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530 million adults worldwide are estimated to have diabetes. Individuals diagnosed with diabetes mellitus are more susceptible to various health complications. Multiple long-term conditions (MLTCs) are health complications related to diabetes that affect more than one person. Imperial College London researchers have discovered that diabetes not only causes MLTCs to occur 15–20 years earlier, but it also drastically shortens the life expectancy of those who have the disease. Approximately 529 million individuals worldwide are estimated by researchers to have diabetes, with 90–95 percent of those cases being type 2 diabetes.

Serious complications such as heart disease, nerve damage, kidney disease, gum disease, dementia, mood disorders, and eye issues are more common in people with diabetes. Multiple long-term conditions (MLTCs) are the terms used to describe the presence of multiple complications in a person with diabetes. According to recent research from Imperial College London in the United Kingdom, diabetes not only causes MLTCs to occur 15–20 years earlier, but it also drastically shortens the life expectancy of those who have the disease. The study was just released in the Nature Medicine journal.

Diabetes patients with several chronic conditions by the age of 50 Researchers examined medical records from more than 46 million U.S. K. utilizing the National Bridges to Health Segmentation Dataset, adults aged 20 and above. Over 3 million individuals in the research had diabetes mellitus, whether it be type 1 or type 2, or another type. After analysis, researchers discovered that roughly one-third of study participants with diabetes had at least three MLTCs by the time they were 50 years old. On the other hand, people without diabetes did not develop three MLTCs until they were 65 to 70 years old.

Researchers also discovered that individuals with diabetes had an average onset age of 66–67 years for at least two MLTCs. Furthermore, a person’s levels of MLTCs would be more severe as they age if they were diagnosed with diabetes at a younger age. One of the most difficult global population health risks has emerged to be multiple long-term conditions, Edward W. Gregg, PhD, as well as the School of Population Health at RCSI University of Medicine and Health Science in Ireland.

Age has been the main cause, and while longer lifespans do play a role, it is not the whole story. We’ve confirmed that this is a serious problem that still shows up in early and middle adulthood,” he said. When Gregg and his team examined specific MLTCs, the most prevalent conditions they observed were depression, asthma, osteoarthritis, and hypertension. People of all ages and genders were observed to have these conditions. Although the link between diabetes and MLTCs was expected, we were surprised by the breadth and depth of the findings, i.e. e. the prevalence of having 3, 4, or 5+ conditions and their comparatively early age of onset, according to Gregg. Hypertension and coronary heart disease were expected. On the other hand, there were no associations with asthma or osteoarthritis. It was surprising that a significant proportion of young adults would also have diabetes, even though the link to depression was expected.

4 years of life lost for each co-occurring condition
The number of years that diabetes patients lost as a result of MLTCs was another area of study for the researchers. Researchers discovered that individuals with more MLTCs lived with them for fewer years and passed away sooner than those without MLTCs. Researchers discovered, for instance, that individuals with diabetes who had three MLTCs lived roughly ten years with them and five years less than the overall population, whereas individuals with diabetes who had at least five MLTCs lived five years with them and passed away six years sooner than those without MLTCs. Gregg and his colleagues also discovered a higher number of life years spent and lost in young adults with diabetes who suffer from MLTCs. For instance, compared to people without MLTCs, a person with diabetes and MLTCs lost roughly 4 years of life by the time they were 40. According to Gregg, “It might be a sign that these conditions are more severe when they arise in young adulthood. However, chronic illnesses typically worsen disability and shorten life expectancy over time, so we must find strategies to prevent people from developing these conditions at an early age. Diabetes can be prevented in many ways, and delaying its onset can help prevent the development of other conditions.

Furthermore, the researcher noted that diabetes is also highly manageable and can reduce the development of MLTCs with good control. The next stages involve determining, creating, and evaluating the effectiveness of interventions that can stop MLTCs from developing or getting worse. Pouya Shafipour, MD, a board-certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, California, told MNT he was not surprised by the study’s findings and asked why so many conditions co-occur with diabetes. Shafipour clarified, “This is something we expected because the state of insulin resistance in the body starts way before someone is diagnosed with diabetes. They frequently have fatty livers and insulin resistance, and that’s when the body’s damage to all of the organs really begins. Diabetes increases the risk of several conditions, including atherosclerotic heart disease, cerebrovascular disease (CVD), stroke, retinopathy, neuropathy, and kidney disease,” he continued. As a result, it was not at all surprising because the ailment actually affects the entire body.

In addition, Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at Fountain Valley, California’s MemorialCare Heart and Vascular Institute at Orange Coast Medical Center, concurred with MNT’s assessment. Diabetes affects a wide range of conditions, according to Ni. We are discussing an issue with the body’s metabolism of sugar. It has an impact on more than just blood sugar levels. It has an all-encompassing effect on how your body functions physically and how well your organs function. From a cardiac perspective, we frequently consider heart disease to include conditions like high blood pressure, coronary artery disease, and the risk of heart attack and stroke,” he said. All of this is related to diabetes; it is not only a direct result of diabetes’s impact on organ and blood vessel function, but it also occurs in tandem with diabetes as a result of underlying metabolic issues, particularly obesity. Therefore, I do not find the study’s conclusions surprising. It merely emphasizes how seriously long-term diabetes exposure can impact your health in a variety of ways.

