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Time limited eating helps in weight loss & type-2 diabetes.

Time limited eating helps in weight loss & type-2 diabetes.

According to recent studies, type 2 diabetics who practise time-restricted eating may experience weight loss and better blood sugar control.

According to a new randomized controlled research, those who restrict their eating to the eight hours from midday to eight o’clock lose more weight than people who lower their overall calorie intake by calorie counting.

However, experts advise patients to work closely with their doctor because certain medications and dietary needs may affect how beneficial a patient’s diet plan is.

In a recent study, people who restricted their eating to the hours between noon and eight o’clock lost more weight than those who merely cut their caloric intake overall by counting calories.

Despite the growing popularity of time-restricted eating, no studies had previously specifically examined an eight-hour meal window in people with type 2 diabetes.

In the study, 57 people with type 2 diabetes and obesity were divided into three groups: one group adhered to time-restricted eating, another group engaged in calorie restriction, and the third group acted as the control group.

The people in the time-restricted eating group could only eat between midday and 8 p.m., whereas the people in the calorie-restriction group could eat whenever they wanted as long as they kept track of their calories.

While the control group maintained eating normally without any special modifications, their objective was to cut their caloric consumption by 25% of what was needed to maintain their current weight.

Eating within a time limit reduces body weight.

The time-restricted eating diet resulted in a 3.55% weight loss in comparison to the control group during the course of the six-month study, according to the researchers.

To put this into perspective, it would mean that a person who weighs 275 pounds would have lost about 10 pounds.

Contrary to expectations, the calorie-restricted group did not significantly lose weight when compared to the control group.

In comparison to the control group, the time-restricted eating and calorie restriction groups both showed lower blood sugar levels (HbA1C), with decreases of about 0.91% and 0.95%, respectively.

The researchers also looked into whether these dietary approaches may lower blood pressure, lower LDL cholesterol, and lower fasting glucose levels, which are all cardiometabolic risk factors.

The weight loss brought on by time-restricted eating, however, did not reach the 5% mark usually linked with improvements in these parameters.

An interview with experts, Vicky Pavlou, registered dietitian nutritionist, University of Illinois at Chicago doctoral student, and author of the study, said, “We found that eating all calories within an 8-hour window is a good alternative to calorie counting for people with type 2 diabetes who want to lose weight and improve their A1C.”

“In comparison to the calorie counting group, the time-restricted eating (TRE) group dropped 4.28% of their body weight in six months. In both groups, the HbA1C was lowered by 1%, the expert said.

Calorie restriction versus intermittent fasting

Studies have previously examined the effectiveness of various dietary strategies among obese people. The prospective effects of time-restricted eating in individuals with obesity and type 2 diabetes, however, have not been studied.

75 obese persons with type 2 diabetes participated in the new study, which was directed by Vicky Pavlou, a doctorate student at the University of Illinois at Chicago who is also a registered nurse. Three groups of participants, ranging in age from 18 to 80, were created: control, calorie restriction, and time-restricted eating.

The calorie intake needed to maintain a person’s present weight (maintenance calories) was lowered by 25% for those in the calorie restriction group and remained unchanged for those in the control group. At any time of day, they could eat.

The time-restricted eating group, on the other hand, was only permitted to eat between noon and 8 p.m. every day without having a set calorie goal or keeping track of their consumption.

For the first three months of the trial, participants in both groups met with a dietician once per week; for the next three months, they met every other week.

Pavlou stated that the dietician “helped them with any challenges in following the diet and gave general nutrition advice,” emphasizing “the importance of reading labels and understanding calories.”

What kind of diet is best for those who have diabetes?

The researcher who was not engaged in this study, Dr. Seun Sowemimo, a board-certified surgeon at Prime Surgicare in Freehold, New Jersey, stressed that “using a combination of disease management tools is more effective than a single effort.”

Time-restricted eating (intermittent fasting) is a powerful strategy for weight loss and blood sugar control because it allows the body to switch from burning sugar to burning fat, resulting in weight loss,” he claimed.

Additionally, it helps diabetic control and lessens the frequency of blood glucose spikes, which can result in insulin surges.

Consuming whole meals with a high fibre content rather than processed foods with added sugar can also help people with diabetes maintain better blood sugar control. Unlike processed foods with free sugar, which are quickly absorbed and cause increased sugar levels and insulin spikes, natural fibre foods help regulate sugar absorption by allowing for a steady release into the bloodstream. Since the idea that fruit contains a lot of sugar is untrue, I also advise persons with diabetes to eat fresh fruits, stated Dr. Seun Sowemimo

Time-restricted eating “may help improve blood sugar control in individuals with type 2 diabetes,” according to registered dietitian Crystal Scott of Top Nutrition Coaching, who was also not involved in the study.

The insulin response may become more efficient by avoiding constant grazing and giving the body longer periods without food intake,” Scott said. Studies have revealed that time-restricted meals can increase insulin sensitivity, glucose levels, and HbA1c levels, which are indicators of long-term blood sugar control. But it didn’t in this study.

Potential effects on type 2 diabetic patients

Dr. Sowemimo stated that this “study adds another layer of clinical evidence that the timing of food consumption is a major contributing factor to diabetes management, weight loss, and overall well-being.

Patients with diabetes can safely be prescribed time-restricted eating, but they should do so in partnership with their physician,” Dr. Sowemimo stated.

Scott also emphasized the significance of investigating potential confounders, such as participant water intake, activity level, and stress-reduction techniques, as well as their use of diabetes medications.

Many additional factors must be addressed concurrently in order for a study like this one on dietary regimens to be entirely successful, according to Scott.

Scott further emphasized that this study shows there are “easier approaches to weight management that don’t involve tracking every piece of food,” even though people may recognize the necessity to implement time-restriction tactics to observe weight loss.


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Dahlias might be the newest diabetes weapon.

Dahlias might be the newest diabetes weapon.

Three chemicals found in the petals of vibrant dahlias may help people with prediabetes or diabetes maintain their blood sugar levels, according to recent studies. These substances lessen brain inflammation, which enhances insulin performance.

The discovery may help millions of individuals throughout the world who lack access to pricey and frequently unavailable drugs to some degree of blood sugar management.

D. pinnata dahlias are more than just exquisitely symmetrical flowers. Three chemicals that were discovered in the petals of these flowers, according to a recent study, may help persons with prediabetes and type 2 diabetes better control their blood sugar levels.

The researchers discovered that an extract containing the three dahlia compounds greatly enhanced the study participants’ control of blood sugar during a randomised, controlled, cross-over clinical trial.

Researchers from the University of Otago in Aotearoa, which is the aboriginal name for New Zealand, found in 2015 that a dietary flavonoid called lutein may be able to lower brain inflammation. Also, it improves blood sugar levels in people who have trouble controlling their blood sugar levels.

The dahlia flower’s petals are identified in the latest study as a source of butein and two additional compounds that increase its effectiveness.

The U.S. Centres for Disease Control (CDC) estimates that 37.3 million Americans have diabetes and 96 million Americans have prediabetes. The CDC believes that 8.5 million of them have not yet received a diagnosis. According to the World Health Organisation, diabetes affected 422 million people globally in 2014. Also, it directly contributed to 1.5 million deaths in 2019.

