diabetes

Data from 8,452 participants in the population-based Rotterdam Study found that, over eight years, 1,100 (13%) developed prediabetes and 798 (9.4%) developed diabetes. The risk of progressing from prediabetes to diabetes was up to 40% higher for those with low thyroid function. Even among those whose thyroid function was in the normal range at first measurement, progression from prediabetes to diabetes was 1.4 times higher for those in the lowest third of thyroid function levels compared with the highest third.

The average age of the participants was 65.

http://www.eurekalert.org/pub_releases/2016-04/tes-sll040116.php

For two years, 70 obese postmenopausal women with normal fasting plasma glucose levels ate either a Paleolithic-type diet or a “prudent” diet. The Paleolithic-type diet was based on lean meat, fish, eggs, vegetables, fruits, nuts and berries, with rapeseed, olive oils and avocado as additional fat sources. The diet excluded dairy products, cereals, added salt and refined fats and sugar. 30% of the calories were supposed to come from protein, 30% from carbohydrates, and 40% from fats with high unsaturated fatty acid content. The prudent control diet had a markedly different target: 15% in protein, 30% in fat, and 55% in carbohydrates.

Both groups took part in 12 group sessions led by a dietitian, and kept ongoing records of their food intake.

Both groups lost significant body weight and had significantly less abdominal obesity, but the women eating the Paleolithic-type diet also had significantly lower levels of specific fatty acids associated with insulin resistance, compared with those on the prudent control diet. Presumably this reflects the marked change in the types of fats eaten. At the end of the two years, the women eating the Paleolithic-type diet reported that their intake of saturated fatty acids decreased by 19%, while monounsaturated fatty acids increased by 47% and polyunsaturated fatty acids by 71%.

http://www.eurekalert.org/pub_releases/2016-04/tes-apd040116.php

A Finnish study involving 2,189 healthy men aged 42-60 found that over 19 years, 417 men (19%) were diagnosed with type 2 diabetes. Those with high omega-6 polyunsaturated fatty acid concentrations in their blood were 46% less likely to develop diabetes. When analyzed, it turned out that this association depended on linoleic and arachidonic acid concentrations only; high serum gamma-linolenic and dihomo-γ-linolenic acid concentrations were linked to a higher risk.

The serum linoleic acid concentration is determined by the person's diet, and the main sources of linoleic acid are vegetable oils, nuts and seeds. Arachidonic acid is present in meat and eggs; however, the human body can also make arachidonic acid from linoleic acid.

Gamma-linolenic acid and dihomo-γ-linolenic acid are mainly formed in the human body from linoleic acid, but their concentrations in serum are very low.

Linoleic acid is the most common omega-6 fatty acid, and has been linked to a reduced risk of cardiovascular diseases as well as type 2 diabetes.

http://www.eurekalert.org/pub_releases/2016-03/uoef-hso032416.php

Teymoor Yary, Sari Voutilainen, Tomi-Pekka Tuomainen, Anu Ruusunen, Tarja Nurmi, Jyrki K Virtanen 2016. Serum n-6 polyunsaturated fatty acids, delta-5- and delta-6-desaturase activities and risk of incident type 2 diabetes in men: The Kuopio Ischaemic Heart Disease Risk Factor Study. American Journal of Clinical Nutrition, Published online March 24, 2016 http://ajcn.nutrition.org/content/early/2016/03/23/ajcn.115.128629.abstract

Frailty, manifesting in weight loss and malnutrition, leading to decreased hyperglycemia and normalization of blood glucose levels, may develop in older diabetics. This in turn leads to an increased risk of hypoglycemia. Current guidelines suggest relaxed glycemic control in diabetic, frail elderly patients.

A British study reviewing the impact of frailty on blood glucose level normalization has suggested not simply a more relaxed glycemic control in frail elderly with diabetes, but that complete withdrawal of hypoglycemic medications may be necessary. The researchers recommend that doctors regularly review medications taken in this vulnerable population “with consideration of gradual reduction or complete withdrawal when frailty and significant weight loss emerge”.

The review is available free to read here: http://www.future-science.com/doi/full/10.4155/fsoa-2015-0016.

http://www.eurekalert.org/pub_releases/2016-03/fsg-dwn031516.php

Data from a five-year sleep study involving 161 Caucasian, 121 African American and 56 Chinese non-shift working women aged 48-58 has found that going to bed later, and having greater variability in bedtime, were associated with higher insulin resistance, and greater bedtime advance (going to bed earlier) was associated with higher body mass index (BMI).

Changes in bedtime, and later bedtimes, were partly due to shifts in bedtime at the weekend.

Diabetes risk increases in midlife women, and this finding suggests that irregular sleep schedules may be an important factor. Metabolic health was better in women who had more regular sleep schedules, including regular bedtimes across weekdays and weekends."

http://www.eurekalert.org/pub_releases/2016-02/aaos-sli020116.php

Taylor BJ, Matthews KA, Hasler BP, Roecklein KA, Kline CE, Buysse DJ, Kravitz HM, Tiani AG, Harlow SD, Hall MH. Bedtime variability and metabolic health in midlife women: the SWAN Sleep Study. SLEEP 2016;39(2):457–465.

