Low-fat vegan diet can cut liver fat by a third and improve insulin function in adults with type 2 diabetes

From medicalxpress.com

By Physicians Committee for Responsible Medicine 

Adults with type 2 diabetes who followed a low-fat vegan diet for 16 weeks, eating as much as they wanted, with no calorie counting or portion control, lost weight, reduced fat build-up in the liver and abdomen and improved insulin sensitivity and beta-cell function, according to a new clinical trial published in BMJ Open Diabetes Research & Care.

The study, led by researchers at the Physicians Committee for Responsible Medicine in collaboration with the Yale School of Medicine, is the first to simultaneously measure liver fat, muscle fat, visceral fat and tissue advanced glycation end products (AGEs) in a single plant-based dietary intervention in people with type 2 diabetes, offering a more complete picture of how diet reverses the underlying mechanisms that drive the disease.

Credit: Unsplash/CC0 Public Domain

"For years, people with diabetes have been told to count calories and measure portions. This study shows that a simple shift in what you eat—toward vegetables, whole grains, legumes and fruit—can reduce the fat clogging the liver by a third and improve how the pancreas makes insulin, without anyone having to count a single calorie," said Hana Kahleova, M.D., Ph.D., the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine.

Key findings include:

• Body weight fell by an average of 6.0 kg (13.2 pounds) (6.6%), driven mainly by loss of fat mass (-4.2 kg (-9.3 pounds)); visceral (abdominal) fat volume dropped by 290 cm³.
• Hepatocellular (liver) lipid content, a key driver of insulin resistance, fell by 33%.
• Tissue accumulation of advanced glycation end products (AGEs), which contribute to insulin resistance and beta-cell damage, decreased significantly.
• Insulin resistance (HOMA-IR) improved, and insulin sensitivity (OGIS and PREDIM) increased.
• Multiple markers of pancreatic beta-cell function improved, including glucose-stimulated insulin secretion, beta-cell glucose sensitivity, rate sensitivity and potentiation factor.
• HbA1c fell by 1.0 percentage point, and total and LDL cholesterol both decreased significantly.
• These changes occurred without a prescribed calorie target; participants were counselled to eat to satiety on a low-fat, plant-based diet (about 75% of calories from carbohydrates, 15% from protein and 10% from fat).

"This research adds to a growing body of evidence that food can work like medicine for people with diabetes. When patients don't have to weigh their portions or track every calorie, healthy eating becomes something they can actually sustain, and that is when we see real, lasting metabolic change," said Kahleova.

More information

Hana Kahleova et al, Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial, BMJ Open Diabetes Research & Care (2026). DOI: 10.1136/bmjdrc-2026-006472

https://medicalxpress.com/news/2026-10-fat-vegan-diet-liver-insulin.html

What Happens to Your Blood Sugar When You Take Ginger Supplements Regularly

From verywellhealth.com

Key Takeaways

• Ginger supplements may modestly lower fasting blood sugar in people with type 2 diabetes, but study results are mixed.

• Most research focuses on ginger powder or supplements, not ginger added to foods, for blood sugar control.
• Ginger supplements may interact with diabetes medications and cause blood sugar to drop too low, so consult a healthcare provider before use.

Ginger is a zesty spice commonly used in foods and beverages. Some research suggests that it may modestly improve blood sugar control in people with type 2 diabetes. However, most studies tested ginger powder or standalone supplements rather than ginger added to foods.

Taking ginger supplements may modestly improve your blood sugar levels, though more research is needed.    MarioGuti / Getty Images

Fasting Blood Sugar Levels May Decrease

Fasting blood sugar measures the amount of glucose (sugar) in the blood after at least 8 hours without eating. Some research suggests that ginger supplements may lower fasting blood sugar in people with type 2 diabetes, but results are mixed.

One systematic review and meta-analysis found that people with type 2 diabetes who took 1.2 to 2 grams of ginger powder daily for 4 to 12 weeks had fasting blood sugar levels about 19 milligrams per decilitre (mg/dL) lower, on average, than those who did not.

However, a more recent review of five clinical trials found no significant overall reduction.

