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Tag: type 2 diabetes

  • Wegovy injections vs. pills: Doctors explain the differences

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    Wegovy injections vs. pills: Doctors explain the differences

    When it comes to GLP-1 pills vs. injections, doctors share which form may be best for you.

    Updated: 3:01 PM PST Jan 15, 2026

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    GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss. There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.Wegovy injection vs. pill: How does each work? GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.Which is most effective for weight loss?It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.Which works best?There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.“The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”Side effectsThe side effects are similar for both medications, Dr. Buettner says.These side effects may include:NauseaVomitingDiarrheaConstipationUpset Stomach “The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.

    GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?

    First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss.

    There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.

    Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.

    There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.

    It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.

    Wegovy injection vs. pill: How does each work?

    GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”

    After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”

    The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)

    These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.

    Which is most effective for weight loss?

    It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.

    Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)

    While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.

    Which works best?

    There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.

    There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.

    “The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”

    Side effects

    The side effects are similar for both medications, Dr. Buettner says.

    These side effects may include:

    • Nausea
    • Vomiting
    • Diarrhea
    • Constipation
    • Upset Stomach

    “The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”

    So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.

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  • Aiming for a healthier year? A doctor shares the 5 science-backed habits that matter most

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    (CNN) — Was that you I spotted at that New Year’s Day group class at my local YMCA? If not, don’t worry. It’s not too late. The start of a new year is a natural time to think about health and make resolutions for science-backed habits that make a difference over months and years.

    Rather than extreme diets or complicated regimens, decades of research point to a handful of simple behaviors that are consistently tied to better long-term health.

    To start the year right, I wanted you to know the most important things you can focus on this year to improve your current physical and mental well-being and have it pay off for decades to come. And yes, I know how hard it can be to realistically follow through when motivation is low or life gets busy.

    I asked CNN wellness expert Dr. Leana Wen to break down five practical, evidence-based actions that can make a real difference in 2026 and beyond. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

    CNN: For your first tip, you said to prioritize regular exercise. Why does exercise matter so much for health?

    Dr. Leana Wen: Regular physical activity is one of the most powerful tools we have for preventing chronic disease and improving quality of life. It benefits virtually every organ system in the body. Even short bouts of moderate exercise, such as brisk walking, can lower blood pressure, improve cholesterol levels, boost mood and strengthen the heart.

    For adults, the US Centers for Disease Control and Prevention recommend at least 150 minutes of moderate-intensity activity per week plus muscle-strengthening activities on two or more days. Even if you can’t hit those recommendations, some activity is better than none. If you do not currently exercise, start with a 5- or 10-minute brisk walk once a day; if you already walk regularly, try adding a few extra minutes at a time and increasing your pace.

    CNN: Your second tip is to get checkups at least annually. Why is that so important?

    Wen: Periodic checkups with a clinician are essential because many high-risk conditions develop silently. Hypertension, or high blood pressure, and type 2 diabetes, for example, often have no obvious symptoms until they have already caused significant damage to the heart, kidneys and blood vessels. Detecting and treating these conditions early dramatically lowers the risk of heart attack, stroke, kidney disease and other serious complications.

    A checkup gives you a chance to assess risk factors like cholesterol, glucose levels, body mass index and lifestyle habits. You also can establish monitoring or treatment plans with your provider before problems become severe. Timely treatment through lifestyle changes, medication or both can slow or even reverse disease progression.

    These visits also pose an important opportunity to review vaccinations. Recommendations and public messaging from federal health agencies may change, but your clinician can help you understand which vaccines are appropriate for you based on your age, health conditions and personal risk. Staying up to date on routine vaccines — such as flu, Covid-19 and others recommended for your situation — remains one of the most effective ways to prevent serious illness and protect both individual and community health.

    CNN: Your third tip is to get adequate sleep. Why does sleep matter as much as diet or exercise?

    Wen: Sleep is not optional; it’s a biological necessity that affects nearly every aspect of health we care about. Without adequate sleep, your body has trouble repairing tissues, regulating hormones and managing energy balance.

    Research suggests that chronic insufficient sleep is linked to greater risk of obesity, type 2 diabetes, cardiovascular disease and mood disorders. One reason may involve hormonal regulation: Sleep deprivation increases hunger hormones and decreases satiety hormones, which can promote overeating, especially of high-calorie foods.

    Sleep also affects immune function and cognitive performance, so consistent rest helps us to better respond to stress and supports memory, attention and emotional regulation. Most adults benefit from seven to nine hours of sleep per night, and prioritizing regular sleep schedules can improve quality over time.

    CNN: Your fourth tip centers on diet quality, in particular cutting out ultraprocessed foods. Why is working toward a healthier diet so important, and what steps can people take to improve nutrition?

    Wen: What you eat influences your health in important ways. Ultraprocessed foods have become a dominant part of the American diet, accounting for more than half of total calories in many age groups. These foods, which include sugary drinks, packaged snacks, fast food, ready meals and sweetened cereals, are generally high in added sugars, unhealthy fats and sodium, and low in fiber, vitamins and minerals.

    High consumption of ultraprocessed foods is linked to obesity, type 2 diabetes, cardiovascular disease, and even depression and mental health conditions. Replacing ultraprocessed items with whole or minimally processed foods (vegetables, fruits, whole grains, lean proteins, legumes and nuts) supports both physical and mental health and helps stabilize energy, blood sugar and appetite.

    CNN: Your fifth tip may surprise some people: Consider social connection a core part of staying healthy.

    Wen: Human beings are social creatures, and our relationships have direct implications for our health. Strong social connections with family, friends, colleagues and community groups are associated with lower rates of anxiety and depression, better immune function, and reduced risk of chronic diseases such as hypertension and diabetes. Conversely, social isolation and loneliness have been linked to increased risk of cardiovascular disease, cognitive decline and early mortality.

    Social connection motivates healthier behaviors and provides emotional support during stress, and it encourages engagement in physical activity and other positive habits. Simple acts, such as going for walks with friends, regular catch-up phone calls, shared meals or other group activities, are good for short-term mental health. These interactions also represent a long-term investment in your mental and physical health.

    CNN: What advice do you have for people trying to follow these five tips in real life?

    Wen: The most important thing is to concentrate on consistency. These habits do not need to be done perfectly to have an impact. Small, repeated actions add up. For instance, walking most days is far better than exercising hard once a month. Going to regular checkups is crucial, rather than waiting until something feels wrong. Improving sleep by even 30 to 60 minutes a night can make a meaningful difference.

    It also helps to remember that these five areas are deeply connected. Getting enough sleep makes it easier to exercise and eat well. Regular physical activity improves sleep quality and mood. Social connection supports motivation and resilience, making it more likely that people stick with healthy routines. So instead of treating these as separate goals, think of them as reinforcing one another.

    Finally, give yourself permission to start where you are. Health is not built in January alone, and it is not derailed by a bad week or a missed goal. The aim is consistent progress. Choosing habits that feel realistic and sustainable, and returning to them when life gets busy, is what makes these five tips work over the long run.

