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Episodes

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Q&A #68 with Dr. Rhonda Patrick (3/1/25)

Posted on March 14th 2025 (3 months)

Dr. Rhonda Patrick discusses saturated fats and LDL, luteolin's benefits, glyphosate risks, natural vs. artificial flavors, and black cumin seed effects.

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Q&A #66 with Dr. Rhonda Patrick (1/4/25)

Posted on January 9th 2025 (5 months)

Dr. Rhonda Patrick discusses GLP-1 agonists, alpha-lipoic acid, ubiquinone vs. ubiquinol, calcium needs, and liquid biopsy cancer screening.

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Q&A #61 with Dr. Rhonda Patrick (8/3/24)

Posted on August 28th 2024 (10 months)

Dr. Rhonda Patrick discusses xylitol safety, strategies to reduce hemoglobin A1C, klotho and dementia risk, and the timing of hormone replacement therapy.

Topic Pages

  • Alcohol

    Ethanol metabolism raises hepatic NADH, inhibiting gluconeogenesis; chronic intake provokes steatosis and systemic insulin resistance, worsening diabetes.

  • Berberine

    Berberine activates AMP-activated protein kinase, enhances insulin receptor signaling, suppresses hepatic gluconeogenesis, thereby lowering type-2 diabetic hyperglycemia.

  • Breast milk and breastfeeding

    Maternal diabetes impairs prolactin-driven lactogenesis, while sustained breastfeeding enhances maternal insulin sensitivity and reduces offspring diabetes risk.

  • Cold exposure

    Cold-induced sympathetic activation of brown adipose tissue augments glucose uptake, improving insulin sensitivity and counteracting diabetic hyperglycemia.

  • Metformin

    Metformin activates AMP-activated protein kinase, inhibiting hepatic gluconeogenesis and improving insulin sensitivity, thereby lowering hyperglycemia in type 2 diabetes.

  • Polyphenol-rich diets and neurodegeneration (glycemic control)
    stub

    Polyphenols improve glycemic control via enhanced insulin sensitivity, consequently mitigating diabetes-induced oxidative and inflammatory neurodegeneration.

  • Sugar-sweetened beverages (SSBs)

    Chronic SSB intake drives postprandial hyperglycemia, promoting pancreatic β-cell stress and peripheral insulin resistance, elevating type-2 diabetes risk.

  • Ultra-processed Foods (UPFs)

    Ultra-processed foods’ high-glycemic carbohydrates and pro-inflammatory additives drive adiposity and insulin resistance, mechanistically linking them to type-2 diabetes.

News & Publications

  • Intensive lifestyle changes—combining a high-protein diet and regular moderate exercise—promoted diabetes remission in 87% of those newly diagnosed. bmcmedicine.biomedcentral.com
    Diabetes Diet Exercise

    The progression of type 2 diabetes is not inevitable, and early-stage disease can often be reversed. However, standard clinical approaches tend to focus on disease management rather than remission. A recent study found that combining a high-protein diet, moderate exercise, and weight-loss medications promoted diabetes remission in nearly 87% of newly diagnosed people with type 2 diabetes, compared to 17% in those receiving standard care.

    Researchers randomly assigned 61 adults with obesity and either prediabetes or newly diagnosed type 2 diabetes to one of two groups. Both received diabetes medications and general lifestyle advice, but one group also participated in a structured program that combined a high-protein diet with supervised moderate exercise (30 minutes daily, five times a week) for 12 months.

    After a year, 73% of participants with prediabetes in the intensive program returned to normal blood glucose levels, compared to just 8% in the standard care group. Among those with type 2 diabetes, 87% experienced remission in the intensive group, while only 17% did in the standard group. People in the intensive group also lost an average of 19 kilograms (~42 pounds)—roughly 17 kilograms (~38 pounds) more than those in standard care—and showed greater reductions in body fat, liver fat, and visceral fat.

