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Time in range: a new blood sugar metric for people with diabetes - STAT

With nearly 300 blood sugar measurements a day, CGMs offer a new way to evaluate how well an individual is controlling his or her diabetes: time in range. This is expressed as a percentage of the time an individual’s blood sugar is within the target values. This metric, recently endorsed by the American Diabetes Association and by an international consensus committee, correlates nicely with control of diabetes and the implied development of complications such as vision loss, kidney problems, and low blood sugar excursions. Greater time in range has been linked to more stable glucose control, which should lead to fewer complications.

Child's gluten intake during infancy, rather than mother's during pregnancy, linked to increased risk of developing type 1 diabetes -- ScienceDaily

New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain (16-20 September) shows that a child's intake of gluten at age 18 months is associated with a 46% increased risk of developing type 1 diabetes for each extra 10g of gluten consumed per day.

Light drinking may be beneficial in type 2 diabetes: Further research needed -- ScienceDaily

The authors found ten relevant RCTs involving 575 participants that were included in this review. Meta-analysis showed that alcohol consumption was associated with reduced triglyceride levels and insulin levels, but had no statistically significant effect on fasting blood glucose levels, glycated haemoglobin (HbA1c, a measure of blood glucose control), or total cholesterol, low density lipoprotein (bad) cholesterol, and high density lipoprotein (good) cholesterol. Subgroup analysis indicated that drinking light to moderate amounts of alcohol decreased the levels of triglycerides (blood fats) and insulin in people with T2DM. Light to moderate drinking was defined by the authors as 20g or less of alcohol per day. This translates to approximately 1.5 cans of beer (330ml, 5% alcohol), a large (200ml) glass of wine (12% alcohol) or a 50ml serving of 40% alcohol spirit (for example vodka/gin).

Short-term study suggests vegan diet can boost gut microbes related to body weight, body composition and blood sugar control -- ScienceDaily

The study included 147 participants (86% women and 14% men; mean age was 55.6±11.3 years), who were randomised to follow a low-fat vegan diet (n=73) or to make no changes to their diet (n=74) for 16 weeks. At baseline and 16 weeks, gut microbiota composition was assessed, using uBiome kits. Dual energy X-ray absorptiometry was used to measure body composition. A standard method called the PREDIM index was used to assess insulin sensitivity. Following the 16-week study, body weight was reduced significantly in the vegan group (treatment effect average -5.8 kg), particularly due to a reduction in fat mass (average -3.9 kg) and in visceral fat. Insulin sensitivity also increased significantly in the vegan group. The relative abundance of Faecalibacterium prausnitzii increased in the vegan group (treatment effect +4.8%). Relative changes in Faecalibacterium prausnitzii were associated with decreases in body weight, fat mass and visceral fat. The relative abundance of Bacteoides fragilis also increased in the vegan group (treatment effect +19.5%). Relative changes in Bacteroides fragilis were associated with decreases in body weight, fat mass and visceral fat, and increases in insulin sensitivity.

Survey shows many primary care doctors are unprepared to help patients avoid diabetes -- ScienceDaily

The researchers received 298 completed surveys, or 34% of the 888 ultimately found eligible for inclusion in the study. "Our results revealed that there are substantial gaps in the knowledge that PCPs have in all three categories we tested," Tseng says. For instance: - On average, respondents selected just 10 out of 15 correct risk factors for prediabetes, most often missing that African Americans and Native Americans are two groups at high risk. - Only 42% of respondents chose the correct values of the fasting glucose and Hb1Ac tests that would identify prediabetes. - Only 8% knew that a 7% weight loss is the minimum recommended by the American Diabetes Association as part of a diabetes prevention lifestyle change program. "Our results also suggests that 25% of PCPs may be identifying people as having prediabetes when they actually have diabetes, which could lead to delays in getting those patients proper diabetes care and management," Maruthur says.

What drives inflammation in type 2 diabetes? Not glucose, says new research - ScienceBlog.com

The team was surprised to find that glycolysis wasn’t driving chronic inflammation. Instead, a combination of defects in mitochondria and elevated fat derivatives were responsible.