Insulin Sensitivity May Improve

Insulin is a hormone that helps move glucose from the bloodstream into cells for energy. With insulin resistance, the body doesn’t respond to insulin effectively, which can cause blood sugar to rise. Insulin resistance is common in people with metabolic syndrome and type 2 diabetes.

Some research suggests that ginger may improve insulin sensitivity. In one study, people with metabolic syndrome who took 2 grams of ginger powder daily for 12 weeks showed improvements in insulin sensitivity and fasting blood sugar.

A systematic review and meta-analysis also found that ginger supplementation may reduce insulin resistance in people with type 2 diabetes and metabolic syndrome.

A1C May Decrease Over Time

Haemoglobin A1C (HbA1C) reflects your average blood sugar levels over the previous 12 weeks. One meta-analysis of 13 studies found that ginger supplements lowered A1C by about 0.4 percentage points in people with type 2 diabetes. The researchers noted that such a small decrease may not significantly affect blood sugar control on its own.

Not all studies have found this benefit. A 2024 review of five clinical trials found no significant overall reduction in A1C. Differences in ginger doses, study length, and design may explain the conflicting results.

Dietary Ginger May Have Less Effect on Blood Sugar

Most research on ginger and blood sugar has involved ginger powder or supplements taken daily for several weeks. Studies of ginger consumed with food or drinks are limited and show conflicting results:

• Ginger water: In one small study, 24 adults without diabetes who consumed a preparation containing 0.2 grams of ginger powder after a glucose drink had a smaller rise in blood sugar and a lower peak blood sugar over the following two hours.
• Ginger with food: Another study of 12 healthy adults found that adding 3 or 6 grams of ginger to rice pudding did not reduce the rise in blood sugar after eating.

These studies suggest adding ginger to meals may not have a meaningful or predictable effect on blood sugar. There is not enough evidence to know whether regularly eating fresh or dried ginger can lower fasting blood sugar or A1C over time.

Ginger Supplements and Safety

Research showing potential blood sugar benefits has primarily involved ginger powder or supplements rather than ginger added to foods. Although supplements may improve blood sugar control in some people with type 2 diabetes, they should not replace diabetes medications or treatments.

Ginger supplements may increase the effects of insulin and other diabetes medications, possibly causing blood sugar to drop too low (hypoglycaemia). Talk to a healthcare provider before taking a ginger supplement while using these medications.

Ginger may also cause side effects, including:

• Heartburn
• Stomach discomfort
• Diarrhoea
• Mouth or throat irritation

https://www.verywellhealth.com/ginger-supplements-and-blood-sugar-12058771 

Yale Researchers Identify New Strategy to Protect the Brain in Type 1 Diabetes

From medicine.yale.edu

By Jordan Shaked 

Insulin is a cornerstone of treatment for patients with type 1 diabetes, essential for lowering blood glucose levels. However, if insulin doses are not appropriately matched to the body’s needs, glucose levels can fall too low, resulting in hypoglycaemia, a common and potentially dangerous complication of treatment. Hypoglycaemia can impair thinking and cause symptoms ranging from dizziness and confusion to loss of consciousness.

New research from Yale, published in Diabetes, identifies a potential new strategy for protecting the brain from the cognitive effects of hypoglycaemia in people with type 1 diabetes.

The brain relies heavily on glucose as its primary source of fuel, explains Raimund Herzog, MD, MHS, associate professor of medicine (endocrinology and metabolism) and senior author of the study. “When glucose falls below a certain threshold, the neurons in the brain stop working properly,” he says.

The goal of all of our studies is to help people achieve better glucose control without the associated hypoglycemia. We’re dedicated to finding a safe way for people to maintain that balance.

Raimund Herzog, MD, MHS

Associate Professor of Medicine (Endocrinology)

“The easiest answer would be to take less insulin, but we know that higher glucose over the long term causes complications,” Herzog adds. “The challenge is balancing good glucose control with the risk of hypoglycaemia.”

Herzog and his team investigated whether ketones, molecules the body can use as an alternative source of energy, could protect the brain from the cognitive effects of low blood sugar. Specifically, the researchers focused on a ketone called beta-hydroxybutyrate.