    These findings suggest that when paired with medications (including metformin and GLP1 receptor agonists), an intensive yet manageable lifestyle program can dramatically improve blood glucose and body composition. Learn about Ozempic, a widely used GLP1 receptor agonist, in this episode featuring Dr. Rhonda Patrick.

    Read more
  • The combined effects of hypertension, diabetes, and smoking may accelerate brain aging, with hypertension being the most significant predictor of structural decline. spj.science.org
    Brain Aging Diabetes Blood Pressure

    Your brain may be aging faster than the rest of your body. While some people maintain brain health well into old age, others experience structural decline much earlier. A recent study found that multiple health factors—including hypertension, diabetes, smoking, and low educational attainment—may speed up brain aging, increasing the risk of cognitive decline and neurodegenerative diseases.

    Researchers analyzed brain scans and long-term health data from 964 adults in northern China, monitoring them for 16 years. They used machine learning to estimate brain age based on imaging techniques and compared brain aging among groups with various high-risk health factors. They also focused on people with high blood pressure to see how it affects brain structure.

    They found that people with four or five high-risk factors had considerably older-looking brains than those with fewer risks, suggesting that multiple health problems may accelerate brain aging. Hypertension, high blood sugar, elevated creatinine (a feature of metabolic disease), smoking, and lower education were the strongest predictors of brain structure decline. However, hypertension had the strongest link, with hypertensive participants exhibiting more substantial structural deterioration.

    These findings suggest maintaining good cardiovascular and metabolic health may help slow brain aging. Hypertension damages the brain’s microvasculature. Learn how exercise preserves these tiny blood vessels, helping to maintain cognitive health.

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  • Sugar-sweetened beverages are linked to 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases globally. www.nature.com
    Diet Diabetes Sugar Sugar-Sweetened Beverages Cardiovascular

    Sugar-sweetened beverages contribute to weight gain and increase the risk of severe health concerns, such as type 2 diabetes and cardiovascular disease. A recent study revealed that in 2020, sugar-sweetened drinks were linked to 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease globally.

    Researchers utilized the Global Dietary Database to assess the global, regional, and national effects of type 2 diabetes and cardiovascular disease associated with sugar-sweetened beverage consumption in 184 countries, comparing data from 1990 to 2020. They also considered factors such as age, sex, education, and whether people lived in urban or rural areas to provide further context for the findings.

    They found that sugar-sweetened beverages were associated with 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases in 2020. The burden was greatest in Latin America and the Caribbean, where sugar-sweetened beverages accounted for 24.4% of type 2 diabetes cases and 11.3% of cardiovascular disease cases. Sub-Saharan Africa also experienced a marked increase in type 2 diabetes and cardiovascular disease related to sugar-sweetened beverages over the past three decades.

    These findings suggest that sugar-sweetened beverages have deleterious effects on human health and underscore the need for targeted interventions to reduce their consumption. Learn more about sugar-sweetened beverages in our overview article.

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  • A daily dose of coenzyme Q10—100 milligrams or less—reduces blood pressure by about 4mmH systolic and 3mmHG diastolic in people with type 2 diabetes, potentially lowering cardiovascular risk. www.clinicaltherapeutics.com
    Diabetes Blood Pressure Antioxidant Cardiovascular

    Most people with type 2 diabetes know they need to manage their blood glucose levels, but many may not realize they are at higher risk for heart disease. One potential option for reducing that risk is coenzyme Q10, a naturally occurring antioxidant. A recent study found that supplementing with coenzyme Q10 (CoQ10) helps lower blood pressure in people with type 2 diabetes.

    Researchers reviewed data from 16 clinical trials that measured CoQ10 levels in people with type 2 diabetes. They focused on changes in blood pressure and cholesterol levels, comparing those who took the supplement to those who did not.

    Their analysis revealed that CoQ10 lowered systolic blood pressure by about 4 mmHg and diastolic blood pressure by about 3 mmHg. While it didn’t improve cholesterol levels overall, some subgroup analyses showed better results with lower doses (100 milligrams daily or less) and shorter study durations (less than 12 weeks). Notably, these findings were more pronounced in studies with larger participant groups (more than 50 people) and participants aged 55 or younger.