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  • Nearly half of people with diabetes don’t know they have it, new study finds

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    (CNN) — When was the last time you had your blood sugar checked? It might be worth looking into, a new study says.

    Forty-four percent of people age 15 and older living with diabetes are undiagnosed, so they don’t know they have it, according to data analysis published Monday in the journal The Lancet Diabetes & Endocrinology.

    The study looked at data from 204 countries and territories from 2000 to 2023 in a systematic review of published literature and surveys. The findings at the global level are for people age 15 and older.

    “The majority of people with diabetes that we report on in the study have type 2 diabetes,” said Lauryn Stafford , the lead author of the study.

    Around 1 in 9 adults live with diabetes worldwide, according to the International Diabetes Foundation. In the United States, 11.6% of Americans have diabetes, according to 2021 data from the American Diabetes Association.

    “We found that 56% of people with diabetes are aware that they have the condition,” said Stafford, a researcher for the Institute for Health Metrics and Evaluation. “Globally, there’s a lot of variation geographically, and also by age. So, generally, higher-income countries were doing better at diagnosing people than low- and middle-income countries.”

    Younger people don’t know they have diabetes

    People under 35 years were much less likely to be diagnosed if they had diabetes than people in middle age or older. Just “20% of young adults with diabetes were aware of their condition,” Stafford said.

    Routine screenings aren’t promoted as much for young adults as for older adults. Many larger organizations, like the American Diabetes Association, suggest annual routine screenings for adults 35 and older.

    “You can survive with elevated glucose levels for many, many years,” Stafford said. “People end up getting diagnosed with diabetes only at the point where they have complications,” which are more common in older adults.

    Depending on how long a person has had diabetes before it’s discovered, the health impacts may vary.

    “Diagnosing diabetes early is important because it allows for timely management to prevent or delay long-term complications such as heart disease, kidney failure, nerve damage, and vision loss,” said Rita Kalyani, chief scientific and medical officer at the American Diabetes Association. She was not involved in the study.

    Around one-third of adults are diagnosed with diabetes later than their earliest symptom, according to a 2018 study.

    What symptoms should you look for?

    “Symptoms of diabetes include increased thirst or hunger, frequent urination, blurry vision, unexpected weight loss, and fatigue. However, in the early stages, most people with diabetes are asymptomatic, which highlights the importance of screening and diagnosis,” said Kalyani, a professor of medicine in the division of endocrinology, diabetes and metabolism at Johns Hopkins University.

    If you experience any of these symptoms or have a history of diabetes in your family, experts recommend you get a glucose screening.

    Globally, in 2023, about 40% of people with treated diabetes were getting optimal results and lowering their blood sugar, said Stafford. That’s why it’s important that future efforts focus on ensuring that more people receive and follow proper treatment post-diagnosis.

    That only 4 in 10 patients were seeing optimal results was surprising, as several well-established treatments, including insulin, Metformin and other drugs like GLP-1s, are available.

    People with diabetes likely also have other health issues, such as hypertension or chronic kidney disease, which can make treatment complex, Stafford added.

    Can you prevent diabetes?

    It depends.

    While there is no known way to prevent type 1 diabetes, there are many ways to prevent the more common form of type 2 diabetes.

    Reducing the amount of red and processed meats you eat can help lower your risk of type 2 diabetes, as previously reported by CNN. You could do this with a Mediterranean diet or by introducing more plant-based foods to your meals.

    In addition, limit the amount of ultraprocessed foods you eat, adding more whole foods, like fruits and nuts, instead.

    Incorporating physical activity into your regular routine can also decrease your risk of developing not only diabetes but also other chronic diseases. Fast walking for at least 15 minutes a day is just one form of exercise you can do.

    “I think, ultimately, if we can also focus more on the risk factors for developing diabetes — preventing people from needing to be diagnosed in the first place — that is also critical,” Stafford said.

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  • U. of Virginia researchers explore new ways to manage diabetes – WTOP News

    U. of Virginia researchers explore new ways to manage diabetes – WTOP News

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    UVA Health is launching clinical trials for a new way to manage Type 2 diabetes that doesn’t rely on medications or weight loss.

    UVA Health is launching clinical trials for a new way to manage Type 2 diabetes that doesn’t rely on medications or weight loss.

    “We teach people how to control their blood glucose,” said Dr. Daniel Cox, professor of psychiatry and internal medicine at UVA Health.

    The treatment, developed by Cox, increases a patient’s physical activity to lower blood glucose levels. It also identifies the foods that patients should avoid because they’re known to raise blood glucose.

    “We encourage people to become more physically active after meals, walk their dog, go out for a walk with family members, do their outdoor chores, et cetera,” said Cox.

    During upcoming clinical trials, volunteers will have their blood glucose levels monitored constantly so they can see the relationship between their physical activities, food choices and their glucose levels.

    “The less their blood glucose level goes up in the first place, the less effort they have to engage in to bring it down, so people learn which foods push your blood glucose levels up a lot and which foods don’t push up your blood glucose levels at all,” said Cox.

    Cox notes that foods like oatmeal and cold cereal “all push your blood glucose up exceedingly,” but scrambled eggs and plain yogurt are examples of dietary options that “don’t push your blood glucose level up much.”

    The Centers for Disease Control and Prevention estimates that more than 38 million people in the United States have diabetes.

    “Type 2 diabetes accounts for about 90% of all diabetes,” Cox said.

    Get breaking news and daily headlines delivered to your email inbox by signing up here.

    © 2024 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

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  • WTF Fun Fact 13725 – Liver Response to Food

    WTF Fun Fact 13725 – Liver Response to Food

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    A recent study has unveiled a fascinating liver response triggered by the mere sight and smell of food, showcasing the body’s intricate connection between sensory input and metabolic processes.

    Food Cues and Rapid Liver Response

    Have you ever wondered what happens inside your body when you’re hungry and suddenly see or smell delicious food? Researchers from the Max Planck Institute for Metabolism Research have discovered a fascinating process in mice that begins in the brain and reaches the liver in just minutes. Their study, recently published in Science, could have significant implications for understanding and treating type 2 diabetes.

    When hungry mice were exposed to the sight and smell of food without eating it, their liver cells underwent rapid changes. The mitochondria, crucial for metabolism and energy production, adapted quickly to prepare for sugar metabolism. This reaction was triggered by the activation of specific nerve cells in the brain known as POMC neurons.

    The Science Behind the Sensory Influence

    The researchers focused on how the liver’s mitochondria changed upon just seeing and smelling food. This process involves a specific phosphorylation—a chemical modification important for regulating protein activity—within the mitochondria. Phosphorylation appeared to increase the liver’s sensitivity to insulin, an essential hormone for controlling blood sugar levels.

    Sinika Henschke, the study’s lead author, explains the significance of these findings. “We already knew that our bodies prepare for food intake by producing saliva and digestive acids,” says Henschke. “But now, we’ve seen how the liver, too, prepares rapidly through changes in the mitochondria.”