Uncontrolled diabetes can result in lower limb amputation, kidney failure, blindness, strokes, and heart attacks. Continuous blood sugar monitoring, lifestyle adjustments, and often taking insulin or medications that can aid with blood sugar control are required to prevent such results.

Treating diabetes with dahlias

The discovery that dahlias might contain the butein that his team had been looking for, according to study author Dr. Alexander Tups, was fairly accidental. He brought it up to a coworker over coffee. They then inquired, “Did you know that dahlias may contain that molecule?

International dahlia experts were cultivating dahlias in the extreme south of New Zealand and were willing to offer the flowers. Thus, this was the beginning of a magnificent trip, according to Dr. Tups.

The group created a button-containing extract, which was successfully tested on mice. The other two compounds that might increase the impact of butein were then discovered in cooperation with a group of plant chemistry specialists.

In a preclinical context, the researchers discovered that all three molecules are necessary to maximise the blood sugar-lowering impact.

Additionally, we were able to demonstrate that the compounds’ ability to suppress brain inflammation in mice. Also, their dependence on doing so for the glucose-lowering impact, said Alexander Tups, M.D.

Human trials revealed the extract was efficient and generated no observable negative effects.

The tablet form of Dahlia

Since then, the group has obtained a patent for their discovery, released their research, and launched Dahlia4, an extract for bettering blood sugar regulation. There is a tablet version of Dahlia4. The American Food and Drug Administration has not yet reviewed it.

Although various plant extracts have been identified and studied, Dr. Thomas Lutz, full professor of veterinary physiology at the University of Zurich, who was not involved in the study, observed that “the question is always about the availability, the efficacy, and potential toxicity.”

The discovery made here has a lot of importance in these regards, according to Dr. Lutz. According to Dr. Tups, the dahlia molecules may be capable of more than just regulating blood sugar.

We are now conducting a clinical trial in people with chronic fatigue syndrome or long COVID syndrome,” he said. “It showed promise in helping to improve brain function.”

Blood sugar regulation and brain inflammation

We know that ‘brain inflammation’ is associated with many metabolic disorders, e.g., access to high energy/high fat food, obesity, type 2 diabetes,” said Dr. Lutz.

The reduction of brain inflammation has been shown to improve/restore the sensitivity to various hormones involved in the physiological control of metabolism. Particularly in insulin and leptin,” the author added.

This idea has been around for a while. The issue was how to approach it in a way that benefits the patients concerned“, according to Dr. Lutz.

Why this finding is significant?

Dr. Lutz claims that “potentially, the discovery described here may be of benefit for a very large number of people.”

He clarified that in addition to the newly developed dahlia extract, there were numerous other therapy options that were either recently approved or that were being studied in pre-clinical or clinical settings.

He stated: “Many of these are pharmacological approaches based on agonists of endogenous hormones.” Adding, “Efficacy and safety is very good, [but] cost is high, and availability has been an issue.”

From a legal standpoint, we are not discussing drugs here; rather, we are discussing food additives. Their broad use may benefit from this,” according to Dr. Lutz.

Dr. Tups stated that there are “literally millions” of people who could gain from promoting normal levels of insulin and blood sugar.

Therefore, the finding is crucial for all patients with metabolic diseases, particularly type 2 diabetes mellitus, but possibly also with other illnesses where brain inflammation is involved, according to Dr. Thomas Lutz.


For Diabetes medications that have been suggested by doctors worldwide are available here

Depression: High blood sugar and lower grey matter links.

Depression: High blood sugar and lower grey matter links.

Around the world, 5% of adults are thought to be depressed. A known risk factor for depression is fluctuations in a person’s blood sugar levels.

The relationship between blood sugar levels and the likelihood of developing depression, according to Sun Yat-sen University researchers, may be mediated by decreased grey matter volume in the brain.

About 5% of the adult population worldwide suffers from depression, a mental illness that makes a person feel incredibly depressed and hopeless to the point where they are unable to enjoy their daily activities.

Variations in glycemia, or a person’s blood sugar levels, are one of the many risk factors for depression.

According to earlier research, people with diabetes, a disorder in which a person struggles to maintain adequate blood sugar levels, are two to three times more likely to experience depression.

The relationship between blood sugar levels and depression may now have a precise biological cause. This is according to researchers from Sun Yat-sen University in Guangzhou, China.

According to research, the association between blood sugar levels and the risk of depression may be mediated by a decreased grey matter volume in the brain.

Depression, blood sugar, and brain structure

According to Dr. Hualiang Lin, a professor in the Department of Epidemiology at Sun Yat-sen University and the study’s corresponding author, they chose to investigate the effect of blood sugar on the risk of developing depression. Earlier research has established a link between changes in blood sugar levels and the development of depression.

Also, a lot of research has shown a clear connection between depression development and changes in brain structure and function. As a result, the information that is now available strongly supports that brain anatomy may play a moderating role in the co-morbidity of diabetes and depression. As a result, we carried out this research to learn more about this connection, said Dr. Lin.

Changes in the amount of grey matter in the brain have been linked in the past to depression. According to a 2019 study, particular changes in gray-matter volume were linked to lifetime major depressive illness.

Additionally, a study conducted in 2022 discovered that individuals with significant depression, bipolar illness, and schizophrenia spectrum disorders frequently have lower hippocampus grey matter volume.

Examining brain’s grey matter

Dr. Lin and his team gathered information from more than 500,000 UK Biobank individuals between the ages of 40 and 69 for this observational study.

Researchers examined the data and discovered a “significant correlation” between sadness, decreased grey matter volume, and raised levels of HbA1c, or glycosylated hemoglobin.

A quick test called HbA1c determines a person’s blood sugar levels during the previous three months, or glycosylated hemoglobin.

In comparison to study participants with or without diabetes, researchers found that a reduced grey matter volume was associated with depression. This association was particularly pronounced in study participants with prediabetes.

Even if the outcome supports our hypothesis, Dr. Lin stated, “We are still very excited about it.”

Previous studies on the specific brain regions connected to depression have been rather scarce, frequently concentrating on well-established clinical regions such the hippocampus or prefrontal cortex. Contrarily, we were able to more thoroughly analyse and identify probable grey matter regions that may be connected to depression in our study since it made use of MRI data from hundreds of different brain areas,” he said.

Age as a risk factor for increased risk

Furthermore, participants in the study who were 60 years of age or older had the strongest correlation between decreased grey matter volume and depression.

According to Dr. Lin, “This finding has important public health implications, particularly for the neurological health of older individuals.”

In particular, the findings indicate that in older people compared to younger people, the decline in grey matter volume is more pronounced for every one unit increase in HbA1c. The difference can be more than twice as great in some brain regions, according to Dr. Hualiang Lin.

This study shows that we may soon face increased dangers to brain health and mental well-being, he said, “given the global trend of population aging and the rising risk of diabetes.”

What does a normal blood sugar level mean?

Glucose, sometimes referred to as blood sugar, is crucial for numerous bodily processes. It is the body’s main source of energy, to start. And glucose is what “feeds” the brain, keeping it active and maintaining connections amongst its associated nerve cells.

