A research group at Osaka University discovered that intensive diabetes treatment can improve the inflammatory state of periodontal disease.
Recent research published in Diabetes, Obesity, and Metabolism has shown that intensive diabetes treatment can positively impact periodontal health. This demonstrates that periodontal inflammation can be improved through intensive diabetes treatment despite the known link between diabetes and periodontal disease.
It is widely believed that diabetes and periodontal disease are interrelated. While it has been shown that treating periodontal disease improves blood glucose control, the effect of diabetes treatment on periodontal disease has remained largely unknown.
A collaborative research team from Osaka University conducted a two-week intensive diabetes treatment study with 29 type 2 diabetes patients. The results showed improvements in blood sugar control and periodontal health indicators. Patients who showed significant periodontal improvement also had higher pre-treatment C-peptide levels, suggesting better insulin secretion and less severe diabetic neuropathy and peripheral vascular disorders.
“These research findings are expected to advance our understanding of the relationship between diabetes and periodontal disease,” says senior author Masae Kuboniwa. “Improving periodontal disease in diabetic patients requires both periodontal treatment and early diabetes management. Promoting collaboration between medical and dental care from the early stages of diabetes can significantly prevent the onset and progression of periodontal disease in diabetic patients.”
A new study led by researchers at UCL finds that people who eat more ultra-processed foods (UPF) are at increased risk of developing type 2 diabetes, but this risk can be lowered by consuming less processed foods instead.
The study, published in The Lancet Regional Health—Europe in collaboration with experts from the University of Cambridge and Imperial College London, examined the connection between the extent of food processing and the risk of type 2 diabetes. It also examined which types of ultra-processed foods (UPF) posed the highest risk.
The team analysed UPF intake and health outcomes for 311,892 individuals from eight European countries over an average of 10.9 years, during which time 14,236 people developed type 2 diabetes.
They discovered that a 10% increase in the consumption of ultra-processed foods is associated with a 17% rise in the risk of type 2 diabetes, but this risk can be reduced by opting for less processed foods instead.
The highest-risk UPF groups were savoury snacks, animal-based products such as processed meats, ready meals, and sugar-sweetened and artificially sweetened beverages, suggesting that particular attention should be paid to these foods to help tackle ill health.
The degree of food processing is commonly evaluated using the Nova classification. This classification divides foods into four groups:
1. Unprocessed or minimally processed foods (MPF), such as eggs, milk, and fruit.
2. Processed culinary ingredients (PCI), such as salt, butter, and oil.
3. Processed foods (PF), including tinned fish, beer, and cheese
.4. Ultra-processed foods, such as ready-to-eat or ready-to-heat mixed dishes, savoury snacks, sweets, and desserts.
The specific reasons for the connection between UPF and type 2 diabetes are not confirmed, although several factors are believed to be involved, including overconsumption and weight gain. In a prior study, supported by new analysis in this study, it was found that increased body fat contributed to about half of the association.
Samuel Dicken, the first author of the study from the UCL Division of Medicine, stated, “We are aware that ultra-processed foods are linked to a higher risk of certain diseases, such as type 2 diabetes. As anticipated, our findings validate this connection and demonstrate that a 10% increase in the consumption of ultra-processed foods significantly increases the risk of developing type 2 diabetes.”
“Most studies to date have only considered ultra-processed foods (UPF) as a whole. However, we suspect that there may be different health risks associated with different types of UPF, and the risks of other processing groups have not been well researched. Our analysis goes further than previous studies by examining all four processing groups in the Nova classification to assess the impact on type 2 diabetes risk when substituting UPF with less processed foods. Additionally, we are looking at nine subgroups of UPF to better understand their impact.”
Replacing UPF with less processed foods was linked to a reduced risk of type 2 diabetes.
In the study, researchers from UCL analyzed data from the EPIC study, which investigated the relationship between diet, lifestyle, and environmental factors, and the incidence of chronic diseases in more than half a million Europeans over time.
Additional analysis was conducted to separate UPF into nine subgroups to better understand the impact of processing level on type 2 diabetes risk.