    A reduction of 4 mmHg in systolic blood pressure may seem modest, but even small reductions can lower the risk of heart disease and stroke. For example, a comprehensive analysis found that a 5-mmHg decrease in systolic blood pressure reduced the risk of major cardiovascular events by approximately 10%00590-0/fulltext).

    These findings suggest that CoQ10 could be a useful addition to diabetes treatment for managing blood pressure and reducing cardiovascular risk. A common feature of diabetes and cardiovascular disease is inflammation. Learn how to reduce chronic inflammation in Aliquot #84: Putting the Brakes on Chronic Inflammation

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  • Nearly half of people with type 2 diabetes have multiple micronutrient deficiencies—the most common being vitamin D. nutrition.bmj.com
    Vitamin D Diabetes Micronutrients Magnesium Vitamin B12 Insulin Metformin

    Micronutrient deficiencies contribute to insulin resistance, a key driver of type 2 diabetes, but researchers still don’t fully understand their role in the disease’s progression. A recent study found that nearly half of people with type 2 diabetes suffer from multiple micronutrient deficiencies, with vitamin D being the most prevalent.

    Researchers analyzed data from studies investigating links between micronutrient deficiencies and type 2 diabetes. Their analysis included 132 studies and more than 52,000 participants.

    They found that 45% of people with type 2 diabetes had multiple micronutrient deficiencies. Women with the disease were more likely to have deficiencies, with 48% affected compared to 41% of men. Vitamin D deficiency was the most common, affecting 60% of participants, followed by magnesium (42%) and vitamin B12 (28%)—the latter being especially prevalent among people with type 2 diabetes who were taking metformin. The prevalence of deficiencies also varied by region.

    These findings suggest that micronutrient deficiencies are widespread in people with type 2 diabetes, particularly among women. Check out our many resources on micronutrients, including vitamin D and magnesium, and the long-term health consequences of deficiencies.

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  • Sulforaphane-rich broccoli sprout extract modestly lowers fasting blood sugar in some people with prediabetes, perhaps due to variations in gut microbiota and individual metabolic traits. www.nature.com
    Diet Diabetes Sulforaphane

    Many people with prediabetes never receive structured treatment, even though early intervention offers the best chance of reversing high blood sugar. While lifestyle changes are the primary recommendation, they are challenging to implement and often ineffective. A recent study found that a broccoli sprout extract rich in sulforaphane modestly lowered fasting blood sugar in some people with prediabetes.

    Researchers conducted a 12-week, randomized, double-blind, placebo-controlled trial involving 74 participants with prediabetes who had not previously taken medication for the condition. Participants took a daily dose of broccoli sprout extract or a placebo, and researchers measured changes in their fasting blood sugar. They also analyzed gut microbial composition and genetic markers to explore potential differences in response.

    Overall, the extract slightly reduced fasting blood sugar levels (3.6 milligrams per deciliter, mg/dL) compared to the placebo but did not meet the predefined target for effectiveness. However, a subgroup of participants with mild obesity, lower insulin resistance, and reduced insulin secretion saw a greater reduction in blood sugar—about 7.2 mg/dL. These participants also had a distinct gut microbiota composition, including a higher abundance of bacterial genes linked to sulforaphane activation.

    Sulforaphane forms when glucoraphanin, found in broccoli sprouts, interacts with the enzyme myrosinase. Myrosinase activates when the plant cells are damaged, such as during chewing or processing. In the absence of myrosinase, some people’s gut microbes produce similar enzymes, helping convert more glucoraphanin into sulforaphane. This variation in gut bacteria may explain why some people respond more strongly to sulforaphane-rich foods or supplements.

    These findings suggest that gut microbes and individual metabolic traits may influence the effectiveness of nutritional interventions for prediabetes. One in three people in the U.S. has prediabetes. Learn more in this clip featuring Dr. Michael Snyder.