The food you eat, especially carbohydrates like starchy vegetables, whole grains, and fruits, provides the body with blood sugar. Glucose is released into the bloodstream as these nutrients are broken down by the body through the digestive tract.

The pancreas starts to secrete insulin as soon as blood glucose levels increase. To give the body’s cells with the energy they require, insulin aids glucose absorption.

An individual with diabetes or one who is at risk for getting it may have high fasting blood sugar levels:

  • A good fasting blood sugar level is one that is 99 mg/dL or lower.
  • Prediabetes is indicated by a fasting blood sugar level between 100 and 125 mg/dL.
  • One has diabetes if their fasting blood sugar level is 126 mg/dL or greater.

Hyperglycemia, or having too much glucose in the bloodstream, can cause the following symptoms:

Could controlling blood sugar lessen depression?

Dr. Daniel Pompa, a cellular health expert, author of the “Cellular Healing Diet,” and host of a weekly Cellular Healing TV podcast and YouTube show. He stated after reviewing this study that it has long been known that blood sugar levels have a significant impact on brain health. Also, this study only serves to further that understanding.

High glucose levels cause brain inflammation, which lowers cognitive function and emotional control. According to Dr. Daniel Pompa, long-term exposure to elevated glucose levels has been related to altered brain circuits that raise the chance of developing depression.

In those with prediabetes and type 2 diabetes, higher levels of glycosylated hemoglobin (HbA1c) are associated with a reduction in brain capacity. Elevated HbA1c is linked to decreased grey matter sizes in regions including the hippocampus, thalamus, and prefrontal cortex. This is according to several other research that have supported this, Dr. Pompa continued.

As a strategy to treat type 2 diabetes, Dr. Pompa said he would like to see further research on the impact of lifestyle modifications and fasting. It also brain scans to measure these people’s grey matter volume.

In particular, he asked, “Can reducing type 2 diabetes symptoms stop or even reverse the loss of grey matter and lower rates of depression?”

Dr. Matthew J. Freeby, director of the Gonda Diabetes Centre and associate director of diabetes clinical programmes at the David Geffen UCLA School of Medicine, said: “Unfortunately, depression is quite common in people living with diabetes, and there’s not much known as to the connection. For a better understanding of the problem’s causes and potential treatments, more research is urgently needed.

Although this research makes an interesting observation, Dr. Freeby stated that he did not believe we could yet identify physical changes in grey matter volume as the explanation.


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Links between sleep brain waves and blood sugar control.

Links between sleep brain waves and blood sugar control.

Diabetes is a disorder that makes it difficult for the body to regulate blood sugar levels.

When the body stops generating or responding to the hormone insulin, which controls blood glucose (sugar), blood glucose levels rise too high.

Poor sleep quality and higher blood sugar levels are related, according to research. A recent study has discovered that certain deep sleep brain waves are connected to the control of blood sugar levels.

The researchers hypothesise that elevating particular deep-sleep brain waves could lower the incidence of type 2 diabetes.

More than 6% of the world’s population currently has diabetes, which is on the rise globally. The American Diabetes Association estimates that 37.3 million Americans, or 11.3% of the population, have diabetes, with more than 35.4 million of those having type 2 diabetes.

96 million Americans aged 18 and older had prediabetes in 2019, which is a condition in which blood glucose (sugar) levels are increased but not high enough to be classified as diabetes.

The risk factor for type 2 diabetes, prediabetes, frequently has no symptoms and can go unnoticed for a very long time.

To lower the chance of acquiring type 2 diabetes, the National Institutes of Health recommend many lifestyle modifications, including:

  • if a person is overweight, reducing 5–7% of their body weight and maintaining that weight loss
  • getting up to 30 minutes of exercise five times each week
  • consuming fewer servings and making an effort to consume nutritious foods the majority of the time.

What connection exists between sleep and diabetes?

Numerous studies have connected poor blood glucose control and sleep issues. Raised blood glucose levels and a higher risk of type 2 diabetes are all linked to inadequate sleep length, poor sleep quality, and sleep disorders such insomnia and sleep apnea.

Now, a study has postulated a mechanism through which deep sleep is associated with lower blood glucose levels and contends that sleep quality rather than quantity is a better predictor of blood glucose levels.

Researchers discovered a connection between some deep sleep brain waves and better blood sugar regulation the next day.

According to the study, which was published in Cell Reports Medicine, deep sleep enhances the body’s sensitivity to insulin by stimulating the parasympathetic nervous system, leading to better blood sugar regulation.

According to study co-author and researcher Vyoma D. Shah of the Centre for Human Sleep Science, “the association with blood glucose control appears to be strongly explained by a link between deep sleep oscillations and specific alteration in insulin sensitivity, rather than insulin synthesis, storage, or secretion.”

The study noted that “the causal chain by which this occurs in humans is still unexplored.”

Brainwaves suggest a metabolic connection

Although she was not engaged in this study, Fiona McLoone, a research communications officer at Diabetes UK, commented:

This study gives us more information about how the brain regulates blood glucose levels while we sleep; however, more research is required to determine whether assistance with improving sleep could benefit those who have type 2 diabetes or are at risk for developing it.”

Previous studies have suggested that decreased glucose metabolism is related to a shortening of slow-wave, or deep, sleep.

In a laboratory experiment, it was discovered that healthy young people’ insulin sensitivity significantly decreased when slow-wave sleep was inhibited, which in turn reduced glucose tolerance and raised the chance of developing diabetes.

Researchers found that clusters of strong wave ripples from the hippocampus, which happen during non-REM sleep, caused a drop in blood sugar levels in the rats within 10 minutes.

In the current investigation, the researchers first examined 647 people’s nocturnal polysomnography results as well as their next-morning glucose and insulin readings. They subsequently conducted their trials once more on a different 1,996 subjects.

They were looking to see if coupled non-REM spindles the night before were linked to better peripheral blood glucose levels the next day.

Other variables known to affect blood glucose management, such as age, gender, race, body mass index (BMI), hypertension, quantity of sleep, and sleep quality, were accounted for in both groups.

They discovered that the coupling of slow waves and sleep spindles during deep sleep was connected to better blood glucose regulation the next morning.

How could REM sleep affect blood sugar?

The parasympathetic nervous system’s activity, according to the authors, may be the cause of the influence on blood glucose.

They discovered that deep sleep activated this area of the nervous system, causing the body to become more sensitive to insulin, causing the body to absorb more glucose from the bloodstream into cells, so reducing blood sugar.

As Shah commented that the results of our study are not applicable to all deep sleep in general, but rather to the coupling (nearly simultaneous or time-locked occurrence) of slow oscillations and spindles in deep sleep, despite the fact that there are numerous techniques that can alter brain waves during sleep, including electrical, audio stimulation, and better sleep hygiene to increase the ease of falling asleep and the likelihood of staying asleep.

The connection might not be direct

The researchers issue a warning that their results do not prove a causal link between better blood glucose regulation and deep sleep. They do, however, offer a theory as to how the link occurred.

According to Shah, “based on a seminal study in rats that inspired this study, it is plausible that during sleep, hippocampal sharp wave ripples which we index by measuring slow oscillation-spindle coupling in this study send a signal to a relay station called the lateral septum, which in turn modulates blood glucose levels.”