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The body produces more of an appetite-suppressive molecule when taking the diabetes drug metformin, according to research from Stanford University in California that was just published in Nature Metabolism. Researchers at Stanford University and Baylor University in Texas found two years ago that the same molecule is also produced during and after intense exercise. Called the anti-hunger molecule, scientists think the lac-phe molecule accounts for the modest effects of metformin, the world’s most prescribed diabetes drug, on weight loss. It was unclear up until now how the blood sugar-controlling medication metformin also caused weight loss, but it turns out that it works by decreasing hunger in the same way as intense exercise. Knowing how these pathways are regulated may help develop practical methods to reduce body mass and enhance millions of people’s health.

Researchers examined blood plasma samples from patients with type 2 diabetes both before and after they took metformin for 12 weeks, following trials conducted on obese mice. The starting dose for each participant was 500 mg, which was progressively increased to 2,000 mg. According to research, the participants’ lac-phe levels considerably rose during this time. Additionally, in a larger study involving 79 individuals with diabetes and heart disease, the researchers examined blood samples. The participants who were taking metformin exhibited significantly higher levels of lac-phe in comparison to the non-medication group.

Conversely, Long and colleagues discovered that inhibiting mice’s production of lac-phe reversed appetite suppression and led to weight gain. It’s strange and intriguing that metformin and sprint training have the same effect on body weight through the same pathway. He went on to say that these discoveries might inspire the creation of novel drugs for weight loss. Within the first few months of starting the medication, there has been evidence of a slight reduction in body weight for those who take metformin, also known by the brand names Fortamet and Glumetza. The Food and Drug Administration has not yet granted metformin approval for use in managing weight loss.

The advantages of metformin for weight loss and overall health go beyond the lac-phe molecule, according to experts in the care of diabetic patients. According to the Diabetes Care Nurse, a virtual diabetes educator who was not involved in the new study, metformin is an incredible medication. Jose has lived with type 1 diabetes for 42 years and has supported others with type 1 and type 2 diabetes for more than 15 years. Jose claimed that during her career, she has worked with thousands of individuals who have type 2 diabetes and has personally witnessed the effects of metformin. It’s among the most economical, safest, and efficient diabetes treatments available. For those with type 2 diabetes who receive a new diagnosis, it remains the standard of care. That will always remain the same.

Although metformin isn’t a medication for weight loss, all providers are aware that it will cause some weight loss. Jose continued, It’s just a positive side effect. Nevertheless, it is generally advised that people with diabetes or obesity lose 7 to 10 percent of their body weight. If metformin is used in conjunction with healthy lifestyle choices, this can definitely be accomplished. Jose emphasized that you have to make a commitment to making significant changes in your daily diet and exercise routine, just like Ozempic and other GLP-1 medications are making headlines. If you stop taking these medications, your weight will return to its initial level if you don’t make those adjustments.

The importance of physical activity is further highlighted by the fact that this medication increases the production of the same molecule that suppresses your appetite after exercise. Exercise enhances every bodily function, not just the burning of calories. It is so important and so underappreciated. Every aspect of your health is impacted by daily exercise, including your mental and physical well-being, your heart and lungs, your metabolism, your energy, and the quality of your sleep. Diabetes management and weight loss necessitate a multifaceted strategy that takes into account all factors. Medication is but one component. You also need to make use of realistic, sustainable eating practices and physical activity.

Since metformin doesn’t garner as much media attention as Ozempic, many people are hesitant to even begin using it. Alternatively, they are adamant about controlling their type 2 diabetes naturally due to the social stigma associated with taking medicine, which implies that you have failed on your own. Metformin, however, improves your body’s performance if your entire metabolic system is lacking. Jose asked people to recognize the advantages of GLP-1 drugs, although their effects are more pronounced and almost instantaneous than those of metformin. Most people with type 2 diabetes who receive a new diagnosis don’t routinely check their blood glucose levels. You will not experience the gradual effects of metformin if those numbers are not visible to you.

REFERENCES:

https://www.medicalnewstoday.com/articles/how-diabetes-drug-metformin-can-suppress-hunger-and-help-with-weight-loss
https://pubmed.ncbi.nlm.nih.gov/9526970/
https://www.healthline.com/health/diabetes/metformin-weight-loss
https://www.webmd.com/diabetes/metformin-cause-weight-loss

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About 537 million adults worldwide live with diabetes, and 90-95% of these cases are type 2 diabetes. People with diabetes are at increased risk of many health problems, including eye problems. These include diabetic retinopathy trusted source, diabetic macular edema, glaucoma, cataract trusted source, chronic dry eye, and retinal detachment. There is currently no cure for diabetic retinopathy or diabetic macular edema. Current treatment options for both conditions include drugs injected directly into the eye, laser treatment, and eye surgery. Soon, less invasive treatment for diabetic retinopathy and diabetic macular edema may be available in the form of eye drops.

Recently released data from a phase 1b/2a trial of the new treatment showed it to be safe and tolerable, with 100% of participants completing the study. Additionally, the researchers reported a significant reduction in central macular thickness and prevention of further increases in vascular leakage after 85 days of use.