The researchers also performed substitution modelling on the data to see how replacing one Nova food group with another would affect type 2 diabetes risk, alongside analyzing how eating UPF affected a person’s risk of developing type 2 diabetes.
The results showed that substituting 10% of UPF in the diet with 10% of MPF/PCI reduced type 2 diabetes risk by 14%.
When 10% of ultra-processed food (UPF) in the diet was replaced with 10% of processed food (PF), the risk of diabetes decreased by 18%. The authors suggest that this could be due to the fact that 30-50% of processed food intake in the study came from beer and wine, which have been linked to a reduced risk of type 2 diabetes in a previous EPIC study. Processed food also includes salted nuts, artisanal breads, and preserved fruits and vegetables.
Analysis of the nine UPF subgroups indicates that savoury snacks, animal-based products, ready meals, and sugar-sweetened and artificially sweetened beverages are linked to a higher incidence of type 2 diabetes.
Consuming large amounts of these less healthy foods increases the overall risk of developing type 2 diabetes. Among the top 25% of highly processed food consumers, where highly processed foods made up 23.5% of their total diet, sweetened beverages alone contributed to almost 40% of their highly processed food intake and 9% of their overall diet.
However, UPF breads, biscuits, breakfast cereals, sweets, desserts, and plant-based alternatives were associated with a lower incidence of type 2 diabetes.
Professor Rachel Batterham, the senior author of the study from the UCL Division of Medicine, stated, “The subgroup analysis of ultra-processed foods (UPF) in this study has been revealing and confirms that not all foods classified as UPF pose the same health risks.”
“Breads and cereals, for example, are a staple of many people’s diets. Based on our results, I think we should treat them differently than savory snacks or sugary drinks in terms of the dietary advice we provide.”
Despite the high use of continuous glucose monitoring and insulin pump therapy, fear of hypoglycaemia (low blood sugar) remains a significant barrier to physical activity and exercise for adults with type 1 diabetes (T1D).
However, the findings suggest that if exercise and diabetes management are discussed in the clinic, this fear could be reduced. “Regular exercise can help individuals with diabetes to achieve their blood glucose goals, improve their body composition and fitness, as well as reduce their risk of heart attacks and strokes which is higher in people with type 1 diabetes,” explained lead author Dr Catriona Farrell from the University of Dundee, Scotland, UK. “Yet many people living with type 1 diabetes do not maintain a healthy body weight or manage to do the recommended amount of physical activity each week.” A number of previous studies have examined barriers to exercise in T1D, but these have been limited by their small sample size.
To fill this important evidence gap, researchers from the University of Dundee assessed knowledge and barriers to physical activity in adults with T1D and associated predictive factors. Adults with T1D were recruited from the NHS Research Scotland Diabetes Network (research register) and internationally via social media. Overall, 463 adults, 221 men and 242 women, with T1D answered an anonymous web-based questionnaire to assess barriers to physical activity (measured on the modified Barriers to Physical Activity in Type 1 Diabetes [BAPAD-1] scale), diabetes management, and attitudes to exercise and sport. Participants were asked to rate on a 7-point Likert scale (1, extremely unlikely to 7, extremely likely) the chance that each of 13 factors would keep them from doing regular physical activity in the next 6 months. Factors included: loss of control over diabetes, the risk of hypoglycaemia, the fear of being tired, the fear of getting hurt, a low fitness level, and lack of social support.
Researchers calculated average scores for each factor and assessed which were most correlated with perceived barriers to physical activity, as well as identifying independent predictors. The participant reported median age of respondents was 45-54 years, median disease duration 21-25 years, and median HbA1c 50-55 mmol/mol (an ideal level is 48 50-55 mmol/mol or below). Over three-quarters (79%) of respondents reported using continuous or flash glucose monitoring, around two-thirds (64%) said they were treated with multiple daily insulin injections, and over a third (36%) reported used insulin pump therapy. The researchers identified that despite advances in technologies and diabetes management, risk of hypoglycaemia with exercise remains a significant barrier to physical activity.