The authors also make the case that monitoring brain waves during deep sleep could be a non-invasive way to determine how well someone is controlling their blood sugar.

What will the upcoming research focus be?

We learned from Shah that “our findings are the first to demonstrate an association between these particular deep sleep brain waves (slow oscillation-spindle coupling) and glucose regulation, reiterating the significance of sleep in the clinical management of hyperglycemia.”

We hope this study paves the way for future research that can better understand the causal mechanisms underlying these associations, and eventually, develop therapeutics to enhance slow-oscillation spindle coupling during sleep, to better control blood sugar levels,” she continued.

She also outlined possible areas for further study, such as measuring glucose levels at various times and examining whether slow oscillation and spindle coupling may be used to change glucose regulation or vice versa.

However, as McLoone cautioned, “Some people are more at risk of developing type 2 diabetes than others, and getting a good night’s sleep is an essential component of good health, but currently the best evidence for reducing the risk of developing type 2 diabetes involves eating a healthy, balanced diet and keeping active.”


For Diabetes medications that have been suggested by doctors worldwide are available here

Exercise & weight loss can improve obesity and prediabetes.

Exercise & weight loss can improve obesity and prediabetes.

According to new research, people who are overweight and have prediabetes may benefit significantly from regular exercise when accompanied with weight loss via diet.

The goal of the study was to ascertain whether exercise had benefits in addition to those provided by diet-only weight loss.

The study examined two groups, one of which followed a diet plan plus exercise training and the other of which followed a diet plan alone.

According to the findings, the group that combined diet and exercise improved their insulin sensitivity by twice as much as the diet-only group, which is essential for controlling prediabetes.

Researchers from the Centre for Human Nutrition at Washington University School of Medicine in St. Louis, Missouri, examined the results of regular exercise paired with a nutrition programme for people in a recent study.

The individuals’ bodies’ sensitivity to the hormone insulin, which regulates blood sugar levels, was tested by the researchers.

According to the findings, those who made changes to their eating and exercise routines saw a twofold increase in their insulin sensitivity compared to those who only made dietary changes.

This indicates that their bodies used insulin to regulate blood sugar levels more effectively.

The participants’ muscles were also examined by the researchers, and they discovered that the group that changed their diet and exercise regimens had higher expression (activity) of genes related to the production of new mitochondria, which are cells’ energy factories, energy metabolism, and the development of new blood vessels.

They discovered no discernible differences between the two groups in terms of the amounts of specific amino acids or particular inflammatory blood indicators.

The composition of their gut bacteria also changed similarly in both groups, which can have an impact on general health.

Exercise for managing and treating obesity

We spoke with Dr. Sergio P. Ramoa of Atrius Health, who was not a part of the study, and he stated that “despite the growing focus and treatment of obesity and diabetes, diabetes-related mortality increased in the first 20 years of the 21st century.”

“The approach to treating obesity has altered, with a focus on treating it like a chronic illness like hypertension or asthma. There have been considerable advancements in the treatment of weight reduction and weight maintenance, according to Dr. Sergio P. Ramoa, as a result of changes in social, educational, and therapeutic attitudes.

In his statement, Dr. Romoa said that “This article demonstrates why exercise continues to be a pillar of not only weight management treatment but the overall health of the community.”

“Exercise should always be used in conjunction with pharmaceutical treatment for persistent lifestyle changes,” he advised.

The National Coalition on Healthcare’s (NCHC) Kelsey Costa, a registered dietitian and health research specialist who was not involved in the study, concurred, saying that “the study findings imply that combining exercise training with a calorie-restricted diet can enhance insulin sensitivity and metabolic health beyond the benefits achieved solely through diet-induced weight loss.”

As Costa said, “It is essential to understand how effectively this combination of therapies can improve metabolic health given what we know about the barriers to exercise in people with obesity.”

For managing prediabetes, insulin sensitivity is essential.

Prediabetes is characterized by persistently elevated blood glucose levels that are not yet high enough to progress to type 2 diabetes.

Although it acts as a warning sign for an elevated risk of getting diabetes, it is frequently preventable or deferred with lifestyle adjustments.

Enhancing insulin sensitivity through exercise

According to Dr. Romoa, “GLUT4, the main insulin-driven glucose transporter, exercise improves insulin sensitivity.”

“GLUT4 is present in adipose and muscular tissue. The amount of these transporters varies depending on a person’s diabetes and obesity condition.

While they drop in adipose tissue, they hold steady in muscular tissue. As a result, exercise can keep enhancing glucose regulation. Due to insulin resistance, adipose tissue can no longer adequately regulate blood glucose. Additionally, exercise will increase the body’s GLUT4 levels. Walking can help lower blood sugar levels, according to Dr. Sergio P. Ramoa.

It was said by Costa that this study showed that “exercise enhances insulin-stimulated glucose uptake, likely due to changes in skeletal muscle biology induced by exercise.”

This includes an improvement in mitochondrial content and function as well as an increase of genes related to substrate oxidation and mitochondrial energy metabolism. The diet plus exercise group consequently saw a more significant rise in muscle insulin sensitivity,” Costa said.

Type 2 diabetes treatment through exercise

Exercise is strongly advised as a main treatment for type 2 diabetes, according to prior research.

Combining 150 minutes per week of moderate to strenuous exercise with dietary and behavioural adjustments can stop, delay, or even reverse the condition.

Exercise of all kinds, including resistance and aerobic training, can regulate blood sugar levels. Small bursts of exercise spread out throughout the day and high intensity interval training are both good.

Exercise in the afternoon or right after a meal, for example, may have additional benefits.

Exercise guidelines that are ideal Working with healthcare experts is crucial for personalised diabetes management because individual aspects are continuously being researched.

Costa stressed “the significance of integrating a calorie-restricted diet with exercise training to enhance metabolic health and physical function.”

Exercise caution

Be sure to consult your doctor before beginning a new workout routine. Make sure you drink enough water before, during, and after the activity.

To keep your blood sugar levels within the desired range, be sure to closely monitor them as well.


For Diabetes medications that have been suggested by doctors worldwide are available here

Higher doses of Ozempic improve blood sugar, weight loss?

Higher doses of Ozempic improve blood sugar, weight loss?

According to experts, glucagon-like peptide 1 (GLP-1) medications like Ozempic, often referred to as semaglutide, can aid in weight loss in those who are obese.

For weight loss, Ozempic is not FDA-approved. There is also the brand Wegovy, which is semaglutide.

Wegovy and Ozempic should not be used by persons who are not diabetic or obese for any reason, including to shed minor amounts of weight, according to experts.

In the latter part of 2017, the FDA approved the use of the GLP-1 medication Ozempic in people with type 2 diabetes. But lately, it’s made news for other reasons as well: Benefits of purported weight loss and scarcity.

“People are talking about them because there is a trend where celebrities and influencers are increasingly turning to off-label use of GLP-1 medications like Ozempic for weight loss by people who are not obese or diabetic,” claims Dr. Rekha Kumar, an endocrinologist in New York City and the head of medical affairs at the weight management program Found.

This, according to Kumar, is very troubling.

