{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:35:53Z","timestamp":1790807753621,"version":"4.1.0"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) represents a systemic disease that extends beyond metabolic dysfunction to include accelerated neurocognitive decline driven by oxidative stress, inflammation, and insulin resistance. Emerging evidence suggests that essential micronutrients may interact synergistically or antagonistically with biguanides, particularly metformin, to influence neurocognitive function. This systematic review synthesized preclinical and clinical evidence on the interactions between essential micronutrients and biguanides (notably metformin) in modulating neurocognitive outcomes in T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020 guidelines, we systematically searched PubMed, Web of Science, and Scopus for studies published between 2010 and 2025. After screening 226 records in Rayyan, 40 studies met the inclusion criteria. Both preclinical and clinical studies were analyzed descriptively to identify patterns of mechanistic and functional outcomes. Extracted data covered intervention types, doses, duration, biomarkers, and cognitive outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 40 studies, 27 (67.5%) were preclinical and 13 (32.5%) were clinical, spanning 14 countries. Most interventions involved vitamin D, zinc, magnesium, vitamin E, or polyphenols, either alone or combined with metformin. Synergistic effects were observed in 77.5% of studies, with significant improvements in fasting plasma glucose, HbA1c, insulin sensitivity, and oxidative balance. Key molecular pathways involved AMPK, PI3K\/Akt, GSK3\u03b2, and Nrf2\u2013CREB, which mediated enhanced glucose utilization, mitochondrial function, and synaptic plasticity. Antagonistic effects (10%) were mainly linked to metformin-induced vitamin B12 depletion, which impaired neurotrophic signaling and elevated homocysteine levels. Across studies, neuroprotective benefits correlated with increased BDNF, PSD-95, and SIRT1 expression, and reduced IL-6, TNF-\u03b1, and MDA levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most (75%) of the studies showed a synergistic interaction between biguanides (metformin) and micronutrients save a few that showed antagonistic interaction. Integrating micronutrient supplementation particularly vitamin D, zinc, and antioxidant compounds into T2DM management enhances both metabolic control and cognitive function. These findings support a paradigm shift toward combined nutraceutical\u2013pharmacologic therapy within clinical and public health frameworks. Future research should focus on dose optimization, mechanistic validation, and long-term clinical evaluation to develop evidence-based, nutrition-sensitive diabetes care models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1764157","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:40Z","timestamp":1771305520000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Essential micronutrients and biguanides (metformin) synergistic and antagonistic interactions on neurocognitive outcomes in type two diabetes mellitus: a systematic review of preclinical and clinical evidence"],"prefix":"10.3389","volume":"17","author":[{"given":"Herbert Izo","family":"Ninsiima","sequence":"first","affiliation":[{"name":"Departmental of Human Physiology, School of Medicine Kabale University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert E.","family":"Ainamani","sequence":"additional","affiliation":[{"name":"Department of Mental Health, School of Medicine Kabale University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Ayebazibwe","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine Kabale University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Matovu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine Kabale University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ejike Daniel","family":"Eze","sequence":"additional","affiliation":[{"name":"Departmental of Human Physiology, School of Medicine Kabale University","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/ndt\/gfaf177","article-title":"IDF Diabetes Atlas 11th edition 2025: global prevalence and projections for 2050","author":"Duncan","year":"2025","journal-title":"Nephrol Dialysis Transplant"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e2004","DOI":"10.1002\/HSR2.2004","article-title":"Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused","volume":"7","author":"Hossain","year":"2024","journal-title":"Health