    The study further reveals a direct link between sensory perception of food and insulin sensitivity adjustments in the body. Jens Brüning, head of the study and director at the Max Planck Institute, emphasizes the importance of this discovery. “Our study shows how closely connected sensory experiences of food are to adaptive processes in the mitochondria and insulin sensitivity. This understanding is crucial, particularly because insulin sensitivity often diminishes in type 2 diabetes.”

    Implications for Diabetes Treatment

    These insights into the liver’s immediate response to food cues through brain signaling open new avenues for treating type 2 diabetes. By harnessing the body’s natural response mechanisms, researchers hope to develop methods to enhance insulin sensitivity and manage diabetes more effectively. Therefore, understanding these rapid adaptive processes in the liver can help in designing interventions that mimic or enhance the body’s natural responses to food stimuli, potentially offering a novel approach to diabetes care.

    In conclusion, this groundbreaking research not only deepens our understanding of the body’s interconnected systems but also offers hope for new treatments that could one day benefit millions of people with diabetes. As we continue to uncover the complex relationships between our senses, the brain, and metabolic processes, the potential for innovative therapeutic strategies expands, potentially transforming how we manage and treat metabolic diseases.

    — WTF fun facts

    Source: Food in sight? The liver is ready! — ScienceDaily

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  • CBD Provides Symptom Relief and Improvement in Gastroparesis – Medical Marijuana Program Connection

    CBD Provides Symptom Relief and Improvement in Gastroparesis – Medical Marijuana Program Connection

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    Pharmaceutical-grade cannabidiol (CBD) relieved symptoms in patients with idiopathic and diabetic gastroparesis and increased tolerance of liquid nutrient intake after 4 weeks of treatment in a phase 2 randomized double-blinded, placebo-controlled study recently published in Clinical Gastroenterology and Hepatology.

    There is “significant unmet medical need in gastroparesis,” and compared with cannabis, which has been used to relieve nausea and pain in patients with the condition, CBD has limited psychic effects with the added potential to reduce gut sensation and inflammation, wrote Ting Zheng, MD, and colleagues at Mayo Clinic in Rochester, Minn.

    The researchers assessed the symptoms of 44 patients (21 randomized to receive CBD and 23 to receive placebo) – each of whom had nonsurgical gastroparesis with documented delayed gastric emptying of solids (GES) by scintigraphy for at least 3 months – with the American Neurogastroenterology and Motility Society’s Gastroparesis Cardinal Symptom Index (GCSI) Daily Diary.

    They measured GES at baseline, and at 4 weeks, they measured GES again as well as fasting and postprandial gastric volumes and satiation using a validated Ensure drink test. (Patients ingested Ensure [Abbott Laboratories] at a rate of 30 mL/min and recorded their sensations every 5 minutes.) The two treatment arms were compared via 2-way analysis of covariance that included body mass index and, when applicable,…

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  • Just 2 Servings of Red Meat Per Week Raises Your Diabetes Risk

    Just 2 Servings of Red Meat Per Week Raises Your Diabetes Risk

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    THURSDAY, Oct. 19, 2023 (HealthDay News) — Think twice about ordering that double cheeseburger, salami on rye or juicy T-bone.

    Just two servings of red meat a week — processed or unprocessed — can increase your risk of type 2 diabetes by 62%, according to a new study.

    “A modest but statistically significant increase in risk was seen with even two servings of red meat per week, and risk continued to increase with higher intakes,” said lead author Xiao Gu, a postdoctoral research fellow at Harvard’s T.H. Chan School of Public Health in Boston. “Our findings suggest that replacing red meat with healthy plant-based protein sources, such as nuts and legumes, or modest intakes of dairy foods, would reduce the risk of diabetes.”

    The study can’t prove that eating red meat causes type 2 diabetes, but there appears to be a link.

    And a serving of meat is likely smaller than you might suspect.

    One serving of unprocessed red meat is about 3 ounces of pork, beef or lamb; a serving of processed red meat is about 1 ounce of bacon or 2 ounces of hot dog, sausage, salami, bologna or other processed red meats, Gu said.
    Red meat is usually high in saturated fat and low in polyunsaturated fat, Gu said.

    “Studies have shown that saturated fat can reduce beta cell function and insulin sensitivity, which results in type 2 diabetes,” he explained.

    “Red meat also has a high content of heme iron, which increases oxidative stress and insulin resistance and impairs beta cell function through its by-product of nitric oxide compounds,” Gu said. “For processed red meats, there is also a high content of nitrates and their byproducts, which promote cell dysfunction and insulin resistance.”

    For the study, Gu and his colleagues collected data on nearly 217,000 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study.

    Their diets were assessed with food questionnaires for up to 36 years. During this time, more than 22,000 participants developed type 2 diabetes.

    People who ate the most red meat had a 62% higher risk for type 2 diabetes, compared with those who ate the least.

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  • New Online Nutrition Program Marks a Pivotal Advancement for Type 2 Diabetes Management With Outstanding Clinical Outcomes

    New Online Nutrition Program Marks a Pivotal Advancement for Type 2 Diabetes Management With Outstanding Clinical Outcomes

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    WATERTOWN, Conn., September 12, 2023 (Newswire.com)
    –
    Innovative digital health research published in NATURE Nutrition & Diabetes on Aug. 27, 2023, demonstrated the effectiveness of the T2Diet Program to change the health of people living with type 2 diabetes. Led by Dr. Jedha Dening, type 2 diabetes nutritionist and founder of Diabetes Meal Plans, the T2Diet Study has shown that people can achieve significant improvements in blood sugar control, and reductions in weight and diabetes medications, in just a short time. 

    “The findings of the T2Diet Study are incredibly important and exciting,” remarks Dr. Dening. “The study proves we can make a significant and positive impact on people’s lives by reaching them anywhere to provide effective, accessible and practical solutions.”

    Addressing a Critical Gap in Diabetes Management

    With type 2 diabetes impacting an estimated 34 million Americans and projected to affect 1.3 billion globally by 2050, innovative solutions are paramount. 

    “With the growing number of people living with type 2 diabetes, scientifically proven digital interventions are the best way to reach people with the education and support they urgently need,” said Dr. Dening. 

    Life-Changing Results of the T2Diet Study

    In the 16-week blinded randomized controlled trial, 98 participants were divided into two groups: one engaging with the online T2Diet Program plus standard care, and the other continuing standard care alone.

    T2Diet Program participants saw vastly improved blood sugar control with an average reduction of nearly 1% in hemoglobin A1c, an average weight loss of 9.6 pounds and considerably reduced diabetes medications. In contrast, the standard care group saw marginal health changes and increased medication.

    “Beyond the confines of the study, we’ve seen people all across America, Canada and Australia achieving great results with the program,” notes Dr. Dening. “One person recently lowered their A1c by 4% and shed 40 pounds in 16 weeks. Witnessing these life-changing results is truly inspiring.” 

