Concerns over rising cases of diabetes in young people

Several studies have shown that more people, especially teenagers are developing diabetes and are greater risk of limb amputation, kidney failure, heart attacks, stroke, blindness and cancer.

Head of the Endocrinology, Diabetes and Metabolism division of the Department of Medicine in the College of Medicine University of Lagos (CMUL) and the Lagos University Teaching Hospital (LUTH) Idi-Araba, Prof. Femi Fasanmade, told The Guardian that the rise in cases of diabetes is due to lifestyle and diet changes accompanying westernization. Fasanmade said there are now about 10 -11 million people with diabetes in Nigeria and the disease is now the commonest cause/factor in lower extremity amputation and kidney failure.

The diabetologist said obesity and diabetes also increase the risk of heart attacks, stroke, blindness and cancer.To address the situation, he recommended increased physical activity, weight loss, healthy diet and regular check ups for early detection.

A cancer expert, Prof. Ifeoma Okoye, told The Guardian: “Yes, globally, there has been an alarming rise in the prevalence of diabetes over the past few decades. The International Diabetes Federation estimates that as of 2019, approximately 463 million adults were living with diabetes worldwide and this number is expected to rise to 700 million by 2045.”

She said several factors are contributing to this surge. Okoye explained: “Consumption of processed foods high in sugars and unhealthy fats has increased substantially. These diets contribute to obesity, which is a significant risk factor for type 2 diabetes.

“Sedentary lifestyles, fuelled by changes in work nature, technology, and urbanization, have led to reduced physical activity. Exercise helps control body weight and improve insulin sensitivity.

“People are living longer due to advances in healthcare. Since the risk of type 2 diabetes increases with age, a larger elderly population results in more diabetes cases.

“Individuals with a family history of diabetes are more prone to developing the condition, but lifestyle factors usually trigger its onset.”

The physician said addressing this rising trend involves prevention, early detection, management, policy and infrastructure, and research and development.

The medical doctor explained: “Promote healthier diets and regular physical activities. Governments, communities, and businesses can work together to make fruits, vegetables, and whole grains more accessible and promote urban planning that encouragers walking or cycling.

“Screen for diabetes in populations at risk. Early detection can lead to earlier intervention and can delay or prevent the onset of diabetes complications.

“Ensuring that people with diabetes have the necessary resources to manage their condition is key. This includes access to medication, routine check-ups, expert advice, and education about managing diabetes.

“Policies and health infrastructure should support initiatives for preventative health, early detection, and treatment of diabetes. This includes regulation of food and promoting availability of health resources.

“Continued investment in research is essential to better understand diabetes, develop new treatments, and improve care.” She said these solutions would require the collective action from individuals, healthcare providers, health agencies, and governments alike.

According to research published in the Lancet, the number of people worldwide with diabetes is projected to more than double in the next three decades, reaching 1.3 billion by 2050.

The researchers found that 529 million people had diabetes in 2021 and that the climb in diabetes numbers would increase the prevalence of the disease from six percent of the world’s population to nearly 10 percent by 2050. The study’s findings are based on the analysis of data from more than 27,000 sources in 204 countries and territories.

Diabetes is a chronic disease that develops when a person’s blood sugar (glucose) level is too high. Ideally, the body converts most of the food you eat into glucose and releases it into the bloodstream, and the pancreas releases insulin, a hormone, to help get the glucose into the cells for energy.

For people who have diabetes, however, the body may make little or no insulin (Type 1 diabetes) or may not make or use insulin properly (Type 2), leaving too much glucose in the bloodstream. Over time, this can lead to serious health problems, including heart disease, stroke, kidney disease, limb amputation, nerve damage and vision loss.

The researchers found that about 96 percent of people worldwide who had diabetes in 2021 had Type 2, noting that the increasing prevalence of Type 2 diabetes worldwide is “primarily due to a rise in obesity.” They wrote that “the continued global spread of diabetes presents a massive public health challenge” for policymakers, health-care professionals and patients.

Also, the number of people living with diabetes is expected to grow over 100 per cent in Africa with the prevalence of the disease in Nigeria projected to rise to eight million by 2045.

This is according to a diabetes care report published by The Access to Medicine Foundation (ATMF), a Netherlands-based non-profit organisation. It added that the current estimate of 3.5 million living with the disease in Nigeria is probably understated due to poor diagnosis in many African countries.

COVID-19 pandemic linked to surge in child and teen diabetes

According to researchers, there has been an unusual rise in the number of children and teenagers around the world diagnosed with type 1 diabetes since COVID-19.

