New research on type 2 diabetes offers fresh hope for treatment

From thenews.com.pk

Scientists may be closer to a cure for Type 2 Diabetes than we think

Scientists at City of Hope have discovered a gene that plays a surprising role in the development of type 2 diabetes (T2D).

The gene, which is called SMOC1, seems to cause certain cells in the pancreas that are normally responsible for lowering blood sugar—to start doing the opposite and raise blood sugar instead.

These findings could open the door to new ways of treating, diagnosing, and possibly preventing T2D.

                                                        New research on type 2 diabetes offers fresh hope for treatment

The study was published in Nature Communications and focused on understanding how insulin-producing cells in the pancreas disappear or stop working properly in people with diabetes.

The pancreas contains small clusters of cells known as islets. Within these islets, beta cells produce insulin, a hormone that lowers blood sugar, and alpha cells produce glucagon to raise blood sugar.

When produced properly by the pancreas the two hormones keep a healthy balance in the body, controlling blood sugar levels.

In people with type 2 diabetes, that balance is thrown off. Some beta cells begin to lose their identity.

Instead of producing insulin, they start acting like alpha cells and begin making glucagon. This leads to higher blood sugar levels and a worsening of diabetes.

To understand why this happens, scientists analysed individual islet cells from 26 people—half had type 2 diabetes and the other half did not.

They used a powerful technique called RNA sequencing to study how the cells change over time.

The research team found that in healthy people, some cells were flexible and could mature into either alpha or beta cells.

But in people with diabetes, this flexibility was lost. Beta cells only transitioned into alpha cells, never the other way around. This one-way shift helps explain why insulin levels drop while glucagon levels rise in people with T2D.

This research does give hope that by targeting the root causes of type 2 diabetes at the genetic level, new treatments may one day be able to help millions of people better manage or even reverse their condition.

https://www.thenews.com.pk/latest/1387200-new-research-on-type-2-diabetes-offers-fresh-hope-for-treatment

What is Driving Type 2 Diabetes in the US?

From patientcareonline.com

Type 2 diabetes and its high and rising rates in the US are the result of a perfect storm of converging systemic, behavioural, environmental, and economic factors.

Type 2 diabetes (T2D) is a chronic, progressive disease marked by the body's inability to properly use insulin, a hormone essential for regulating blood glucose levels. In this metabolic condition, cells become resistant to insulin’s effects, prompting the pancreas to produce more of the hormone in an attempt to compensate. Over time, this compensatory mechanism fails, resulting in persistent hyperglycaemia. Prolonged elevation of blood sugar levels leads to systemic complications, including cardiovascular disease, neuropathy, chronic kidney disease, and vision impairment.

The scope of this disease in the US is staggering. As of 2021, approximately 38.4 million Americans (~11.6% of the population) were living with diabetes, with T2D accounting for between 90% and 95% of those cases.² Of these individuals, 29.7 million were diagnosed, while an estimated 8.7 million (nearly 23%) were unaware of their condition. Prediabetes is even more prevalent: nearly 98 million US adults—over one in three—were identified as having elevated blood glucose levels that place them at increased risk of progressing to type 2 diabetes.

The US faces a perfect storm of converging systemic, behavioural, environmental, and economic factors that drive its high and rising T2D prevalence.

Overweight and Obesity

Obesity is the most significant modifiable risk factor. More than 40% of American adults meet the clinical criteria for obesity, an endocrinologic condition that directly contributes to insulin resistance and metabolic dysfunction. Obesity in childhood is also rising and and poses a growing concern. Currently obesity affects nearly 20% of children and adolescents, a trend that further increases future risk of diabetes and related chronic diseases.

Sedentary Lifestyle

The lack of physical activity in the US is widespread with many contributing factors. Despite strong evidence that moderate exercise improves glucose control and reduces insulin resistance, fewer than 1 in 4 US adults meet the CDC’s physical activity guideline of 150 minutes of moderate-intensity exercise per week. Of interest, there is a growing body of research that supports "weekend warrior" activity, where an individual reaches the weekly exercise target in just 1 or 2 sessions. Evidence has shown that even this irregular exercise pattern is associated with a 33% reduction in cardiovascular mortality and a 21% decrease in all-cause mortality among people with T2D.