“The trend of medispas, boutique weight-loss clinics, and illegal telehealth businesses liberally prescribing to people who don’t meet criteria is not only irresponsible prescribing, but it may also prevent the medication from reaching those who need it most,” Kumar claims.

By responding to the following frequently asked questions regarding Ozempic, Kumar and other professionals distinguished fact from fantasy.

What is Ozempic?

Dr. Angela Fitch, FACP, FOMA, president of the Obesity Medicine Association and chief medical officer of knownwell, a weight-inclusive healthcare firm, says that Ozempic is a brand name for the medication recognised as semaglutide.

Ozempic is an injectable medicine for persons with type 2 diabetes, according to Kumar. The FDA first approved it for 0.5 mg or 1 mg dosages. The FDA authorized a higher dose of 2 mg in 2022.

According to Kumar, it helps the pancreas produce insulin, which decreases blood sugar levels.

Adverse effects of semaglutide

All GLP-1 medications, as pharmacological agents, have the potential to have side effects, according to Dr. Jay Shubrook, professor of the Primary Care Department at Touro University in California.

According to Dr. Shubrook, these “are frequently dose-dependent and can be more obvious during dose changes.”

In any case, typical adverse effects of semaglutide “include an excessive loss of appetite, nausea, and less frequently, vomiting or diarrhoea. Most patients only experience temporary adverse effects, he noted.

He pointed out that teaching patients to eat slowly and mindfully, as well as how to control their portions, can lessen the negative effects of semaglutide.

Is Ozempic an FDA-approved weight-loss product?

No. “Ozempic is only approved for diabetes,” claims Dr. Charlie Seltzer, a Philadelphia-based medical professional who is board-certified in both internal medicine and obesity.

But here’s where some of the ambiguity arises. “The active ingredient, semaglutide, is approved for weight loss under the trade name Wegovy,” claims Seltzer.

Elon Musk tweeted about Wegovy’s assistance with his weight loss in October 2022.

Distinction between Wegovy and Olympic

Semaglutide and injectables are both sold under the trade names Ozempic and Wegovy. They aren’t precisely the same, though.

“Wegovy is FDA-approved for the treatment of overweight and obesity,” claims Kumar. “Wegovy was developed specifically for the treatment of overweight and obesity,” according to the manufacturer. “It contains a higher dose of semaglutide, [2.4 mg], than Ozempic.”

Does Ozempic aid in shedding pounds?

Kumar points out that Wegovy’s dosing was employed in the studies on semaglutide and weight loss, including one from 2021 that showed that once-weekly doses of 2.4 mg of semaglutide could lower body weight when paired with dietary and lifestyle modifications.

“[In the] study,] those who took the medication and made lifestyle changes lost almost 15% of their body weight, on average, compared to 3% in the placebo group,” Kumar claims.

So certainly, semaglutide may aid in weight loss, at least at a greater dose of 2.4 mg. Although Seltzer observes that the two medications function similarly, it is uncertain whether the 0.4 mg dosage difference between Ozempic and Wegovy is significant.

As food takes longer to leave the stomach and suppresses hunger, ozempic prolongs satiety, according to Seltzer. “It does nothing magical to the metabolism.”

In addition, Kumar points out that despite what some celebrities and social media influencers may say, these medications are not intended for those who just want to drop a few pounds.

“Normal-weight patients without diabetes might lose weight if they take GLP-1s, but the risks of the medication outweigh the benefit of weight loss just to be thin versus treating a disease,” says Kumar. “GLP-1s have not been studied in this population, and with this type of inappropriate use, we probably will see more side effects.”

Is Ozempic safe?

For adults with type 2 diabetes, ozempic is typically regarded as safe in doses up to 2 mg, however doctors agree that some people shouldn’t take it.

“It should be avoided in many populations, including but not limited to people with a history of pancreatitis, people who have had medullary thyroid cancer, or who are at increased risk for medullary thyroid cancer,” says Seltzer.

If you are a good candidate for Ozempic, your doctor can help you decide. Furthermore, some persons might suffer negative effects. According to Fitch, typical ones include:

  • nausea
  • constipation
  • dizziness
  • reduction in appetite
  • diarrhea

Can you regain weight after using semaglutide?

Patients who quit taking 2.4 mg dosages of semaglutide had gained back two-thirds of the weight they had lost one year after stopping, according to a trial of nearly 2,000 patients published in 2022.

The same problems that got the people into difficulty in the first place will still exist once the drug is stopped or loses its effectiveness, according to Seltzer, and the weight will quickly regain.

Fitch concurs,

Whatever you do personally to aid in weight loss, Fitch advises, “You have to keep doing it, or the weight will come back.” “The human body was created in this manner. It is constructed to safeguard its weight at all costs. Care for the elderly is crucial.

“Since obesity is a chronic disease, you must treat it chronically, ongoingly, and in a coordinated, comprehensive way,” adds Fitch. For a comprehensive approach to metabolic health, weight control, and primary care, patients must collaborate with their doctor.

What other therapies are there for obesity?

First, Fitch emphasises the need of being nonjudgmental and emphasising joint decision-making in all obesity treatments.

According to Fitch, “obesity is a lifelong chronic disease and should be treated in a compassionate and thorough patient-centered way, such as shared decision making around taking medication or having surgery with the risks and benefits in mind.”

Although diet and exercise are frequently suggested as first-line therapy, they are not always effective.

“Obesity is a complex disease with many factors,” explains Fitch. “We add in other treatments to help patients live longer, healthier, better quality lives when lifestyle changes are not enough.”


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Once-weekly insulin vs daily injection: Which is better?

Once-weekly insulin vs daily injection: Which is better?

The effectiveness of once-weekly and once-daily insulin therapy for type 2 diabetes was compared by researchers.

They discovered that the once-weekly medication icodec reduced blood sugar levels more successfully than the conventional once-daily injections.

Further research is required, according to experts, to validate the findings. A novel, once-weekly insulin regimen may revolutionize care for type 2 diabetics, finds a recent study.

In a Phase 3 experiment, researchers compared the effectiveness and safety of once-weekly insulin termed “icodec” with the conventional once-daily injection degludec in adults with type 2 diabetes.

A long-acting insulin medication called Degludec aids in controlling blood sugar levels.

After 26 weeks, they discovered that once-weekly icodec therapy reduced blood sugar levels more than once-daily degludec. The research was released in JAMA.

Icodec may have similar glucose-lowering effects to daily insulin injections, according to a recent study.

Adherence issues with daily insulin injections

In the US, there are more than 37 million diabetics. These persons have type 2 diabetes in 90–95% of cases.

The hormone insulin, which is produced by the pancreas, enables cells to utilise glucose as fuel. When cells no longer react to insulin as they should, type 2 diabetes develops and elevated blood sugar levels follow.

The eyes, kidneys, and heart are just a few of the organs that elevated blood sugar can harm over time. Therefore, either lifestyle changes or the use of drugs that do not lower blood sugar with insulin is required for treatment.

When non-insulin treatments are ineffective, it is currently recommended by guidelines that persons with type 2 diabetes take insulin-based therapies to reduce blood sugar levels.

Currently, type 2 diabetes medications based on insulin necessitate daily injections. However, patients may find it difficult to administer daily injections, which lowers adherence rates.

