Understanding how mutations affect diseases such as diabetes

Natália Ružičková Institute of Science and Technology Austria

PhD student Natália Ružičková

Many statistical models and algorithms scientists use can be imagined as a “black box.” These powerful models give accurate predictions, but their internal workings are not easily understood. In an era dominated by deep learning, where an ever-increasing amount of data can be processed, Natália Ružičková, a physicist and PhD student at the Institute of Science and Technology Austria (ISTA), chose to take a step back at least in the context of genomic data analysis.

Ružičková, along with recent ISTA graduate Michal Hledík and Professor Gašper Tkačik, has proposed a model to analyze polygenic diseases—conditions where multiple regions of the genome contribute to dysfunction. This model also aids in understanding the role of these identified genomic regions in developing these diseases. Their research provides valuable findings by integrating advanced genome analysis with fundamental biological insights. The results have been published in the Proceedings of the National Academy of Sciences (PNAS).

Decoding the human genome

In 1990, the Human Genome Project was launched to decode human DNA fully—the genetic blueprint that defines humanity. By 2003, the project was completed, leading to numerous scientific, medical, and technological breakthroughs. By deciphering the human genetic code, scientists aimed to learn more about diseases linked to specific mutations and variations in this genetic map. The human genome comprises approximately 20,000 genes and even more base pairs, which are the letters of the blueprint. This complexity made ample statistical power essential, resulting in the development of “genome-wide association studies” (GWAS).

GWAS approach the issue by identifying genetic variants potentially linked to organismal traits such as height. Notably, they also include the propensity for various diseases. The underlying statistical principle is relatively straightforward: participants are divided into two groups—healthy and sick individuals. Their DNA is then analyzed to detect variations—changes in their genome—that are more prominent in those affected by the disease.  

An interplay of genes

When genome-wide association studies emerged, scientists expected to find just a few mutations in known genes linked to a disease that would explain the difference between healthy and sick individuals. The truth, however, is much more complicated. “Sometimes, hundreds or thousands of mutations are linked to a specific disease,” says Miss Ružičková. “It was a surprising revelation and conflicted with our understanding of biology.”

Each individual mutation contributes only minimally to the risk of developing a disease. However, when combined, these mutations can provide a better—though not complete—understanding of why some individuals develop the disease. Such diseases are known as “polygenic.” For instance, type 2 diabetes is considered polygenic because it cannot be attributed to a single gene; rather, it involves hundreds of mutations. Some of these mutations influence insulin production, insulin action, or glucose metabolism, while many others are found in genomic regions that have not been previously linked to diabetes or have unknown biological functions.

The omnigenic model

In 2017, Evan A. Boyle and colleagues from Stanford University proposed a new conceptual framework called the “omnigenic model.” They proposed an explanation for why so many genes contribute to diseases: cells possess regulatory networks that link genes with diverse functions.

“Since genes are interconnected, a mutation in one gene can impact others, as the mutational effect spreads through the regulatory network,” Ružičková explains. Due to these networks, many genes in the regulatory system contribute to a disease. However, until now, this model has not been formulated mathematically and has remained a conceptual hypothesis that was difficult to test. In their latest paper, Ružičková and her colleagues introduce a new mathematical formalization based on the omnigenic model named the “quantitative omnigenic model” (QOM).

Combining statistics and biology

To demonstrate the new model’s potential, they needed to apply the framework to a well-characterized biological system. They chose the typical lab yeast model Saccharomyces cerevisiae, better known as the brewer’s yeast or the baker’s yeast. It is a single-cell eukaryote, meaning its cell structure is similar to that of complex organisms such as humans. “In yeast, we have a fairly good understanding of how regulatory networks that interconnect genes are structured,” Miss Ružičková says.

Using their model, the scientists predicted gene expression levels—the intensity of gene activity, indicating how much information from the DNA is actively utilized—and how mutations spread through the yeast’s regulatory network. The predictions were highly efficient: The model identified the relevant genes and could clearly pinpoint which mutation most likely contributed to a specific outcome.

The puzzle pieces of polygenic diseases

The scientists’ goal was not to outdo the standard GWAS in prediction performance but rather to go in a different direction by making the model interpretable. Whereas a standard GWAS model works as a “black box,” offering a statistical account of how frequently a particular mutation is linked to a disease, the new model also provides a chain-of-events causal mechanism for how that mutation may lead to disease.

In medicine, understanding the biological context and such causal pathways has huge implications for finding new therapeutic options. Although the model is far from any medical application, it shows potential, especially for learning more about polygenic diseases. “If you have enough knowledge about the regulatory networks, you could also build similar models for other organisms. We looked at the gene expression in yeast, which is just the first step and proof of principle. Now that we understand what is possible, one can start thinking about applications to human genetics,” says Miss Ružičková.