Dietary Habits, Ultra-processed Food

The American diet has also evolved in ways that increase risk for T2D. Consumption of ultra-processed foods and sugar-sweetened beverages is common, while intake of fibre-rich whole foods remains below national recommendations, according to the Department of Agriculture and Health and Human Services Agency. This dietary imbalance is particularly harmful in low-income neighbourhoods where access to fresh, healthy food options is limited. Research has consistently shown that this pattern of high-calorie, nutrient-poor intake is a potent contributor to the development of insulin resistance and progression to type 2 diabetes.

Demographics, Genetics

T2D prevalence is unevenly distributed across demographics and has genetic underpinnings as well. The likelihood of developing T2D increases with age, and the disease is more common in individuals with a family history of diabetes. Certain racial and ethnic groups, including Black, Hispanic, American Indian/Alaska Native, and Asian American populations, are at significantly higher risk. Remarkably, Black adults in the US are nearly 60% more likely to be diagnosed with T2D compared to white adults. Among American Indian and Alaska Native adults, the age-adjusted prevalence is 14.5%, nearly double the 7.4% seen in non-Hispanic white populations. While genetic predisposition accounts for up to 72% of heritable diabetes risk, individual gene effects are usually modest.

Social Determinants of Health, Health Care Access

Beyond individual behaviours and biological risk factors, the structure of the US health care and social safety net systems contributes to the crisis. Despite high per capita healthcare spending, many Americans lack reliable access to preventive care, nutrition counseling, diabetes education, and ongoing disease management. The economic burden is equally concerning. The average annual cost of diabetes per person is $16,750, and approximately 1 in every 4 US health care dollars is spent on diabetes-related care. The US also spends approximately $35 billion annually on insulin, yet cost-related underuse remains a barrier to glycaemic control for many people.

Although the National Diabetes Prevention Program, supported by both NIH and CDC, has demonstrated that modest weight loss and physical activity can reduce the risk of T2D by nearly 60%, the program is underutilized and also underfunded. Lack of awareness, poor reimbursement models, and logistical barriers have all hindered broader adoption, particularly in underserved communities.

The Built Environment Contributes

Research has demonstrated that environmental and urban design factors further exacerbate the issues that contribute to the escalating prevalence of T2D. Many American cities and towns are built in ways that discourage physical activity. Communities often lack sidewalks, bike lanes, or access to safe green spaces. This design limits opportunities for routine movement, which is essential for maintaining metabolic health. Additionally, growing evidence suggests that environmental pollutants, including airborne particulate matter, may increase diabetes risk, especially in urban areas with poor air quality.

When combined, all of these factors create a uniquely challenging public health landscape. While lifestyle-related contributors to T2D are well known, their impact is magnified by systemic inequities in food access, housing, education, and healthcare. These intersecting issues form a web of vulnerability that makes the US particularly susceptible to the epidemic levels of diabetes.

How to Stem the Tide

Yet the trajectory is not irreversible. Evidence-based interventions, including lifestyle modification, early screening, community-based prevention programs, and policy reforms targeting food systems and urban planning, offer powerful tools to reduce new cases and improve outcomes for those already affected. To succeed, these interventions must be accessible, equitable, and supported by systemic changes that address the root causes of diabetes, not just its symptoms.

https://www.patientcareonline.com/view/what-is-driving-type-2-diabetes-in-the-us- 

Can you prevent type 2 diabetes if it runs in your family?

From hindustantimes.com

Health experts reveal whether diabetes can be prevented and if not prevented, can it be delayed if it runs in your family

If diabetes runs in your family, there is a fair chance that many of you might be pre-diabetic and some of you will get diabetes sooner or later. However, whether it's because of genetics or other factors, there are ways to lower the risk by developing a healthier lifestyle, form healthy habits and minimise your risk of getting diabetes even if you have inherited a diabetic causing gene.

