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Diabetes and its complications: molecular mechanisms, prevention and treatment
Lijun Zhao, Jiamin Yuan, Qing Yang, Jing Ma, Fenghao Yang, Yutong Zou, Ke Liu, Fang Liu. Signal Transduction and Targeted Therapy, 2026-01-19
Topic: Risk, prevention and care in population studies
Diabetic complications represent a formidable clinical challenge characterized by hyperglycemia-induced multiorgan dysfunction and dysregulated intercellular signaling networks. Advances in spatial multiomics and single-cell transcriptomic techniques, along with insights into aberrant signaling via myokines, cytokines, hormones, the gut microbiota, and exosomes, have revealed the molecular heterogeneity and dynamic inter-organ crosstalk underlying diabetes. Digital diabetes prevention programs have demonstrated effectiveness in high-risk populations through the use of remote tools to support lifestyle changes, reduce hemoglobin A1c, and delay the onset of type 2 diabetes. The therapeutic landscape for diabetic complications has been reshaped by agents with proven cardiorenal benefits, including sodium‒glucose cotransporter 2 inhibitors, glucagon‒like peptide-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists, with combination therapies offering potential additive or synergistic effects. However, their optimal application requires careful benefit-risk assessment across diverse patient populations. Novel therapeutic strategies involving mesenchymal stem cells and their derived exosomes, gut microbiota modulation, bioactive compounds from traditional Chinese medicine, and AI-assisted disease management systems offer promising approaches to correct molecular dysfunctions. This review summarizes recent advances in the mechanisms, prevention, and treatment of diabetic complications, alongside a critical examination of current bottlenecks in translational applications. The remaining challenges include establishing long-term safe regenerative therapies and effectively integrating AI into clinical workflows. Although AI shows promise, issues such as limited data diversity and low model interpretability hinder its generalizability and clinical trust. Addressing these challenges will be essential for transitioning toward a proactive, personalized, and patient-centered model of care.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Zhao, L., Yuan, J., Yang, Q., Ma, J., Yang, F., Zou, Y., et al. (2026). Diabetes and its complications: molecular mechanisms, prevention and treatment. Signal Transduction and Targeted Therapy. https://doi.org/10.1038/s41392-025-02401-w
Vancouver
Zhao L, Yuan J, Yang Q, Ma J, Yang F, Zou Y, et al. Diabetes and its complications: molecular mechanisms, prevention and treatment. Signal Transduction and Targeted Therapy. 2026. doi:10.1038/s41392-025-02401-w. PMID: 41549124.
BibTeX
@article{zhao2026-41549124,
author = {Zhao, Lijun and Yuan, Jiamin and Yang, Qing and Ma, Jing and Yang, Fenghao and Zou, Yutong and Liu, Ke and Liu, Fang},
title = {{Diabetes and its complications: molecular mechanisms, prevention and treatment}},
journal = {Signal Transduction and Targeted Therapy},
year = {2026},
doi = {10.1038/s41392-025-02401-w},
pmid = {41549124},
url = {https://doi.org/10.1038/s41392-025-02401-w}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Advances in spatial multiomics and single-cell transcriptomic techniques, along with insights into aberrant signaling via myokines, cytokines, hormones, the gut microbiota, and exosomes, have revealed the molecular heterogeneity and dynamic inter-organ crosstalk underlying diabetes.
- Digital diabetes prevention programs have demonstrated effectiveness in high-risk populations through the use of remote tools to support lifestyle changes, reduce hemoglobin A1c, and delay the onset of type 2 diabetes.
Why it matters
This review is about diabetes and its complications, not Alzheimer's disease. It reports that digital diabetes prevention programs can support lifestyle change and delay type 2 diabetes, and that certain diabetes drugs have proven heart and kidney benefits.
New to this subject? Start with our plain-English guide: Prevention →
Study details
- Evidence strengthLow
How this study scored 51/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 49 of the 96 points we could judge it on, which is 51 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Signal Transduction and Targeted Therapy) |
| Journal's citation record | 3 / 4 | Signal Transduction and Targeted Therapy: journal h-index 289 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 74 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 37.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 6 / 6 | Cited 347.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 74 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Fang Liu holds only 1 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | Sichuan University: institution h-index 720 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41549124) |
| Free to read | 2 / 2 | Free to read |
| Points | 49 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 49 of the 96 points we could judge it on is 51 out of 100. |
| Total | 51 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1038/s41392-025-02401-w
- PubMed: 41549124
- Original source →
- Free full text: Signal Transduction and Targeted Therapy →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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