People with type 2 diabetes who eat low-carb may be able to discontinue medication

Study finds low-carbohydrate diet may improve beta-cell function in people with type 2 diabetes
The study finds that a low-carbohydrate diet may improve beta-cell function in people with type 2 diabetes.

Adults with type 2 diabetes on a low-carbohydrate diet may see benefits to their beta-cell function, allowing them to manage their disease better and possibly discontinue medication, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.


Beta-cells are endocrine cells in the pancreas that produce and release insulin, the hormone that controls blood sugar levels.

More than 38 million Americans have diabetes, and over 90% of them have type 2 diabetes. Type 2 diabetes most often develops in people 45 or older, but more and more children, teens and young adults are also developing the disease.

People with type 2 diabetes have a compromised beta-cell response to blood sugar, possibly due in part to eating too many carbohydrates. Beta-cell failure or insufficiency on top of insulin resistance is responsible for the development and progression of type 2 diabetes.


“This study shows people with type 2 diabetes on a low-carbohydrate diet can recover their beta-cells, an outcome that cannot be achieved with medication,” said lead study author Barbara Gower, PhD, of the University of Alabama at Birmingham in Birmingham, Ala. “People with mild type 2 diabetes who reduce their carbohydrate intake may be able to discontinue medication and enjoy eating meals and snacks that are higher in protein and meet their energy needs.”

The researchers gathered data from 57 white and Black adults with type 2 diabetes, half on a low-carbohydrate diet and the other half on a high-carbohydrate diet. They examined their beta-cell function and insulin secretion at baseline and after 12 weeks.

All of the participants’ meals were provided. People on the carbohydrate-restricted diet ate 9% carbohydrates and 65% fat, and participants on the high-carbohydrate diet ate 55% carbohydrates and 20% fat.

The researchers found that those on a low-carbohydrate versus a high-carbohydrate diet saw improvements in the acute and maximal beta-cell responses, which were 2-fold and 22% greater, respectively. Within each race group, Black adults on a low-carbohydrate diet saw 110% greater improvements in the acute beta-cell response and White adults had improvements in the maximal beta-cell response that was 48% greater than their respective counterparts on the high-carbohydrate diet.

“Further research is needed to determine if a low-carbohydrate diet can restore beta-cell function and lead to remission in people with type 2 diabetes,” Gower said.

Ultra-processed foods pose huge dangers for people with diabetes

Researchers found ultra-processed foods, even diet ones, bring distinct risks for people with diabetes.
Researchers found that ultra-processed foods, even diet ones, bring distinct risks for people with diabetes.

A team of researchers in nutritional sciences, kinesiology, and health education at the University of Texas at Austin has found that eating more ultra-processed foods—from diet sodas to packaged crackers to certain cereals and yoghurts—is closely linked with higher blood sugar levels in people with Type 2 diabetes.

In a recent paper published in the Journal of the Academy of Nutrition and Dietetics, the team describes how, more than just the presence of sugar and salt in the diet, consuming more ultra-processed foods loaded with additives can lead to higher average blood glucose levels over several months, as measured by HbA1C.

“We wanted to understand the impact of different types of foods on blood sugar control in people with Type 2 diabetes,” said Marissa Burgermaster, assistant professor of nutritional sciences at UT and the senior author of the study. “Our findings showed that individuals who consumed more ultra-processed foods had poorer blood sugar control, while those who included more minimally processed or unprocessed foods in their diet had better control.”

The researchers examined the diet recalls and scored them against three widely used indexes that look at the overall quality or nutrition in a person’s diet. Still, those tools were not associated with blood glucose control. Instead, how many grams of ultra-processed food the participants ate or drank was linked to worse control, and a correspondingly better control occurred in participants who ate more whole foods or foods and drinks with minimal processing.

Recent studies have indicated that eating more ultra-processed foods is linked to higher rates of cardiovascular disease, obesity, sleep disorders, anxiety, depression and early death. Ultra-processed foods are typically higher in added sugars and sodium. Still, the researchers concluded that the A1C increases were not about merely added sugar and sodium, or they would have correlated with the tools that measure overall nutritional quality in the diet. Synthetic flavours, added colours, emulsifiers, artificial sweeteners and other artificial ingredients may be in part to blame, hypothesized Erin Hudson, a graduate student author of the paper, and this would suggest that dietary guidelines may need to begin to place more emphasis on ultra-processed foods.

Having a sweet tooth is linked to higher risk of depression, diabetes, and stroke, study finds

People with a preference for sweets are at a higher risk of developing depression, diabetes, and suffering a stroke, according to new research from the University of Surrey.
People with a preference for sweets are at a higher risk of developing depression, diabetes, and suffering a stroke, according to new research from the University of Surrey.