A new study in JAMA Network Open journal has collated available data from different countries, including the United Kingdom (UK), on more than 38,000 young people diagnosed during the pandemic.

The authors describe the increase in cases of diabetes as “substantial”. Before the pandemic, the incidence rate of childhood type 1 diabetes was already increasing – by about three per cent a year.

The recent study found: there was a 14 per cent rise in the rate during the first year of the pandemic, compared to before COVID-19 in the second year of COVID-19, the rate was up about 27 per cent on pre-pandemic levels.

What’s behind the rise? Experts say it is unclear what has triggered the surge in cases, but there are some theories. One such theory is that COVID-19 can trigger a reaction in some children which increases the risk of diabetes. But among the studies looking for this type of autoimmune reaction – where the body starts to attack some of its own healthy cells – not all have found evidence to support this theory.

Another hypothesis is that exposure to some germs in childhood can help guard against a number of conditions, including diabetes. Some scientists believe it is possible that lockdowns and physical distancing during COVID-19 meant many children did not get sufficient exposure to germs and missed out on this additional protection.

Can exercise help counteract genetic risk of disease?

New research has revealed being active could lower the risk of type 2 diabetes, even in people with a high genetic risk of developing the medical condition.

The University of Sydney-led study found higher levels of total physical activity, especially moderate- to vigorous-intensity physical activity, had a strong association with a lower risk of developing type 2 diabetes.

The findings were published in the British Journal of Sports Medicine. The researchers say the study demonstrates higher levels of physical activity should be promoted as a major strategy for type 2 diabetes prevention.

Fit to beat diabetes: study confirms power of exercise

In a recent study published in Nature Communications, researchers investigated the causality of the relationship between cardiorespiratory fitness and diabetes mellitus type 2 (T2D).

Fitness is linked to lower T2D risk; however, the causality of the association remains unclear. The United Kingdom Biobank (UKBB) data analysis showed that genes are linked to fitness. However, interpreting these findings is challenging due to skewed risk-stratified sub-maximal bike test data estimations.

In the present genome-wide association study (GWAS), researchers examined causal associations between fitness and T2D using genetic risk scores for cardiorespiratory fitness as variables in Mendelian randomization (MR).

The UKBB cohort of 450,000 Europeans was used to devise an optimised genomic instrument for cardiorespiratory fitness. The study identified 160 fitness-associated loci, validated in the Fenland trial comprising 10,707 individuals.

Overall, the study findings showed a strong linear inverse association between exercise-measured cardiorespiratory fitness and the risk of developing T2D. Fasting insulin, an indicator of insulin resistance associated with fitness, was most likely the cause of the relationship.

Since both have similar physiological functions with the oxidative ability of skeletal muscles, the link between cardiorespiratory fitness and insulin sensitivity is scientifically feasible.

On the other hand, the immediate impact of cardiorespiratory fitness on T2D risk was only marginally reduced, indicating that other mechanisms may be involved.

The researchers found several genes that code for proteins essential for smooth and cardiac muscle function and growth, supporting the relationship between cardiorespiratory fitness and T2D risk. Whole-food, plant-based diet linked to type 2 diabetes remission

New research shows that lifestyle intervention, including eating a whole-food, plant-predominant diet, could result in type 2 diabetes remission.

Plant-predominant diets may help with the reversal of insulin resistance.

Along with adopting healthier eating habits, weight loss, exercise, stress reduction, and avoiding alcohol can help treat diabetes.

Growing evidence supports the benefits of a whole-food, plant-based diet, which includes reduced blood pressure, lower cholesterol, improved heart health, and diabetes outcomes.

According to a new study published in the American Journal of Lifestyle Medicine, following a lifestyle intervention that involved adopting a whole-food, plant-predominant diet, patients showed potential to achieve type 2 diabetes remission.

The researchers examined the health records of 59 type 2 diabetes patients from a cardiac wellness program between 2007 and 2021, who followed a whole-food, plant-based eating pattern. The average age of the patients was 71.5 years, ranging from 41 to 89 years.

These patients demonstrated noticeable improvements in blood glucose control, and 37 per cent of the individuals in the study achieved full diabetes remission.

Additionally, the study showed an average reduction of glucose-lowering medications among patients who implemented these changes in their lifestyles.

An endocrinologist at Northwell Lenox Hill Hospital, who was not involved in this study, Dr. Caroline Messer, told Medical News Today: “This study demonstrates that high-fiber, low-fat plant-based diets can help achieve remission from (type 2 diabetes mellitus) in patients already receiving standard-of-care treatment. The study was unique because it did not require caloric restriction or fasting and had a primary endpoint of remission rather than improvement of diabetes.”

