insulin

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Brain insulin sensitivity determines body weight and fat distribution

If the brain reacts sensitively to the hormone, you lose a significant amount of weight, reduce unhealthy abdominal fat and can maintain weight in the long term. If the brain reacts only slightly or not at all to insulin, you only lose some weight at the beginning of the intervention and then gain weight again.

Just where fat is deposited in the body and to what degree a person may benefit from a lifestyle intervention depends, among other things, on how sensitive the brain is to insulin. If the person’s brain responds sensitively to the hormone, a significant amount of weight can be lost, unhealthy visceral fat reduced, and the weight loss can be maintained over the long term. However, If the person’s brain responds only slightly or not at all to insulin, the person only loses some weight at the beginning of the intervention and then experiences weight regain. Over the long term, the visceral fat also increases. These are the results of a long-term study by the German Center for Diabetes Research (DZD), Helmholtz Zentrum München and Tübingen University Hospital which has now been published in Nature Communications.

To which extent body fat has an unhealthy effect depends primarily on where it is stored. If fat accumulates in the abdomen, this is particularly unfavorable. This is because the visceral fat releases numerous neurotransmitters that affect blood pressure, influence the secretion of the hormone insulin and can cause inflammation. This increases the risk of diabetes, cardiovascular disease and certain types of cancer. The subcutaneous fat which accumulates on the buttocks, thighs and hips has no adverse health effects. However, it is still unclear why fat storage does not occur in the same place in all people. Studies in the Tübingen Lifestyle Intervention Program (TULIP) [1] suggest that brain insulin responsiveness could play an important role here. They showed that people with a high insulin sensitivity in the brain benefit significantly more from a lifestyle intervention with a diet rich in fiber and exercise than people with insulin resistance in the brain. Not only did they lose more weight, they also had a healthier fat distribution. But how does insulin sensitivity affect the distribution of body fat and weight in the long term? Researchers from the German Center for Diabetes Research (DZD), Helmholtz Zentrum München and Tübingen University Hospital investigated this question in a long-term study. For this purpose, they recorded the follow-up data of 15 participants over a period of nine years, in which the insulin sensitivity in the brain was determined by magnetoencephalography before the start of a 24-month lifestyle intervention.

High insulin sensitivity associated with reduction in visceral fat and weight

It was found that insulin action in the brain not only determines body weight, but also the distribution of fat in the body. “Subjects with high insulin sensitivity in the brain benefited from the lifestyle intervention with a pronounced reduction in weight and visceral fat. Even after the lifestyle intervention had ended, they only regained a small amount of fat during the nine-year follow-up,” said the head of the study, Professor Martin Heni from Tübingen University Hospital. In contrast, people with brain insulin resistance only showed a slight weight loss in the first nine months of the program. “Afterwards, their body weight and visceral fat increased again during the following months of lifestyle intervention,” said first author PD Dr. Stephanie Kullmann from the IDM.

Since the insulin action in the hypothalamus is crucial for the regulation of peripheral energy metabolism, the researchers also investigated how insulin sensitivity in this area of the brain is related to the distribution of body fat. For this purpose, they examined a cross-sectional cohort of 112 participants. The analysis of the data showed that people with high insulin sensitivity in the hypothalamus form little visceral fat. However, insulin sensitivity has no influence on the mass of subcutaneous fat.

Our study reveals a novel key mechanism that regulates fat distribution in humans. Insulin sensitivity in the brain determines where fat is deposited, “said Heni, summarizing the results. Since visceral fat not only plays a role in the development of type 2 diabetes, but also increases the risk of cardiovascular disease and cancer, the study results may also open up new approaches for treatment options beyond metabolic diseases. The researchers in Tübingen are already working on new therapies to abolish insulin resistance in the brain and thus have a beneficial effect on body fat distribution.

Posted on Diabetes

Our bodies may cure themselves of diabetes in the future







Ordinary cells are not static and predetermined, as was earlier believed. They can change identity and function. This discovery may provide an approach for new types of treatments in the future. CREDIT Luiza Ghila

Diabetes is caused by damaged or non-existing insulin cells inability to produce insulin, a hormone that is necessary in regulating blood sugar levels. Many diabetes patients take insulin supplements to regulate these levels.