High-fat diet and gut bacteria linked to insulin resistance -- ScienceDaily

Overall, the research highlights a robust connection between high fat diets, obesity and the lack of gut IgA in promoting inflammation and insulin resistance. The knowledge that this class of antibodies regulate pathogenic bacteria, and protects against a "leaky gut," and additional complications of obesity, is a powerful tool in the fight against diabetes.

Coca-Cola Funds Scientists Who Shift Blame for Obesity Away From Bad Diets - The New York Times

“Coca-Cola’s sales are slipping, and there’s this huge political and public backlash against soda, with every major city trying to do something to curb consumption,” said Michele Simon, a public health lawyer. “This is a direct response to the ways that the company is losing. They’re desperate to stop the bleeding.” Coke has made a substantial investment in the new nonprofit. In response to requests based on state open-records laws, two universities that employ leaders of the Global Energy Balance Network disclosed that Coke had donated $1.5 million last year to start the organization.

Rye is healthy, thanks to an interplay of microbes -- ScienceDaily

Many of the compounds found in rye are processed by gut bacteria before getting absorbed into the body. The study found that gut microbes and microbes found in sourdough produce compounds that are partially the same. However, gut microbes also produce derivatives of trimethylglycine, also known as betaine, contained in rye. An earlier study by the research group has shown that at least one of these derivatives reduces the need for oxygen in heart muscle cells, which may protect the heart from ischemia or possibly even enhance its performance. The findings can explain some of the health benefits of rye, including better blood sugar levels and a lower risk of cardiovascular diseases.

The Startling Link Between Sugar and Alzheimer's - The Atlantic

Melissa Schilling, a professor at New York University, performed her own review of studies connecting diabetes to Alzheimer’s in 2016. She sought to reconcile two confusing trends. People who have type 2 diabetes are about twice as likely to get Alzheimer’s, and people who have diabetes and are treated with insulin are also more likely to get Alzheimer’s, suggesting elevated insulin plays a role in Alzheimer’s. In fact, many studies have found that elevated insulin, or “hyperinsulinemia,” significantly increases your risk of Alzheimer’s. On the other hand, people with type 1 diabetes, who don’t make insulin at all, are also thought to have a higher risk of Alzheimer’s. How could these both be true? Schilling posits this happens because of the insulin-degrading enzyme, a product of insulin that breaks down both insulin and amyloid proteins in the brain—the same proteins that clump up and lead to Alzheimer’s disease. People who don’t have enough insulin, like those whose bodies’ ability to produce insulin has been tapped out by diabetes, aren’t going to make enough of this enzyme to break up those brain clumps. Meanwhile, in people who use insulin to treat their diabetes and end up with a surplus of insulin, most of this enzyme gets used up breaking that insulin down, leaving not enough enzyme to address those amyloid brain clumps.

Cholesterol medication could invite diabetes, study suggests: Patient data shows association between statins and type 2 diabetes -- ScienceDaily

Statins are a class of drugs that can lower cholesterol and blood pressure, reducing the risk of heart attack and stroke. More than a quarter of middle-aged adults use a cholesterol-lowering drug, according to recent federal estimates. Researchers found that statin users had more than double the risk of a diabetes diagnosis compared to those who didn't take the drugs. Those who took the cholesterol-lowering drugs for more than two years had more than three times the risk of diabetes. "The fact that increased duration of statin use was associated with an increased risk of diabetes -- something we call a dose-dependent relationship -- makes us think that this is likely a causal relationship," Zigmont said.

Facebook posts better at predicting diabetes, mental health than demographic info -- ScienceDaily

For example, "drink" and "bottle" were shown to be more predictive of alcohol abuse. However, others weren't as easy. For example, the people that most often mentioned religious language like "God" or "pray" in their posts were 15 times more likely to have diabetes than those who used these terms the least. Additionally, words expressing hostility -- like "dumb" and some expletives -- served as indicators of drug abuse and psychoses.

