Miodrag Janić

Verified

Miodrag verified their affiliation via an institutional email.

Learn more

Verified

Miodrag verified their affiliation via an institutional email.

Learn more

• MD, PhD
• Medical Doctor at Ljubljana University Medical Centre

Citation: Janić, M.; Janež, A.; El-Tanani, M.; Rizzo, M. Obesity: Recent Advances and Future Perspectives. Biomedicines 2025, 13, 368. https://doi.10.3390/ biomedicines13020368

Chronic respiratory disorders are the leading cause of mortality worldwide, necessitating the continuous search for novel therapeutic interventions. GLP-1 and GIP/GLP-1 receptor agonists, in addition to their role in the regulation of glycemia and weight, have potential in the treatment of respiratory disorders due to their diverse biological effec...

Psoriasis is a chronic, immune-mediated disease. The systemic inflammation triggered by psoriasis contributes significantly to increased cardiovascular risk. While various treatments completely clear the skin, the associated effects on systemic inflammation are not yet clear. We investigated residual systemic inflammation in successfully treated pa...

Diabetes is a chronic metabolic disorder distinguished by persistent hyperglycemia [...]

Chronic respiratory disorders are the third leading cause of mortality globally. Consequently, there is a continuous pursuit of effective therapies beyond those currently available. The therapeutic potential of the glucagon-like peptide-1 (GLP-1) and the glucose-dependent insulinotropic polypeptide/GLP-1 (GIP/GLP-1) receptor agonists extends beyond...

Background/Objectives: People with type 1 diabetes have an unmet need for cardiovascular protection due to the lack of new recommended antidiabetic therapies with cardiovascular benefits. We examined whether the addition of an empagliflozin/metformin combination, and each drug alone, can complement insulin to improve glucometabolic parameters in ov...

Atherosclerotic cardiovascular disease is a major burden of morbidity and, despite recent therapeutic advances, is the leading cause of mortality worldwide [...]

Introduction Endothelial dysfunction is an early precursor of atherosclerosis and is common in patients with psoriasis, presumably primarily due to psoriasis-related inflammation. We investigated endothelial function, arterial stiffness, and circulating markers of endothelial activation in young patients with psoriasis vulgaris of varying severity,...

Metabolic disorders are common in patients with psoriasis and contribute significantly to an increased cardiovascular risk. While biologic therapy is very successful in clearing skin lesions, its impact on metabolic parameters is uncertain. Our aim was to investigate the residual metabolic burden in psoriasis patients successfully treated with biol...

Common inflammatory ground links obesity, insulin resistance, and asthma. As recognition of their interplay, one worsening the natural course of the other, is recognised, questions remain about how to adequately address them altogether to improve clinical outcomes. The present manuscript sheds light on the problem, describing possible pathophysiolo...

The development of modern antidiabetic drugs, a continuous adaptation of recommendations for treating diabetes and the development of advanced technologies have been on a steep rise in recent years. Nevertheless, diabetes and obesity remain significant public health problems with a steadily increasing prevalence. In Slovenia, we eagerly await for t...

Sodium-glucose cotransporter-2 inhibitors (SGLT-2) are increasingly prescribed in diabetology and other internal medicine specialties. They mainly have a beneficial effect on metabolic parameters, that is, glycaemia and body weight. Additionally, they were shown to protect target organs, the cardiovascular system, and kidneys in people with or with...

Objective To explore the effects of oral semaglutide on glycaemic parameters, body weight, and satisfaction in the first recipient patients with type 2 diabetes mellitus in Slovenia, in a real-world clinical practice setting. Methods The first consecutive adult patients with type 2 diabetes who were eligible for oral semaglutide treatment were inc...

Psoriasis is a chronic systemic inflammatory disease. Systemic inflammation in psoriasis leads to several comorbidities, among which cardiovascular diseases are the leading cause of morbidity and mortality. The detection of cardiovascular risk factors and their management is still insufficient; therefore, the education of physicians treating patien...

Optimal glycemic control and multifactorial treatment are important for type 2 diabetes control. Non-pharmacological treatment is the mainstay of antihyperglycemic treatment, but it usually merits timely escalation of pharmacological intervention. One of the barriers to pharmacological treatment with GLP-1 receptor agonists was injectable treatment...

Psoriasis is a chronic systemic inflammatory disease. Due to systemic inflammation, it is associated with many comorbidities. Among them, cardiovascular diseases represent the most common causes of morbidity and mortality in this population. Therefore, physicians treating patients with psoriasis should keep in mind that, as important as the treatme...