The current standard of care for diabetic macular edema involves anti-VEGF agents in the eye, so new approaches to treating diabetic retinopathy and diabetic macular edema are required, according to the study’s presenting author and manufacturer of new eye drops. entails several injections, which are painful and need clinical time to complete even though they are effective.
A non-invasive approach is required to enhance these patients’ quality of life by promoting comfort and lowering pain levels through self-management. According to Dr. Lhuillier, patients with non-proliferative diabetic retinopathy in the early stages of the condition are not given a treatment option other than to wait for their symptoms to get better. It’s possible that the condition won’t worsen due to proliferative diabetic retinopathy. When the patient’s condition reaches an advanced stage or they develop diabetic macular edema, anti-VEGF injections are recommended. He said that treating diabetic retinopathy patients with non-invasive, safe, and effective therapies early on will help stop the condition from getting worse. About 7 and a half million Americans are thought to have non-proliferative diabetic retinopathy, and another 1 and a half million have advanced the disease to more severe forms, which hasten its progression and deteriorates vision. There is a strong motivation to cut back. Dangerous complications.

According to reports, the novel eye drop, known as EXN407, is the first topical treatment for retinal vascular conditions like diabetic macular edema and diabetic retinopathy. The eye drop is a small molecule treatment that employs an inhibitor of serine-arginine protein kinase 1 (SRPK1). Numerous factors contribute to the development of diabetic eye disease, but the primary cause is the overgrowth of blood vessels in the retina. These blood vessels eventually leak, causing subretinal edema to appear and blindness to result. VEGFTrusted Source is a growth factor that causes this phenomenon. According to him, EXN407 is a molecule that only inhibits the members of the family that cause disease, leaving the non-disease-causing members intact, allowing the VEGF to be balanced again. In addition to being more convenient as an eyedrop formulation as opposed to an injection, it provides a more nuanced approach than anti-VEGF agents.

REFERENCES:

https://www.sciencedirect.com/science/article/pii/S0753332218346705
https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy
https://my.clevelandclinic.org/health/diseases/8591-diabetic-retinopathy
https://www.medicalnewstoday.com/articles/could-an-intervention-as-simple-as-eye-drops-treat-eye-damage-in-diabetes#Improvements-in-macular-thickness,-vascular-leakage

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Yogurt has been associated with several health benefits, including a potential reduction in the risk of type 2 diabetes. Several studies have suggested that yogurt consumption may be linked to a lower risk of developing type 2 diabetes, possibly due to its nutrient content and its effects on factors such as weight management and insulin sensitivity. Yogurt is a good source of protein, calcium, and probiotics, which are beneficial bacteria that may contribute to gut health. Some research suggests that probiotics may play a role in improving insulin sensitivity and reducing inflammation, which are important factors in the development of type 2 diabetes.

Furthermore, yogurt is low in carbohydrates and has a relatively low glycemic index, meaning it has less of an impact on blood sugar levels compared to high-carbohydrate foods. Including yogurt as part of a balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins may help reduce the risk of type 2 diabetes. However, it’s essential to note that while yogurt can be a healthy addition to the diet, it’s not a guarantee against developing type 2 diabetes. Other lifestyle factors, such as maintaining a healthy weight, staying physically active, and avoiding smoking, also play crucial roles in diabetes prevention. Always consult with a healthcare professional for personalized dietary recommendations and diabetes prevention strategies.

Manufacturers of yogurt are permitted by federal regulators to make restricted statements on their packaging suggesting that yogurt could lower the risk of type 2 diabetes. According to the officials, specific language can be used to make qualified health claims as long as it is made clear that the claims are supported by scant data. According to experts, the decision might be perplexing for customers, who might read the label incorrectly and believe that yogurt is a foolproof method of lowering type 2 diabetes.

According to the Food and Drug Administration (FDA), yogurt manufacturers can now assert that consuming yogurt made from dairy products regularly may lower your risk of developing type 2 diabetes. The FDA selects which health claims are approved when manufacturers’ claims are substantiated by enough data. Manufacturers of yogurt are not allowed to suggest unless they have a valid health claim that eating yogurt lowers the risk of diabetes on their products or in their advertising. They can now converse with one in three adult Americans, though, who may be thinking about changing their diet to improve their health and have prediabetes. Before you reach for a spoon, here are some things to know about the new claim and whether it applies to your favorite yogurt.

Based on 28 observational studies that suggest a potential association between regular yogurt consumption and a decreased risk of type 2 diabetes, a new qualified health claim was developed that centers around yogurt. The yogurt health claim, like other qualified health claims, can only be explained to customers in extremely precise and authorized language. For instance: Consuming yogurt regularly at least two cups, or three servings may lower the risk of type 2 diabetes. The FDA has determined that the evidence for this claim is weak. Based on limited scientific evidence, eating yogurt regularly at least 2 cups (3 servings) per week may lower the risk of type 2 diabetes. For the claim which is limited to dairy-based yogurt products to be deemed compliant with the enforcement discretion, it must additionally contain language regarding two cups (or three servings) per week.