According to research, weekly injections increase adherence. According to one study, individuals who receive insulin treatments once per week follow their treatment plans for an average of 333 days as opposed to 269 days for patients who receive daily injections.

Insulin therapy non-compliance might have serious repercussions. According to research, persons with diabetes who do not stick to their insulin medication have a higher risk of dying and being admitted to the hospital.

Thus, raising adherence rates is essential to enhancing diabetes patients’ quality of life and health outcomes.

Which is more effective? Once-weekly vs. daily insulin injection.

The researchers gathered 588 participants for the study, with an average age of 58, from 11 nations, including the USA, Argentina, and China.

Over a third of the participants were women, and every participant was on non-insulin glucose-lowering medication.

They were thereafter randomly assigned to receive one of the following treatment plans for a total of 26 weeks during the study:

  • once every week icodec
  • monthly placebo
  • every day degludec
  • a single-dose placebo

In the end, the scientists discovered that icodec more effectively lowered haemoglobin A1c (HBA1c) levels than degludec.

A measurement of the average blood sugar levels over the previous three months is called HBA1c. Those with diabetes are advised to maintain levels of 6.5% or lower. People without diabetes typically have HBA1c values of less than 5.7%.

Participants in the icodec group had HBA1c values that dropped from an average of 8.6% to 7% after 26 weeks. HBA1c values in the degludec group decreased from an average of 8.5% to 7.2% over this time.

The study’s authors found no discernible differences in participants’ fasting blood sugar levels or body weight between those taking icodec and those taking degludec.

We enquired about the potential causes of icodec’s superior results in lowering HBA1c readings from Dr. Absalon Gutierrez, associate professor of endocrinology at McGovern Medical School at UTHealth Houston who was not engaged in the study.

Although we can’t be certain, it probably has to do with the patient’s compliance with the drug. According to how the trial was set up, it was significantly simpler to forget to administer the degludec injections than the icodec injections. According to Dr. Gutierrez, this is most likely the case in real life as well.

Side effects of icodec weekly insulin

The researchers also reported that from the beginning of the study until week 31, 5.8% of those using Degludec and 8.9% of those taking icodec suffered hypoglycemia. This is characterized by blood sugar levels that are below the normal range.

Additionally, during the duration of the experiment, 167 patients receiving degludec and 177 patients getting icodec both had adverse effects. According to the researchers, 46 and 60 incidents, respectively, were in the degludec group and the icodec group. This may have been caused by the use of insulin.

However, they pointed out that the majority of the incidents were minor, and that these included COVID-19, influenza, and diabetic retinopathy, an eye disorder that can impair vision in people with diabetes.

What are the research’s constraints?

The study’s shortcomings were listed by the researchers in their paper. They pointed out that because the trial only lasted 26 weeks, longer-term consequences are still undetermined.

They also stated that they did not gather information on patient-reported outcomes or data from continuous glucose monitoring.

Dr. Gutierrez stated: “Icodec exhibited higher hypoglycemia even though it worked somewhat better in decreasing HBA1c. Given that it can’t be titrated as regularly, this is to be expected. Additionally, the degludec titrations were not ideal according to the study’s design.

Dr. Lushun Wang, Senior Consultant Orthopaedic Surgeon and Medical Director of Arete Orthopaedic Clinic in Singapore and a non-participant in the study, was also interviewed by us:

“The trials’ duration can be extended further in order to guarantee dependable long-term efficacy and safety. To comprehend Icodec more fully, rigorous and in-depth testing should be conducted.

Data from continuous glucose monitoring may ensure a more thorough understanding of blood glucose control and its impact on the quality of life of the patient. In addition, the trial’s design used more Icodec injections than would be necessary for a daily regimen, which does not adequately reflect real-world use or any potential advantages for treatment adherence.

Effects of once weekly injection on diabetes

The researchers observed that by lowering the number of injections from at least 365 to 52 annually, icodec may increase treatment adherence and convenience for individuals with type 2 diabetes.

They went on to say that the “small absolute risk of hypoglycemia” should be outweighed by the ease and little additional glycemic advantage of once-weekly dosing.

Icodec’s practical design enables daily injections to be replaced with this once-weekly alternative, according to Dr. Wang. Its main benefit is from its capacity to deliver an insulin release that is steady and continuous over the course of a week. Hence minimizing swings in blood glucose levels. The improved HbA1c reduction seen in the studies is evidence that Icodec’s ability can result in better overall blood glucose control.

Dr. Guitierrez concurred that icodec insulin would be a viable choice for patients who struggle to take once-daily basal insulin as prescribed. To better understand the risk of hypoglycemia associated with using icodec in comparison to once-daily insulin injections, he pointed out that more research is required.


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Time constraint breakfast might improve blood sugar levels.

Time constraint breakfast might improve blood sugar levels.

When someone restricts their daily meals to the first 6 to 8 hours of the day, this practise is known as early time-restricted feeding.

This eating behaviour may help stabilise variations in blood glucose levels and reduce the chance of developing prediabetes, according to research.

According to experts, one reason early time-restricted feeding is successful is because it enables people to engage in physical activity even after they have completed eating for the day.

The blood glucose variations can be improved by early time-restricted eating (TRE). This is supported by a study that was presented today at the annual conference of the Endocrine Society.

Researchers indicate that this type of intermittent fasting can lessen the amount of time that blood glucose levels are above normal levels in their findings, which have not yet been published in a peer-reviewed journal.

According to a press release from Dr. Joanne Bruno, a study author and endocrinology fellow at NYU Langone Health in New York, “our research shows that just one week of following this diet strategy reduces fluctuations in blood sugar levels and reduces the time that the blood sugar is elevated above normal levels.”

This indicates that early time-restricted meals may be a useful strategy for people with prediabetes or obesity to maintain their blood sugars in a normal range and stop them from developing type 2 diabetes, she continued.

How prediabetes eating schedules were examined?

A type of eating called early time-restricted feeding limits meals to just the first six to eight hours of the day.

The researchers created a study in which they contrasted early time-restricted eating with a typical diet pattern to investigate the effects of this approach of dieting on blood glucose levels.

Ten participants with prediabetes or obesity were randomly assigned to the regular eating pattern group, where they consumed 50% of their calories after 4 p.m., or the early time-restricted feeding group, where they consumed 80% of their calories before 1 p.m.

After following this diet for 7 days, they switched to the other strategy for the following week.

Throughout the whole research, individuals wore continuous glucose monitors. Additionally, they had tests of their glucose tolerance before the trial started, as well as on days 7 and 14.

The subjects’ weight remained constant during the whole two-week study, according to the researchers. When compared to the regular eating pattern, the early time-restricted feeding method of eating resulted in a lower amount of time spent over the normal blood glucose range.

Dr. Bruno explained that eating the majority of calories earlier in the day shortens the duration that blood sugar is raised and enhances metabolic health.

If early time-restricted feeding could be utilised as a successful intervention technique for preventing obesity, the experts suggested more research is required.

Time-restricted eating advantages

The study’s results, according to Dr. Pouya Shafipour, a family and obesity medicine specialist at Providence Saint John’s Health Centre in California, are not unexpected and corroborate his own advice to patients.