In collaboration with other international researchers, researchers at the University of Bergen have, discovered that glucagon.producing cells in the pancreas, can change identity and adapt so that they do the job for their neighbouring damaged or missing insulin cells.

“We are possibly facing the start of a totally new form of treatment for diabetes, where the body can produce its own insulin, with some start-up help,” says Researcher Luiza Ghila at the Raeder Research Lab, Department of Clinical Science, University of Bergen (UiB).




Cells can change identity

The researchers discovered that only about 2 per cent the neighbouring cells in the pancreas could change identity. However, event that amount makes the researchers are optimistic about potential new treatment approaches.

For the first time in history, researchers were able to describe the mechanisms behind the process of cell identity. It turns out that this is not at passive process, but is a result of signals from the surrounding cells. In the study, researchers were able to increase the number of insulin producing cells to 5 per cent, by using a drug that influenced the inter-cell signalling process. Thus far, the results have only been shown in animal models.

“If we gain more knowledge about the mechanisms behind this cell flexibility, then we could possibly be able to control the process and change more cells’ identities so that more insulin can be produced, ” Ghila explains.

Possible new treatment against cell death

According to the researchers, the new discoveries is not only good news for diabetes treatment.

“The cells´ ability to change identity and function, may be a decisive discovery in treating other diseases caused by cell death, such as Alzheimer´s disease and cellular damage due to heart attacks”, says Luiza Ghila.

Facts: Pancreas

There are three different types of cells in the pancreas: alpha-cells, beta-cells and delta-cells. These produce different kinds of hormones for blood sugar regulation.

The cells make clusters. Alpha-cells produce glucagon, which increases the blood sugar levels. Beta-cells produce insulin, which decreases glucagon levels. Delta-cells produce somatostatin, which controls the regulation of the Alpha and Beta Cells.

Persons with diabetes have a damaged beta-cell function, and therefore have constant high blood sugar levels.

 

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Diabetes – What is Continuous Glucose Monitoring?

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Get your diabetes awareness tee shirt here.

What is Continuous Glucose Monitoring?

Continuous glucose monitoring (CGM) is a method of monitoring blood glucose levels through the use of a thin wire sensor placed just under the skin, which samples glucose levels every few minutes throughout the day. The information is transmitted to a device that enables the user to view the information in real time. The data is useful for individuals with diabetes who need to constantly monitor glucose readings in order to prevent dangerous highs or lows. CGM data is also stored for later upload to a computer to help evaluate trends and make treatment optimization.

Why Is It Important To Monitor Blood Glucose Levels?

Many people with diabetes may not have noticeable symptoms until their blood glucose levels are either too high or too low. Hyperglycemia occurs when blood glucose levels are too high. If left untreated, this can lead to more serious complications, such as ketoacidosis.

Alternatively, hypoglycemia occurs when blood glucose levels are too low. If hypoglycemia is left untreated, the individual may experience a seizure or lose consciousness. Blood glucose levels must be controlled in order to avoid serious complications of diabetes.

Monitoring Blood Glucose Levels With a Standard Blood Glucose Meter

The most traditional method of checking blood glucose levels is through the use of a small lancing device to prick the tip of the finger to obtain a drop of blood. The blood sample is inserted into a blood glucose meter, which then measures glucose levels. These meters provide a single data point in time, and are effective for many individuals with diabetes when used several times per day, including before and after meals. For individuals who may need to test their glucose levels more often, CGM may offer an easier and more effective solution than finger sticks alone.

Monitoring Blood Glucose Levels with a CGM

Continuous glucose monitoring is a blood glucose monitoring method that can provide more than 250 readings per day. Minimal finger-stick readings from a standard blood glucose monitor are still required to double check the CGM device accuracy.