In an interview with HT Lifestyle, Dr Ravi Gaur, Founder and Director of DRG Path Labs, shared, “There are many ways to lower the risk or definitely delay the onset of diabetes. Healthy lifestyle habits like, regular exercises (2-4 hours a week) and healthy eating (low sugar intake, specially in drinks and desserts) play a very important role in reducing the risk. One important thing to remember is that timing of your meal matters. Some people might do better with smaller and more frequent meals, while some do better with intermittent fasting. In general it's advisable to avoid eating late in the evening, when our glycaemic response to food, tends to be higher and less optimal.”

He suggested a few of the other ways including -

1. Avoid alcohol and smoking

2.Get enough sunshine and vitamin D

3. Monitor weight at regular intervals and keep weight a little below ideal limit

4. Avoid stress - Stress can increase craving for sugars and can prevent insulin producing cells from working the way they should .

5. Take preventive health checks at regular intervals in thyroid function tests. The important blood tests to be taken are - Blood sugar fasting & two hours after meals, HBa1C, urine routine ,liver enzymes and lipids.

6. Monitor blood pressure at regular intervals.

Dr Ravi Gaur insisted, “Everyone can have different response to different factors, so it's advisable to consult your healthcare provider at regular intervals for guidance. It can be tough managing even just one method. You may start slow to incorporate all in your daily routine. Once you have managed to do that ,you can definitely reduce your risk for developing diabetes, even if you are genetically susceptible.”

Bringing her expertise to the same, Dietitian Garima Goyal echoed, “Family history of diabetes predisposes a person to the risk of diabetes and even pre-diabetes. Diabetes can be prevented and if not prevented, it can definitely be delayed by following a healthy lifestyle, being physically active, eating a healthy diet and aiming to reduce to or maintain the ideal body weight.”

For preventing or delaying diabetes, she recommended following these lifestyle changes -

1. Weight loss - First, having a genetic history of diabetes and secondly being overweight or obese increases the chances of developing diabetes by two to three times. Shred the extra fat of the body with physical activity and diet.

2. Physical activity - Physical activity is very crucial for controlling the risk of developing diabetes. The activity can be of any form - walking, cycling, yoga or aerobics. Body’s insulin sensitivity increases and blood sugar levels remain maintained with physical activity. Include at-least 150 minutes of aerobic exercise in a week and you can also combine this exercise form with weight training sessions of 30-45 minutes twice or thrice a week.

3. Diet management - Have a diet full of complex carbohydrates and cut down refined carbohydrates and sugar. Eating a diet with fresh fruits and vegetables, legumes etc. helps a person to remain healthy and keep blood sugar levels regulated. Also watch your portion sizes and consume small and frequent meals.

4. Optimum sleep - For overall health, having 7 hours of sleep at a stretch is important. Diabetes is a lifestyle disease and if it runs in the family, chances of being diabetic increases but it is not necessary and it can surely be managed.

https://www.hindustantimes.com/lifestyle/health/can-you-prevent-diabetes-if-it-runs-in-your-family-101670723484969.html 

Ask the Doctors: Eating better, moving more help reduce Type 2 diabetes risk

From chicago.suntimes.com

Lifestyle changes — reaching a healthy weight and adopting a healthful and balanced diet — are important moves toward reducing your risk of developing the disease

Dear Doctors: Does Type 2 diabetes run in the family? My dad and sister both have it. I’m worried I’m next. We are a meat-and-potatoes family, and I’ve got a sweet tooth. I want to lose weight and eat healthier. Would a more plant-based diet help? What else can I do?

Dear Reader: Yes, Type 2 diabetes can run in families.

It’s a disease in which the body loses the ability to keep levels of blood glucose, also known as blood sugar, within a healthy range.

Too much glucose in the blood for extended periods leads to a range of serious health problems. Untreated, Type 2 diabetes can damage the heart, kidneys and nerves, cause vision problems and increase the risk of stroke.