The study, which was published in the Journal of Translational Medicine, utilized anonymized data on the food preferences of 180,000 volunteers from the UK Biobank. Artificial intelligence was employed to categorize them into three general profiles:

  • Health-conscious: prefer fruits and vegetables over animal-based and sweet foods. 
  • Omnivore: Likes most foods, including meats, fish, and some vegetables, as well as sweets and desserts. 
  • Sweet tooth: Prefer sweet foods and sugary drinks and is less interested in healthier options like fruit and vegetables.  

The Surrey team analyzed UK Biobank data on blood samples, measuring 2,923 proteins and 168 metabolites to observe how these levels varied in each group.

Proteins are essential for various functions in the body, such as fighting infections, muscle contractions, and cognitive processes. Metabolites, on the other hand, are small molecules produced during digestion and other chemical processes in the body, providing valuable insights into our body’s functioning. By comparing these blood-based proteins and metabolites, researchers can gain a better understanding of the biological variances between different groups.

Professor Nophar Geifman, said: 

“The foods that you like or dislike appear to be directly linked to your health. If your favorite foods are cakes, sweets, and sugary drinks, our study’s results suggest that this may have negative effects on your health. We found that the group with a sweet tooth is 31% more likely to have depression. Additionally, this group had higher rates of diabetes and vascular heart conditions compared to the other two groups.”

“Importantly, by utilizing data-driven artificial intelligence methods, we managed to categorize individuals based on their food preferences. These categories have significant associations with health outcomes and biological markers.”

“Processed sugar is a significant part of many people’s diets. These results provide further evidence that, as a society, we should be mindful of what we eat. It’s important to stress that we’re not trying to tell people what to do; our job is simply to inform.”

The researchers also looked at differences between the three groups in standard blood biochemistry tests.  

Professor Geifman continues: 

“In the sweet tooth group, they had higher levels of C reactive protein, which is a marker for inflammation. Their blood results also show higher levels of glucose and poor lipid profiles, which is a strong warning sign for diabetes and heart disease.” 

Conversely, the health-conscious group, which also had higher dietary fibre intake, had lower risks for heart failure, chronic kidney diseases and stroke, while the omnivore group had moderate health risks. 

According to the British Nutrition Foundation, on average, in the UK, between 9% to 12.5% of an individual’s calories come from free sugar – this is defined as sugar that is added to food or drink.  Biscuits, buns, cakes, pastries and fruit pies are the biggest single contributors for adults, but together, sugary soft drinks and alcoholic drinks contribute the most to free sugar intake. 

How muscle energy production is impaired by diabetes

Anna Krook

Anna Krook Credit Johannes Frandsén

A new study from Karolinska Institutet shows that people with type 2 diabetes have lower protein levels that break down and convert creatine in the muscles. This leads to impaired function of the mitochondria, the cell’s ‘powerhouses’.

Creatine is a natural compound found in foods such as meat and fish. It is also a popular supplement for improving exercise performance, as it can make muscles work harder and longer before they become fatigued. Despite creatine’s recognized positive effects, previous studies have suggested a possible link between high blood creatine levels and an increased risk of type 2 diabetes. This has raised questions about whether creatine supplementation may contribute to that risk.



New research based on studies in both humans and mice shows that people with type 2 diabetes have lower protein levels in their muscles that metabolise and convert creatine—a protein called creatine kinase.

“This reduced protein level leads to impaired creatine metabolism in the muscle. This may explain why people with type 2 diabetes accumulate creatine in their blood,” says Anna Krook, Professor at the Department of Physiology and Pharmacology at Karolinska Institutet and the study’s principal investigator.

Scientists don’t know exactly what high creatine levels in the blood mean for the body, but they do know that they affect cells outside the cells.

“The findings indicate that impaired creatine metabolism is a consequence of type 2 diabetes rather than a cause of the disease,” says Anna Krook.

The study also shows that low levels of creatine kinase are linked to higher creatine levels in the blood and the impairing function of mitochondria in the muscle. Mitochondria, which convert nutrients into energy, function less well in muscle cells with reduced creatine kinase, leading to lower energy production and increased cell stress.

“This is quite consistent with the fact that people with type 2 diabetes have poorer energy metabolism. In the future, one possibility could be to regulate creatine kinase as part of treating metabolic diseases such as obesity and diabetes,” says Anna Krook.

An unexpected finding of the study was that changes in creatine kinase levels affected the appearance of mitochondria and also their ability to produce energy, regardless of the amount of creatine available.

“This suggests that although the main role of creatine kinase is to process creatine, it affects mitochondrial function in other ways,” explains David Rizo-Roca, the study’s first author.

“Our next step is to find the molecular mechanisms behind these effects,” he says.