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  • Interrupting sedentary behavior every 30 minutes aids blood sugar control and may mitigate the risk of cardiometabolic disorders, according to a meta-analysis. onlinelibrary.wiley.com
    Exercise Diabetes Blood Sugar Cardiovascular

    Sitting for long periods isn’t just harmful to your back—it may also increase your risk of cardiometabolic disorders, such as diabetes and cardiovascular disease. Some research indicates that breaking up sedentary time with movement can enhance cardiometabolic health, but scientists are uncertain about the best frequency for these breaks. A recent study discovered that taking frequent breaks—at least every 30 minutes—might be more effective at managing blood sugar than having less frequent interruptions.

    Researchers conducted a systematic review and meta-analysis of randomized crossover trials that compared different frequencies of activity breaks during prolonged sitting. They included data from 13 studies with 211 participants, examining the effects of more frequent movement breaks (every 30 minutes or less) versus less frequent ones (every 30 minutes or more) on glucose, insulin, triglycerides, blood pressure, and vascular function.

    Their analysis revealed that taking more frequent movement breaks—every 30 minutes or more—reduced blood glucose levels more effectively than less frequent breaks. However, they found no significant differences between the two approaches for insulin levels, blood pressure, triglycerides, or vascular function. In addition, they rated the overall quality of evidence as low, highlighting the need for further research.

    These findings suggest that interrupting sedentary time at least every 30 minutes is a practical strategy for improving blood sugar control. An effective way to interrupt sedentary time is to engage in “exercise snacks"—short bursts of activity that improve cardiorespiratory fitness. Watch this video to learn about a two-minute exercise snack that improves blood glucose, mitochondrial health, and more.

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  • GLP-1 receptor agonists may lower risks for major illnesses like dementia and seizures. www.nature.com
    Diabetes Drug Dementia Weight Loss Cardiovascular

    Ozempic, Wegovy, and other glucagon-like peptide-1 (GLP-1) drugs have catapulted into the mainstream of diabetes care, with more than 15 million people in the U.S. currently taking one. Evidence suggests GLP-1 drugs have many off-target effects—both good and bad—but healthcare providers don’t currently know the full extent of the drugs' effects. However, a recent analysis found that GLP-1s may reduce the risk of dementia, seizures, respiratory illnesses, cardiometabolic disorders, and certain infections more effectively than other diabetes drugs and typical care.

    Using the U.S. Department of Veterans Affairs healthcare databases, researchers identified roughly two million people with diabetes who were using a GLP-1 drug, one of three common anti-diabetes drugs (sulfonylureas, DPP4 inhibitors, or SGLT2 inhibitors), or continuing their usual care without adding new therapies. They tracked the participants' health for about 3.6 years.

    They found that GLP-1 use was associated with a reduced risk of dementia (8%), seizures (10%), respiratory illnesses (10% to 25%), cardiometabolic disorders (7% to 22%), and certain infections (12% to 25%). However, the drugs were associated with an increased risk of gastrointestinal issues (5% to 20%), low blood pressure (10%), kidney problems (10% to 15%), arthritic disorders (10% to 16%), and pancreatitis (15% to 20%).

    These findings suggest that GLP-1 receptor agonists offer promising benefits for people with diabetes while highlighting potential risks. Further research will illuminate the full range of the drugs' effects. Learn more about GLP-1 drugs in this clip featuring Dr. Rhonda Patrick.

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  • Diagnosis of type 2 diabetes before the age of 50 nearly doubles the risk of dementia, while concurrent obesity triples the risk. journals.plos.org
    Obesity Diabetes Dementia

    Type 2 diabetes is becoming increasingly common among younger adults, shifting from its traditional association with older populations. A recent study found that the age at which a person develops type 2 diabetes influences their risk of developing dementia, with obesity more than tripling risk, especially at younger ages.

