
Borneo Journal of Pharmacy.2026; 9(1): 48. CrossRef
From pathophysiology to therapy: molecular mechanisms of stem cell and extracellular vesicle-mediated repair in diabetic peripheral neuropathy
Jiayi Zhou, Yang Yu, Liuchang Song, Peipei Qian, Mengni Zhao, Fei Ding, Xuegan Lian, Miaomei Yu
Frontiers in Cell and Developmental Biology.2026;[Epub] CrossRef
Quality of life in older adults with diabetic peripheral neuropathy: International Classification of Functioning, Disability and Health (ICF) framework
Oktaviani Fitriyah, Dwi Rosella Komalasari, Umi Budi Rahayu
Fisioterapia em Movimento.2026;[Epub] CrossRef
Mechanistic Insights into Diabetic Neuropathy: Oxidative Stress, Mitochondrial Injury, and Translational Therapeutics
Muzafar Ahmad Mir, Showkat ul Nabi, Rakeeb Ahmad Mir, Sofi Imtiyaz Ali, Irfan Ahmed Noorani, Shabista Muzaffar, Ibraq Khurshid
SN Comprehensive Clinical Medicine.2026;[Epub] CrossRef
Restless legs syndrome or diabetic peripheral neuropathy: diagnostic dilemmas and clinical insights from a case report
Yongwen Zhang, Xiaoxi Nan, Lanfang Chu
Frontiers in Endocrinology.2026;[Epub] CrossRef
Targeting the gut microbiota: emerging strategies to enhance healing of diabetic foot ulcers
Zheyan Chen, Wen Wu, Yijie Chen, Feifei Li, Xiaona Xie, Yue Lin, Xueliang Zhang, Qian Ye
Frontiers in Endocrinology.2026;[Epub] CrossRef
Pain and Neuropathic Manifestations as Clinical Predictors of Infection, Osteomyelitis, and Lower-Limb Amputation in Patients with Diabetic Foot Ulcers: A Case-Control Study
Dr.Nitin S. Nagane, Dr. Shaheen B. Shaikh, Dr.M.S.Moosabba, Dr.Haji Mohammed Ismail
PAIN, JOINTS, SPINE.2026; 16(4S): 916. CrossRef
Neuromodulation therapies for diabetic neuropathy: mechanisms, efficacy, and impacts on nerve health: a narrative review
Ethan M. Larson, Brian D. Dalm, Kristy L. Townsend
Frontiers in Neurology.2026;[Epub] CrossRef
Oral, intravenous, or sequential alpha-lipoic acid for diabetic peripheral neuropathy? A Bayesian network meta-analysis of randomized controlled trials
Jinshui Shen, YuJing Zheng, MiaoMiao Yu, Xu Wang
Frontiers in Neurology.2026;[Epub] CrossRef
Press needle combined with plum blossom needle improves diabetic peripheral neuropathy by inhibiting pro-inflammatory cytokines: a randomized controlled trial
Yongwen Zhang, Xiaoxi Nan, Lanfang Chu
Frontiers in Endocrinology.2026;[Epub] CrossRef
Longitudinal clinical trajectories and vascular–inflammatory–neurophysiological associations in diabetic peripheral neuropathy: an exploratory analysis of a TENS-treated cohort
Qian Gao, Liwan Yang, Bin Wang, Lijuan Gao, Qing Yao, Jiangwei Hu
Frontiers in Endocrinology.2026;[Epub] CrossRef
The role of brain mechanisms in diabetic peripheral neuropathy: recent advances and comprehensive analysis
Min Wei, Ye Jiang, Jiayin Shou, Guogang Xing, Min Li
Frontiers in Cellular Neuroscience.2025;[Epub] CrossRef
On a Phenotypic Approach to Diabetic Peripheral Neuropathy (Diabetes Metab J 2025;49:542-64)
Antonio Alcántara Montero
Diabetes & Metabolism Journal.2025; 49(6): 1349. CrossRef
Effects of CXCR1/2 Blockade with Ladarixin on Streptozotocin-Induced Type 1 Diabetes Mellitus and Peripheral Neuropathy and Retinopathy in Rat (Diabetes Metab J 2025;49:990-1005)
Heung Yong Jin
Diabetes & Metabolism Journal.2025; 49(6): 1351. CrossRef
Clinical Phenotypes of Diabetic Peripheral Neuropathy: Implications for Phenotypic-Based Therapeutics Strategies (Diabetes Metab J 2025;49:542-64)
Jie-Eun Lee, Jong Chul Won
Diabetes & Metabolism Journal.2025; 49(6): 1354. CrossRef
Precision approach to diabetic peripheral neuropathy: modified nerve decompression surgery and MNGF treatment
Yanji Zhang, Hehua Song, Yang Jian, Silang Cai, Chengliang Deng, Zairong Wei
Frontiers in Medicine.2025;[Epub] CrossRef
Apolipoprotein E genotypes are associated with diabetic peripheral neuropathy in Lebanese adults with type 2 diabetes: a case-control study
Rita Nemr, Sabrina Zidi, Akram Echtay, Eddie Racoubian, Nisrine Beydoun, Wassim Y. Almawi
Frontiers in Endocrinology.2025;[Epub] CrossRef
Neuroinflammation-Based Novel Biomarkers for Early Detection of Diabetic Neuropathy
Jee Hee Yoon, Ho-Cheol Kang
The Journal of Korean Diabetes.2025; 26(4): 222. CrossRef