A study has revealed that the immune system has a seasonal cycle, in which its activity is boosted during the winter and relaxes during the summer. While the winter increase in immune defences presumably helps us stave off infections, it also raises the risk of harmful inflammation, effectively lowering the threshold for heart attacks, stroke, diabetes and even some psychiatric conditions. This may explain why deaths from conditions ranging from heart attacks to diabetes and schizophrenia increase in winter.

The study used blood samples from more than 16,000 people living in both the northern and southern hemisphere

http://www.theguardian.com/science/2015/may/12/winter-immune-boost-may-actually-cause-deaths-study-suggests

Dopico, X. C., Evangelou, M., Ferreira, R. C., Guo, H., Pekalski, M. L., Smyth, D. J., … Todd, J. A. (2015). Widespread seasonal gene expression reveals annual differences in human immunity and physiology. Nature Communications, 6, 7000. http://doi.org/10.1038/ncomms8000

Anecdotal and scientific evidence suggests curcumin, a compound found in turmeric, promotes health because it lowers inflammation. However, it is not absorbed well by the body. Most curcumin in food or supplements stays in the gastrointestinal tract, and any portion that's absorbed is metabolized quickly.

A new study thinks they've come up with a better and more effective way to deliver curcumin, and in so doing has demonstrated how it works. Curcumin powder was mixed with castor oil and polyethylene glycol, allowing it to dissolve and be more easily absorbed by the gut to enter the bloodstream and tissues.

When this was given to mice who had been injected with an extract that stimulates an immune reaction, a key protein that triggers an immune response was blocked. The mice given plain curcumin, on the other hand, showed the same protein actively triggering an immune response.

The emulsified curcumin also stopped recruitment of macrophages. Inflammation triggered by overactive macrophages has been linked to cardiovascular disease, disorders that accompany obesity, Crohn's disease, rheumatoid arthritis, inflammatory bowel disease, diabetes and lupus-related nephritis.

http://www.eurekalert.org/pub_releases/2014-11/osu-nra110614.php

Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. With age, they shorten, and as their structural integrity weakens, the cells age and die quicker. Telomere length thus is a biomarker of cellular age. Stress is also thought to shorten telomere length.

A year-long study that looked at the effects of three healthy behaviors in 239 post-menopausal, non-smoking women has found that women who engaged in lower levels of healthy behaviors showed a significantly greater telomere shortening for every major life stressor that occurred. However, stress didn't lead to greater shortening in those women who maintained active lifestyles, healthy diets, and good quality sleep.

Shorter telomeres have become associated with a broad range of aging-related diseases, including stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis diabetes, and many forms of cancer.

http://www.eurekalert.org/pub_releases/2014-07/uoc--hlm072414.php

Puterman, E., Lin, J., Krauss, J., Blackburn, E. H., & Epel, E. S. (2015). Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter. Molecular Psychiatry, 20(4), 529–535. http://doi.org/10.1038/mp.2014.70

One big issue for which there is as yet no clear answer, is the question of whether it's the intensity or the amount of exercise which is more important.

One study involving 300 obese adults aimed to test this in a 6-month trial comparing those who maintained their usual activity level, those who did a low amount (around 30 minutes) of low-intensity exercise, those who did a high amount (around an hour) of low-intensity exercise, and those who did around 40 minutes of high-intensity exercise. All had five exercise sessions every week.

After 24 weeks of this, all the exercise groups showed smaller mean waist circumference and greater mean weight loss, compared to the control group, but there was no difference between the exercise groups in these measures. However, only the high-high group had lower 2-hour glucose levels than the controls, and only the two groups who did a higher amount of exercise had better insulin sensitivity.

Ross R et al. Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: A randomized trial. Ann Intern Med 2015 Mar 3; 162:325. (http://dx.doi.org/10.7326/M14-1189)

Medical and genetic data from thousands of patients has enabled researchers to compare the similarity between patients with type 2 diabetes, revealing three distinctive clusters. These sub-types of type 2 diabetes are associated with different genetic variants, and have quite different health implications.

Subtype 1 patients were more likely to suffer from well-known diabetes problems with kidneys and eyes (diabetic nephropathy and diabetic retinopathy); subtype 2 was more likely to suffer from cancer and cardiovascular diseases; and subtype 3 was associated most strongly with cardiovascular diseases, neurological diseases, allergies, and HIV infections.

http://www.fastcoexist.com/3052935/the-latest-breakthrough-in-understanding-diabetes-was-made-by-an-algorithm

Li, L., Cheng, W.-Y., Glicksberg, B. S., Gottesman, O., Tamler, R., Chen, R., … Dudley, J. T. (2015). Identification of type 2 diabetes subgroups through topological analysis of patient similarity. Science Translational Medicine, 7(311), 311ra174-311ra174. http://doi.org/10.1126/scitranslmed.aaa9364