1.4 million new cases of diabetes are diagnosed in the US each year, making it one of the top 10 causes of death. Type 2 diabetes accounts for the great majority of these cases; fortunately, lifestyle modifications like increasing physical activity and eating more nutrient-rich foods can reduce the risk of this condition. Yogurt doesn’t seem to directly lower blood sugar or insulin sensitivity, although blood sugar is a major factor in type 2 diabetes and diet plays a part in management. That being said, yogurt still has health benefits for those who are susceptible to the illness. Even though more research is required to fully understand how yogurt may lower the risk of type 2 diabetes, Hackworth said that researchers have a few theories, including “pointing to the overall complexity of yogurt and its matrix of proteins, fats, and micronutrients which may have bioactive activities that contribute to lower risk of type 2 diabetes.” Yogurt is a nutrient-dense food that provides a good or excellent source of nine essential nutrients: calcium, protein, phosphorus, vitamin B12, riboflavin, pantothenic acid, zinc, selenium, and iodine. The whey protein in dairy products and live, active cultures may also have an impact on the risk of diabetes, according to research cited by Hackworth. Some research supports these theories. Yogurt is a fermented food containing live cultures, to start.

Through a number of different mechanisms, yogurt may help reduce the risk of type 2 diabetes. Probiotics are good bacteria that are found in yogurt and can have a positive impact on gut health. Probiotics have been linked to decreased inflammation and increased insulin sensitivity, both of which are critical elements in the onset of type 2 diabetes. Nutrient Content: Protein, calcium, and other important nutrients can be found in good amounts in yogurt. As part of a balanced diet, nutrient-rich foods like yogurt can support general health and may help lower the risk of chronic illnesses like type 2 diabetes. Low Glycemic Index: Yogurt usually has a low glycemic index, which means that consuming it doesn’t quickly raise blood sugar levels. Selecting foods with a lower glycemic index may lower the risk of insulin resistance and type 2 diabetes while also assisting in blood sugar regulation. Weight management: Consuming yogurt may help with weight management, according to some research. Since obesity is a major risk factor for type 2 diabetes, maintaining a healthy weight is crucial to preventing the disease. Calcium: A vital component of many bodily metabolic processes, yogurt is a good source of this mineral. According to certain research, the risk of type 2 diabetes may be negatively correlated with the amount of calcium consumed. Overall, adding yogurt to a diet rich in fruits, vegetables, and other nutrients will help you achieve a balanced diet.

REFERENCES:

https://www.medicalnewstoday.com/articles/fda-allowing-labels-that-claim-yogurt-can-help-reduce-type-2-diabetes-risk
https://www.hsph.harvard.edu/news/hsph-in-the-news/yogurt-may-reduce-type-2-diabetes-risk/
https://www.verywellhealth.com/yogurt-diabetes-qualified-health-claim-8605480#:~:text=The%20FDA%20is%20allowing%20food,you%20won’t%20develop%20diabetes.

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The FDA has approved Wegovy, an anti-obesity drug, for reducing cardiovascular risk in adults with overweight or obesity and established cardiovascular disease. The label expansion now allows for the once-weekly injection of semaglutide 2.4 mg to be used to reduce risks for major adverse cardiovascular events (MACEs). These events include cardiovascular death, nonfatal heart attack, or nonfatal stroke. The drug should be used in combination with a reduced-calorie diet and increased physical activity. This approval makes Wegovy the first weight loss medication to also help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight, according to the FDA with type 2 diabetes.

Several clinical trials, including the SUSTAIN and PIONEER trials, have demonstrated that semaglutide can reduce the risk of major adverse cardiovascular events (MACE) in people with type 2 diabetes who are at high risk for cardiovascular disease. These trials have shown a reduction in the risk of cardiovascular events such as heart attack, stroke, and cardiovascular death in participants treated with semaglutide compared to those treated with a placebo or other diabetes medications.

The exact mechanisms by which semaglutide reduces cardiovascular risk are not fully understood, but it is believed to be related to its effects on blood sugar control, body weight, blood pressure, and other metabolic factors. Additionally, semaglutide may have direct effects on the cardiovascular system, such as reducing inflammation and improving vascular function. Overall, the cardiovascular benefits of semaglutide make it an important treatment option for individuals with type 2 diabetes who are at high risk for cardiovascular disease. However, as with any medication, it’s essential to discuss the potential risks and benefits with your healthcare provider to determine if semaglutide is the right choice for you.

This patient population has a higher risk of cardiovascular death, heart attack, and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health, he added. The approval was based on results from the 3-year SELECT trial, which randomly assigned 17,604 patients with cardiovascular disease and body mass index 27 to weekly semaglutide or placebo. None of the patients had diabetes, although two-thirds met prediabetes criteria. The incidence of MACEs was reduced by 20% with the drug. The label will also reflect the risk reduction of 15% for cardiovascular death and 19% for death from any cause. Participants also lost a mean of 9.4% of body weight over the first 2 years with semaglutide vs 0.88% with placebo.

Adverse events leading to discontinuation of treatment occurred in 16.6% in the semaglutide group, mostly gastrointestinal effects, and in 8.2% in the placebo group. The maker of the weight loss medication, Novo Nordisk, has also filed for a label expansion in the European Union, with a decision expected in 2024. 