“When patients with type 1 diabetes hear ketones, some of their alarm bells go off,” says Herzog. Ketones are often a warning sign for patients with type 1 diabetes because they can indicate diabetic ketoacidosis, a potentially life-threatening complication of severe insulin deficiency. When the body lacks insulin, as is the case in untreated type 1 diabetes, it rapidly breaks down fat and produces ketones, which can accumulate to dangerous levels and make the blood acidic, explains Herzog.

However, Herzog and his team found benefits of ketones when they explored them in a different metabolic setting. Participants in the study continued to receive treatment with insulin, while dietary supplementation was used to modestly increase ketone levels as an additional source of fuel for the brain when glucose was low.

The study found that participants who received dietary supplementation to increase their ketone levels performed better on tests of working memory during hypoglycaemia than those who received a standard diet, suggesting that increasing ketone availability may help preserve cognitive function when blood glucose is low.

The researchers believe this effect may be related to how the brain adapts to repeated episodes of low blood sugar. Previous studies have shown that recurrent hypoglycaemia increases the brain’s ability to transport certain alternative fuels, including ketones, across the blood-brain barrier. The findings suggest that dietary supplementation could take advantage of this adaptation, providing the brain with an alternative source of fuel when glucose is scarce.

Herzog hopes these findings could eventually offer an additional layer of protection for patients who experience recurrent hypoglycaemia, particularly those without access to technologies that continuously monitor glucose levels.

“Continuous glucose sensors and modern insulin pumps have made hypoglycaemia much less frequent, but not everybody has access to that technology,” says Herzog. “Globally, many patients still rely on insulin injections and finger sticks to measure their glucose, so hypoglycaemia remains a significant risk.”

Herzog also emphasized the collaborative nature of the research, which brought together expertise in endocrinology, neuroscience, and brain imaging through longstanding partnerships with Yale’s Magnetic Resonance Research Center. He believes this multidisciplinary approach will continue to drive advances in diabetes research.

“The goal of all of our studies is to help people achieve better glucose control without the associated hypoglycaemia,” says Herzog. “We’re dedicated to finding a safe way for people to maintain that balance.”

Endocrinology and Metabolism, one of 10 sections in the Yale Department of Internal Medicine, improves the health of individuals with endocrine and metabolic diseases by advancing scientific knowledge, applying new information to patient care, and training the next generation of physicians and scientists to become leaders in the field. To learn more, visit Endocrinology and Metabolism.

https://medicine.yale.edu/news-article/protecting-brain-type-1-diabetes/

Type 2 diabetes over time: What to expect as you age

From mcpress.mayoclinic.org

By Jessica R. Wilson, M.D.

Type 2 diabetes is one of the most common chronic conditions in the U.S. The way it affects each person, however, often varies substantially.

If you have type 2 diabetes, your age and the length of time since you were diagnosed are two major factors likely to influence your condition. Understanding these factors and anticipating changes can help you and your care team create a diabetes management plan that offers you ideal support now and for years to come.

How insulin production and insulin resistance change over time

When you eat food, your body breaks it down into a type of sugar called glucose. Glucose is fuel for your body’s cells. It enters your blood and gets into your cells with help from a naturally occurring hormone called insulin.

All forms of diabetes stem from an insulin issue. If you have type 2 diabetes, your body either doesn’t make enough insulin, can’t use insulin effectively or both. This causes glucose to build up in your blood. If your blood glucose level is too high, too often, it can cause issues throughout your body.

Your amount of insulin and its effectiveness tend to change over time. “It’s a supply and demand issue,” says Jessica R. Wilson, M.D., M.S., an endocrinologist and diabetes expert at Mayo Clinic in Jacksonville, Florida.

When you’re first diagnosed with type 2 diabetes, your pancreas — a vital organ in your abdomen — is typically able to produce insulin. However, the amount produced isn’t enough to match the demand. Type 2 diabetes also makes your cells less sensitive to insulin — a phenomenon known as insulin resistance. This means that more of the hormone is required to move sugar from your bloodstream into your cells.