Others
Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients: Jae-Seung Yun, Kyuho Kim, Yu-Bae Ahn, Kyungdo Han, Seung-Hyun Ko; Diabetes Metab J. 2024;48(4):531-545. Published online July 26, 2024; DOI: https://doi.org/10.4093/dmj.2024.0310

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Abstract PDF PubReader ePub

Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.

Citations

Citations to this article as recorded by

Reproductive Lifespan and Reproductive Factors in Relation to Dementia Risk in Postmenopausal Women With Type 2 Diabetes
Jin Yu, Jae-Hyoung Cho, Kyungdo Han, Yong-Moon Mark Park, Seung-Hwan Lee
Diabetes Care.2026; 49(2): 292. CrossRef
Knowledge, perceptions and attitudes toward diabetes care in oncology: a pilot survey across specialties (DiaLog Study)
Guler Nur Tekustun, Besra Hazal Yesil-Gurel, Sait Kitapli, Ali Alkan, Ozgur Tanriverdi
Endocrine.2026;[Epub] CrossRef
Managing Bone Fragility in Older Adults with Diabetes: Pathophysiology, Assessment, and Therapeutic Considerations
Gulistan Bahat, Tugba Erdogan, Savas Ozturk, Ozlem Soyluk Selcukbiricik, Serdar Ozkok, Dilek Gogas Yavuz, Mehmet Akif Karan, Jean-Yves Reginster
Drugs & Aging.2026; 43(4): 341. CrossRef
City- and county-level gaps in diabetes mortality improvement in the southeastern coastal region of China from 2005 to 2020, with provincial-level projections to 2030
Xiuquan Lin, Chenglin Yang, Yuying Chen, Shaofen Huang, Yanrong Yin, Wenling Zhong, Weimin Ye
Frontiers in Public Health.2026;[Epub] CrossRef
Impact of mixed reality on the care of the elderly: a scoping review
Fátima Avilés-Castillo, Jorge Buele, Guillermo Palacios-Navarro
GeroScience.2026;[Epub] CrossRef
Telehealth effectiveness for glycaemic control of older adults with Type 2 diabetes: An integrative review
Gabriel Boateng, Bosun-Arije Stella Foluke
Diabetes Research and Clinical Practice.2026; 239: 113447. CrossRef
Nursing interventions for foot health and self-management in frail older adults with diabetes: A narrative review
Meryem Kılıç, Döndü Bilici
Geriatric Nursing.2026; 73: 104276. CrossRef
Association between cumulative biological risk and hypertension in older adults in Korea: a population-based cross-sectional study
Hyemin Hwang, Kyeongmin Jang
Journal of Korean Biological Nursing Science.2026; 28(3): 377. CrossRef
Diabetes Fact Sheets in Korea 2024
Se Eun Park, Seung-Hyun Ko, Ji Yoon Kim, Kyuho Kim, Joon Ho Moon, Nam Hoon Kim, Kyung Do Han, Sung Hee Choi, Bong Soo Cha
Diabetes & Metabolism Journal.2025; 49(1): 24. CrossRef
The effect of multidisciplinary team and experience-based co-design on the care of older adult patients with type 2 diabetes: A randomized controlled trial
Yujun Zhuang, Hongjiang Ye, Xiaoyan Yang, Lifang Zheng, Zhizhen Chen, Jianjia Jiang, Lunpan Mou, Pingping Li, Jiawei Qin, Yaduan Dai, Yanling Mao
Diabetes Research and Clinical Practice.2025; 221: 112028. CrossRef