Foods high in fibre make one feel fuller longer, which decreases the likelihood of experiencing cravings and overeating.

“High-fibre foods can help slow down the spikes in blood sugar. High-fibre foods move slowly through the stomach and can help you feel full for longer. This, in turn, may make you less likely to reach for other foods or snacks, for example,” she explained.

“By avoiding meat, plant-based diets are often hypocaloric and therefore associated with improved insulin sensitivity. Some studies show that individuals following plant-based diets experience improved satiety and are therefore more likely to adhere to these diets,” Messer explained.

Additionally, plant-based diets are lower in saturated fats, which are thought to harm pancreatic B-cell function.

“A whole grain high fibre diet may improve insulin resistivity. Fibre may attenuate the glycemic response to oral carbohydrates by slowing the absorption of nutrients,” said Messer.

“Whole grains and legumes reduce postprandial blood sugars; whole grain foods may be fermented by bacteria in the small intestine, thereby producing fatty acids which improve insulin sensitivity after passing through the liver. In addition, whole grains contain high levels of micronutrients such as vitamin D, magnesium, antioxidants, etc., which all potentially improve insulin sensitivity.”

Previous studies have shown that whole-food, plant-predominant eating patterns can improve diabetes outcomes. However, the research mainly involved significant calorie restriction, often including fasting or liquid meal replacements.

“Healthy lifestyle dietary choices are most important. A balanced diet of high fiber foods, lean proteins, fruits, and vegetables as well as complex carbohydrates while avoiding refined sugars can help to improve blood glucose levels,” she advised.

Along with adopting healthier eating habits, weight loss, exercise, stress reduction, and avoiding alcohol can help treat diabetes.

To incorporate more whole and plant-based foods into their diet, it may be helpful to plan meals in advance, the experts interviewed by MNT suggested.

Frogs could spawn a new treatment for type 2 diabetes

New research presented at the Diabetes UK Professional Conference 2023, in April 2023, had revealed that a molecule secreted by frogs could offer a new treatment option for people with type 2 diabetes. The early-stage research found that a protein secreted by the East Asian bullfrog (Hoplobatrachus rugulosus) was effective at boosting insulin production as well as improving glucose tolerance in mice.

For many people with type 2 diabetes, keeping blood sugar levels within a healthy range can be challenging, and it is important that there are a variety of treatment options available, so people can find the approach that best suits them.

The GLP-1 group of type 2 diabetes drugs, such as dulaglutide (for example Trulicity) and semaglutide (for example Ozempic), have been based on molecules found in animal venom, and skin secretions from frogs are also known to have insulin-stimulating properties. Previous research funded by Diabetes UK identified a molecule within these secretions, called tigerinin-1r, that can boost insulin release and suppress glucagon, a hormone that raises blood sugar levels.

Dr. Opeolu Ojo at the University of Wolverhampton explored the effects of combining tigerinin-1r with a hormone called GIP, a component of an existing type 2 diabetes drug, tirzepatide (Mounjaro), which triggers the release of insulin from the pancreas and suppresses appetite.

The team found that when combined, the two molecules did not cause any safety concerns, and improved insulin secretion in cells in the lab. The dual-combination drug increased insulin production by 50 per cent in mice with type 2 diabetes compared to tigerinin-1r, and by 30 per cent compared to GIP alone. The combination drug was also more effective at improving glucose tolerance – a measure of how well the body moves glucose out of the blood and into cells in mice, than tigerinin-1r or GIP alone.

Ojo said: “Our research has uncovered great potentials of peptides from amphibian skin secretions, particularly their potential clinical use as novel agents for treating type 2 diabetes. By combining these peptides with some of the molecules that our body produces naturally, our desire is to create a safe and powerful alternative to current anti-diabetic medications which have many challenges, including their side effects and the ability to restore the body’s ability to control blood glucose.”

Sea cucumbers: The marine delicacy that can deter diabetes

They are a marine delicacy loved across Asia, but the humble sea cucumber is also proving to be a key ingredient in preventing diabetes, according to new research from the University of South Australia.

Exploring the medicinal properties of sea cucumbers (Holothuria scabra), researchers found that processed dried sea cucumber with salt extracts can inhibit a compound that is associated with increased risk of diabetes, thereby reducing the likelihood of the disease.

To date, there is no commercially available therapeutic agent to inhibit the formation of this compound, called Advanced Glycation End product (AGE).

AGEs form when proteins and/or fats combine with sugars in the bloodstream. When accumulated in high levels, they increase diabetic complications, including heart disease, Alzheimer’s, Parkinson’s, kidney disease, and cancer.