Wegovy is now the first weight loss medication to also be approved to help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight, This patient population has a higher risk of cardiovascular death, heart attack, and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health.

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor antagonist, a class of medications that has gathered much media attention as of late.1 The FDA said that semaglutide should not be used in combination with other medication containing semaglutide or other GLP-1 receptor agonists.
The approval was based on efficacy and safety in the multicentered, placebo-controlled, double-blind SELECT (NCT03574597) trial, which had over 17,600 individuals in the cohort. Treatment was randomized between semaglutide or the placebo, with both groups receiving standard-of-care treatment, including management of blood pressure and cholesterol, and healthy lifestyle counseling, including diet and physical activity, according to the FDA. Investigators of the study found that semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE) such as CVD death, heart attack, and stroke, which occurred in 6.5% of individuals in the semaglutide group compared with 8% of those in the placebo group.

The FDA approved Wegovy (semaglutide) for a new use: reducing the risk of cardiovascular (CV) death, heart attack, and stroke in adults with both cardiovascular disease (CVD) and overweight or obesity. Wegovy is the first weight-loss medication approved for this specific purpose. It should be used alongside a reduced-calorie diet and increased physical activity.

REFERENCES:

https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix?src=&form=fpf
https://www.dicardiology.com/content/fda-approves-wegovy-cardiovascular-risk-reduction-adults-known-heart-disease-and-overweight
https://www.pharmacytimes.com/view/fda-approves-semaglutide-for-new-indication-involving-cardiovascular-disease

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Ozempic (semaglutide) is a medication primarily used to treat type 2 diabetes. Recent studies have suggested that it may have potential benefits beyond glycemic control, including possible effects on kidney disease progression. Some research indicates that Ozempic may slow the progression of kidney disease in people with type 2 diabetes, though more studies are needed to confirm these findings and understand the mechanisms involved. It’s always essential for individuals to discuss potential treatment options and their implications with their healthcare providers.

Type 2 diabetes is a condition that results from the body no longer responding to insulin, the hormone that controls blood glucose levels. People with type 2 diabetes are at high risk of developing chronic kidney disease. Semaglutide sold under the brand name Ozempic is a drug that, in conjunction with diet and exercise, improves blood glucose (sugar) control in people with diabetes. Now, trial results show that semaglutide may also reduce the progression of kidney disease.

Chronic kidney disease affects one in three adults with diabetes. Both type 1 and type 2 diabetes increase the risk of chronic kidney disease if blood glucose (sugar) levels are not controlled. The resulting damage to blood vessels and nephrons in the kidneys means they cannot function effectively. As the early stages of kidney disease cause few or no symptoms, people with diabetes should manage their blood glucose, blood pressure, and cholesterol levels. They should also get regular checks from their doctor.
Semaglutide which is marketed as Ozempic, is one of a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. These mimic a hormone GLP-1 that makes the body produce more insulin, reduces appetite, and gives feelings of fullness.

The Food and Drug Administration (FDA) has approved Ozempic as a treatment for type 2 diabetes, in addition to diet and exercise. As well as helping control blood glucose, it may also reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes and heart disease. One study has shown that it could also reduce inflammation, which may explain these other health effects.

Now, the manufacturer of Ozempic Novo Nordisk has announced headline results of their latest trial, suggesting that semaglutide can reduce the risk of kidney disease progression by 24% in people who have type 2 diabetes and chronic kidney disease. The detailed results of the FLOW trial will be presented at a scientific conference later this year. They have not yet appeared in a peer-reviewed journal. This is a very significant finding; over 500 million people have diabetes, and 30-40% have chronic kidney disease, and we need treatments to stop or reduce progression of the kidney disease as well as to reduce the burden of cardiovascular disease which is high in this population. People with [type 2 diabetes] and [chronic kidney disease] are at amplified risk for cardiovascular-related morbidity and mortality and progression to kidney failure. Treatment options capable of mitigating heart and kidney risk in this population are greatly needed, he told us.

Researchers on the FLOW trial recruited 3,533 people with type 2 diabetes and chronic kidney disease from 418 locations in 28 countries. They randomly allocated them to semaglutide or placebo. Participants self-administered both semaglutide and the visually identical placebo by weekly subcutaneous injection. Those in the semaglutide group started on a dose of 0.25 milligrams (mg) per week for 4 weeks, increasing the dose to 0.5 mg, then to 1 mg after 8 weeks and for the rest of the trial.

In addition, all participants received the maximum labeled or tolerated dose of a RAAS blocking agentTrusted Source unless contraindicated or not tolerated which helps control hypertension, acute myocardial infarctionTrusted Source (heart attack), chronic systolic heart failure, stroke, and diabetic renal disease. Participants had a mean age of 66.6 years, 69.7% were men and 65.7% were white. All participants had type 2 diabetes diagnosed, on average, 17.4 years before the start of the trial and chronic kidney disease. The trial was meant to run until the end of 2024 but was stopped early after it reached its primary endpoint. The endpoint is composed of kidney disease progression and cardiovascular and kidney death, and in particular progression to kidney failure and mortality of cardiovascular events. These are frequent in this population of [type 2 diabetes] with [chronic kidney disease], so that we can reduce this by 24% is important and meaningful for patients.