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef
Preventing End-Stage Kidney Disease in Older Adults with Type 2 Diabetes Mellitus: Optimal Blood Pressure Targets
Jae-Seung Yun, Seung-Hyun Ko
Diabetes & Metabolism Journal.2025; 49(6): 1198. CrossRef
Optimizing Physical Activity Strategies for Older Adults with Diabetes
Hyeon-Jin Yu, Doyoun Hong, Kyuho Kim, Ji Hye Heo, Dong-Hyeok Cho, Yoshitaka Hashimoto, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(6): 1178. CrossRef
The Relationship Between Diabetes Burden and Frailty in Older Adults with Diabetes
Tuğçe Türten Kaymaz, Ezgi Mutluay Yayla, Hanife Efsane Demiröz
Global Nursing Insights.2025; 12(3): 257. CrossRef
The burden of atherosclerotic cardiovascular disease in an aging population: A comprehensive review of risk factors, risk assessment, and prevention
Witold Żurański, Mariusz Gąsior, Bartosz Hudzik
Annales Academiae Medicae Silesiensis.2025; 79: 404. CrossRef
MODERN TECHNOLOGIES IN MONITORING AND TREATING TYPE 2 DIABETES IN THE ELDERLY
Elżbieta Stec-Sawina, Agnieszka Sawina, Sara Rakotoarison, Jakub Fiegler-Rudol, Karolina Lau, Janusz Kasperczyk
Health Problems of Civilization.2025;[Epub] CrossRef

Sulwon Lecture 2022

Others
Opening the Precision Diabetes Care through Digital Healthcare: Joonyub Lee, Jin Yu, Kun-Ho Yoon; Diabetes Metab J. 2023;47(3):307-314. Published online March 29, 2023; DOI: https://doi.org/10.4093/dmj.2022.0386

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The national healthcare systems of every country in the world cannot sustain the rise in healthcare expenditure caused by chronic diseases and their complications. To sustain the national healthcare system, a novel system should be developed to improve the quality of care and minimize healthcare costs. For 20 years, our team developed patient-communicating digital healthcare platforms and proved their efficacy. National scale randomized control trials are underway to systematically measure the efficacy and economic benefits of this digital health care system. Precision medicine aims to maximize effectiveness of disease management by considering individual variability. Digital health technologies enable precision medicine at a reasonable cost that was not available before. The government launched the “National Integrated Bio-big Data Project” which will collect diverse health data from the participants. Individuals will share their health information to physicians or researchers at their will by gateway named “My-Healthway.’ Taken together, now we stand in front of the evolution of medical care, so-called “Precision medicine.” led by various kinds of technologies and a huge amount of health information exchange. We should lead these new trends as pioneers, not as followers, to establish and implement the best care for our patients that can help them to withstand their devastating diseases.