A one-size-fits-all approach to nutrition doesn't work, even for twins, gene study finds - ABC News

“Genetics may not explain most nutritional differences among people,” said Spector. “Most of this variation that affects our weight, risk of diabetes and heart problems is potentially modifiable for an individual.” The researchers also analyzed how a person's metabolism may influence food choices, such as if it drives them to prefer savory or sweet foods or vice versa. However, Spector said that it was still unknown "how food preferences relate to food responses, but we do have the data.” Spector’s study also found that microbiomes differ between identical twins, who shared only about 37% of their gut microbes with each other. By comparison, the study found that unrelated people share about 35% of the same gut microbiota.

Insulin under the influence of light -- ScienceDaily

To better assess the effect of light on tissue sensitivity to insulin, researchers measured insulin-induced glucose absorption. It turns out that a small disturbance in photic inputs (e.g. an hour of light exposure in the middle of the dark cycle, or light removal for 2 days) is enough to cause a negative effect. Indeed, increased or decreased light exposure can profoundly influence the sensitivity of tissues to insulin and the alteration, however minimal, of this mechanism is sufficient to significantly disrupt metabolic homeostasis. This would explain why people exposed to light at the wrong time -- workers in shift patterns, for example -- are more likely to develop metabolic diseases (e.g. diabetes).

Inflammation might be the root of preventable disease | Harvard Magazine

“Chronic inflammation is uniformly damaging and is absolutely causal to the process, because if you interfere with it, you can reverse the pathology.” And this ability to control such diseases simply by reversing inflammation is a biological response, dating far back to the time of a common ancestor, that has been retained across diverse species of animals to the present day, he says, pointing to experimental evidence: “If you can make Drosophila [fruit fly] diabetic, and then block the inflammatory response systems, you can cure diabetes in Drosophila, the same way you can reverse it in the mouse, in primates, and in humans, provided that you do it with the right tools. Of course, the higher the organism, the more complex these pathways are, so it takes more effort to define the precise mechanisms to manipulate.”

On the keto diet? Ditch the cheat day: Just one dose of carbohydrates can damage blood vessels -- ScienceDaily

"Since impaired glucose tolerance and spikes in blood sugar levels are known to be associated with an increased risk in cardiovascular disease, it made sense to look at what was happening in the blood vessels after a sugar hit." For their test, the researchers recruited nine healthy young males and had them consume a 75-gram glucose drink before and after a seven-day high fat, low carbohydrate diet. The diet consisted of 70 per cent fat, 10 per cent carbohydrates and 20 per cent protein, similar to that of a modern ketogenic diet. "We were originally looking for things like an inflammatory response or reduced tolerance to blood glucose," says Durrer. "What we found instead were biomarkers in the blood suggesting that vessel walls were being damaged by the sudden spike in glucose." Little says the most likely culprit for the damage is the body's own metabolic response to excess blood sugar, which causes blood vessel cells to shed and possibly die. "Even though these were otherwise healthy young males, when we looked at their blood vessel health after consuming the glucose drink, the results looked like they might have come from someone with poor cardiovascular health," adds Little. "It was somewhat alarming."

The DAILY (Daily Automated Intensive Log for Youth) Trial: A Wireless, Portable System to Improve Adherence and Glycemic Control in Youth with Diabetes | Request PDF

Blood glucose (BG) monitoring (BGM) is an important component of diabetes management. New wireless technologies may facilitate BGM and help to optimize glycemic control. We evaluated an integrated wireless approach with and without a motivational game in youth with diabetes. Forty youth, 8-18 years old, each received a handheld device fitted with a wireless modem and diabetes data management software, plus a wireless-enabled BG monitor. Half were randomized to receive the new technologies along with an integrated motivational game in which the participants would guess a BG level following collection of three earlier readings (Game Group). BG data, insulin doses, and carbohydrate intake were displayed graphically prior to the glucose estimation. The other group received the new technologies alone (Control Group). Both groups were instructed to perform BGM four times daily and transmit their data to a central server via the wireless modem. Feasibility of implementation and outcomes were ascertained after 4 weeks. Ninety-three percent of participants successfully transmitted their data wirelessly to the server. The Game Group transmitted significantly more glucose values than the Control Group (P < 0.001). The Game Group also had significantly less hyperglycemia (glucose >/=13.9 mmol/L or >/=250 mg/dL) than the Control Group (P < 0.001). Youth in the Game Group displayed a significant increase in diabetes knowledge over the 4-week trial (P < 0.005). Finally, there was a trend for more youth in the Game Group to maintain hemoglobin A1C values </=8% (P = 0.06). Thus a pediatric population with diabetes can successfully implement new technologies to facilitate BGM. Use of a motivational game appears to increase the frequency of monitoring, reduce the frequency of hyperglycemia, and improve diabetes knowledge, and may help to optimize glycemic control.