    A Leap Forward for Diabetes Health

    “Research on the effectiveness of digital dietary interventions for people with type 2 diabetes is still extremely limited, so this is a big step forward,” said Dr. Dening. 

    The success of the T2Diet Program marks a pivotal advancement in the field of type 2 diabetes management. By harnessing the power of online nutrition education and support, people can access the tools and resources they need to achieve lasting health improvements.

    The T2Diet Program is available to people around the globe, and provided alongside standard care, the study results show the enormous potential to make a real difference in many people’s lives.

    For more information on the T2Diet Program, visit https://t2diet.com 

    Source: Diabetes Meal Plans

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  • Recent Study Highlights the Impact of ApoA-IV on Diabetic Foot

    Recent Study Highlights the Impact of ApoA-IV on Diabetic Foot

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    WASHINGTON, August 30, 2023 (Newswire.com)
    –
     A recently published article in Experimental Biology and Medicine (Volume 248, Issue 8, April 2023) addresses the possible mechanisms by which Apolipoprotein A-IV (ApoA-IV) glycosylation exacerbates peripheral arterial atherosclerosis in patients with type 2 diabetes. The study, led by Dr. Tao Wang, Department of Thoracic and Cardiovascular Surgery, University of Chinese Academy of Science Shenzhen Hospital, utilizes a microfluidic real arterial chip model, using human internal mammary arteries to study the role of ApoA-IV glycosylation in diabetic peripheral atherosclerosis that can lead to diabetic foot syndrome. 

    Diabetic foot is a serious complication in Type 2 diabetes. At least 30~40% of patients with diabetic foot must undergo amputation because of poor lower extremity microcirculation and complete occlusion of lower limb small arteries. Apolipoprotein A-IV is a lipid-binding protein, and animal studies have shown that it has a role in anti-atherosclerosis, prevention of platelet aggregation and thrombosis. Poor glycemic control in patients with long-term diabetes leads to glycosylation of ApoA-IV, which stimulates the peripheral arterial inflammation, which leads to the arteriosclerotic and prethrombotic state. It is possible to prevent and delay the occurrence and development of diabetic foot by lowering blood glucose, recombinant Apo A-IV therapy and limiting the glycation of Apo A-IV

    The study, led by Dr. Wang, constructed a microfluidic arterial chip model that can precisely simulate real hemodynamics. They found that the glycated Apo A-IV from diabetic foot patients could significantly increase the production of tumor necrosis factor alpha in chip arteries, making the blood vessels more susceptible to atherosclerosis and thrombosis, which in Type 2 diabetic patients may lead to the development of diabetic foot. This work provides an experimental basis to further understand the pathogenesis of diabetic foot peripheral vascular disease. 

    Dr. Wang said, “Diabetes is a complex chronic metabolic disease that takes time for it to develop into diabetic foot complications. In addition to changing daily living and eating habits, the most important thing is to control blood sugar in the prevention of diabetic foot. Long-term hyperglycemia can lead to an increase in advanced glycation end products in tissue, which may cause glycosylation of a variety of proteins including Apo A-IV, which induces formation of peripheral arterial atherosclerosis and promotes the development of diabetic foot. The pathogenesis of diabetic foot is still not clear, but Apo A-IV-glycosylation-induced diabetic peripheral arterial disease may be one of the important mechanisms of diabetic foot.”

    Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicine, said, “This elegant study by Dr. Wang and colleagues uses a real human vascular organ on a chip model to study the mechanisms leading to diabetic peripheral arterial atherosclerosis that may eventually lead to diabetic foot syndrome. I see this microfluidic technology as a valuable tool for future studies on the pathogenesis of various vascular diseases and curative therapeutic approaches.”

    Experimental Biology and Medicine is a global journal dedicated to the publication of multidisciplinary and interdisciplinary research in the biomedical sciences. The journal was first established in 1903. Experimental Biology and Medicine is the journal of the Society of Experimental Biology and Medicine. To learn about the benefits of society membership, visit www.sebm.org. If you are interested in publishing in the journal, please visit http://ebm.sagepub.com/.

    For more information, please contact ebm@sebm.org.

    Source: Experimental Biology and Medicine

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  • Medicare targets 10 drugs for price cuts

    Medicare targets 10 drugs for price cuts

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    Medicare targets 10 drugs for price cuts – CBS News


    Watch CBS News



    The White House on Tuesday released a list of 10 medications that will be subject to price negotiations under Medicare. Ed O’Keefe reports on how this could affect prices and what other drugs could be added going forward.

    Be the first to know

    Get browser notifications for breaking news, live events, and exclusive reporting.


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  • Novo Nordisk limits distribution of low doses of Wegovy in U.S.

    Novo Nordisk limits distribution of low doses of Wegovy in U.S.

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    Eli Lilly seeks FDA approval for weight loss drug


    Eli Lilly seeks FDA approval for weight loss drug tirzepatide

    01:57

    Novo Nordisk is holding back low doses of Wegovy, its recently approved obesity medication, in the U.S. to conserve supplies for patients already using the drug, the company said Thursday.

    The Danish drugmaker is supplying “limited quantities” of 0.25 mg, 0.5 mg and 1 mg dose strengths to wholesalers for distribution to retail pharmacies, according to the statement. The holdback is a move to ensure existing patients have “continuity of care” amid the booming demand, a company spokesperson told the Wall Street Journal. 

    The Food and Drug Administration (FDA) approved Wegovy as a weight-management treatment in 2021. Like Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro, Wegovy belongs to a class of drugs known as GLP-1 agonists that have taken the weight-loss industry by storm. 


    The weight loss and type 2 diabetes drugs facing shortages | 60 Minutes

    01:54

    Endorsements by celebrities on social media touting the drugs’ powerful weight-loss effects have fueled nationwide shortages for people who rely on the life-saving medications for other health issues, such as Type 2 diabetes.

    “Today we are serving hundreds of thousands of U.S. patients with Wegovy,” the company said in the announcement. “However, trends indicate that demand for Wegovy in the U.S. will exceed our current supply capacity.”

    Working on expanding supply

    The Danish drugmaker is working to gradually expand its supply capacity by pausing promotions for the drug and closely managing shipments to wholesalers in the U.S., the company said. 

    Novo Nordisk did not immediately reply to CBS MoneyWatch’s request for comment. 

    Adult obesity rates in the U.S. have skyrocketed over the past two decades. The U.S. adult obesity rate jumped from 30.5% in 1999 to 41.9% in 2020, data from the National Health and Nutrition Examination Survey (NHANES) shows. In addition, the prevalence of severe obesity nearly doubled to 9.2% over the same time period.  

    The prevalence of obesity in the states makes the U.S. an ideal market for Novo Nordisk’s weight loss drugs — and it shows in the company’s earnings. Sales for its North America operations increased 47%, according to the company’s financial report for the first quarter of 2023.


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  • What’s New in Diabetes Treatment?

    What’s New in Diabetes Treatment?