The reason it can run in families is partly due to genetic makeup, which can give you a predisposition to the disease. Researchers have linked several genetic mutations to Type 2 diabetes.

Environmental factors also play an important role. Obesity, poor diet, sedentary lifestyle, low or high birth weight and stress all can contribute to developing the disease. But they don’t affect all people the same way. When these risk factors are present, people with a family history of Type 2 diabetes are more likely to develop the disease than those with no familial link.

The lifestyle changes that you are considering — reaching a healthy weight and adopting a healthful and balanced diet — would be important moves toward reducing your risk.

Adding regular daily exercise, which helps the body to manage blood glucose levels, would also improve your chances of avoiding the disease. And a strong body of research shows that a plant-forward diet is associated with a lower risk of Type 2 diabetes.

A recent study at Harvard University examined a vast body of data from 10,000 people who participated in a trio of decades-long health surveys. The participants were sorted into groups based on diet, and blood plasma samples and long-term health outcomes were analysed. The researchers found a strong correlation between a healthful diet rich in fresh vegetables, fruits, leafy greens, whole grains, nuts and legumes and a decreased risk of Type 2 diabetes.

Study participants with less-healthful diets — high in refined grains, sugary beverages, fruit juices, potatoes and sweets and desserts — had a measurably higher incidence of Type 2 diabetes.

They also were more likely to be overweight, have high blood pressure and cholesterol levels and use medications to control those conditions.

Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.

https://chicago.suntimes.com/2022/6/2/23151171/diabetes-diet-nutrition-eating-better-wellness-exercise

 

What causes type 1 diabetes and how to know whether you're at risk

From insider.com

Type 1 diabetes occurs when your immune system mistakenly attacks the pancreas and it no longer produces insulin.

The major risk factors for type 1 diabetes are a family history of the condition, the presence of other autoimmune diseases, and living in colder climates. 

Scientists don't yet know how to prevent type 1 diabetes from developing, but you can manage the condition by checking blood sugar often and living a healthy lifestyle. 

This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine. 

Diabetes is a chronic health condition that impairs the body's ability to use or produce insulin, a hormone that regulates the conversion of sugar from food into energy, resulting in dangerously elevated blood sugar levels.

This can happen whether you have type 1 or type 2 diabetes, though type 1 diabetes is less common.

There are many differences between type and type 2 diabetes, and only about 5% to 10% of people with diabetes have type 1 (roughly 0.5% of Americans).

Here's what you should know about the causes and risk factors for type 1 diabetes.

Causes 

"With type 1 diabetes, the body is essentially attacking itself at the pancreas so that it cannot produce any insulin," says Stephanie Redmond, PharmD, a certified diabetes educator and co-founder of Diabetes Doctor Supplements.

Scientists classify type 1 diabetes as an autoimmune disease, which is when your immune system mistakenly attacks your own body. But they don't know exactly what causes the body to attack the pancreas and halt the production of insulin.

Without insulin — a hormone that allows the cells in the body to absorb sugar (glucose) from the food you eat — the body is unable to fuel itself and is essentially starving. This may cause feelings of fatigue and hunger.

Most people with type 1 diabetes experience sudden and severe symptoms, in a matter of days or weeks. These can include rapid weight loss, vomiting, or loss of consciousness in the most extreme cases. If this occurs, you should seek medical attention immediately.

Risk factors

Although scientists don't know exactly what causes type 1 diabetes, they have identified certain risk factors, including:

Genetics and family history 

Variations in the HLA gene group on chromosome 6 are associated with type 1 diabetes. Specifically, the HLA-DR3 and HLA-DR4 genes have been linked to type 1 diabetes in caucasians, who appear to develop the condition more than other races.

Research shows that the younger a person is diagnosed, the higher the chance that their development of type 1 diabetes is a result of genetic factors. In fact, people who were diagnosed before age 11 are twice as likely to have a child with type 1 diabetes.