Importantly, participants who best understood the importance of adjusting insulin dose before and after exercise as well as adjusting carbohydrate intake for exercise were found to be less fearful of hypoglycaemia associated with physical activity. This knowledge is essential in order to adapt insulin and/or carbohydrate intake to prevent hypoglycaemia induced by exercise. The researchers also found that being asked about exercise or sport within a diabetes clinic was negatively correlated with fear of hypoglycaemia, and identified exercise confidence as the strongest independent predictor of fear of physical activity.
“Our findings demonstrate that in order to break down the barriers to physical activity, and empower our patients to exercise safely and effectively, we need to improve the education we provide and our dialogue about exercise in clinics,” said Dr Farrell. “In turn, this should help them to achieve the multitude of health benefits that exercise offers.”
A new class of insulin that is injected once a week is as effective as daily insulin injections for effective and safe blood sugar management in patients with type 2 diabetes
When individuals with type 2 diabetes discover that their oral medications are no longer effective in controlling their blood sugar, insulin therapy is introduced. The frequency of insulin injections (such as daily injections) is one of the primary factors that can lead to difficulties in adhering to the treatment. Other factors include concerns about weight gain and experiencing hypoglycemic episodes, also known as “hypos.”
Insulin efsitora alfa (efsitora) is a new basal insulin designed for once-weekly administration. Clinical data on its safety and effectiveness so far have been limited to small phase 1 or phase 2 trials. This new phase 3 study compared the effectiveness of once-weekly visitors to daily injections of insulin degludec (standard insulin) in adult patients who had not yet started insulin therapy despite being on multiple oral diabetes medications and still not reaching their glycemic goals.
The authors state: “Among adults with type 2 diabetes who had not previously received insulin, once-weekly efsitora was found to be as effective as once-daily degludec in controlling high blood sugar by reducing glycated hemoglobin levels.”
“The potential of a once-weekly insulin is to simplify dose administration and reduce barriers to starting insulin therapy by decreasing injection frequency compared to a once-daily insulin. A recent study on preferences for once-weekly basal insulin in adults with type 2 diabetes showed that both patients and providers would favor once-weekly basal insulin over current basal insulin preparations.”
There has been concern that common diabetes drugs could increase the risk of suicide and self-harm. A new study led by researchers at Karolinska Institutet.
GLP-1 analogues are drugs used by millions of people worldwide to lower blood sugar levels. They are primarily used to treat diabetes, but medications like Ozempic have also been found to be effective against obesity, which has contributed to their growing popularity.
Both American and European drug regulators have simultaneously cautioned about potential risks associated with the drugs.
Last year, the European Medicines Agency (EMA) launched an investigation into approximately 150 reported potential cases of suicidal thoughts and self-injury linked to the use of GLP-1 analogues.
The investigation concluded in the spring. Based on the limited data available at the time, it was determined that there were no obvious connections. Researchers at the Karolinska Institutet can now further support this conclusion. They have analyzed large amounts of data from people treated with GLP-1 analogues in Sweden and Denmark.
“We found no clear link between the use of the drugs and an increased risk of suicide, self-harm, or depression and anxiety-related disorders. This is reassuring,” says Björn Pasternak, principal researcher at the Department of Medicine, Solna, Karolinska Institutet, and one of the study’s lead authors.
The data includes around 300,000 adults aged 18–84 who began treatment with either GLP-1 analogs or SGLT2 inhibitors, another type of diabetes medication, between 2013 and 2021.
After a mean follow-up period of just over two years, there was no apparent increase in the proportion of individuals who committed suicide, engaged in self-harm, or suffered from depression or anxiety-related disorders among users of GLP-1 receptor agonists.
Peter Ueda, an assistant professor at the same department and one of the main authors of the study, emphasizes the importance of conducting larger studies to collect more data.
“It is important to specifically examine people with previous self-harm or suicidal thoughts as they are at increased risk and it is possible that the drug’s safety profile differs in this group,” he says.
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