Sci Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/S13098-025-01759-9","article-title":"Prevalence and impact of microvascular complications in type 2 diabetes mellitus on cognitive impairment and depression: a systematic review and meta-analysis","volume":"17","author":"Satapathy","year":"2025","journal-title":"Diabetol Metab Syndrome"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"402","author":"He","year":"2023","journal-title":"Lancet"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/BIOLOGY12030480","article-title":"Environmental enrichment and metformin improve metabolic functions, hippocampal neuron survival, and hippocampal-dependent memory in high-fat\/high-sucrose diet-induced type 2 diabetic rats","volume":"12","author":"Ismail","year":"2023","journal-title":"Biology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/PH17060783","article-title":"Evaluating the antihyperalgesic potential of sildenafil\u2013metformin combination and its impact on biochemical markers in alloxan-induced diabetic neuropathy in rats","volume":"17","author":"Pus","year":"2024","journal-title":"Pharmaceuticals"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/S11845-024-03634-4","article-title":"Vitamin B12 deficiency in diabetic patients treated with metformin: A narrative review","volume":"193","author":"Al Zoubi","year":"2024","journal-title":"Irish J Med Sci (1971 -)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"E37291","DOI":"10.1097\/MD.0000000000037291","article-title":"Determinants of Vitamin D deficiency among type 2 diabetes mellitus patients: A retrospective study","volume":"103","author":"Alzahrani","year":"2024","journal-title":"Med (United States)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2025.127733","article-title":"Type 2 diabetes mellitus and zinc dysregulation: From basic and epidemiological evidence to interventions","volume":"91","author":"Martinez-Morata","year":"2025","journal-title":"J Trace Elements Med Biol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/nu12020491","article-title":"Vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low- and middle-income countries: A systematic review and meta-analysis","volume":"12","author":"Oh","year":"2020","journal-title":"Nutrients"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1007\/S11357-025-01670-1","article-title":"Dietary vitamin D intake and 2-year changes in cognitive function in older adults with overweight or obesity and metabolic syndrome","author":"V\u00e1zquez-Lorente","year":"2025","journal-title":"GeroScience"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"29","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS25136904\/S1","article-title":"Environmental enrichment prevents gut dysbiosis progression and enhances glucose metabolism in high-fat diet-induced obese mice","volume":"25","author":"Manzo","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/J.BBREP.2024.101735","article-title":"Attenuation of PI3K\/AKT signaling pathway by Ocimum gratissimum leaf flavonoid-rich extracts in streptozotocin-induced diabetic male rats","volume":"38","author":"Ajiboye","year":"2024","journal-title":"Biochem Biophysics Rep"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1530\/EC-24-0016","article-title":"Changes in metabolic hormones and trace elements in CSF in active smokers indicate oxidative damage to brain cells","volume":"13","author":"Zheng","year":"2024","journal-title":"Endocrine Connections"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/J.NUMECD.2023.10.012","article-title":"Carnosine supplementation improves glucose control in adults with pre-diabetes and type 2 diabetes: A randomised controlled trial","volume":"34","author":"Hariharan","year":"2024","journal-title":"Nutrition Metab Cardiovasc Dis"},{"key":"B17","doi-asserted-by":"publisher","first-page":"47","DOI":"10.4103\/IJEM.IJEM_414_22","article-title":"Evaluation of effect of montelukast in the model of streptozotocin induced diabetic nephropathy in rats","volume":"28","author":"Kokate","year":"2024","journal-title":"Indian J Endocrinol Metab"},{"key":"B18","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1055\/A-2191-9969","article-title":"Vitamin D alleviates type 2 diabetes mellitus by mitigating oxidative stress-induced pancreatic \u03b2-cell impairment","volume":"131","author":"Liu","year":"2023","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/ANTIOX12061220","article-title":"Liposome-encapsulated berberine alleviates liver injury in type 2 diabetes via promoting AMPK\/mTOR-mediated