    Researchers tracked more than 1,200 adults aged 50 and older who had diabetes but no dementia at the start of the study. They grouped participants based on the age they were diagnosed with diabetes—before age 50, in their 50s, 60s, or 70s—and by whether they had obesity. They tracked new dementia cases for about 10 years, using cognitive assessments and considering factors like lifestyle and medication use.

    They found that people diagnosed with diabetes at younger ages had higher dementia risks than those diagnosed after 70. Those diagnosed before age 50 were nearly twice as likely to develop dementia, and obesity more than tripled this risk. Among obese participants diagnosed with diabetes before age 50, dementia risk was highest.

    These findings suggest that diabetes, especially in the setting of obesity, markedly increases dementia risk. Self-monitoring of blood glucose levels can help identify pre-diabetes—a precursor to diabetes—providing a window of opportunity to prevent the disease with lifestyle and dietary changes. Learn more in this clip featuring Dr. Michael Snyder.

    Read more
  • High-protein, low-calorie diets—whether animal or plant-based—lead to an average weight loss of ~18 pounds and improved glucose metabolism in people at risk for type 2 diabetes. dom-pubs.pericles-prod.literatumonline.com
    Diet Obesity Diabetes Muscle Protein Weight Loss

    The global obesity epidemic is driving a marked increase in the incidence of type 2 diabetes, and some experts estimate that by 2024, more than 780 million adults worldwide will develop the disease. A recent study found that high-protein, low-calorie diets promote weight loss and improve cardiometabolic markers in people at risk for type 2 diabetes.

    The study involved 117 adults with either prediabetes or type 2 diabetes and a body mass index (BMI) over 27.5—considered overweight or obese. Participants consumed an animal- or plant-based high-protein diet that provided 35% of their total calories for six months. The remainder of their calories came from fat (30%) and carbohydrates (35%).

    Participants in both groups saw similar improvements in body composition, including an average weight loss of approximately 8 kilograms (~18 pounds) and reduced visceral (abdominal) fat. Glucose metabolism indicators, such as fasting glucose and glycated hemoglobin levels, improved equally in both groups, as did lipid levels, liver enzymes, and inflammatory markers.

    These findings suggest that high-protein, low-calorie diets—whether animal- or plant-based—can improve body composition, glucose metabolism, and other cardiometabolic markers in people with prediabetes or type 2 diabetes.

    Dietary protein supports muscle hypertrophy and maintenance—critical aspects of glucose metabolism. Learn how to optimize protein intake to support muscle health when following a plant-based diet in this clip featuring Dr. Luc van Loon.

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  • A daily cup of coffee could reduce your risk of heart disease and diabetes by half. academic.oup.com
    Sleep Heart Disease Diabetes Biomarkers Coffee Green Tea Caffeine Stroke Cardiovascular

    Drinking your daily cup of coffee or tea might do more than give you a boost—it could lower your risk of developing multiple serious cardiometabolic conditions simultaneously, like diabetes, heart disease, or stroke. A recent study found that moderate coffee or caffeine consumption may cut your risk of cardiometabolic multimorbidity by as much as 50%.

    Researchers analyzed data from more than 172,000 participants enrolled in the UK Biobank who had no cardiometabolic diseases at the start. Participants reported their coffee, tea, and caffeine consumption; about half provided blood samples for metabolic marker analysis.

    They found that people who drank about three cups of coffee daily (or consumed 200 to 300 milligrams of caffeine daily) were 40% to 50% less likely to develop multiple cardiometabolic diseases than those who drank little or no caffeine. They also discovered that specific blood markers, such as certain lipid components, were linked to coffee and caffeine consumption and a lower risk of cardiometabolic conditions.

