Frantzeska Nimee

Diabetes mellitus, particularly type 2 diabetes mellitus (T2DM), represents a rapidly expanding global health challenge with substantial public health and economic consequences. Recent advances in antidiabetic therapy—including dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dual GIP/GLP-1 receptor agonists, and sodium–glucose cotransporter-2 (SGLT-2) inhibitors—have transformed diabetes management by providing benefits beyond glycemic control, such as cardiovascular and renal protection, weight reduction, and improved quality of life. As the therapeutic landscape becomes increasingly complex and patient-centered, ensuring the safe and effective use of these agents in real-world settings has emerged as a key concern for pharmacoepidemiology and pharmacovigilance. Community pharmacists, as highly accessible healthcare professionals, play an expanding role in diabetes care through medication optimization, patient education, adherence support, and monitoring of adverse drug reactions in primary care. Evidence from systematic reviews and meta-analyses indicates that pharmacist-led interventions improve glycemic outcomes, enhance self-care behaviors, and facilitate the appropriate adoption of contemporary antidiabetic therapies. This narrative review synthesizes current evidence on novel pharmacological treatments for T2DM and examines the evolving contribution of community pharmacists in translating therapeutic innovation into routine practice. Barriers to implementation and future perspectives for integrating pharmacist-led services into diabetes management and pharmacovigilance frameworks are also discussed.

Cancer-related fatigue (CRF) is a common distressing complaint of breast cancer (BC) patients treated with chemotherapy. Nutritional quality plays a pivotal role in CRF, while increased interest towards new pharmacological agents has been observed. Melatonin, an endogenous hormone that regulates the human sleep–wake cycle, could alleviate CRF. In the present randomized, placebo-controlled 3-month trial, we investigated the effects of melatonin intake (i.e., 1 mg/day) vs. placebo in BC patients on CRF. In both arms, the Mediterranean diet (MD) was implemented. Medical history, anthropometry and blood withdrawal were performed. CRF was evaluated by the Functional Assessment of Chronic Illness Therapy—Fatigue questionnaire and MD adherence by the MedDietScore. In total, 49 BC women (median age 52 years) were recruited, namely N = 23 in the intervention arm and N = 26 in the placebo arm. At baseline, CRF was positively associated with body mass index (BMI), even when adjusted for age, waist circumference and blood indices related to disease prognosis (beta = −0.882, p = 0.003). At 3 months, both groups showed a BMI decrease (p < 0.05), but only the intervention group improved CRF compared to baseline (p = 0.003). No differences in CRF were observed between the groups. In conclusion, melatonin oral supplementation could ameliorate CRF in BC patients.

Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic.