Cooking, diabetes and self-management education

An August 2022 study by the Ohio State University Wexner Medical Centre and College of Medicine said, 

• “… Cooking Matters for Diabetes may be an effective method of improving diet-related self-care and health-related quality of life, especially among individuals living with food insecurity…” 

• “Teaching cooking skills has been shown to help reduce the burden of food insecurity. But broader skills required to get food on the table, such as meal planning, shopping, budgeting, food safety and nutrition, are also of critical importance,”

• “We found that study participants ate more vegetables and fewer carbohydrates. We saw improvements, including significant changes in diabetes self-management activities and numerical lowering of A1C among food-insecure study participants. This is important, because food insecurity and a lack of access to nutritious food can make diabetes management and A1C control more difficult,” 

• “Many outcomes improved more substantially among individuals with food insecurity compared to those without. But during the post-intervention follow-up period, the food insecure group experienced greater regression, emphasizing the importance of sustained follow-up in populations made vulnerable related to one or more social determinants of health,”

Time restricted eating and diabetes

A July 2022 study by NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, the Netherlands said, 

“Mechanisms underlying the improvement in glucose regulation upon TRE [Time Restricted Eating] remain unclear. Our results show that TRE did not improve peripheral and liver insulin sensitivity, skeletal muscle mitochondrial function, energy metabolism or liver fat content, all of which are known to be affected in T2D [Type 2 Diabetes].” 

They concluded,  

“A daytime 10 h TRE regimen for 3 weeks decreases glucose levels and prolongs the time spent in the normal blood sugar range in adults with T2D as compared with spreading daily food intake over at least 14 h. These data highlight the potential benefit of TRE in T2D”

And “Since our TRE protocol was feasible and safe, and resulted in improved 24 h glucose levels, it would be interesting to examine the impact of 10 h TRE on glucose regulation and insulin sensitivity in type 2 diabetes in the long term to address the clinical relevance of TRE.”

Type 2 diabetes and Brown Fat

A June 2021 study by UT Southwestern said,

"We may be able to help make fat depots more metabolically healthy and potentially prevent or treat obesity-associated diabetes,"

Diabetes type 2: New Treatment pathway

A June 2021 study from University of Arizona College of Agriculture and Life Sciences and BIO5 Institute, and  Washington University in St. Louis, the University of Pennsylvania and Northwestern University,

• "All current therapeutics for Type 2 diabetes primarily aim to decrease blood glucose. So, they are treating a symptom, much like treating the flu by decreasing the fever,”

• "Obesity is known to be a cause of Type 2 diabetes and, for a long time, we have known that the amount of fat in the liver increases with obesity,”

• "As fat increases in the liver, the incidence of diabetes increases."

• "We found that fat in the liver increased the release of the inhibitory neurotransmitter Gamma-aminobutyric acid, or GABA," 

• "We then identified the pathway by which GABA synthesis was occurring and the key enzyme that is responsible for liver GABA production - GABA transaminase."

• "When the liver produces GABA, it decreases activity of those nerves that run from the liver to the brain. Thus, fatty liver, by producing GABA, is decreasing firing activity to the brain," 

• "That decrease in firing is sensed by the central nervous system, which changes outgoing signals that affect glucose homeostasis."

• "Inhibition of excess liver GABA production restored insulin sensitivity within days," 

• "Longer term inhibition of GABA-transaminase resulted in decreased food intake and weight loss."

Heart Health, Obesity: Cut 200 calories and exercise

An August 2021 study by Sticht Center for Healthy Aging and Alzheimer’s Prevention at Wake Forest School of Medicine in Winston-Salem, North Carolina found that 

• "Cutting 200 (not 250) calories daily and exercising may improve heart health in obese older adults" 

• “This is the first study to assess the effects of aerobic exercise training with and without reducing calories on aortic stiffness, which was measured via cardiovascular magnetic resonance imaging (CMR) to obtain detailed images of the aorta,” 

• “We sought to determine whether adding caloric restriction for weight loss would lead to greater improvements in vascular health compared to aerobic exercise alone in older adults with obesity.”

• “Our findings indicate that lifestyle changes designed to increase aerobic activity and moderately decrease daily calorie intake may help to reduce aortic stiffness and improve overall vascular health,”

• “However, we were surprised to find that the group that reduced their calorie intake the most did not have any improvements in aortic stiffness, even though they had similar decreases in body weight and blood pressure as the participants with moderate calorie restriction.”

• “These results suggest that combining exercise with modest calorie restriction — as opposed to more intensive calorie restriction or no-calorie restriction — likely maximizes the benefits on vascular health, while also optimizing weight loss and improvements in body composition and body fat distribution. The finding that higher-intensity calorie restriction may not be necessary or advised has important implications for weight loss recommendations to improve cardiovascular disease risk in older adults with obesity.”

Low GI dietary regime and diabetes

An August 2021 study found that low GI/GL dietary patterns “are considered an acceptable and safe dietary strategy that can produce small meaningful reductions in the primary target for glycaemic control in diabetes, HbA1c, fasting glucose, and other established cardiometabolic risk factors.”

“Our synthesis supports existing recommendations for the use of low GI/GL dietary patterns in the management of diabetes.”

Dietary Inflammatory Index and pre-Diabetes

Another study regarding the Dietary Inflammatory Index.

A 2017 study entitled Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study said,

“Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.”

Source

Department of Nutritional Sciences, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Heart Disease and Diabetes

An April 2021 study by Bichat-Claude Bernard Hospital, France, said, 

"Obesity and lack of exercise are common risk factors for both diabetes and heart disease and our results highlight the urgent need to improve nutrition and raise activity levels globally," 

"Countries worst affected by diabetes are also at the epicentre of the obesity epidemic, which can be in part attributed to urbanisation and associated changes in physical activity and food intake."

"Diabetes was linked with worse outcomes even in areas with the lowest prevalence. In Europe, for instance, diabetes was linked with a 29% greater risk of the combined outcome of heart attack, stroke, or cardiovascular death. This indicates that management of these very high-risk patients with heart disease and diabetes should be improved. Each country needs to identify these patients and provide tailored educational and prevention programmes."

"The importance of healthy eating and living cannot be overemphasised. Everyone can lower their chances of developing diabetes with weight control and exercise, and early detection is needed so that blood sugar can be controlled. Those with heart disease and diabetes also need an active lifestyle and a good diet to protect their health. Avoiding smoking is crucial, as is controlling blood pressure and cholesterol levels."

Sardines and Diabetes

A May 2021 study the Universitat Oberta de Catalunya's (UOC) Faculty of Health Sciences and the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) said,

"Not only are sardines reasonably priced and easy to find, but they are safe and help to prevent the onset of type 2 diabetes. This is a huge scientific discovery. It is easy to recommend this food during medical check-ups, and it is widely accepted by the population”

"As we get older, restrictive diets (in terms of calories or food groups) can help to prevent the onset of diabetes. However, the cost-benefit ratio is not always positive, as we found in other studies" 

"However, the results lead us to believe that we could obtain an equally significant preventive effect in the younger population."

"Nutrients can play an essential role in the prevention and treatment of many different pathologies, but their effect is usually caused by the synergy that exists between them and the food that they are contained in. Sardines will therefore have a protective element because they are rich in the aforementioned nutrients, whereas nutrients taken in isolation in the form of supplements won't work to the same extent”

metabolic pathways and disease

A March 2021 study headed up by Dr. Claudia Langenberg, looked at a number of unassociated metabolic processes linked to various diseases.

"We wanted to know whether there are certain markers in the blood that indicate a risk, not only for one but for several diseases at the same time," 

"We found, for example, that an increased concentration of the sugar-like molecule N-acetylneuraminate increased the risk of no less than 14 diseases," 

"Gamma-glutamylglycine, on the other hand, is exclusively associated with the occurrence of diabetes. Other members of the same molecular groups simultaneously increase the risk of liver and heart disease." 

"Overall, we observed that two-thirds of the molecules are associated with the occurrence of more than one disease. This is in line with the fact that patients often develop a range of diseases in the course of their lives. If we succeed in influencing these key factors, this could make it possible to counter multiple diseases simultaneously."

Eat earlier to reduce risk of diabetes

A March 2021 study by Northwestern University in Chicago found that, 

"People who started eating earlier in the day had lower blood sugar levels and less insulin resistance, regardless of whether they restricted their food intake to less than 10 hours a day or their food intake was spread over more than 13 hours daily," 

"With a rise in metabolic disorders such as diabetes, we wanted to expand our understanding of nutritional strategies to aid in addressing this growing concern," 

"These findings suggest that timing is more strongly associated with metabolic measures than duration, and support early eating strategies," 

The Liver, high blood sugar and muscle loss

A March 2021 study by Monash University said, 

"The ageing-related diseases of skeletal muscle loss and type 2 diabetes are very prevalent and are a huge societal and economic burden. We have known for some time that the ageing-related diseases of skeletal muscle loss and type 2 diabetes were linked but we didn't know how.”

"Our studies demonstrate that the liver is a critical control point for muscle protein metabolism; a discovery that is quite surprising. We believe that our new findings highlight the need to examine the role of skeletal muscle atrophy in type 2 diabetes more closely in human clinical populations."

Treatment for type-2 diabetic heart disease

In a very interesting March 2021 study by the University of Otago it was said,

• "Based on the results of laboratory testing, we identified the number of microRNAs that are impaired in stem cells of the diabetic heart”

• "Among several microRNAs we identified that one particular microRNA called miR-30c - which is crucial for the stem cells' survival, growth and new blood vessel formation - is reduced in the diabetic stem cells. All these functions are required for stem cell therapy to be successful in the heart.

• "Importantly, we also confirmed that this microRNA is decreased in the stem cells collected from the heart tissue of the patients undergoing heart surgery at Dunedin Hospital.”

• A "simple injection” “…resulted in significantly improving the survival and growth of stem cells in the diabetic heart,"

• "This fascinating discovery has newly identified that impairment in the microRNAs is the underlying reason for the stem cells being not functional in the diabetic heart. More importantly, the results have identified a novel therapy for activation of stem cells in the heart using microRNA, without the need to inject stem cells, which is a time and cost consuming process."

• "Apart from identifying the reasons for poor stem cells function in a patient with diabetes, the novel therapy of using microRNA could change the treatment method for heart disease in diabetic individuals."

• "Our initial analysis revealed that there might be another four potential candidate microRNAs. Therefore, it is essential to test the function of those microRNAs as well. It may be possible that combination therapy with more than one microRNA could further increase the beneficial effects."

Diabetes and Bedtime

A September 2020 study by the University of South Australia and the University of Leicester found that,

• "There is a massive need for large-scale interventions to help people with diabetes initiate, maintain and achieve the benefits of an active lifestyle,”

• "For people who prefer to go to bed later and get up later, this is even more important, with our research showing that night owls exercise 56 per cent less than their early bird counterparts.

• "Exercise plays an important role for people with diabetes, helping maintain a healthy weight and blood pressure, as well as reducing the risk of heart disease - all significant factors for improving diabetes management.”

• "This makes understanding the factors that can mitigate a person's propensity to exercise, extremely important."

• “The links between later sleep times and physical activity is clear: go to bed late and you're less likely to be active,”

• "As sleep chronotypes are potentially modifiable, these findings provide an opportunity to change your lifestyle for the better, simply by adjusting your bedtime."

• "For someone with diabetes, this is valuable information that could help get them back on a path to good health."

Eating Protein At Night

It may be that the time you eat protein impacts on the blood sugar level in different ways according to July 2020 research by the University of Bath. Eating protein at night may have a higher impact on blood sugars levels the following morning.

Eleanor Smith, who presented the work, said: "Future research will look at whether this applies to older and overweight people who tend to have more problems controlling their blood sugar levels. It would also be interesting to know to what extent our findings are due to eating at an unusual time or the type of protein consumed."

Sitting, Insulin Resistance, and Heart Disease

A February 2020 study by the Arizona State University College of Health Solutions said,

“We were surprised to observe such a strong negative link between the amount of time spent sitting and insulin resistance, and that this association was still strong after we accounted for exercise and obesity,"

"The findings of this study build upon earlier research including our own, which showed, among older women, that too much time in sedentary behaviors was associated with higher risk for diabetes and heart disease. Reducing sitting time improves glucose control and blood flow, and engaging in physical activities, even light-intensity daily life activities like cooking and shopping, show favorable associations with reduced mortality risk and prevention of heart disease and stroke."

"Health care providers should encourage patients, including older adults, to reduce their sitting time, take breaks in their sitting time and replace sitting with brief periods of standing or light physical activity."

Diabetes Management, Young & Old

A February 2020 study by the Mayo Clinic said,

"Patients who are older or who have serious health conditions are at high risk for experiencing hypoglycemia, which, for them, is likely to be much more dangerous than a slightly elevated blood sugar level … At the same time, the benefits of intensive treatment usually take many years, even decades, to realize. So many patients may be treated intensively and risk hypoglycemia for no real benefit to them."