    These findings suggest that moderate coffee or caffeine intake reduces the risk of developing cardiometabolic diseases but also slows their progression if they occur. Other evidence points to the many health benefits associated with coffee and caffeine, but it’s crucial to remember their effects on sleep. Learn more in this Aliquot featuring Drs. Guido Kroemer, Satchin Panda, Elissa Epel, Matthew Walker, and Rhonda Patrick

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  • Lifestyle interventions that focus on diet, exercise, and weight management reduce the risk of diabetes—despite underlying genetic risk. pubmed.ncbi.nlm.nih.gov
    Exercise Diet Diabetes Genetics Weight Loss

    Although a person’s genes play a pivotal role in whether they develop diabetes, lifestyle factors—like diet, exercise, and body weight—influence their risk, too. A recent study found that lifestyle interventions reduce the risk of developing diabetes, especially among those at high genetic risk.

    The study involved nearly 1,000 middle-aged men with metabolic syndrome—a constellation of health conditions that increases the for diabetes. About half of the men had a low genetic risk for the disease, while the remainder had a high genetic risk. The men participated in a three-year-long group-based lifestyle intervention program that involved dietary counseling, exercise guidance, and weight management. Researchers monitored the men’s health and diabetes incidence throughout the study period.

    They found that the intervention reduced the risk of developing diabetes by 70% among participants with high genetic risk and 31% among those with low genetic risk. However, the latter reduction wasn’t statistically significant. The intervention promoted weight loss and prevented increased blood glucose levels in both groups.

    These findings suggest that lifestyle interventions can have marked effects on diabetes incidence in people at risk. Exercise, in particular, makes the body’s tissues more sensitive to insulin, helping to maintain healthy blood glucose levels. Learn more about how exercise may prevent diabetes in this episode featuring Dr. Guido Kroemer.

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  • Genetics plays a key role in the body's response to exercise. scitechdaily.com
    Exercise Obesity Metabolism Diabetes Genetics

    Many factors influence the extent to which exercise promotes weight loss, including exercise intensity, dietary habits, and overall lifestyle. Evidence suggests genetic differences play a role, too. A recent study found that mice with certain variants of PGC1-alpha—a key regulator of metabolism—consume less oxygen and burn less fat during workouts and are more likely to gain weight despite increased activity.

    Researchers analyzed gene expression in mice to determine the distribution of the three variants of PGC1-alpha: A, B, and C. Then, they assessed the animals' muscle growth, fat burning, and oxygen consumption during rest, short-term exercise, and long-term exercise. They performed the same assessments on 20 men, half of whom had type 2 diabetes.

    They found that although the three variants have similar functions, the A variant is widely distributed throughout the body, but the B and C variants are primarily found in brown adipose tissue, skeletal muscle, and the heart. They found that mice lacking the B and C variants had a diminished response to exercise, consuming less oxygen and burning less fat. These mice gained weight, developed high insulin levels, and were intolerant of cold temperatures. Men who had higher expression of the B and C variants consumed more oxygen and had less body fat, even among those with type 2 diabetes.

    These findings suggest that variants of PGC1-alpha influence the body’s response to exercise and highlight potential strategies for treating obesity.

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  • Individualized responses to macronutrients influence metabolic health, with consequences for people with type 2 diabetes. www.sciencedaily.com
    Diet Diabetes Fat Insulin Protein Carbohydrates

    Carbohydrates are the principal driver of insulin secretion, facilitating the uptake and metabolism of this macronutrient. However, a recent study found that fats and proteins also stimulate insulin secretion, potentially affecting people with type 2 diabetes.

    Researchers collected pancreatic islet cells responsible for insulin secretion from 140 donors after their deaths. About half of the donors had type 2 diabetes. They exposed the cells to carbohydrates, fats, and proteins and assessed insulin secretion.

    They found that most donors' islet cells exhibited a robust insulin response to carbohydrates, a moderate response to protein, and a low response to fat. However, some donors' cells elicited responses to protein (9%) and fat (8%) greater than their response to carbohydrates. Cells from donors with type 2 diabetes exhibited diminished responses to carbohydrates and fats, but their protein response was preserved.