autophagy and reducing ER stress: morphometric and immunohistochemical scoring","volume":"12","author":"Khater","year":"2023","journal-title":"Antioxidants"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/FNINS.2023.1073924\/BIBTEX","article-title":"Large vessel occlusion stroke outcomes in diabetic vs. non-diabetic patients with acute stress hyperglycemia","volume":"17","author":"Duan","year":"2023","journal-title":"Front Neurosci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/FNUT.2022.1019562","article-title":"Resveratrol regulates insulin resistance to improve the glycolytic pathway by activating SIRT2 in PCOS granulosa cells","volume":"9","author":"Liang","year":"2023","journal-title":"Front Nutr"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/FPHAR.2023.1194809\/BIBTEX","article-title":"Green synthesis of silver nanoparticles from plant Fagonia cretica and evaluating its anti-diabetic activity through indepth in-vitro and in-vivo analysis","volume":"14","author":"Khan","year":"2023","journal-title":"Front Pharmacol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/J.BIOPHA.2018.10.070","article-title":"Ascorbic acid therapy: A potential strategy against comorbid depression-like behavior in streptozotocin-nicotinamide-induced diabetic rats","volume":"109","author":"Shivavedi","year":"2019","journal-title":"Biomedicine Pharmacotherapy"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1177\/1074248416653831","article-title":"Beneficial effects of magnesium treatment on heart rate variability and cardiac ventricular function in diabetic rats","volume":"22","author":"Amoni","year":"2017","journal-title":"J Cardiovasc Pharmacol Ther"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/aps.2015.167","article-title":"Rutaecarpine ameliorates hyperlipidemia and hyperglycemia in fat-fed, streptozotocin-treated rats via regulating the IRS-1\/PI3K\/Akt and AMPK\/ACC2 signaling pathways","volume":"37","author":"Nie","year":"2016","journal-title":"Acta Pharmacologica Sin"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS232113531","article-title":"Palm oil derived tocotrienol-rich fraction attenuates vascular dementia in type 2 diabetic rats","volume":"23","author":"Shaikh","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/S12011-021-02649-7","article-title":"The effects of zinc sulfate supplementation on serum copeptin, C-reactive protein and metabolic markers in zinc-deficient diabetic patients on hemodialysis: A randomized, double-blind, placebo-controlled trial","volume":"200","author":"Hosseini","year":"2022","journal-title":"Biol Trace element Res"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1016\/J.CRFS.2022.09.001","article-title":"Antidiabetic potential of polysaccharides from Brasenia schreberi regulating insulin signaling pathway and gut microbiota in type 2 diabetic mice","volume":"5","author":"Liu","year":"2022","journal-title":"Curr Res Food Sci"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0172429","article-title":"Oxidative stress and expression of insulin signaling proteins in the brain of diabetic rats: Role of Nigella sativa oil and antidiabetic drugs","volume":"12","author":"Balbaa","year":"2017","journal-title":"PloS One"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS23094771\/S1","article-title":"Quantification and improvement of the dynamics of human serum albumin and glycated human serum albumin with astaxanthin\/astaxanthin-metal ion complexes: physico-chemical and computational approaches","volume":"23","author":"Wibowo","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3390\/MOLECULES26051239","article-title":"Tiliacora triandra (Colebr.) diels leaf aqueous extract inhibits hepatic glucose production in hepG2 cells and type 2 diabetic rats","volume":"26","author":"Pasachan","year":"2021","journal-title":"Molecules (Basel Switzerland)"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1186\/S12967-014-0364-1","article-title":"Abroma augusta L. (Malvaceae) leaf extract attenuates diabetes induced nephropathy and cardiomyopathy via inhibition of oxidative stress and inflammatory response","volume":"13","author":"Khanra","year":"2015","journal-title":"J Trans Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"32","DOI":"10.4103\/JAPTR.JAPTR_309_17","article-title":"Effect of Vitamin E and omega 3 fatty acids in type 2 diabetes mellitus patients","volume":"9","author":"Dass","year":"2018","journal-title":"J Advanced Pharm Technol Res"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS222413660\/S1","article-title":"Metformin