Insulin resistance pushes the pancreas to produce more insulin. For some people, the pancreas is able to keep up with high demand. For others, it might not. Pancreas damage and age both can lower insulin production, says Dr. Wilson.

To address insulin supply and demand issues, people who have type 2 diabetes often take a medicine designed to lower their demand for insulin. If this isn’t enough to balance supply and demand or if their insulin production drops over time, extra insulin might be needed. This is known as insulin therapy.

Rarely will a person who has diabetes use the same treatment for a lifetime. Certain medicines may become less effective after a while. Switching to a different therapy could make it easier to manage blood glucose. Other factors such as diet and exercise might lower blood glucose and eliminate the need for one or more medicines.

The risk of type 2 diabetes complications can increase over time

Most people who have type 2 diabetes have an elevated risk of complications. Because blood flows throughout the entire body, the impacts of high blood glucose levels can affect many organs and structures. Common type 2 diabetes complications include issues in the heart, kidneys, nerves, eyes and feet.

Effective diabetes management can reduce these risks. Research shows that people with sustained high blood glucose have an elevated risk of developing a complication within the next 10 years. In comparison, people with blood glucose levels that are within the diabetic range, but are near the low end of that range, are less likely to develop a complication within the next 10 years.

Still, any level of sustained elevated blood glucose, including living with a blood glucose level in the prediabetes range, can increase the risk of complications. In addition, the risk of developing complications may be further elevated if you’re an older adult.

Regardless of your age or how long you’ve had diabetes, it’s important to monitor more than just your blood glucose. According to Dr. Wilson, you should start routine screenings for common complications immediately after you’ve been diagnosed with type 2 diabetes. This testing helps your care team identify and address any issues early on.

Why early type 2 diabetes treatment matters

Starting a diabetes management plan immediately after you’re diagnosed can limit the amount of time your blood glucose is too high. Additionally, some research suggests that treating type 2 diabetes early and intensively can create a “legacy effect.” By quickly lowering your blood glucose level with lifestyle changes, medications or other methods, you may have a lower long-term risk of complications, even if your level rises in the future.

Some diabetes treatments are more effective for people with a recent diabetes diagnosis. Metformin is a common diabetes medicine that lowers blood glucose in part by improving insulin sensitivity in the body’s cells. Research suggests that beginning treatment with metformin in the early stages of diabetes — before insulin production may have declined substantially — can lower blood glucose more effectively than starting the medicine later on.

How age influences type 2 diabetes management

Several factors influence how diabetes may affect you. Ethnicity, sex, genetics and other traits all play a part in the condition and are worth considering when planning your diabetes management strategy.

Age is one of the most influential factors in diabetes management. As part of a management strategy, a 30-year-old who has diabetes might benefit from a combination of medicines designed to quickly lower blood glucose. A 70-year-old with diabetes might benefit especially from a plan that includes weight-bearing exercise, such as walking or strength training. These types of activity may simultaneously help with losing excess body weight and preserving bone density, which naturally declines with age.

To ensure that you’re following the best management plan for your diabetes, consult healthcare professionals you trust. Finding a capable care team that recognizes your distinct needs and helps you build a personalized plan is a critical first step toward improved wellness.

https://mcpress.mayoclinic.org/diabetes/type-2-diabetes-over-time-what-to-expect-as-you-age/

What to Do If You’re Stranded at the Airport Without Insulin

From beyondtype1.org

By Christine Fallabel

Travel season is quickly approaching, and a lot of people will be racking up frequent flyer miles in the coming months. Air travel can seem miraculous: you wake up in your regular bed, in your regular town and can go to sleep across the country or even the world, just a few hours later. 

But like with any kind of travel, flying doesn’t come without hiccups. Delayed and cancelled flights, bad weather, mechanical issues, and missed connections can leave travellers stuck this summer. And for people living with diabetes, those hiccups can spell danger.

If you find yourself separated from your diabetes supplies—and most importantly, your insulin—it can turn into an emergency quickly.

This article will tell you exactly what you should do if you find yourself stranded at the airport without insulin. 

First, check in with your body

Maybe you missed your connection, and your checked luggage with your supply of insulin went with it. Maybe your flight got rerouted. Maybe you forgot your insulin at home. Maybe your site is ripped out and you don’t have any insulin in your carry-on bag. 

