Diabetes & Metabolism

Guidelines Recommend Treating Obesity First, Comorbidities Later

New guidelines from the Endocrine Society recommend first managing obesity with lifestyle changes and medications, then managing any remaining comorbidities such as dyslipidemia, hypertension, and impaired glucose tolerance. People with diabetes who are obese or overweight should receive medications that promote weight loss or have no effect on weight as first- and second-line treatments. Diet, exercise, and behavioral modifications should be part of all obesity management approaches.

Sedentary Time Linked with Increased Health Risks

A new meta-analysis of 47 published studies indicates that prolonged sedentary time is independently linked with potentially harmful health outcomes including premature death from any cause, cardiovascular disease and cardiovascular disease-related death, cancer and cancer-related death, and type 2 diabetes. Health risks associated with sedentary time were generally more pronounced in individuals with lower levels of physical activity than in those with higher levels.

Unique Insulin Produced by Sea Snails May Provide Insights on Insulin Function and Energy Metabolism

Researchers have found that cone snails produce a venom containing a unique form of insulin that causes small fish on which the snails prey to go into hypoglycemic shock. The snail insulin could prove useful for studying how different forms of insulin control blood sugar and energy metabolism. It consists of 43 amino acid building blocks, fewer than any known insulin. The new findings are published in PNAS.

Joining a Regular Walking Group May Help Reduce Health Risks

A meta-analysis of 42 studies found that walking groups are effective and safe, with good adherence and wide-ranging health benefits. Among 1843 participants from over 14 countries, those who joined walking groups experienced significant reductions in blood pressure, body fat, BMI, resting heart rate, and total cholesterol. Walkers also demonstrated improved lung function, better general fitness, and lower depression levels. The evidence was less clear for other outcomes related to waist circumference, fasting glucose, mental health scores, and serum lipid levels.

Blocking TH17 Receptors May Help Fight Type 1 Diabetes

Researchers have found that targeting 2 nuclear receptors that play critical roles in the development of TH17 cells can prevent autoimmunity against pancreatic beta cells in a mouse model of type 1 diabetes. Blocking the receptors also reduced pro-inflammatory cytokine expression, reduced autoantibody production, and increased the frequency of CD4+Foxp3+ T regulatory cells.

FDA Clears Mobile Medical App for Continuous Glucose Monitoring

The US Food and Drug Administration announced the approval of a mobile medical app that allows patients with diabetes to automatically and securely share data from a continuous glucose monitor (CGM) with other people. Dexcom Share’s mobile medical app receives CGM data and transmits it to a web-based storage location. After a patient designates “followers,” the app of a follower can download the CGM data and display it in real-time. 

Canadian Guidelines Recommend BMI Measurements for All Adults

New Canadian guidelines recommend that primary care physicians measure patients’ BMI at every visit. The guidelines also suggest that overweight and obese adults, especially those at high risk of diabetes, be referred to structured behavioral interventions for weight loss; however, medications should not routinely be offered to help people lose weight.

Engineered Bacteria Reprogram Intestinal Cells into Insulin-Secreting Cells

When diabetic rats were fed a strain of lactobacillus (a type of bacteria found in the human gut) that was engineered to secrete glucagen-like peptide-1, the animals showed significant increases in insulin levels and were more glucose tolerant than animals fed the parent bacterial strain. The rats developed insulin-producing cells within the upper intestine in numbers sufficient to replace 25% to 33% of the insulin capacity of nondiabetic healthy rats.

Insulin-Producing Cells Derived from Skin Normalize Blood Sugar Levels in Diabetic Mice

Investigators have reprogrammed human skin cells to create induced pluripotent stem cells, which were then coaxed into forming insulin-producing cells through the presence of pancreatic growth factors. When the differentiated cells were transplanted under the kidney capsules of diabetic immunodeficient mice, the animals’ blood sugar levels decreased to normal or near-normal levels over 150 days. In MRI analyses, a 3D organoid appeared as a white patch on the transplanted kidneys but not on control kidneys.

A Cancer Diagnosis May Affect Diabetics’ Medication Adherence

Diabetics may become less adherent to diabetes medications following a cancer diagnosis, a new study shows. There was a 6.3% drop in patients’ Medication Possession Ratio (MPR) (an indicator for medication adherence) at the time of cancer diagnosis, plus an ongoing monthly decline in MPR of 0.20% after diagnosis. The largest drops in MPR at the time of cancer diagnosis were seen among patients with stage IV cancer and gastrointestinal or pulmonary cancers.

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