treatment attenuates brain inflammation and rescues pacap\/vip neuropeptide alterations in mice fed a high-fat diet","volume":"22","author":"Mandwie","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2981","DOI":"10.2337\/DC13-0229","article-title":"Increased risk of cognitive impairment in patients with diabetes is associated with metformin","volume":"36","author":"Moore","year":"2013","journal-title":"Diabetes Care"},{"key":"B36","doi-asserted-by":"publisher","first-page":"45","DOI":"10.5607\/EN.2018.27.1.45","article-title":"The improving effect of HL271, a chemical derivative of metformin, a popular drug for type II diabetes mellitus, on aging-induced cognitive decline","volume":"27","author":"Bang","year":"2018","journal-title":"Exp Neurobiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"89","DOI":"10.4103\/AJPRHC.AJPRHC_30_22","article-title":"Decreased serum B12 due to antidiabetic drugs","volume":"14","author":"Pus","year":"2022","journal-title":"Asian J Pharm Res Health Care"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3390\/CELLS13161359","article-title":"Zinc and diabetes: A connection between micronutrient and metabolism","volume":"13","author":"Ahmad","year":"2024","journal-title":"Cells"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3923\/IJP.2019.724.730","article-title":"Neuroprotective role of vitamin D3 against insulin resistance and diabetic induced memory dysfunction in rats","volume":"15","author":"Al-Zahrani","year":"2019","journal-title":"Int J Pharmacol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/J.SJBS.2021.12.060","article-title":"Aqueous Ajwa dates seeds extract improves memory impairment in type-2 diabetes mellitus rats by reducing blood glucose levels and enhancing brain cholinergic transmission","volume":"29","author":"Mani","year":"2022","journal-title":"Saudi J Biol Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.7324\/JAPS.2023.112499","article-title":"The potential of Clausena lansium (Lour.) peel extract consumption on hyperglycemia, hyperlipidemia and augmented oxidative stress in type-2 diabetic model rats ARTICLE INFO","volume":"13","author":"Phachonpai","year":"2023","journal-title":"J Appl Pharm Sci"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/J.JTEMB.2021.126724","article-title":"Effect of zinc supplementation on hemogram parameters and circulating concentrations of homocysteine, vitamin B12, and folate in zinc-deficient children and adolescents","volume":"65","author":"Ozkarakaya","year":"2021","journal-title":"J Trace Elements Med Biol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3390\/BIOLOGY14070885","article-title":"Alpha-lipoic acid and metformin combination therapy synergistically activate nrf2-AMPK signaling pathways to ameliorate cognitive dysfunction in type 2 diabetic encephalopathy: A preclinical study","volume":"14","author":"Alrefaei","year":"2025","journal-title":"Biology"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJPS.2021.106105","article-title":"Vitamin D mitigates diabetes-associated metabolic and cognitive dysfunction by modulating gut microbiota and colonic cannabinoid receptor 1","volume":"170","author":"Hussein","year":"2022","journal-title":"Eur J Pharm Sci"},{"key":"B45","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1002\/FFT2.498;JOURNAL:JOURNAL:26438429;ISSUE:ISSUE:DOI","article-title":"Impact of vitamin A on the risk of mild cognitive impairment and Alzheimer\u2019s disease pathology in high-fat-diet\u2013treated APP\/PS1 mice","volume":"6","author":"Wang","year":"2025","journal-title":"Food Front"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/J.MCE.2023.111852","article-title":"Neuromodulatory effect of the combination of metformin and vitamin D3 triggered by purinergic signaling in type 1 diabetes induced-rats","volume":"563","author":"da Silva Pereira","year":"2023","journal-title":"Mol Cell Endocrinol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e06548","DOI":"10.1016\/J.HELIYON.2021.E06548","article-title":"DFT and molecular dynamics studies of astaxanthin-metal ions (Cu2+ and Zn2+) complex to prevent glycated human serum albumin from possible unfolding","volume":"7","author":"Wibowo","year":"2021","journal-title":"Heliyon"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1007\/S40200-020-00699-7","article-title":"Polydatin-loaded chitosan nanoparticles ameliorates early diabetic nephropathy by attenuating oxidative stress and inflammatory responses in streptozotocin-induced diabetic rat","volume":"19","author":"Abd