Try not to panic. You are not powerless in this situation, especially if you’re still within the United States, where diabetes is a protected disability. 

Start by assessing your physical state and how you feel. If you can check your blood sugar or have access to your continuous glucose monitor (CGM), make sure you’re within a healthy and safe range.

Next, hydrate

If your blood sugar is rising and you’re without any insulin (your insulin pump reservoir is empty or has been pulled out, or all your syringes and vials aren’t within reach), start drinking water immediately. Hydration is key. 

Hydrating won’t lower your blood sugar, but it can help you manage a spiralling high blood sugar in the short term. It will also help prevent dehydration, which can contribute to life-threatening diabetic ketoacidosis (DKA). So, drink up! 

This is the part where you ask for help 

Ask for help immediately. Do not wait, and do not apologize. 

Even if your blood sugar is lower than 100 mg/dL, you will need insulin eventually. Airports are staffed environments with layers of support—and for good reason! 

Millions of people with many different types of chronic conditions pass through airports every single day, and you aren’t the first person with diabetes to find themselves without their insulin. 

• Find an airport employee, go to the information desk, or ask an airline for a supervisor. Explain the situation: you have insulin-dependent diabetes, and you’re without your insulin. Explain that it is a medical necessity. 
• Some airports have pharmacies where you may be able to get an emergency supply of insulin. If not, most airports have first aid stations that are equipped to deal with medical emergencies, including diabetes. If nothing is available on-site, airport employees can connect you with local emergency services.
  
• On-site paramedics can assess your condition and, if necessary, transport you to a nearby hospital where insulin is available. If you’re hesitant about the cost or escalation, remember that untreated high blood sugar levels can become dangerous quickly. This is not an overreaction, and your health comes first. 
• Lastly, you can also talk with your airline. While they’re not medical providers, they do commit to passenger safety, especially if you’re stranded without insulin on a layover. 

In some cases, they may be able to help you with the logistics of your travel: rebooking a flight, helping you exit the airport and re-enter security more smoothly or connecting you with airport medical resources more quickly. 

Keep your phone charged and ready 

If you’re able, use your phone as a lifeline. Call your doctor, who may be able to send a prescription to a nearby pharmacy for an emergency pickup. 

Sometimes pharmacists can fill an emergency supply of insulin without a prescription, depending on your state. 

You can use your phone to map out the closest pharmacy and medical center to the airport where you’re located.

Leave the airport if you need to

Understandably, you may be hesitant to leave the airport. But forget about the logistics of your trip and remember that your health is the priority. Flights can always be rebooked. Accept that your travel plans might get derailed due to your diabetes, and that’s okay. So leave the airport if you need to. 

If you have family or friends in the city where you’re stuck, they may also be able to help. A trusted loved one may be able to drive you for medical care or to a pharmacy. 

Especially if you’ve let your airline know what’s going on, you should be able to re-enter the airport and catch your connection if your layover is long enough.

Don’t keep this to yourself

If you’re traveling with others, let them know what’s going on. It doesn’t help anyone to stress alone, and people almost always want to help.

Whether they can watch your bags for you while you seek assistance or stay with you as you call your doctor for guidance, support is crucial. 

Additionally, let your loved ones not traveling with you know what’s going on as well. If you’re at an airport nearby, they may be able to get your insulin to you quickly or know someone who can. Help is usually within six degrees of separation. 

You will get through this

Life happens. But you will get through this. Bags get lost, flights get rerouted and insulin vials shatter. But what’s important is to remember that most people know what diabetes is and they realize how important insulin is for a person living with diabetes.

If you lose money on a flight, so be it. You can rebook for another day. Nothing is worth the risk of DKA or life-threatening hypoglycemia. These are hard and unfair choices to make, but it is life with diabetes. 

So if you find yourself stranded at an airport without your insulin, take a breath. Drink some water. Ask for help loudly and fast. Use every resource available to you, and don’t board another flight until you have a backup plan in place. Your diabetes, your health and your life matter the most. 

https://beyondtype1.org/stranded-at-the-airport-without-insulin/