In the announcement, Novo Nordisk stated that the trial had achieved a statistically significant and superior reduction in kidney disease progression as well as cardiovascular and kidney death of 24% for people treated with semaglutide 1.0 mg compared to placebo. There needs to be repeated assessments with different samples of participants across the world. In the real world setting, people behave differently and have other conditions as well. So, we need more effectiveness trials [because] effectiveness trials find how well a medication works [unlike] efficacy trials that measure how well it works in RCT/lab studies. The recently released headline results are impressive, yet we await the presentation and publication of the complete trial results to fully understand the efficacy and safety outcomes of the trial.

Ozempic is not without side effects. While Ozempic (semaglutide) can be effective in managing type 2 diabetes, it’s important to be aware of potential side effects. Like many medications, Ozempic does carry the risk of side effects, some of which can be serious. It’s crucial for individuals to discuss these potential risks with their healthcare providers before starting the medication and to monitor for any adverse reactions while taking it.

REFERENCES:

https://www.medicalnewstoday.com/articles/ozempic-may-delay-kidney-disease-progression-latest-trial-results-show
https://www.healthline.com/health-news/ozempic-cuts-risk-of-kidney-disease-related-events-new-trial-shows
https://health.economictimes.indiatimes.com/news/pharma/pharma-industry/novo-nordisk-ozempic-trial-delays-progression-of-chronic-kidney-disease/108237567?utm_source=top_news&utm_medium=tagListing
https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-ozempic-trial-delays-progression-chronic-kidney-disease-2024-03-05/

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Diabetes, more especially type 2 diabetes, is emerging as one of the 21st century’s most difficult medical issues. It is also anticipated that 380 million individuals globally will receive a diabetes diagnosis by 2025. Diabetes management and treatment are increasingly important because it is a risk factor for many other diseases and chronic health conditions, including stroke, kidney disease, cardiovascular disease, and blindness, to name a few. However, many people are thought to be in a precursor stage known as prediabetes before they go on to develop type 2 diabetes. People with this illness have blood sugar levels that are higher than normal but not high enough to be classified as type 2 diabetes. However, a significant risk factor for type 2 diabetes is prediabetes. The statistics of those who have prediabetes provide a clear picture when it comes to scaling this issue: more than one in three persons in the U.S. S. along with the U. K. have been identified as prediabetic. Therefore, if prediabetes is considered an early warning sign of type 2 diabetes, people can take  steps to reverse the course of this condition and it is possible to reverse this condition with significant lifestyle changes.

On our May podcast, “In Conversation: Can diet and exercise help reverse prediabetes?” Dr. Thomas Barber, an associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire, joined Dr. Hilary Guite and me. Additionally, Healthline Media and Medical News Today Managing Editor Angela Chao shared her personal story of reversing her diagnosis of prediabetes and the lifestyle changes she made to maintain it. In Angela’s instance, few medical professionals would have thought that her blood sugar levels were concerning. She is not thin, young, and energetic like most people with prediabetes or those at risk of getting diabetes. She did, however, admit that at the time she led a fairly sedentary lifestyle. She said that because my readings were so low on the spectrum, I don’t even think my primary care physician at the time talked to me about it beyond providing the range and the diagnosis. She did, however, add that some doctors and her medical friends seemed concerned about the changes to the cutoff point for readings that qualified as prediabetes.

According to Dr. Barber, the diagnosis of diabetes and prediabetes was previously made using fasting glucose readings or a conventional glucose tolerance test. In this test, participants were given 75 grams of a sugar-filled beverage, and their blood sugar levels were monitored for the following two hours. Additionally, the definition of prediabetes is constantly changing and may vary from nation to nation. Definitions vary amongst societies and prestigious organizations. According to Dr. Barber, the first thing to really keep in mind is that there is a continuum involved when discussing diabetes or prediabetes. Should we choose the U. S. along with the U. K. For instance, there are variations in the thresholds and units of measurement applied when diagnosing prediabetes. As you point out, there are various units, which makes it a little confusing. However, in essence, in the U. K. for glucose, we use millimoles per liter, and in the U.S. S. milligrams per deciliter, to be exact. We typically use millimoles per mole in clinical settings now, and we have for a while, according to Dr. Barber. He went on, “I think that further complicating matters is the hemoglobin A1C, which has two different percentage units, one that we have historically used and the other that is now replaced by millimoles per mole.

According to Dr. Barber, glucose is a continuous variable rather than a discrete measure. He clarified that while everyone can agree on what is elevated and what is normal, there are kind of disagreements about everything in between. The World Health Organization approved hemoglobin A1C as a test for diabetes a few years ago. While additional glucose readings can be useful, Dr. Barber stated that medical professionals do primarily rely on A1C in current clinical practice. With regard to prediabetes in the U.S. K. this is predicated on an A1C of 39 to 47 mmol per mol; according to him, 39 is equal to an A1C of 5 points 7 percent. Anything that raises the hemoglobin A1C level above 48 millimoles per mole, or 6.5% of the baseline, is considered diabetes by definition. According to him, in order to diagnose type 2 diabetes, we should ideally have at least two of those readings that are elevated. When Angela was diagnosed, her A1C was 5 points8 percent, and anything above 5 points7 was considered prediabetes. Dr. Barber reminded us that, in the United States, Angela’s readings would not have been regarded as prediabetes and that, in recent years, the diagnostic criteria for diabetes have gradually decreased. K. at the time, since the values were extremely near to normal and not quite below the cut-off.