El-Hameed","year":"2020","journal-title":"J Diabetes Metab Disord"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/FPHAR.2023.1222642\/FULL","article-title":"The applications of functional materials-based nano-formulations in the prevention, diagnosis and treatment of chronic inflammation-related diseases","volume":"14","author":"Wang","year":"2023","journal-title":"Front Pharmacol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1038\/s41401-020-00583-3","article-title":"DL-3-n-butylphthalide ameliorates diabetes-associated cognitive decline by enhancing PI3K\/Akt signaling and suppressing oxidative stress","volume":"42","author":"Wang","year":"2021","journal-title":"Acta Pharmacologica Sin"},{"key":"B51","doi-asserted-by":"publisher","first-page":"23","DOI":"10.3164\/JCBN.15-98","article-title":"Identification of cysteinylated transthyretin, a predictive biomarker of treatment response to partially hydrolyzed guar gum in type 2 diabetes rats, by surface-enhanced laser desorption\/ionization time-of-flight mass spectrometry","volume":"58","author":"Naito","year":"2015","journal-title":"J Clin Biochem Nutr"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/J.ORCP.2023.06.003","article-title":"Effect of zinc supplementation on blood sugar control in the overweight and obese population: A systematic review and meta-analysis of randomized controlled trials","volume":"17","author":"Yang","year":"2023","journal-title":"Obes Res Clin Pract"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/J.DSCB.2024.100139","article-title":"Emerging the role of trace minerals and vitamins in Alzheimer\u2019s disease","volume":"14","author":"Kamaljeet","year":"2024","journal-title":"Brain Disord"},{"key":"B54","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s13098-024-01366-0","article-title":"REVIEW Open Access Effect of zinc supplementation on glycemic biomarkers: an umbrella of interventional meta-analyses","volume":"16","author":"Daneshvar","year":"2024","journal-title":"Diabetol Metab Syndrome"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.12688\/f1000research.173985.1","article-title":"Integrative network pharmacology and molecular docking approaches in herbal medicine research","volume":"14","author":"Terkimbi","year":"2025","journal-title":"A Systematic Rev Applications Advances Trans Potential. F1000Research"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/J.JFUTFO.2023.03.009","article-title":"Hypoglycemic effect of Moringa oleifera leaf extract and its mechanism prediction based on network pharmacology","volume":"3","author":"Hong","year":"2023","journal-title":"J Future Foods"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS26157566","article-title":"The inflammatory bridge between type 2 diabetes and neurodegeneration: A molecular perspective","volume":"26","author":"Kacem","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B58","volume-title":"The Global Diabetes Compact what you need to know.\u201d","year":"2021"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26599\/FSHW.2022.9250001","article-title":"Targeting gut microbiota in osteoporosis: impact of the microbial based functional food ingredients","volume":"13","author":"Duffuler","year":"2024","journal-title":"Food Sci Hum Wellness"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1016\/J.BIOPHA.2023.114772","article-title":"Memantine mitigates ROS\/TXNIP\/NLRP3 signaling and protects against mouse diabetic retinopathy: Histopathologic, ultrastructural and bioinformatic studies","volume":"163","author":"ElSayed","year":"2023","journal-title":"Biomedicine Pharmacotherapy"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.26599\/FSHW.2024.9250002","article-title":"Effects of probiotics, prebiotics and synbiotics supplementation on cardiovascular risk factors in patients with type 2 diabetes mellitus: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials","volume":"14","author":"Tian","year":"2025","journal-title":"Food Sci Hum Wellness"},{"key":"B62","unstructured":"United nations decade of action on nutrition, (2016 2025) extended to 2030.\n          \n          2025"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1764157\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:42Z","timestamp":1771305522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1764157\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":62,"alternative-id":["10.3389\/fendo.2026.1764157"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1764157","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"article-number":"1764157"}}