Methods: 40 individuals with type 1 diabetes (average age of 44.7 ± 2.5 years) were randomized into four groups: (1) control (placebo), (2) empagliflozin 25 mg daily, (3) metformin 2000 mg daily, and (4) empagliflozin-metformin combination (25 mg and 2000 mg daily, respectively). At inclusion and after 12 weeks of treatment, the blood samples were...

The bidirectional link between diabetes and coronavirus disease 19 (covid-19) is further driven and perpetuated by socio-environmental factors. Diabetes has been consistently reported as an important risk factor for severe covid-19, leading to more frequent hospitalisations and greater risk for intensive care admission, mechanical ventilation, and...

Introduction: Type 2 diabetes (T2D) management has reached a point where not only optimal glycaemic control is necessary, but also additional interventions with proven cardiovascular risk reduction benefit. Subcutaneous semaglutide has been shown to provide cardiovascular protection, but its use may be limited by its injection formulation. To overc...

The year 2020 will undoubtedly be marked by the coronavirus disease 2019 (covid-19) pandemic, caused by the novel coronavirus SARS-CoV-2. It has been shown that in diabetes patients, covid-19 occurs in a more severe form, with these patients being more prone to the need for mechanical ventilation and having higher mortality rates than non-diabetic...

Diabetes mellitus per se is a risk factor for cardiovascular diseases, the risk rising even further with concomitant dyslipidemia. Diabetic dyslipidemia is secondary and present in patients with type 2 diabetes and those with insulin resistance. It has a characteristic lipid profile with increased triglycerides and very low-density lipoprotein (VLD...

In the vast majority of people with diabetes, good glycaemic control can only be achieved by regular blood glucose measurements and appropriate dose adjustment of antidiabetic drugs, particularly insulin. In Slovenia, this is mostly done by measuring the glucose concentration in the finger-prick blood sample with the use of a glucometer. However, c...

Introduction. Cystic fibrosis (CF) is a genetic disorder of cystic fibrosis transmembrane conductance regulator (CFTR) resulting in production of thick mucus. The latest novelty in treatment of CF patients is triple combination of CFTR modulators (elexacaftor-tezacaftor-ivacaftor) that greatly improves CFTR function in epithelial cells leading to b...

Diabetes mellitus is a major healthcare problem. It is not only characterized by hyperglycemia and chronic complications, but in longer lasting diabetes and a longer living population, it is also associated with accelerated arterial ageing, which importantly contributes to cardiovascular complications. The accelerated arterial ageing in patients wi...

Background: Optimal glycemic control and proper basal insulin initiation timing when non-insulin treatment becomes insufficient is critical in type 2 diabetes mellitus (T2DM). The DUNE study investigated the effectiveness and safety of newly initiated basal insulin in T2DM patients compared to those who already received insulin. The impact of backg...

Background: Favourable cardiovascular effects of SGLT2 inhibitors have been clearly revealed, whereas the underlying mechanism(s) still remain unknown. We explored the anti-oxidative action of empagliflozin (alone and in combination with metformin) in type 1 diabetes mellitus (T1DM) patients. Methods: Forty T1DM male patients (age 44.7 ± 2.5 years...

Background and Aims: Poor glycemic control is type 1 diabetes mellitus patients a common issue. There is an increasing interest for addition of SGLT2 inhibitors to standard insulin treatment in these patients. This study was aimed at exploring the effects of empagliflozin on time in range parameters in overweight type 1 diabetes mellitus patients w...

Diabetes increases cardiovascular risk by two to three times. Improved glycaemic control leads to decreased incidence of microvascular complications, whereas it has only a small impact on the incidence of cardiovascular events (macrovascular complications). In addition to blood glucose lowering, some antidiabetic drugs have protective cardiovascula...

The incidence of aging-related disorders may be decreased through strategies influencing the expression of longevity genes. Although numerous approaches have been suggested, no effective, safe, and easily applicable approach is yet available. Efficacy of low-dose fluvastatin and valsartan, separately or in combination, on the expression of the long...

In diabetic patients, cardiomyopathy is an important cause of heart failure, but its pathophysiology has not been completely understood thus far. Myocardial hypertrophy and diastolic dysfunction have been considered the hallmarks of diabetic cardiomyopathy (DCM), while systolic function is affected in the latter stages of the disease. In this artic...

Background: The mechanism for post-thrombotic syndrome (PTS), the most important long-term sequelae of deep venous thrombosis, is not entirely known. It is probably caused by venous hypertension due to venous insufficiency and venous obstruction. Venous hypertension could also be a consequence of the May-Thurner syndrome (MTS), i.e. the obstruction...

Background: Deteriorated arterial function and high incidence of cardiovascular events characterise diabetes mellitus. Metformin and recent antidiabetic drugs, SGLT2 inhibitors, reduce cardiovascular events. We explored the possible effects of empagliflozin’s effect on top of metformin treatment on endothelial function and arterial stiffness parame...