Usually, prediabetes shows no symptoms at all. On the other hand, some people may occasionally have frequent thirst, wake up in the middle of the night to urinate, experience blood sugar spikes, or have energy crashes. Prediabetes is frequently asymptomatic, so many people who are diagnosed with it may have had it for months or even years. Furthermore, it can easily go unreported unless people are tested for it, according to Dr. Barber. In describing her personal experience, Angela said, “I definitely didn’t have a wide range of symptoms.”. On the other hand, I was definitely already drinking water on a regular basis. I therefore found it difficult to determine whether anything was changing. Low blood sugar, particularly if she went for prolonged periods without eating, was something she did notice prior to the diagnosis. Over the years, she said, there has been a consistent pattern of significant fluctuations in her blood sugar levels, which she could feel physically. She can, however, fast trouble-free for more than 16 hours now because of certain lifestyle adjustments. Sugar surges and falls may be considered preemptive indicators of diabetes.

According to Dr. Dot Barber, prediabetes is a general term that can refer to either elevated fasting glucose or elevated postprandial glucose. Dr. Dot Barber stated that fluctuations in blood sugar levels, or glycemia, were often observed in the context of insulin resistance. Glucose levels tend to rise a little higher than they should, he explained, because the beta cells can’t produce enough insulin, for example, or the insulin isn’t as effective after a meal. He explained that without careful monitoring of blood sugar levels throughout the day, people might not physically notice these changes. “I guess the difference really is that most of the time, in the context of prediabetes, we’re not aware of this,” he said. It makes perfect sense that as you lead a healthier lifestyle, lose weight, and reverse prediabetes, your blood sugar levels will stabilize. He mentioned Angela’s description of the changes she saw and said that the insulin becomes more effective and can handle the fluctuations in glycemia better.

Obesity, having a high body mass index, and being overweight are some of the most well-known risk factors for type 2 diabetes. Additionally, as we age, our vulnerability increases. And the reason for that is that as we age, the beta cells and insulin’s receptors can no longer function as well, and insulin itself becomes slightly less effective. Accordingly, as we age, our chance of having prediabetes and diabetes rises, according to Dr. Barber. Dr. Barber added that eating a diet heavy in high-glycemic foods and sugary drinks, as well as stress, can all raise risk. Conversely, he asserted that a diet low in simple carbohydrates and high in fiber can delay the onset of dysglycemia. Genetics and ethnic origin are other factors to consider. Dr. Dot Barber presented the results of a recent study she and her colleagues carried out in the U. K. which revealed that, at a BMI of 23.9%, individuals of South Asian ethnicity had the same risk of developing diabetes as did white people at 30.

In contrast, Angela’s risk was increased by her family history. My mother, a retired medical doctor, had warned me since I was a teenager about the slight family history of type 2 diabetes on my father’s side. She also mentioned that everyone on that side of the family was thin and had no weight problems. Dr. According to Barber, diabetes is frequently attributed to lifestyle decisions, but many people are unaware that it is a hereditary disorder. According to him, patients with a strong family history may not always exhibit the characteristics of type 2 diabetes, such as being middle-aged, male, obese, and having a large abdomen. That’s the idea that most people with type 2 diabetes have of the typical person. And, he added, as you say, Angela doesn’t conform to any of those stereotypes of what that entails. Dr. Barber also emphasized that having a genetic predisposition to diabetes at birth can result in dysglycemia even in the absence of those other factors. More than 40 genes and gene mutations have been found to increase your risk of developing type 2 diabetes. Additionally, he stated that even though each effect is relatively weak on its own, adding them all together can have a cumulative effect. Through a combination of intermittent fasting, a balanced diet with an increased amount of lower-glycemic index foods and complex carbohydrates, and a sig, Angela was able to reverse her diabetes.

She advised against strict dieting, keto, and quick, drastic changes that aren’t long-term. Dr. Barber acknowledged that while this approach obviously worked for Angela, not many people would be able to make such drastic life changes and may find it challenging. According to Dr. Barber, there is evidence to suggest that intensive lifestyle treatments that prioritize diet, physical activity, weight loss, and other related factors can effectively prevent or postpone the onset of type 2 diabetes. In my opinion, it serves as a kind of early warning system that indicates when a person needs to make a lifestyle change. He added that it must be beneficial if it inspires or motivates people to alter their way of life.