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    Advances in Diabetes Treatment


    By
    Camille Peri
    WebMD Feature

    Diabetes treatment is getting better every day. Scientists may be just a few years away from making an artificial pancreas that can safely detect and adjust blood sugar (glucose) levels. In the meantime, new medications and insulin devices can make living with diabetes easier and safer now.

    “We’re getting more and more options,” says Michael German, MD, clinical director of the Diabetes Center at the University of California, San Francisco. “That’s good because no two people with diabetes are the same. It helps us get the right medicine for each person.”

    Recommended Related to Diabetes


    Is There a Hypoglycemia Diet?

    If you’ve ever gone too long between meals to eat and suddenly felt shaky, lightheaded, anxious, and cranky, you’ve had hypoglycemia. These unpleasant symptoms are your body’s way of warning you that your blood sugar (glucose) levels have fallen too low. (That’s what “hypoglycemia” means.)
    Glucose is the body’s main source of energy. In most people, blood sugar levels should be within a range of 70 to 99 milligrams per deciliter (mg/dL).
    Most healthy people only need a quick high-carb snack, such…


    Read the Is There a Hypoglycemia Diet? article > >

    Progress in Diabetes Care

    These treatments are or will soon be available in the U.S.


    • Afrezza. This insulin inhaler for adults with type 1 and type 2 diabetes hit the market in February 2015. You use it at the beginning of a meal for a boost of short-acting insulin. Unlike an older inhaler, which was the size of a can of shaving cream, Afrezza is easier to use and not as clunky to carry around. “It’s quite small – a little bigger than a whistle,” says Sethu K. Reddy, MD, chief of adult diabetes at Joslin Diabetes Center at Harvard Medical School in Boston. It’s probably not for you if you smoke or have a lung condition like asthma or emphysema.


    • Medtronic MiniMed 640G. This combined insulin pump and continuous glucose monitor is a step toward the artificial pancreas. It automatically stops pumping insulin when your blood sugar levels are trending down and starts again when they’re back up. “Hypoglycemia [low blood sugar] is a real problem, particularly for people with type 1 diabetes,” German says. It could be especially useful for people who have hypoglycemia but feel no symptoms. The device isn’t available in the U.S. yet, but it may come to the FDA for approval soon. 


    • Lucentis. Doctors already use this drug to treat the eye disease macular edema in people who don’t have diabetes. But in February 2015, the FDA made it the first eye medication for diabetic retinopathy, a serious eye problem linked to diabetes and a leading cause of blindness among U.S. adults.

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  • What’s New in Diabetes Treatment?

    What’s New in Diabetes Treatment?

    [ad_1]

    Advances in Diabetes Treatment


    By
    Camille Peri
    WebMD Feature

    Diabetes treatment is getting better every day. Scientists may be just a few years away from making an artificial pancreas that can safely detect and adjust blood sugar (glucose) levels. In the meantime, new medications and insulin devices can make living with diabetes easier and safer now.

    “We’re getting more and more options,” says Michael German, MD, clinical director of the Diabetes Center at the University of California, San Francisco. “That’s good because no two people with diabetes are the same. It helps us get the right medicine for each person.”

    Progress in Diabetes Care

    These treatments are or will soon be available in the U.S.


    • Afrezza. This insulin inhaler for adults with type 1 and type 2 diabetes hit the market in February 2015. You use it at the beginning of a meal for a boost of short-acting insulin. Unlike an older inhaler, which was the size of a can of shaving cream, Afrezza is easier to use and not as clunky to carry around. “It’s quite small – a little bigger than a whistle,” says Sethu K. Reddy, MD, chief of adult diabetes at Joslin Diabetes Center at Harvard Medical School in Boston. It’s probably not for you if you smoke or have a lung condition like asthma or emphysema.


    • Medtronic MiniMed 640G. This combined insulin pump and continuous glucose monitor is a step toward the artificial pancreas. It automatically stops pumping insulin when your blood sugar levels are trending down and starts again when they’re back up. “Hypoglycemia [low blood sugar] is a real problem, particularly for people with type 1 diabetes,” German says. It could be especially useful for people who have hypoglycemia but feel no symptoms. The device isn’t available in the U.S. yet, but it may come to the FDA for approval soon. 


    • Lucentis. Doctors already use this drug to treat the eye disease macular edema in people who don’t have diabetes. But in February 2015, the FDA made it the first eye medication for diabetic retinopathy, a serious eye problem linked to diabetes and a leading cause of blindness among U.S. adults.

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  • High Caffeine Levels Linked to Lower Body Fat, Diabetes Risk

    High Caffeine Levels Linked to Lower Body Fat, Diabetes Risk

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    March 17, 2023 — Having a higher level of caffeine in your blood could reduce body fat and the risk of type 2 diabetes, according to a new study published in BMJ Medicine. 

    Although additional research is needed, the findings open possibilities about the role that calorie-free caffeinated drinks could play in lowering the risks for obesity, diabetes, and other conditions.

    “Caffeine has been implicated in affecting metabolism and is commonly consumed in drinks. It is therefore important to better understand what causal effect it might have on metabolism,” said senior study author Dipender Gill, PhD, professor of epidemiology at Imperial College London.

    “However, we would like to emphasize that individuals should not change their dietary preferences or lifestyle based on the findings of our study alone,” he said. “Further validation in the form of clinical trials is warranted first. Furthermore, too much caffeine can also have harmful effects, so a balance is necessary.”

    Previous studies have found that drinking 3-5 cups of coffee per day is associated with a lower risk of type 2 diabetes and heart disease and drinking 100 milligrams of caffeine per day can increase energy expenditure by about 100 calories per day. An average cup of coffee contains about 70-150 milligrams of caffeine.

    However, most of the published research has focused on observational studies, which don’t prove cause and effect. Plenty of other factors could be involved, including other ingredients in caffeinated drinks and foods, according to lead author Susanna C. Larsson, PhD, of the Karolinska Institute in Stockholm, Sweden, and colleagues.

    Katarina Kos, MD, PhD, a senior lecturer in diabetes and obesity at the University of Exeter, UK, agrees. She said that this genetic study “shows links and potential health benefits for people with certain genes attributed to a faster [caffeine] … metabolism as a hereditary trait and potentially a better metabolism.”

    “It does not study or recommend drinking more coffee, which was not the purpose of this research,” she told the U.K. Science Media Centre. Kos wasn’t involved with this study.

    In the new analysis, the researchers examined data from 10,000 people mainly of European ancestry who participated in six long-term studies. 

    They examined two specific genetic mutations that have been linked to a slower speed of caffeine metabolism. In general, people with these two common genetic variants will have higher levels of caffeine in their blood after consuming coffee, or other caffeinated drinks, than those with faster caffeine metabolism.

    They then looked at how caffeine levels tracked with body fat, risk of type 2 diabetes, and risk of major heart conditions such as coronary artery disease, stroke, heart failure, and irregular heart rhythm.   