Peripheral arterial disease is more frequent in patients with diabetes mellitus compared to general population, it also evolves differently. Screening for peripheral arterial disease in diabetes mellitus patients is more difficult since it is altered by the coexistence of diabetic neuropathy and arterial mediocalcinosis. Additionally, the progressi...

Metformin is a first-line drug for the treatment of type 2 diabetes mellitus. It is usually prescribed along with non-pharmacological treatment. Metformin effectively reduces blood glucose levels, does not increase the risk for hypoglycaemia and has favourable effects on body weight. Additionally, it prevents cardiovascular complications. In the tr...

Pojavnost srčno-žilnih bolezni je dosegla pandemične razsežnosti. Zato se čedalje večja pozornost posveča tudi z življenjskim slogom pogojenemu zdravju prebivalstva, še posebej načinu prehranjevanja in vnosu določenih skupin živil. Številne epidemiološke raziskave so dokazale, da je uživanje pijač z dodanim sladkorjem povezano z nastankom debelosti...

Sodium glucose co-transporter-2 (SGLT-2) inhibitors are the newest group of drugs for the treatment of diabetes mellitus type 2, which have been in clinical use for the last few years. They act in the proximal renal tubules by reducing the glucose reabsorption, the glucose then being excreted in the urine. Consequently, by decreasing blood glucose...

Background: The largest population that suffers from cardiovascular events are subjects at moderate cardiovascular risk. However, no effective and safe preventive treatment is available for this population. We investigated whether their arterial wall phenotype could be turned to a lower risk direction by low-dose fluvastatin/valsartan combination...

Background: Venous thromboembolism (VTE) is the most common unpredictable cause of in-hospital death. Despite the fact that VTE prophylaxis has been proven to be efficacious and safe it remains underused. The aim is to determine the use of VTE prophylaxis in patients admitted to medical wards of the Division of Internal Medicine of the University Me...

In diabetes mellitus (DM), hyperglycaemia and insulin resistance progressively lead to both microvascular and macrovascular complications. Whereas the incidence of microvascular complications is closely related to tight glycaemic control, this does not apply to macrovascular complications. Hyperglycaemia influences many interweaving molecular pathw...

Background: Statins and sartans can, in therapeutic doses, induce pleiotropic cardiovascular effects. Similar has recently been shown also for sub-therapeutic doses. We thus explored and compared the cardiovascular pleiotropic efficacy of sub-therapeutic vs. therapeutic doses. Methods: Wistar rats were randomly divided into 7 groups receiving fluva...

Metformin je zdravilo prve izbire in hkrati najbolj pogosto predpisano zdravilo pri bolnikih s slad-korno boleznijo tipa 2. Uporablja se tudi v kombinaciji z drugimi peroralnimi antihiperglikemiki ali insulinom. Dodatno ga uporabljamo tudi pri zdravljenju bolnikov s sladkorno boleznijo tipa 1, pri stanjih s povečanim tveganjem za razvoj sladkorne b...

Metformin represents the first line of treatment and is the most widely prescribed antihypergycemic drug in type 2 diabetic patients. It can be used as monotherapy or in combination with other oral antihyperglycemic drugs or insulin. Additionally, it is also prescribed in type 1 diabetic patients, it proved to be effective in prediabetes and also p...

Aims Previously we revealed the effectiveness of a new therapeutic approach with a short-term, very-low dose fluvastatin-valsartan combination on the improvement of arterial function in type 1 diabetes mellitus patients (T1DM). In this study we explored whether this approach influences inflammation and oxidative stress and explored any association...

Treatment with low, subtherapeutic doses of statins and sartans expresses beneficial pleiotropic effects on the arterial wall. The present study explored whether these effects depend on treatment duration. Wistar rats were randomly divided into 4 groups and received low-dose atorvastatin, low-dose losartan, their combination, or saline (control) da...

We have previously shown that slightly to moderately aged arteries in middle-aged males can be functionally rejuvenated by subtherapeutic, low-dose fluvastatin and valsartan treatment. Herein, we aim to explore whether this treatment could also increase telomerase activity. We hypothesized that telomerase activity might be associated with i) an imp...

Improvement of arterial wall (AW) characteristics decreases cardiovascular risk. In a previous study, it was observed that AW characteristics in patients with diabetes mellitus type 1 are significantly improved by short‑term treatment with a low‑dose combination of fluvastatin and valsartan. Additionally, a unique phenomenon of prolonged effect aft...

We have developed a new " drug " and approach that appear to be effective in reducing arterial age. This " drug " represents a low, subtherapeutic dose of statin and sartan and particularly their low-dose combination. The improvement of arterial wall characteristics, also reflecting in a decrease of arterial age, was achieved after a short period o...