But younger people, who are less likely to experience severe hypoglycaemia, "should be treated more aggressively, meaning that we should not shy away from using insulin or multiple medications to lower the A1C … We need to ensure that all our patients with diabetes receive high-quality care and are able to manage their disease to prevent complications both now and in the future."

"Patients who are treated intensively are those who are most likely to be harmed by it … But at the same time, patients who would benefit from more intensive treatment are not receiving the basic care that they need. The paradox and misalignment of treatment intensity with patients' needs is really striking."

"Patients least likely to benefit from intensive glycemic control and most likely to experience hypoglycemia with insulin therapy were most likely to achieve low HbA1c levels and to be treated with insulin to achieve them…These HbA1c levels reflect HbA1c levels achieved by the patient, not necessarily HbA1c levels pursued by the clinician."

"Most importantly, clinicians should continue to engage their patients in shared and informed decision-making, weighing the risks and benefits of glucose-lowering treatment regimens in the specific context of each patient, carefully considering the patient's comorbidity burden, age, and goals and preferences for care."

“We have a great opportunity to simplify and de-intensify the treatment regimens of our more elderly patients, which would reduce their risk of hypoglycemia and treatment burden without spilling over into hyperglycemia,"

"At the same time, we need to better engage younger, healthier patients, work with them to identify barriers to diabetes management, and support them to improve their glycemic control."

“As clinicians, we need to be current on the guidelines and the evidence, know our patients, and work closely with them to do what is right for them."

Sugar, Longevity, Uric Acid, Gout and Stones

A March 2020 study by the MRC London Institute of Medical Sciences and Kiel University said,

• "Just like humans, flies fed a high-sugar diet show many hallmarks of metabolic disease - for instance, they become fat and insulin resistant."

• "Obesity and diabetes are known to increase mortality in humans, and so people always assumed that this was how excess sugar is damaging for survival in flies".

• "Water is vital for our health, yet its importance is often overlooked in metabolic studies. Therefore, we were surprised that flies fed a high-sugar diet did not show a reduced lifespan, simply by providing them with an extra source of water to drink. Unexpectedly, we found that these flies still exhibited the typical metabolic defects associated with high dietary sugar".

The researchers found that the excess sugar is related to a build up of uric acid but that,

• "the sugar-fed flies may live longer when we give them access to water, but they are still unhealthy. And in humans, for instance, obesity increases the risk of heart disease. But our study suggests that disruption of the purine pathway is the limiting factor for survival in high-sugar-fed flies. This means that early death by sugar is not necessarily a direct consequence of obesity itself".

• "Strikingly, just like flies, we found that dietary sugar intake in humans was associated with worse kidney function and higher purine levels in the blood."

• "It will be very interesting to explore how our results from the fly translate to humans, and whether the purine pathway also contributes to regulating human survival."

• "There is substantial evidence that what we eat influences our life expectancy and our risk for age-related diseases. By focusing on the purine pathway, our group hopes to find new therapeutic targets and strategies that promote healthy ageing".

Diabetes, Fasting in Ramadan

A March 2020 study by the University of California of a protocol called “Fasting Algorithm for Singaporeans with Type 2 Diabetes” (FAST) found greater improvements in glycemic control of fasting adults with type 2 diabetes for that “those who managed their condition in collaboration with their health care provider using [the protocol].”

Low carbohydrate diets are also something which should be considered.

Diabetes, Obesity and Bacteria

A March 2020 study by McMaster University, Université Laval, and the Québec Heart and Lung Institute said,

• "Our findings suggest that in people suffering from severe obesity, bacteria or fragments of bacteria are associated with the development of type 2 diabetes,"

• "We know that the intestinal barrier is more permeable in obese patients."

• "Our hypothesis is that living bacteria and bacterial fragments cross this barrier and set off an inflammatory process that ultimately prevents insulin from doing its job, which is to regulate blood glucose levels by acting on metabolic tissues."

• "Location, location location...Beyond knowing the names of bacteria, their location is key to understanding how gut microbes influence host metabolism."

• "Our next objective is to determine if the bacteria found in the liver and fat deposits of people suffering from severe obesity are also present in those who are overweight or moderately obese."

• "We also want to see if certain pathogenic bacteria found in the tissues can trigger type 2 diabetes in an animal model. And lastly, we want to find out if certain beneficial bacteria found in these tissues can be used to prevent the development of the disease. If so, they might lead us to a new family of probiotic bacteria or a source of bacteria-based treatments to help fight diabetes."