All of these readings together provide a pattern of blood glucose levels that may identify trends. Healthcare providers can use these trends to understand fluctuating glucose levels and how they relate to:

●  The kinds of food a patient eats

●  The types of activity they do

●  Medications and dosages

Trends may also help reveal:

●  Fluctuations in glucose levels overnight, which are often undetected

●  Blood glucose spikes early in the morning

This information enables healthcare providers to understand the effectiveness of an individual’s current treatment plan, and to make adjustments when needed.

Making Continuous Glucose Monitoring More Convenient

A variety of insulin pumps now integrate with CGM systems, helping reduce the number of devices that have to be carried.  Newer models even have bright, color touchscreens like smartphones, making them simple to learn and use.

How Does Continuous Glucose Monitoring Work?

Continuous glucose monitoring uses a sensor that is placed under the skin of the abdomen for up to 7 days. The sensor reads the amount of glucose in the surrounding fluid using an enzyme called glucose oxidase, the same technology used for testing strips.

When glucose in the surrounding fluid interacts with glucose oxidase, the enzyme converts the glucose into hydrogen peroxide. The hydrogen peroxide reacts with platinum inside the sensor that then sends a signal to a transmitter. This signal is converted into a glucose reading.

Who Can Use Continuous Glucose Monitoring?

Individuals with diabetes who may benefit from the use of continuous glucose monitoring include those who:

●  Have unexplained extreme highs or lows in glucose levels

●  Have a diagnosis of gestational diabetes

●  Have consistent high or low blood glucose levels

●  Are currently using an insulin pump

Speak With Your Healthcare Provider

Continuous glucose monitoring systems may require extra training and practice to use the device properly. Speak with your healthcare provider and your diabetes management team to learn more about continuous glucose monitoring and to determine whether CGM would be an effective addition to your current diabetes management plan.

Resources:

http://www.niddk.nih.gov/health-information/health-topics/Diabetes/continuous-glucose-monitoring/Pages/index.aspx

http://www.webmd.com/diabetes/guide/continuous-glucose-monitoring

http://www.joslin.org/info/the_facts_about_continuous_glucose_monitoring.html

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html?referrer=https://www.google.com.mx/

http://www.brunet.ca/en/advices/the-importance-of-monitoring-blood-glucose-levels.html

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html?referrer=https://www.google.com.mx/

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

http://www.diabetesforecast.org/2014/05-may/anatomy-of-a-cgm-sensor.html?referrer=https://www.google.com.mx/

http://www.fauquierhealth.org/diabetes.diabetes_continuous_glucose_monitoring_right_for_me

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Fear and shame leading to people with Type 2 diabetes risking future life threatening conditions


diabeteshighsandlows.co.uk

diabeteshighsandlows.co.uk




  • Research amongst patients with Type 2 Diabetes on insulin reveals how emotional and psychological factors are negatively impacting their condition
  • A quarter suffer from anxiety over getting hypos (low blood glucose levels) with more than 40% preferring to have high blood glucose levels instead of risking another hypo. This can lead to serious long term health risks
  • A new campaign launches today called ‘Diabetes Highs & Lows: Better Balance for a Better Future’ which highlights how emotional and psychological factors can have an impact on effective T2 diabetes management
  • The campaign includes the launch of a patient support website, DiabetesHighsAndLows.co.uk which is dedicated to helping patients with T2 diabetes better manage their blood glucose levels. The website is developed and funded by Sanofi.

A quarter of people with T2 diabetes feel anxious or fearful about ‘hypos’ (low blood glucose levels), with 42% preferring to have high blood glucose levels instead, despite the risk of life threatening conditions in the future.[i]

The findings also revealed that a significant proportion of patients with T2 diabetes believe that other people think they are to blame (15%), and some patients believe that other people think they are just greedy (14%) 1 . Likewise, 25% of patients with T2 diabetes only tell close friends, family or their healthcare professional about their diabetes, and 58% feel self-conscious or avoid injecting in front of other people, negative emotions are stopping people managing their condition properly.[i]




 Another Sanofi-funded study conducted in adults with Type 1 and Type 2 diabetes in the UK, and  published in the journal Diabetic Medicine, showed even modest improvement in blood glucose control could help prevent almost a million serious medical complications such as eye disease, kidney disease, foot ulcer and amputations, and potentially blindness, which could  avoid billions in future NHS costs.[ii]