Inactivity Induces Resistance to the Metabolic Benefits Following Acute Exercise. - PubMed - NCBI

METHODS: Ten untrained to recreationally active men (n=5) and women (n=5) completed a counterbalanced, crossover study. Four days of prolonged sitting without exercise (SIT) were compared to four days of prolonged sitting with a 1-hr bout of treadmill exercise (SIT+EX; 63.1±5.2% V̇O2max) on the evening of the fourth day. The following morning, participants completed a high fat/glucose tolerance test (HFGTT), during which plasma was collected over a 6-hr period and analyzed for triglycerides, glucose, and insulin. RESULTS: No differences between trials ( P > 0.05) were found in the overall plasma triglyceride, glucose, or insulin responses during the HFGTT. This lack of difference between trials comes with similarly low physical activity (~3,500-4,000 steps/day) on each day except for the 1-hr bout of exercise during SIT+EX the day before the HFGTT.

Protein released from fat after exercise improves glucose -- ScienceDaily

"In contrast to the negative effects of many adipokines, our study identified transforming growth factor beta 2 (TGF-beta 2) as an adipokine released from adipose tissue (fat) in response to exercise that actually improves glucose tolerance," says Laurie J. Goodyear, PhD, Head of Joslin's Section on Integrative Physiology and Metabolism and study co-author. Not only did exercise-stimulated TGF-beta 2 improve glucose tolerance, treating obese mice with TGF beta 2 lowered blood lipid levels and improved many other aspects of metabolism. "The fact that a single protein has such important and dramatic effects was quite impressive," says Goodyear, Professor of Medicine at Harvard Medical School. Two years ago, the international research team first demonstrated that adipose tissue offers beneficial metabolic effects in response to exercise. "Our hypothesis was that exercise is changing the fat, and as a result of that change, the fat releases these beneficial proteins into the bloodstream," says Goodyear. "Before this discovery, we always just focused on the positive effects of muscle."

Forget the Blood of Teens. Metformin Promises to Extend Life for a Nickel a Pill | WIRED

He was confident that metformin was good enough for the job. He has maintained this confidence ever since he read a 2014 study that reviewed the fate of 90,400 type 2 diabetics taking either metformin or another medication. The metformin patients in the study not only outlived the diabetics taking the other drug—a not especially surprising result if metformin is a superior treatment—but also outlived the nondiabetics studied as a comparison.

Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial | The American Journal of Clinical Nutrition | Oxford Academic

Loge relative weight change over the intervention phase was −7.1% ± 0.7% (mean ± SEM) with ICR, −5.2% ± 0.6% with CCR, and −3.3% ± 0.6% with the control regimen (Poverall < 0.001, PICR vs. CCR = 0.053). Despite slightly greater weight loss with ICR than with CCR, there were no significant differences between the groups in the expression of 82 preselected genes in adipose tissue implicated in pathways linking obesity to chronic diseases. At the final follow-up assessment (week 50), weight loss was −5.2% ± 1.2% with ICR, −4.9% ± 1.1% with CCR, and −1.7% ± 0.8% with the control regimen (Poverall = 0.01, PICR vs. CCR = 0.89). These effects were paralleled by proportional changes in visceral and subcutaneous adipose tissue volumes. There were no significant differences between ICR and CCR regarding various circulating metabolic biomarkers.