Since 2015, I have advocated for time-restricted eating. I also began using it myself. According to studies, time-restricted meals and prolonged fasting can improve insulin sensitivity and lower blood sugar levels. Thus, it either puts the body into or increases the state of ketosis that we enter in the evening. So in a sense, ketosis improves blood sugar control by reducing highs and lows, peaks and valleys in blood sugar. Family and obesity physician Dr. Pouya Shafipour

One type of intermittent feeding is early time-restricted feeding. Other examples include the 5:2 diet, which calls for eating regularly five days a week but consuming only 500 to 600 calories on two of those days.

The 16:8 diet is an additional strategy that calls for 16 hours of fasting and 8 hours of eating.

Advantages of eating breakfast

Dr. Marilyn Tan, an endocrinologist at Stanford University in California, claims that having time to exercise after eating may be an advantage of consuming the majority of calories earlier in the day.

We consume the majority of our calories during dinnertime, at least in America. We frequently eat our largest meal of the day at that time, then sit down in front of the TV or computer to watch something, before going to bed and sleeping for eight hours. Therefore, after that, we really don’t have a chance to exercise and increase our insulin sensitivity, she explained.

We don’t fully understand how moving that time-restricted feeding to earlier in the day improves metabolic benefit. The fact that humans are more active throughout the day is one possibility, though. Therefore, she continued, “If people are moving about more and engaging in greater physical activity soon after eating, that may improve the glycemic response”.

This study indicates that a considerable effect may not only result from a time restriction but also from the timing of that restriction. There hasn’t been a significant randomized trial, but there have been other studies looking at this and suggesting that exercising early in the day offers additional metabolic advantages, doctor of endocrinology Marilyn Tan said

Time-restricted eating can be advantageous for cardio-metabolic health, but it should only be carried out under a doctor’s supervision, according to Dr. Anne Peters, an endocrinologist at Keck Medicine of USC in California.

Advice for eating well

When it comes to dieting, the Centres for Disease Control and Prevention (CDC) advises finding a strategy that can be adhered to for life.

A smart place to begin is with a plan that emphasises healthy eating and is also something that can be maintained.

The CDC offers 12 recommendations for eating well. They involve planning ahead for periods of the day when snacking can be alluring, including right after a long day at the office.

Time-restricted eating is one of the simplest diets to follow, especially for people who are busy, according to Tan’s clients.

Because you’re not as focused on the meal content, per se, as you are on the timing, many of my patients find this to be one of the most maintainable diets, she said. “And honestly, time-restricted feeding works out better for those who are busy since you don’t have to think about your meals throughout the day. Many patients actually discover that having this small window of time to eat is far easier and more enduring than adhering to many highly strict diets.”

Tan continued, “You don’t have to concentrate so much on the macronutrient breakdown of the food. “Although a ketogenic diet, for example, may be quite helpful in the short term at helping people lose a lot of weight, maintaining that kind of diet over the long run is very challenging. Whereas with time-restricted eating, all you’re actually doing is changing when you eat. For long-term safety, I don’t see any pressing issue as long as you talk to your doctor about when to take your medications and how much to take before starting a diet.”


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Can a common diabetes drug could lower COVID risk?

Can a common diabetes drug could lower COVID risk?

Metformin, a common diabetes drug, was tested by researchers to see if it could stop lengthy COVID.

Metformin can cut down lengthy COVID diagnosis by 40%, according to their research. If these results apply to the general population, more research is required.

Long COVID is characterised by continuous health issues that continue even after a COVID-19 diagnosis and cannot be attributed to any other causes.

The duration of symptoms might range from weeks to years. Long COVID has been associated with more than 200 symptoms, from exhaustion and nausea to memory loss, stomach discomfort, and dyspnea or difficulty breathing.

What causes lengthy COVID has been the subject of several different theories. Mechanistic research, however, are still in their early stages. The illness is still in its early stages of development, as are treatments and prevention strategies.

The coronavirus that causes COVID-19, SARS-CoV-2, is currently the greatest strategy to prevent lengthy COVID, according to the Centres for Disease Control and Prevention (CDC). This can be done, for example, by staying current on vaccines.

The quality of life and reduction of long-term handicap among patients could be improved by measures to prevent protracted COVID after contracting COVID-19.

Three widely used medications were recently investigated for their ability to prevent extended COVID.

They discovered that lengthy COVID was considerably less likely to occur in participants taking metformin compared to those taking a placebo. A common diabetes drug called metformin raises insulin sensitivity to reduce blood sugar levels.

Metformin may reduce the occurrence of long-term COVID.

It was a phase 3 randomised clinical trial. 1,126 individuals with COVID-19 symptoms and a positive PCR or antigen test for this viral infection, ranging in age from 30 to 85 years, were enrolled by the researchers.

The patients had either fat or overweight, which increased their likelihood of developing severe COVID even though they were not hospitalised for COVID-19.

The individuals were randomly assigned to one of six groups, each of which received a different dosage of metformin for 14 days, ivermectin for 3 days, fluvoxamine for 14 days, and placebo. Fluvoxamine is used to treat obsessive-compulsive disorder (OCD), and ivermectin is an antiparasitic medication.

For ten months, the subjects were monitored. Throughout the follow-up period, they were questioned multiple times about whether they had obtained a medical provider’s diagnosis of extended COVID.

After 300 days of follow-up, 8.3% of patients overall reported a lengthy COVID diagnosis. Only 6.3% of patients who took metformin, as opposed to 10.4% of those who received a placebo, experienced lengthy COVID.

In comparison to a placebo, ivermectin and fluvoxamine had no effect on the incidence of long-term COVID.

The Safe Drug Metformin Has Proven Antiviral Effects

Based on the knowledge that metformin is safe and has proven anti-inflammatory and antiviral capabilities, the study team pursued it as a potential long-COVID treatment.

Hector Fabio Bonilla, MD, is the co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic and has observed laboratory test outcomes that support metformin’s potential to lessen antiviral and anti-inflammatory activities that can result in thrombosis (when blood clots block blood arteries) and lung harm.

Dr. Bonilla, who is also a clinical associate professor of infectious diseases at Stanford University, adds, “Plus, this drug is relatively safe, with no increased risk of hypoglycemia low blood sugar and no increased risk of lactic acidosis lactic acid buildup related to low oxygen levels.” There is no need to cease taking metformin before surgery because it is safe to take during pregnancy, breastfeeding, and in individuals with renal failure.

Underlying processes

We discussed how metformin may have decreased long COVID risk with Dr. Mark Guido, an endocrinologist from Novant Health Forsyth Endocrine Consultants in Winston Salem, NC, who was not involved in the study.

It is difficult to say because we still don’t fully comprehend extended COVID, but it might be connected to lowering inflammation, he suggested. Additionally, metformin has been demonstrated to potentially lessen severe COVID and to halt the reproduction of the [SARS-CoV-2] virus in a lab setting, both of which may also be involved.

We also discussed how metformin may have decreased long COVID risk with Dr. Daniel Kim, a board-certified family doctor of Medical Offices of Manhattan who was not part in the study.

He concurred that it is still unknown exactly how certain things work. Nevertheless, he added that earlier research suggests that metformin has an antiviral effect by preventing viral multiplication.