Men with type 1 diabetes have a 1 in 17 chance of having a child with the condition. Women with type 1 diabetes have a 1 in 25 chance of passing it on if they have a child before age 25, but that decreases to 1 in 100 if the child is born after the woman turns 25. 
Read more about type 1 diabetes and genetics, and what to do if it runs in your family.

Weather and climate  

Researchers have identified cold weather as a possible trigger for type 1 diabetes, though it is unclear why. According to the American Diabetes Association, the condition is more common in colder climates, and develops more often in the winter than the summer.
Moreover, a 2016 study published in the journal of the European Society of Paediatric Endocrinology concluded that cases of type 1 diabetes "seems increased in relatively cold weather."

Other autoimmune diseases

Existing autoimmune diseases may increase your risk of developing type 1 diabetes. For example, the following conditions occur at higher rates in those with type 1 diabetes:

• Autoimmune thyroid diseases (Hashimoto's thyroiditis and Graves' disease): 15% to 30% 
• Autoimmune gastritis or pernicious anaemia: 5% to 10% 
• Celiac disease: 4% to 9% 
• Vitiligo: 2% to 10% 

Prevention

There is little that can be done to prevent type 1 diabetes from developing because researchers don't yet understand exactly why the condition occurs.

However, research has indicated that breastfeeding and waiting until at least 4 months to feed babies solid food may reduce your child's risk of developing type 1 diabetes. Although researchers don't know exactly why this may be protective, they theorize that early feeding habits affect the health of the gut microbiome, which could have protective qualities against type 1 diabetes.

In addition, people with type 1 diabetes can prevent further health complications by actively managing their condition. For example, type 1 diabetics need to check their blood sugar regularly and take insulin daily. An insulin pump or continuous glucose monitor is usually an optimal form of treatment. Read more about how to check your blood sugar at home — and the best testing devices to use.

Overall, taking medication, exercising regularly, and eating a healthy diet can all help get your blood sugar levels under control. In fact, every 1% drop in A1C levels (a measure of blood sugar) can reduce your risk for serious health complications, such as nerve or blood vessel damage, Redmond says.

"Actively managing diabetes is so important because you don't want to cause damage that can't be reversed," Redmond says. "The more you can keep blood sugars in range, the less risk for complications down the road."

https://www.insider.com/what-causes-type-1-diabetes

What causes type 2 diabetes? Know the major risk factors and how to prevent it

From insider.com

Type 2 diabetes is caused by insulin resistance that develops over time. 

The main risk factors for type 2 diabetes include being obese, lacking physical activity, getting older, having a family history of diabetes, and belonging to certain races or ethnicities. 

To prevent type 2 diabetes, you can lose weight, exercise more, and adjust your diet — here's how. 

This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine. 

Diabetes affects more than 34 million Americans, or about 10% of the US population. There are two types of diabetes — and 90% to 95% of those with diabetes have type 2.

Type 2 diabetes is closely associated with obesity and is most common in people over the age of 45, although anyone can develop it. Here's what causes type 2 diabetes, the major risk factors, and how you can prevent it.

What causes type 2 diabetes?  

Type 2 diabetes is caused by insulin resistance, which is when the body can't use insulin properly. Insulin is a hormone produced in the pancreas, a gland located near the stomach. This hormone regulates the process of converting the sugar from food into fuel for your body.

When you have insulin resistance, excess blood sugar, in the form of glucose, builds in your body and deprives you of energy from the food you eat.

"The pancreas can still create insulin, it just doesn't work as well as it should, meaning sugar gets stuck in the blood instead of the insulin moving it into the cells of the body for energy," says Stephanie Redmond, a doctor of pharmacy and co-founder of Diabetes Doctor Supplements.

Insulin resistance first develops in people with prediabetes. One-third of Americans have prediabetes and up to 70% of those people will progress to type 2.

Unfortunately, many people with prediabetes don't know it because they have no symptoms, so regular check-ups — including blood work to check your blood sugar levels — is important.
The Centres for Disease Control and Prevention (CDC) also maintains a risk assessment tool for people concerned about their risk for prediabetes.