Background Statin use is frequently associated with muscle-related symptoms. Coenzyme Q10 supplementation has yielded conflicting results in decreasing statin myopathy. Herein, we tested whether coenzyme Q10 supplementation could decrease statin-associated muscular pain in a specific group of patients with mild-to-moderate muscle symptoms. Materia...

New preventive strategies for atherosclerosis are needed. In this study, we tested whether a new therapeutic approach consisting of low dose treatment with a statin and sartan combination could prevent atherogenic diet-induced impairment of the arterial wall in guinea pigs. Twenty-five Dunkin-Hartley guinea pigs were randomly assigned to five exper...

The world population is aging and the number of old people is continuously increasing. Arterial structure and function change with age, progressively leading to arterial stiffening. Arterial stiffness is best characterized by measurement of pulse wave velocity (PWV), which is its surrogate marker. It has been shown that PWV could improve cardiovasc...

We have previously shown that a "short-term, low-dose" treatment approach with statins, angiotensin receptor blockers, and especially their low-dose combination, is effective in improving arterial wall properties in apparently healthy middle-age men. This study was performed to expand investigation of its effects on inflammation and oxidative stres...

We tested whether short-term, low-dose treatment with the fluvastatin and valsartan combination could improve impaired arterial wall characteristics in type 1 diabetes mellitus patients. A total of 44 type 1 diabetes mellitus patients were randomised into the treatment group [n = 22; received a low-dose combination of fluvastatin (10 mg daily) and...

Ageing is a progressive process that according to available knowledge cannot be effectively reversed, slowed or stopped. Here we propose a new anti-ageing approach that may lead to the design of effective therapeutic intervention. First, we hypothesize that the “organ system” oriented anti-ageing approach represents a better anti-ageing target than...

Recently it has been shown that statins and angiotensin receptor blockers (ARBs) at low doses express beneficial pleiotropic vascular effects. We aimed to explore whether these drugs at low doses induce the expression of vasoactive-related genes. Sixty adult Wistar rats were treated with low-dose atorvastatin (2 mg/kg), low-dose losartan (5 mg/kg),...

Objective: Early arterial wall changes are already present in the apparently healthy, middle-aged population and continuously progress with age. The aim of our study was to investigate whether 30 days low-dose fluvastatin treatment could improve and reverse these arterial changes that are primarily associated with ageing, in otherwise healthy middl...

Background: Structure and function of arterial system change with advancing age. The most important aging-induced changes of arterial system are: endothelial dysfunction, increased stiffness of arterial wall, an increase in arterial lumen size and increased intima-media thickness. As a consequence of these changes, arterial wall becomes more prone...

The cardiovascular pleiotropic effects of statins and angiotensin receptor blockers (ARBs) could be of interest for innovative preventive approaches. We aimed to investigate whether low-dose atorvastatin and losartan, separately not possessing protective cardiovascular pleiotropic effects, express them when combined. Forty-five adult male Wistar ra...

Statins and angiotensin receptor blockers at therapeutic doses have beneficial cardiovascular effects, which can be applied for cardiovascular protection. We explored whether low doses of atorvastatin, losartan, and particularly their combination, possess important pleiotropic vasodilatory effects. Wistar rats were treated daily with low-dose atorv...

The arterial wall possesses several functional and structural properties that define arterial health. Once they become impaired, cardiovascular risk increases. We aimed to ascertain the pattern of correlations among different arterial wall properties and to explore their relations to traditional risk factors and cardiovascular risk stratification....

Ageing progressively diminishes arterial functions, even in the absence of traditional risk factors. Our aim was to explore whether age-related arterial changes in middle-aged males could be reversed using short-term, low-dose fluvastatin/valsartan combination intervention. Forty apparently healthy, middle-aged males (43.3 ± 5.8 years) were recruit...

Background: Functional and morphological arterial wall impairment progresses with ageing. Angiotensin II in the arterial wall is involved in this process. Appropriate early intervention might theoretically slow the progress of age-related changes. Herein, we investigated a new approach to this issue: whether arterial wall changes present in middle...

Endothelial dysfunction represents one of the earliest changes in arterial function and is an important event in the atherosclerotic process. Reduced production or bioavailability of nitric oxide is the most important in the process of endothelial dysfunction, while on the other hand, it also includes a mismatch between the vasodilators and vasocon...

Early arterial wall changes are already present in the apparently healthy, middle-aged population and continuously progress with age. The aim of our study was to investigate whether 30 days low-dose fluvastatin treatment could improve and reverse these arterial changes that are primarily associated with ageing, in otherwise healthy middle-aged male...