    These findings suggest that insulin responses to macronutrients differ among individuals, with some preferentially responding to proteins and fats over carbohydrates. They also suggest that higher protein diets could benefit people with type 2 diabetes. Some evidence suggests that current guidelines for protein intake are too low, with implications for people more responsive to protein. Learn more about protein requirements in this clip featuring Dr. Stuart Philips.

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  • Taurine supplementation can help regulate blood glucose and lower blood pressure, reducing risk factors associated with metabolic syndrome. pubmed.ncbi.nlm.nih.gov
    Obesity Diabetes Cholesterol Triglycerides Blood Pressure Metabolic Syndrome Taurine Stroke Cardiovascular Supplements

    Metabolic syndrome is a cluster of conditions that includes hypertension, high blood glucose, excess abdominal fat, and abnormal blood lipids. Having metabolic syndrome markedly increases a person’s risk of cardiovascular disease, type 2 diabetes, and stroke. A recent meta-analysis found that taurine supplementation improves conditions associated with metabolic syndrome.

    Researchers analyzed the findings of 25 studies (with more than 1,000 participants) investigating links between taurine supplementation and metabolic syndrome. They also explored the effects of taurine dose and examined secondary outcomes of taurine supplementation, including body composition, lipid profile, and blood glucose control.

    They found that taurine doses ranged from 0.5 to 6 grams, with study durations ranging from five days to one year. On average, taurine supplementation reduced systolic blood pressure by 4 mmHg, diastolic blood pressure by 1.5 mmHg, fasting blood glucose by 6 milligrams per deciliter, and triglycerides by 18 milligrams per deciliter. The researchers did not observe an effect on high-density lipoprotein cholesterol. The reduction in diastolic blood pressure and fasting blood glucose was dose-dependent, with higher doses eliciting more robust effects.

    These findings suggest that taurine supplementation improves factors associated with metabolic syndrome. Interestingly, other research shows that an acute bout of exercise increases blood taurine levels, providing a mechanistic link between exercise and better metabolic health.

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  • Moderate to high nighttime light exposure increases type 2 diabetes risk by up to 53 percent, comparable to genetic factors. t.co
    Metabolism Diabetes Circadian Rhythm Insulin Blue Light

    Circadian rhythms regulate metabolic processes, including glucose metabolism and insulin sensitivity. Disruptions in circadian rhythms can lead to metabolic impairments, increasing the risk of obesity, type 2 diabetes, and metabolic syndrome. A recent study found that personal light exposure patterns predict the risk of developing type 2 diabetes.

    Researchers assessed the light exposure patterns of more than 84,000 UK Biobank participants. Participants wore light sensors for one week to record their day and night light exposure. The researchers tracked the incidence of type 2 diabetes among the participants over an average follow-up period of nearly eight years.

    They found that diabetes risk increased as night light exposure increased. Compared to low light exposure, the risk of diabetes increased by - 29 percent with moderate light exposure. - 39 percent with high-moderate light exposure. - 53 percent with high light exposure. The increased risk associated with night light exposure was comparable to the difference between people with low and moderate genetic risk for diabetes.

    These findings suggest that nighttime light exposure is a risk factor for developing type 2 diabetes, comparable to genetic risk factors. Interestingly, low solar angle light – as in the early morning or late evening – resets the body’s circadian rhythms, improving metabolic health and mood. Learn more about low solar angle light exposure in this episode featuring Dr. Andrew Huberman.

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  • In older adults with type 2 diabetes, high-intensity resistance training decreases blood glucose levels by 12 percent and strengthens muscles by 33 percent. pubmed.ncbi.nlm.nih.gov
    Exercise Aging Diabetes Muscle

    Type 2 diabetes is a metabolic disorder characterized by high blood glucose, increasing the risk for a wide range of complications, including kidney dysfunction, vision loss, and circulatory problems. However, evidence suggests that exercise improves blood glucose control. A 2002 study found that resistance training improved blood glucose control in people with type 2 diabetes.