Do all people fall within the study’s conclusions?

Dr. Guido responded to a question concerning the study’s limitations by saying, “Since our understanding of long COVID is still evolving, there were no specific diagnostic criteria used to determine who did or did not qualify as having long COVID.”

The trial was also restricted to participants who were overweight or obese and were not currently on metformin. It is unknown if people who are already on metformin for other disorders or who have a normal weight will experience the same effects from metformin,” he added.

The trial was limited to examining the use of metformin to stop long-term COVID during a patient’s initial COVID infection. It is uncertain whether metformin would guard against extended COVID if a patient had previously contracted COVID-19, he continued.

According to Dr. Kim, “It is also unknown if [the results] can be generalized to early outpatient treatment of COVID-19 patients who were previously diagnosed with COVID-19 infection.”

Avoiding prolonged COVID

The results, according to Dr. Guido, could have a significant impact on short COVID prevention.

“Long COVID is turning into a public health emergency. Long-term public health would greatly benefit if it could be successfully decreased by a cheap, well-tolerated, and easily accessible medicine like metformin,” he said.

Dr. Kim concurred that the results are encouraging. He did point out that additional research is required to evaluate whether metformin is as effective for the broader populace.


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Cardiovascular benefits in elderly from antidiabetic drugs.

Cardiovascular benefits in elderly from antidiabetic drugs.

Researchers found that some types of diabetes medications can lower the risk of heart illnesses when coupled with other diabetic medications in a trial including older military veterans.

According to experts, heart health problems are widespread in diabetics, thus a larger segment of the population may benefit from the research. Drugs for GLP1, DPP4, and SGLT2 were used in the trial.

According to a study published today in the Annals of Internal Medicine, some diabetic drugs may reduce the risk of cardiovascular events when combined with other diabetes treatments.

Researchers compared conventional diabetes treatment plans to three key classes of diabetes medications: GLP1, DPP4, and SGLT2.

Recent clinical trials for novel diabetes medicines, the researchers noted:

  • tested the medications only against a placebo, not in competition with one another
  • only tested on individuals with heart disease when examining the cardiovascular benefits

The best pharmaceutical class for lowering the risk of cardiovascular disease, even in those without a history of the condition, was something the researchers sought to determine.

They claimed that when compared to DPP4 treatments, GLP1 therapies lowered the risk of adverse cardiovascular events and hospitalisations for heart failure.

Compared to DPP4 medications, SGLT2 therapies did not lower the number of hospitalisations for heart failure or cardiovascular events.

Information about the diabetic drug study

Between 2001 and 2016, the researchers examined the medical records of approximately 100,000 veterans who had been prescribed diabetes drugs including metformin, insulin, or sulfonylurea.

Then, one of the three more recent drugs—GLP1, DPP4, or SGLT2—was introduced. Following up was done until 2019.

Agonists of the GLP1 receptor included:

  • Exenatide
  • Liraglutide
  • Semaglutide

Inhibitors of SGLT2 included:

  • Empagliflozin
  • Dapagliflozin
  • Canagliflozin

Among the DPP4 inhibitors were:

  • Alogliptin
  • Linagliptin
  • Saxagliptin
  • Sitagliptin

Participants’ median ages ranged from 67 to 8.5 years, and their median time with diabetes was 8.5 years.

The results revealed:

When compared to DPP4 inhibitors, GLP1 reception agonists have a 20% lower incidence of significant adverse cardiovascular events and heart failure hospitalisations in persons with type 2 diabetes who have never had a heart condition. The risk reduction amounts to around three fewer heart failure episodes, strokes, or fatalities per 1,000 patients using the drug for a year.

When compared to DPP4 inhibitors, SGLT2 inhibitors did not lower hospitalisations for heart failure and cardiovascular events.

Dr. Kathleen Dungan, an endocrinologist at The Ohio State University Wexner Medical Centre, said that therapy should focus on effectiveness in reaching and maintaining treatment objectives for glucose and weight management.

As a result, she said, “some GLP1-based therapies have greater potential to help patients achieve these goals than SGLT2i or DPP-4 inhibitors.” The complexity and method of administration, patient desire, other co-occurring illnesses, side effects, and cost are all person-centered aspects that may be more significant.

Dungan stated that “some limitations [of this study] prevent our ability to directly apply the findings to usual care.” These include a brief follow-up period, a lack of demographic diversity, missing or incomplete data, and nonrandom prescribing patterns, any of which could affect the study findings.

He told us, “This study provides important information on using two classes of diabetes medications, especially for people without known cardiovascular disease.”

The significance of the diabetic medication research

People with diabetes have a younger average age of onset and a twofold increased risk of heart disease. According to the Centres for Disease Control and Prevention, having diabetes increases your risk of developing heart disease.

Additionally, elevated blood pressure, “bad” cholesterol, and triglyceride levels are more prevalent among diabetics. These ailments can make you more likely to experience a cardiovascular incident.

Dr. Sanjay Bhojraj, an interventional cardiologist at Providence Mission Hospital in California, remarked, “This study is a superb example of the new convergence of therapeutics for diabetes and cardiovascular diseases.”

In the past, the cardiology community has mainly refrained from optimizing diabetic drugs either out of worry over medication-related problems or out of fear of alienating other treating physicians. Primary prevention studies like this one are an appeal to cardiologists to finally enter the fray and treat diabetes like we treat cholesterol or deal with quitting smoking.”

According to Bhojraj, “Now we have real-world data, in a [veterans] population, suggesting a significant decrease in major adverse cardiovascular events using GLP-1 receptor antagonists in patients who have diabetes without prior [cardiovascular disease],” she said. This could help the doctor decide which class of diabetic medication to add to standard-of-care treatment regimens to reduce cardiovascular risk.

It’s interesting to note that both the GLP-1 and SGLT-2 medication classes had positive treatment outcomes in the whole group of individuals undergoing primary and secondary prevention.

The bottom line, the cardiology community needs to take action and incorporate glucose optimization into our treatment strategies, according to Bhojraj, “if we truly want to protect our patients from serious adverse cardiovascular events.”

Treating coexisting conditions common with diabetes

According to a 2019 study, nearly 75% of patients had at least one other chronic health condition when they received a type 2 diabetes diagnosis. 44% of people have two or more conditions.

Diabetes and a number of other common comorbid illnesses include:

  • obesity
  • dyslipidemia
  • blood pressure is high.
  • heart condition
  • renal illness
  • mental health conditions
  • sleep problems
  • cancer

According to Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York, “Generally speaking, a GLP1 RA is preferred over an SGLT-2 for the weight benefit in patients with diabetes and obesity – two conditions which overlap more often than not.”

But she added, “This study also reveals another advantage of selecting a GLP1 over an SGLT-2 in patients without cardiovascular disease.”

These medications can help with other comorbid conditions as well, experts point out.

Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Centre in California, said, “This research is encouraging and supports a growing body of evidence that these medications have multiple beneficial effects.”

“GLP-1 receptor agonists are currently being used to treat obesity off-label, according to the literature. He informed us that SGLT2 inhibitors are also licensed to treat chronic renal disease and heart failure.”


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