    The two gene variants resulted in “genetically predicted, lifelong, higher plasma caffeine concentrations,” the researchers note “and were associated with lower body mass index and fat mass, as well as a lower risk of type 2 diabetes.”

    There weren’t any strong associations in this study with a lower risk of developing any of the major heart conditions.

    They found that weight loss contributed to about 43% of the effect of caffeine on type 2 diabetes risk.

    “The finding that higher plasma caffeine levels may reduce bodyweight and risk of type 2 diabetes seems to fit with what is known about its effects on metabolism,” Gill said. “We are now exploring the broader effects of caffeine on health outcomes and potential mechanisms that may be mediating this.”

    The researchers noted several limitations, including that they only studied two genetic variants and that the study participants had predominantly European ancestry. They also emphasized caution about drawing strong conclusions or changing behaviors.

    Kos agrees. “When considering coffee consumption and caffeine-containing energy drinks, one must be mindful of the potential negative offset by surplus calories in the form of sugar and fat in many of these drinks,” she noted. 

    “Even for the option of increasing the use of calorie-free caffeine drinks, a benefit has yet to be proven,” Kos said. 

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  • 80% With Diabetes Eligible for New Drugs, but Cost Is a Barrier

    80% With Diabetes Eligible for New Drugs, but Cost Is a Barrier

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    March 6, 2023 — More than 80% of U.S. adults with type 2 diabetes meet the criteria to use new treatment drugs, such as semaglutide, which is marketed as Ozempic, according to a new study published in the Annals of Internal Medicine.

    However, only about 1 in 10 of those who meet the criteria used the drugs in recent years, the study found. In addition, the high prices for some of the drugs means they may put them out of reach as the first drug treatment for these patients. Most people with type 2 diabetes are prescribed metformin initially, but generally have other medications added on, but some of the newer drugs are now recommended as first-line treatment for some. 

    “It’s critical that we continue to study the best ways to manage type 2 diabetes (including medications and lifestyle changes), but it’s also important to examine how available these methods are to people,” says lead author Shichao Tang, PhD, a researcher with the Division of Diabetes Translation at the CDC’s National Center for Chronic Disease Prevention.

    “This includes researching how many people are using certain tools or medications and how many people are eligible for them, which was the aim of this study,” Tang says. 

    A 2022 report from the American Diabetes Association and European Association for the Study of Diabetes recommended the use of certain drugs, such as Ozempic, which is given as a weekly injection, with other similar drugs available as daily injections, and oral tablets, for patients with type 2 diabetes. 

    This is because, as well as lowering blood sugar, these new drugs have been found to reduce the risks of complications of diabetes, such as heart disease and kidney disease, and they also result in weight loss, compared with older drugs. 

    The researchers estimated that, for the 22.4 million U.S. adults with diagnosed type 2 diabetes, about 82.3% would meet the recommended criteria to use drugs from these two new classes. About 94.5% of Medicare recipients with type 2 would be recommended to use them as well.

    However, only 3.7% of those who met the criteria used them during the study period and just 5.3% of those eligible for the oral tablets used them. 

    About 9.1% used either of them before the most recent 2022 guidelines, which opened up the medications as first-line treatment for patients with type 2 diabetes.

    Based on retail prices listed on a US-based website, a 30-day supply of an oral tablet drug can cost about $550-$600/month, while common injected drugs can run from a few hundred dollars for a daily injection or close to $1,000 for a version given weekly.

    Prior studies suggest that the two drug types could be cost-effective as second-line treatments, the authors note. However, the current costs would need to drop by 70% for them to be cost-effective as first-line treatments. 

    Additional studies are needed to understand if the new treatments are cost-effective for certain patient subgroups as first-line medications.

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  • Common Plastics Chemical Tied to Higher Diabetes Risk in Women

    Common Plastics Chemical Tied to Higher Diabetes Risk in Women

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    By Cara Murez 

    HealthDay Reporter

    THURSDAY, Feb. 9, 2023 (HealthDay News) — Chemicals found in plastic personal care products, kids’ toys, and food and drink packaging could be raising the risk of type 2 diabetes among women, new research suggests.

    To study the impact of these chemicals, known as phthalates, researchers followed just over 1,300 U.S. women for six years to see if exposure contributed to the incidence of diabetes.

    About 5% of the women developed diabetes during the study period.
     

    The researchers found that white women exposed to high levels of some phthalates had a 30% to 63% higher chance of developing diabetes. The harmful chemicals were not linked to diabetes risk in Black or Asian women.

    Exposure to these endocrine-disrupting chemicals has previously been associated with reduced fertility and other endocrine disorders.

    “Our research found phthalates may contribute to a higher incidence of diabetes in women, especially white women, over a six-year period,” said Sung Kyun Park, an associate professor of epidemiology and environmental health sciences at the University of Michigan School of Public Health, in Ann Arbor.

    “People are exposed to phthalates daily, increasing their risk of several metabolic diseases. It’s important that we address [endocrine-disrupting chemicals] now as they are harmful to human health,” Park said in a news release from the Endocrine Society.

    The study, which was published online Feb. 8 in the Journal of Clinical Endocrinology & Metabolism, received funding from the U.S. National Institutes of Health, the SWAN Repository, the National Center for Research Resources and the National Center for Advancing Translational Sciences.

    “Our research is a step in the right direction towards better understanding phthalates’ effect on metabolic diseases, but further investigation is needed,” Park added.

    More information

    The U.S. Centers for Disease Control and Prevention has more on phthalates.

     

     

    SOURCE: Endocrine Society, news release, Feb. 8, 2023

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  • Artificial Pancreas Device May Help Folks With Type 2 Diabetes

    Artificial Pancreas Device May Help Folks With Type 2 Diabetes

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    By Denise Mann 

    HealthDay Reporter

     

    FRIDAY, Jan. 13, 2023 (HealthDay News) — An artificial pancreas has long been considered the holy grail for people with type 1 diabetes, and new research suggests a more convenient version of this technology may help the millions of people living with type 2 diabetes.

    Type 2 is the more common form of diabetes, and is closely linked to obesity.

    The pancreas produces insulin, the hormone that helps blood sugar (or glucose) enter cells to be used as energy.People with type 1 diabetes make little to no insulin. When insulin is in short supply, glucose builds up, causing extreme fatigue, blurry vision, weight loss and confusion. Some people with type 2 diabetes also need to take daily insulin to keep their blood sugar in check.

    Enter the artificial pancreas, an automated insulin delivery system that mimics the pancreas’ function.

    “About 20% to 30% of people living with type 2 diabetes use insulin therapy to manage their diabetes, and we have shown that this way of delivering insulin with a closed-loop system is much more effective than their current insulin injections at reaching glucose targets,” said study author Dr. Charlotte Boughton, a clinical lecturer at the University of Cambridge in England.

    With closed-loop systems for type 1 diabetes, the user enters information several times a day about the timing and size of their food intake, but insulin delivery between meals and overnight is automated. By contrast, the new system for people with type 2 diabetes is a fully closed loop. This means users don’t have to input any information.