Citations

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Federated multimodal AI for precision-equitable diabetes care
Bing Bai, Xilin Liu, Hong Li
Frontiers in Digital Health.2026;[Epub] CrossRef
β‐cell recovery revisited: Is prediabetes remission driven by insulin sensitivity or β‐cell function?
Joonyub Lee, Kun‐Ho Yoon
Journal of Diabetes Investigation.2026; 17(5): 716. CrossRef
AI digital-twin ecosystem translating gut-microbiome–neuroimmune signals into precision sleep–mood interventions
Xue Yu, Ling Fan, Shiqing Fan, Hong Li
Frontiers in Psychiatry.2026;[Epub] CrossRef
Data, Process, and Data-Driven Representations of Digital Twins in Diabetes: Scoping Review (Preprint)
Beyza Cinar, Louisa van den Boom, Maria Maleshkova
JMIR Diabetes.2026;[Epub] CrossRef
Social determinants of health and type 2 diabetes in Asia
Kyunghun Sung, Seung‐Hwan Lee
Journal of Diabetes Investigation.2025; 16(6): 971. CrossRef
Digital health: current applications, challenges, and future directions for enhancing healthcare quality and safety
Saidi Hu, Danyang Song, Siran Wan, Shunhong Zhang, Chenchen Luo, Nian Li, Guangyue Liu, Jailson da Graça Espírito Santo Vasconcelos, Leonilde Lavres Ceita de Carvalho, Eveline Neobísi, Monazeri Lima Bragança da Costa, José Etchu Takounjou, Karem Maimite D
Frontiers in Public Health.2025;[Epub] CrossRef
A New Era in Islet Transplantation: Stem Cell-Derived and Gene-Edited Islet Therapies
Joonyub Lee, Seung-Hwan Lee
Diabetes & Metabolism Journal.2025; 49(6): 1201. CrossRef
Bridging the digital divide: student-led literacy initiatives in diabetes management
Pedro Almeida Moyano, Mohammed Raddaoui, Andrea de Barros Coscelli Ferraz, Gustavo José Martiniano Porfírio, Luciana Aparecida Campos, Ovidiu Constantin Baltatu
Frontiers in Clinical Diabetes and Healthcare.2025;[Epub] CrossRef
Technological Innovations Transforming Diabetes Care in Practice
Shinae Kang
The Journal of Korean Diabetes.2024; 25(2): 57. CrossRef
Islet transplantation in Korea
Joonyub Lee, Kun‐Ho Yoon
Journal of Diabetes Investigation.2024; 15(9): 1165. CrossRef

Review

Metabolic Risk/Epidemiology
Nonalcoholic Fatty Liver Disease: A Drug Revolution Is Coming: Soung Won Jeong; Diabetes Metab J. 2020;44(5):640-657. Published online October 21, 2020; DOI: https://doi.org/10.4093/dmj.2020.0115

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The worldwide prevalence of non-alcoholic fatty liver disease is around 25%, and that of nonalcoholic steatohepatitis (NASH) ranges from 1.5% to 6.45%. Patients with NASH, especially those with fibrosis, are at higher risk for adverse outcomes such as cirrhosis and liver-related mortality. Although vitamin E, pioglitazone, and liraglutide improved liver histology in randomized trials, there are currently no Food and Drug Administration-approved drugs for NASH. Five pharmacologic agents—obeticholic acid, elafibranor, cenicriviroc, resmetirom, and aramchol—are being evaluated in large, histology-based phase 3 trials. Within 2 to 4 years, new and effective drugs for the treatment of NASH are expected. Additionally, many phase 2 trials are ongoing for various agents. Based on the results of phase 2 and 3 trials, combination treatments are also being investigated. Future treatment strategies will comprise drug combinations and precision medicine based on the different phenotypes of NASH and treatment response of the individual patient.

Citations

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Next-generation lipid nanoplatforms for phytoconstituent delivery in MASLD management
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Inhibition of 11β-hydroxysteroid dehydrogenase 1 relieves fibrosis through depolarizing of hepatic stellate cell in NASH
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