REFERENCES:

https://www.medicalnewstoday.com/articles/in-conversation-can-diet-and-exercise-reverse-prediabetes?utm_source=ReadNext
https://www.hopkinsmedicine.org/health/wellness-and-prevention/prediabetes-diet
https://www.healthline.com/health/diabetes/how-to-reverse-prediabetes-naturally
https://www.healthcentral.com/condition/type-2-diabetes/how-can-you-reverse-prediabetes
https://www.breathewellbeing.in/blog/reverse-your-prediabetes-with-the-best-diet-and-exercise/

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According to research, adults with chronic conditions can exercise more effectively when they participate in aquatic high-intensity interval training (AHIIT). They observed that AHIIT had an effect comparable to that of land-based training (LBHIIT) and that it might be a useful and safe substitute for those with long-term medical conditions who are unable to engage in land-based exercise. Although there is conflicting data regarding the physiological benefits of exercising in the water, experts agree that it can help reduce joint strain and enable individuals to perform movements that they may not be able to on dry land. For those with long-term medical conditions who find land-based training too challenging, researchers have a message. Come on in. The water is clear. Currently available in the BMJ Open Sport and Exercise Medicine journal. According to the study, adults with chronic conditions like diabetes and arthritis can exercise more effectively when they participate in high-intensity interval training (AHIIT), which is conducted in water. Additionally, the researchers claim that AHIIT has an effect comparable to that of land-based training (LBHIIT) and that it could be a beneficial and safe substitute for LBHIIT for those with long-term medical conditions. Dr. Sports medicine expert Mark Slabaugh of Mercy Medical Center in Baltimore told Medical News Today that exercising in the water has obvious advantages for those with chronic pain, arthritis, and tendinitis.

Salbaugh, who was not involved in the study, said, “This study gives us as clinicians even more options for patients who are interested in cross training and doing HIIT workouts but can not due to joint pain.”. “I advise my patients to begin with these brief AHIIT sessions and work their way up to longer swimming sessions, as swimming is a sport that can be continued well into old age. The study team examined 18 trials to compare the effects of AHIIT and LBHIIT on participants’ ability to exercise (as determined by oxygen consumption, walking tests, and other physical fitness assessments). Additionally, they contrasted AHIIT with a control group that did not exercise and moderate-intensity exercise in water (AMICT). Using the widely accepted GRADE system, the researchers evaluated the degree of certainty in the evidence. They examined 868 participants with a variety of illnesses, including multiple sclerosis, back pain, arthritis, type 2 diabetes, and chronic lung disease (COPD), with 74% of the participants being female. A few individuals were dealing with multiple chronic illnesses. Standardized mean differences (SMD) were used in the study to represent group differences. A small effect was indicated by an SMD of 0.2-0.49, a moderate effect by 0.5-0.79, and a large effect by 0.8 or more.

According to the study, AHIIT had a minor positive impact when compared to AMICT (SMD 0.45) and a moderately positive impact when compared to no exercise (SMD 0.78). Furthermore, there was no discernible difference in the exercise capacity between LBHIIT and AHIIT. Compared to LBHIIT, fewer adverse events were reported with AHIIT. The range of 84 percent to 100 percent was the adherence rate for AHIIT. Physical therapist Sydnee Corbin is also the clinic director of SporTherapy in Texas, where therapy is conducted in a swimming pool. Water-based therapy, according to Corbin, who was not involved in the study, helps people with conditions like osteoarthritis, balance issues, sensory processing disorders, generalized weakness/deconditioning, and post-operative patients by offloading joints while increasing resistance. According to Corbin, “the pool is a great opportunity to provide resistance and sensory feedback—a unique property that is difficult to replicate on land.”. Reaching a patient population that would otherwise be sedentary or inactive can be greatly facilitated by an aquatic setting. “.

According to Corbin, individuals who suffer from osteoarthritis, persistent low back pain, or other long-term medical conditions might not be able to fully engage in LBHIIT and reap the full benefits of HIIT. “By introducing AHIIT, we can decrease further health risks to those populations and be more inclusive to them,” the speaker stated. In addition to offloading joints, the aquatic environment gives users’ systems sensory input that might otherwise be sensitized due to chronic pain, constant resistance from the water, and, if done in a heated pool, the ability to relax otherwise painful muscles and joints. “Mr. Medical News Today was informed by William Ashford, an orthopedic surgeon at AICA Orthopedics in Atlanta who was not involved in the study, that AHIIT presents a highly effective treatment modality, especially for individuals with musculoskeletal conditions like chronic back pain and arthritis. According to Ashford, the buoyancy of the water minimizes joint stress and offers a natural resistance, enabling people to engage in exercises that would be too painful or impractical on land. Additionally, Ashford noted that the cardiovascular benefits of HIIT are well-established, and applying this knowledge to an aquatic setting appears to enhance these benefits for some populations. According to Ashford, maintaining an exercise routine is essential to managing chronic illnesses.

Water exercise has its limitations as well. “Although beneficial for numerous individuals, it may not be appropriate for all patients, particularly those with specific chronic lung conditions, as the water pressure may cause difficulties in breathing,” stated Ashford. Also, some patients may find it difficult to get to the right facilities. Having said that, Ashford recommended further study to find strategies for expanding the reach of water-based therapy. “AHIIT is a highly effective, flexible, and patient-centered method for treating a range of chronic illnesses,” the speaker stated. The benefits of HIIT are combined with the special qualities of water to create a synergistic effect that can be especially helpful for patients who have trouble with land-based exercises. “.

REFERENCES:

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise/swimming-diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347725/
https://www.swimming.org/justswim/diabetes-and-swimming/
https://www.medicalnewstoday.com/articles/how-high-intensity-water-exercise-can-help-people-with-diabetes-and-other-conditions

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