    It was developed using over-the-counter devices, including an off-the-shelf glucose monitor and an insulin pump with an app called CamAPS HX. This software predicts how much insulin is needed to keep blood sugar levels in the target range. People wear the blood sugar sensor and insulin pump and carry a smartphone with them for the system to work, Boughton said.

    “This fully automated closed-loop system is a safe and much more effective way for people living with type 2 diabetes to manage their glucose levels than current standard treatment with insulin,” she said.

    Just how effective was it? When people with type 2 diabetes used the new system, they spent twice as much time with glucose levels in the target range than when they tested blood sugar and gave themselves insulin shots, the investigators found.

    Boughton said this is equivalent to an additional eight hours a day and was achieved without increasing the risk of dangerously low glucose levels.

    “We anticipate that the improvement in glucose control we have seen may reduce the risk of diabetes complications such as eye disease, kidney disease and amputations, but a much larger study with longer follow-up is required to investigate this,” she added.

    The new study included 26 people with type 2 diabetes. One group used the artificial pancreas for eight weeks and then switched to multiple daily insulin injections. The others were treated in the opposite order.

    On average, people using the artificial pancreas were within their target blood sugar range two-thirds of the time. This is double what was seen with standard insulin shots, according to the report.

    What’s more, people delivering insulin via shots spent two-thirds of their time with high glucose levels, compared with 33% when using the artificial pancreas, the researchers found.

    The system also helped reduce levels of glycated hemoglobin, or HbA1c, which provides a snapshot of blood sugar levels over time.

    No one in the study experienced dangerously low blood sugar, or hypoglycemia, which can occur if the device doesn’t keep blood sugar levels in the target range.

    And then there is the quality-of-life improvement that comes with not needing to constantly check blood sugar levels, inject insulin or take medication. Nine of 10 participants said they spent less time managing their diabetes when they used the artificial pancreas.

    This technology could be game-changing for millions.

    “The number of people diagnosed with type 2 diabetes is increasing globally, and people are diagnosed at a younger age, so they are living with type 2 diabetes for longer,” Boughton said. “Anyone with type 2 diabetes who struggles to keep glucose levels where they should be with insulin injections could benefit from this system.”

    The devices do cost more than standard insulin injections and glucose testing kits.

    “If the closed-loop system can reduce the risk of very expensive diabetes complications in the long-term — such as the need for dialysis, visual impairment and amputations — then they may be cost-effective. But a much larger study with longer follow-up is required to investigate this,” Boughton stressed.

    The researchers have previously shown that an artificial pancreas run by a similar algorithm is effective for those with type 1 diabetes and have also tested this system in people with type 2 diabetes who require kidney dialysis.

    These systems can be fairly simple to use: You wear the devices, load them with insulin and go about your daily routine, explained Dr. John Buse, chief of endocrinology and director of the Diabetes Center at the University of North Carolina at Chapel Hill.

    “No such device is available in the U.S. or, to my knowledge, anywhere in the world,” said Buse, who reviewed the new study.

    Similar investigational technologies cost about $10,000 per year for the devices, supplies, insulin and provider support, he said. “[They cost] more in the first year with acquisition costs and less over time,” he explained.

    More research is needed before this device is ready for prime time, but the promise is real, Buse added.

    “Keeping glucose in a relatively narrow range holds the promise of reducing long-term complications of diabetes — blindness, kidney failure, amputations, heart attacks, strokes, as well as minimizing the risk of urgent hospitalization related to high or low glucose, as well as potentially reduced risk of infection, cognitive decline and other important issues common in diabetes,” he said.

    The findings were published online Jan. 11 in Nature Medicine.

    More information

    Learn more about the artificial pancreas at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

     

    SOURCES: Charlotte Boughton, PhD, clinical lecturer, University of Cambridge, U.K.; John Buse, MD, PhD, professor, medicine, director, Diabetes Center and N.C. Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill; Nature Medicine, Jan. 11, 2023, online

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  • Could Intermittent Fasting Help People Ditch Diabetes Meds?

    Could Intermittent Fasting Help People Ditch Diabetes Meds?

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    Dec 15, 2022 – Some people with type 2 diabetes may be able to lose weight, lower their blood sugar, and stop taking diabetes drugs, if they follow anintermittent fasting diet for 3 months, new research suggests.

    Intermittent fasting – such as the 5:2 diet, which consists of eating few calories for 2 days followed by eating normally for 5 days – has led to weight loss in previous studies.

    But it hasn’t been clear whether intermittent fasting might lower HbA1c levels – a measure of a person’s average blood sugar levels over the past 2 to 3 months.

    And specifically, it was not known if intermittent fasting could let people revert to a non-diabetic state, known as diabetes remission – defined as having a blood sugar level below 6.5% for at least 3 months after stopping all diabetes medications. 

    This new study in 72 patients with type 2 diabetes in China showed that indeed, the 36 patients in the intermittent fasting group lost roughly 13 pounds and maintained this weight loss for 1 year, and close to half achieved diabetes remission. This compared with barely any weight loss for the 36 patients in the control group, of whom just 3% achieved remission.

    The results show that “type 2 diabetes is not necessarily a permanent, lifelong disease,” senior author Dongbo Liu, PhD, from the Hunan Agricultural University in China, said in a news release. “Diabetes remission is possible if patients lose weight by changing their diet and exercise habits.”

    “The large amount of weight reduction is key to continuing to achieve diabetes remission,” Amy E. Rothberg, MD, PhD, a professor of nutritional sciences at the University of Michigan, said in an interview. Rothberg was not involved with this study.

    The bottom line is that “lifestyle changes work,” she says.

    Although these findings are specific for an Asian population, they suggest that a similar approach could be tailored to other populations.

    People with type 2 diabetes who would like to try intermittent fasting need guidance from a dietitian, Rothberg says, to make sure their diet includes all the necessary micronutrients, vitamins, and minerals on fasting days. They also need to maintain a relatively balanced diet and not gorge themselves on feast days. 

    She also advises patients: “Try to reduce your calories by a method that you find sustainable, so that you can lose weight and maintain that reduced weight.” 

    The study was published Dec. 14 in The Journal of Clinical Endocrinology & Metabolism. 

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  • Low-Carb Diet May Be Better Than Counting Calories for Diabetes

    Low-Carb Diet May Be Better Than Counting Calories for Diabetes

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    Dec. 14, 2022 — Forget about counting calories. People with type 2 diabetes can lose weight and keep their blood sugar under control by eating a low-carb, high fat diet.

    This is according to a new study that found this type of diet did more to help patients with type 2 diabetes than a high-carbohydrate, low-fat diet. And this was true no matter how many calories the person ate. 

    These findings were based on a randomized, controlled trial, and the results were published in the journal Annals of Internal Medicine this week. 

    The trial looked at 185 patients with type 2 diabetes, for whom low-calorie diets are often recommended to help people lose weight and improve glycemic control, a medical term referring to the typical levels of sugar in a person’s blood.