With the UK having the worst control of T2 diabetes blood glucose levels in Europe[iii], Sanofi, who conducted the report, is launching a new patient support website to help the 52% of T2 diabetes patients who find it hard to balance their blood glucose levels.[i]

The Sanofi ‘Diabetes Highs and Lows: Better Balance for a Better future’ campaign aims to help people with Type 2 diabetes feel in control and positive about how they can balance their blood glucose levels. A new website, developed and funded by Sanofi has been launched, diabeteshighsandlows.co.uk, which includes key information on recognising and managing blood glucose highs and lows.

[i] Sanofi Data on File 2016. “Highs and lows: better balance for a better future” market research

[ii] Baxter et al, Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the

number of clinical complications and the associated financial benefit. Diabetic Medicine (2016). DOI: 10.1111/dme.13062

[iii] Khunti K et al. Study of Once Daily Levemir (SOLVETM) insights into the timing of insulin initiation in people with poorly

controlled Type 2 diabetes in routine clinical practice. Diabetes, Obesity and Metabolism (2012)

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Diabetes – so what are Type 1, Type 2, Type 3, Type 1.5 and gestational diabetes? (and pre-diabetes as well)


Doctor Max Pemberton

Doctor Max Pemberton

One of the big confusions, for a lot of people, is what are the different types of diabetes. In fact a lot of people have never heard of type 1.5 and type 3 diabetes. So we though we would ask Dr Max Pemberton who is an expert in this field!

He told us “I think this causes people a lot of confusion. There’s three main ones – Type 1, Type 2 and gestational diabetes and they’re all quite different. Type 1 diabetes is caused by an immune response whereby the body creates antibodies to the cells that make insulin in the pancreas, and it destroys those cells. So people with Type 1 diabetes no longer have the cells that make insulin, and so therefore they have low or no insulin in their blood.




Type 2 is quite different and that’s where the cells in the body have become resistant to the effects of insulin, so their body still makes insulin but the cells aren’t responding to it in the way that they should.

Now, gestational diabetes, that refers to a condition where women who are pregnant can sometimes develop diabetes and it’s just for the time that they are carrying a baby. So when they then give birth the majority of them, the diabetes then sort of passes. It’s really a response to being pregnant and the physical and hormonal changes that take place. People with gestational diabetes are at risk in the future of possibility developing diabetes but it is one of those things at the time, it then does go.

Now there’s these other terms that you mention, 1.5 and Type 3 and to be honest these complicate matters a bit. So all that 1.5 means really, it used to be thought that Type 1 diabetes affected people when they were very, very young and that’s when they first got diagnosed with it, and Type 2 was a result of lifestyle like being obese and so on, and that tended to happen when people were much older. Actually what they realised, that there is a group of people who despite might be relatively normal weight, they don’t have high cholesterol and so on and so on, so relatively physically healthy and yet still it’s often in their 40s or so they develop diabetes. So it’s not clear if it’s because of lifestyle changes, and it’s got a component probably of auto immune to it but it’s just presented much later, so it sits in-between Type 1 and Type 2 so they call it Type 1.2. To be honest I don’t think it is particularly helpful, I think it just confuses people.




Type 3 again I find it a slightly confusing term. It’s used by researchers just to talk about the evidence that shows that in some types of Alzheimer’s, the brain has become resistant to the effects of insulin. It’s just purely one of those scientific anomalies no one really quite understands quite what this means or the implications for either Alzheimer’s or indeed diabetes, but it’s one of these things you hear very occasional, sort of banded around usually within academic circles. It’s not something to worry about. Personally I definitely don’t think about Type 3 diabetes. The main three don’t forget are Type 1, Type 2 and gestational diabetes. ”

We also asked for a definition of pre-diabetes.  Max told up “Although there are three main types of diabetes, there’s also a stage before diabetes and that’s called pre-diabetes. It’s noticed impaired glucose tolerance and it’s a condition where your blood “