A gut bacterium as a fountain of youth? Well, let’s start with reversing insulin resistance - Orlando Sentinel

But insulin resistance is also linked to a rogue’s gallery of ills, from obesity and inflammation to the sagging immunity and frailty that comes with advancing age. If a readily available means of slowing or reversing insulin resistance could be identified, it might have broad and powerful anti-aging effects (in addition to protecting some of the world’s 650 million adults who are obese against developing type 2 diabetes). First identified in 2004, Akkermansia muciniphila inhabits the large intestine and is thought to account for between 1% and 5% of all intestinal bacteria in adults. Scientists suspect it helps preserve the coat of mucus that lines the walls of our intestines. It may also play a role in making the polyphenols we eat in plant-based foods more available to our cells. Evidence is mounting that A. muciniphila is involved in obesity, glucose metabolism and intestinal immunity. For instance, a 2018 study of cancer patients suggests that it plays a role in immune response. Compared to patients who failed to be helped by a new generation of immunotherapy, those who did had a greater abundance of Akkermansia in their guts. When researchers took the stool of a patient who responded positively to the cancer-fighting therapy and transplanted it into lab animals with human cancers, the recipients became more likely to respond positively to the same treatment. In the new research, a team from the National Institute on Aging examined the molecular chain of events that appears to result from A. muciniphila’s depletion in mice and macaque monkeys. And they assessed the effects of restoring this gut microbe to elderly animals. First, they documented that the guts of older animals had markedly smaller populations of A. muciniphila than the guts of young animals, and that as A. muciniphila became more scarce, so did butyrate, one of the gut’s key protectors. The deficiency of these two substances caused the mucous walls of the of the aged animals’ intestines to thin and grow leaky. That corrosive process unleashed a chain of events that touched off inflammation, prompted an immune response and, in a final step, increased insulin resistance. Key to that final step was the accumulation in the gut of a specific kind of immune cell called 4BL cells. If the detrimental chain of events was to be disrupted, the accumulation of those 4BL cells probably had to be stopped, the researchers surmised. The researchers also documented what appeared to be a role for A. muciniphila in fostering healthy diversity among the garden of other microbes that colonize the gut. In animals with scant populations of A. muciniphila, a host of other common gut bacteria — as well as their beneficial byproducts, particularly butyrate — also suffered.

Weightlifting is good for your heart and it doesn't take much -- ScienceDaily

Less than an hour of weekly resistance exercise (compared with no resistance exercise) was associated with a 29 percent lower risk of developing metabolic syndrome, which increases risk of heart disease, stroke and diabetes. The risk of hypercholesterolemia was 32 percent lower. The results for both studies also were independent of aerobic exercise.

It's not just for kids -- even adults appear to benefit from a regular bedtime: Adults with varied sleep-wake times weigh more, have higher blood sugar, risk of disease -- ScienceDaily

Of all three measures, however, regularity was the best at predicting someone's heart and metabolic disease risk, the researchers found. As one might expect, irregular sleepers experienced more sleepiness during the day and were less active -- perhaps because they were tired, Lunsford-Avery said. Researchers plan to conduct more studies over longer periods in hopes of determining how biology causes changes in sleep regularity and vice-versa. "Perhaps there's something about obesity that disrupts sleep regularity," Lunsford-Avery said. "Or, as some research suggests, perhaps poor sleep interferes with the body's metabolism which can lead to weight gain, and it's a vicious cycle. With more research, we hope to understand what's going on biologically, and perhaps then we could say what's coming first or which is the chicken and which is the egg."

Everything You Know About Obesity Is Wrong - The Huffington Post

the decisive factor in obesity care was not the diet patients went on, but how much attention and support they received while they were on it. Participants who got more than 12 sessions with a dietician saw significant reductions in their rates of prediabetes and cardiovascular risk. Those who got less personalized care showed almost no improvement at all.

Everything You Know About Obesity Is Wrong - The Huffington Post

Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call “the lean unhealthy.” A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people. Habits, no matter your size, are what really matter. Dozens of indicators, from vegetable consumption to regular exercise to grip strength, provide a better snapshot of someone’s health than looking at her from across a room.