    The trouble with this common recommendation, the investigators wrote, is that it often leads to hunger, so few patients stick to it.

    “Therefore, calorie-unrestricted diets may be a better alternative to achieve long-term maintenance,” wrote study author Camilla Dalby Hansen, MD, of the University of Southern Denmark, and colleagues.

    Study Methods and Results

    In the new study, the participants were randomly assigned to one of two diet-based groups. Twice as many participants were put into a group that ate the low-carb, high-fat diet and the other participants were assigned to the high-carb, low-fat diet for 6 months. No calorie restrictions were placed on either group.

    Patients’ weight, blood sugar control, and other health measures based on lab tests were evaluated at the beginning of the study, at 3 months, at 6 months. The final analysis included 165 patients.

    While patients in both groups lost weight, those in the low-carb, high fat group lost, on average, about 8 pounds more than those in the other group.

    The low-carb, high fat diet was linked to improved blood sugar control, but it also led to slightly higher LDL, or what doctors consider to be bad cholesterol levels. 

    “I believe we have sufficient data to include [low-carb, high-fat] as one of the diet options for people with type 2 diabetes,” Hansen said in a written comment.

    But she predicted that some patients would still struggle to stay on it in the real world.

    “The LCHF diet can be difficult for some people to follow,” Hansen said. “It is a bit more expensive, and it can be difficult to comply to in social gatherings simply because our society is not suited for this type of diet.”

    The Magic of Unrestricted Calories

    Jay H. Shubrook, DO, a diabetologist and professor at Touro University California, offered a similar view.

    “When you start to fiddle with the diet, it affects not only the person, but all the people they eat with, because eating is a communal experience,” Shubrook said in an interview.

    “What’s magic about this study is because it wasn’t calorie restricted, I think it made it a little bit more flexible for people to continue,” Shubrook said.

    He said he thinks patients will need a fair amount of coaching and education about food choices in order to lose weight on a diet without calorie restrictions.

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  • You Are Your Own Best Advocate

    You Are Your Own Best Advocate

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    You know managing your type 2 diabetes may bring challenges, but you shouldn’t feel this way in your doctor’s exam room. If you feel that you have unanswered questions about your condition, you may be able find ways to share your concerns and get better care. Being your own advocate and speaking up is key for managing your type 2 diabetes.

    What Is Self-Advocacy?

    Self-advocacy is representing your own interests as you manage your condition. It will help you as you  find, evaluate, and use information for your health. Learning to be your own advocate can help you feel like you’re in control of your type 2 diabetes, rather than the other way around, says Sneha Srivastava, PharmD, a certified diabetes care and education specialist in Chicago.

    Learn What You Can About Type 2 Diabetes

    You want to educate yourself and put a healthy living plan into action, with the understanding that you may need to tweak your plan along the way. “Learning as much as you can about type 2 diabetes is important. It’s the knowledge plus action that leads to healthy blood sugar levels and not having the complications associated with high blood sugars,” Srivastava says.

    To start, know your numbers (A1c, blood pressure, cholesterol levels) and what they mean. Get familiar with technology options you may have, Srivastava advises. There are apps and devices that can help you manage different aspects of diabetes. These include free phone apps to log what you eat or continuous glucose meters that can measure your blood sugar.

    “Understand the ‘How’ and ‘Why’ of your medication,” Srivastava says. “There now are meds that help lower your blood sugar, protect your kidneys or heart, or help you get to a healthy weight. And sometimes, depending on what insurance you have or if you have insurance, there are ways to choose the right medications that are also affordable.”

    Lifestyle has a big effect, too. Following your treatment plan helps prevent complications such as heart disease, nerve damage, and blindness. Habits like watching your intake of refined carbs, staying active, and managing stress can keep you off medication.

    All this may seem like a big ask at first. For help, you can ask for a referral to a diabetes care and education specialist (DCES). They’ll guide you through any fears or issues and to learn what to expect at your next appointment.
     

    How to Self-Advocate When You Face Care Disparities 

    Diabetes affects more than 34 million people in the United States, but it doesn’t affect all communities equally, according to the CDC. Managing type 2 diabetes can be especially important for Black, Native American, and Hispanic men and women. These groups are at a greater risk of getting type 2 diabetes, but often face an uphill battle when it comes to diagnosis and treatment. 

    “There are very real statistics that show people of color have higher rates of type 2 diabetes and complications from diabetes. What contributes to this disparity are injustices and unequal access to care and resources that exists in some communities,” Srivastava says.  

    “Being your own advocate is essential,” Srivastava says. According to her, this means ensuring that: 

    • Everything on your diabetes checklist is being addressed.
    • You are being referred to the right specialists as soon as you may need to see them.
    • You feel respected and heard.
    • Your values, culture, and preferences are being considered in your care. 

    If you don’t feel that this is the case, you have the right to find a health care provider that does do all of this and makes you feel a part of the team, Srivastava says.“No matter your race, ethnicity, or gender, diabetes can be managed in a healthy way [with care] based on patient preferences.” 

    Work With Your Health Care Team 

    Diabetes can affect you from head to toe, so make sure you are being referred to get your eyes checked, teeth cleaned, feet looked at, lab tests taken, and anything else in between. It takes a medical team to help keep you in your best health with type 2 diabetes.

    “Knowing where to get your information is just as important as the information itself,” Srivastava says. “Your health care team can help you navigate to find the right resources. It’s easy to get overwhelmed because there is so much information about diabetes, but you don’t need to know it all at once.”
     

    How to Be a Self-Advocate

    Be open and honest. Don’t be afraid of being judged. Even if you’re not usually comfortable speaking up, try to push yourself. If something isn’t working, your doctors may not know if you don’t tell them. It can mean the difference in your care and quality of life.

    “It is very natural to be hesitant or feel uncomfortable bringing up what you may need for your diabetes care during medical appointments,” Srivastava says. “It can be overwhelming, and sometimes, appointments can feel rushed.” There are things you can do to make it easier for you to be a part of the conversation:

    • Come prepared. Keep a diabetes notebook with all your information and all your questions to bring to your appointments.
    • Bring support. A trusted friend or family member can be calming and can also help you remember all that is said during the visit.

    “Too many times, people with diabetes are just told to eat better, move more, and take medications,” Srivastava says. “But what if … the medication costs too much, or you can’t figure out how to make the time to cook, or exercise isn’t working because your knees hurt too much?”

    “When you are part of the conversation, you can share what your barriers or challenges are to change, discuss what you are able and willing to do, and understand the recommendations being made,” Srivastava says. “And lastly, to be an advocate means trusting yourself. If something doesn’t feel right or if you feel like you are not truly understanding the recommendations or how to incorporate them, share and ask.”

    And when your treatment plan is working well, keep communicating with your doctors and pass along the good news. “At the center of this team is you, the person with diabetes. You know your body, experiences, goals, expectations, questions, and schedule,” Srivastava says. “You know how you’re going to best be able to make the changes to keep your blood sugar at healthy levels and keep the complications away.”

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