Risk factors

There are many proven factors that can increase your risk for type 2 diabetes:

Obesity 

Being overweight or obese vastly increases the risk for type 2 diabetes. In fact, research shows 80% to 85% of the risk of developing type 2 diabetes is controlled by obesity.

Overall, obese people with a body mass index (BMI) of 30 or more, are 80 times more likely to develop type 2 diabetes than people with a BMI of less than 22 (which is within the healthy range).

Sedentary lifestyle 

Not getting enough exercise or movement also increases the risk for type 2 diabetes.

For example, a 2016 study of nearly 2,500 people found that every extra hour of sedentary time each day increased the risk of developing type 2 diabetes by 22%.

Conversely, exercising for 30 minutes daily can reduce the risk of developing diabetes by up to 58% when combined with dietary changes. That's because during exercise your muscles use more blood sugar for fuels, reducing your blood sugar levels.

Age

Diabetes is most common in people over 45. In fact, about 25% of Americans over 65 have diabetes, and nearly all of that figure has type 2.

That's because insulin resistance increases with age, at the same time that the pancreas begins losing function, both of which can contribute to the development of type 2 diabetes.

Genetics

Although type 2 diabetes is largely caused by obesity and a sedentary lifestyle, genetics is also an important risk factor. For example, having a parent with type 2 diabetes increases your risk for the condition by 2 to 4 times.
"My favourite saying about type 2 diabetes is that genetics loaded the gun, and lifestyle pulls the trigger," says Redmond.
Read more about whether type 2 diabetes is genetic, and what to do if it runs in your family.

Race and ethnicity

Non-white Americans are more likely to develop type 2 diabetes. According to the American Diabetes Association, type 2 diabetes occurs in:

7.5% of non-hispanic white Americans

9.2% of Asian Americans

11.7% of non-Hispanic blacks

12.5% of Hispanics

14.7% of American Indians

A 2018 study looking at diabetes rates in Black Americans found that biological differences, including a body type that was more likely to have fat around the abdomen, accounted for most of the increased risk. But there are also socioeconomic risk factors: minorities may have less access to affordable health care or quality food options.

"Why these groups are more at risk is a complex question with no simple answer. For the most part, it's related to both environmental and genetic factors," says the Food and Drug Administration (FDA).

How to prevent type 2 diabetes 

Even if you have risk factors for type 2 diabetes, you can prevent the disease and reverse it during the initial stages of insulin resistance and prediabetes. In fact, researchers estimate that 90% of type 2 diabetes cases in the US can be prevented.

"The key is to act early so you can prevent the pancreas from wearing out and getting damaged," Redmond says.

For example, people who participate in lifestyle change programs backed by the CDC — including exercise and weight loss — can reduce their risk of type 2 diabetes by 58%. For people over 60, risk drops by 70%.

Here's what you can do to prevent type 2 diabetes if you're at risk:

• Lose weight. Dropping 7% to 10% of your body weight can reduce your risk for developing type 2 diabetes by 50%. Follow our guide for how to lose weight and talk to your doctor about what's right for you. 
• Exercise. Even moderate exercise, such as walking briskly for 30 minutes every day, can reduce your risk of developing type 2 diabetes by 30%. 
• Stop smoking. Cigarette smokers are twice as likely to develop type 2 diabetes. 
• Avoid excessive drinking. Heavy alcohol consumption can increase risk for type 2 diabetes, although moderate alcohol consumption may reduce risk by improving insulin effectiveness. 
• Adjust your diet. Eating whole-grain foods and avoiding sugary, processed snacks can help regulate your blood sugar levels. 

Preventative care and regular physicals are also important, since most people discover they have elevated blood sugars during routine blood work.

"This is why regular annual screenings are so important, to make sure if you have no symptoms we can still flag a higher than normal blood sugar and take action early," Redmond says.

https://www.insider.com/what-causes-type-2-diabetes