    The study involved 62 older adults with type 2 diabetes. Half of the participants engaged in a 16-week high-intensity resistance training program (gradually increasing in intensity), while the other half maintained their typical activities. Researchers measured participants' glycated hemoglobin levels (HbA1c, a measure of long-term blood glucose control), body composition, and muscle glycogen stores before and after the intervention.

    They found that among resistance training participants, HbA1c decreased by approximately 12 percent, muscle glycogen increased by 31 percent, and muscle strength increased by 33 percent. Those who engaged in resistance training also experienced reductions in blood pressure and body fat, and their need for diabetes medications decreased.

    These findings suggest that resistance training is a robust adjunct to type 2 diabetes treatments, effectively improving blood glucose control and metabolic health. Resistance training involves pushing or pulling against the resistance of an object, such as weights, bands, or even one’s body weight. Older adults starting a resistance training program may benefit from using lighter weights and performing more repetitions, especially if they have chronic joint problems. Learn more in this episode featuring Dr. Brad Schoenfeld.

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  • Late-night eating increases the risk of death from diabetes by as much as 131 percent. www.nature.com
    Diet Diabetes Circadian Rhythm Mortality Time-Restricted Eating

    The body’s circadian rhythms – its 24-hour biological, hormonal, and behavioral cycles – are optimized for daytime eating. Consequently, eating in the late evening or nighttime hours may increase a person’s risk of developing chronic diseases, such as type 2 diabetes. A recent study found that nighttime eating increased the risk of premature death from diabetes by as much as 131 percent.

    The investigation included more than 41,000 adults enrolled in NHANES, an ongoing study that assesses the health and nutritional status of people in the U.S. Researchers gathered information about the participants' eating habits (including timing and food quality) and tracked their health and death rates for about nine years.

    They found that compared to eating before 10 p.m., - Eating between 11 p.m. and midnight increased the risk of premature death from diabetes by 131 percent. - Eating between midnight and 1 a.m. increased the risk of premature death from any cause by 38 percent. - Eating between 1 a.m. and 2 a.m. increased the risk of premature death from cancer by 109 percent.

    When they considered the frequency of eating late, they found that eating at night at least once increased the risk of premature death from all causes, including diabetes. Food quality influenced death risk, too, with high-calorie foods increasing the risk of premature death from all causes by 21 percent and from diabetes by 97 percent. Participants who ate late tended to have higher HbA1c, fasting glucose, and oral glucose tolerance test results, indicative of poor glucose metabolism.

    These findings suggest that late-night eating, particularly high-calorie foods, increases the risk of early death from all causes, especially diabetes. Shift work, jet lag, parenting, and modern lifestyles contribute to late-night eating, increasing disease and early death risk. Learn more in this clip featuring Dr. Satchin Panda.

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  • Interrupting prolonged sitting with ten body-weight squats improves blood glucose levels better than a 30-minute walk. onlinelibrary.wiley.com
    Exercise Diabetes Muscle Blood Sugar

    Prolonged sitting is a prominent feature of modern life. Unfortunately, it carries considerable health risks, including impaired glucose metabolism and an increased risk of type 2 diabetes. A recent study found that interrupting prolonged sitting periods with short bursts of activity – especially frequent walks or squats – improves blood glucose levels.

    The study involved 18 men with overweight and obesity who engaged in four different activities on separate days: sitting uninterrupted for 8.5 hours, or sitting interrupted by a single 30-minute walk, ten three-minute walks (every 45 minutes), or ten three-minute squat sessions (every 45 minutes). Researchers assessed the participants' blood glucose levels using continuous glucose monitors and gauged their muscle activity, especially in the quadriceps, hamstrings, and gluteal muscles, using an electromyogram.

    They found that any form of sitting interruption reduced blood glucose levels better than uninterrupted sitting, with the frequent three-minute walks and squat exercises outperforming the single 30-minute walk. Increased muscle activity, particularly in the quadriceps and gluteal muscles, correlated strongly with these improvements.

    These findings suggest that interrupting prolonged sitting with frequent, short bouts of physical activity, especially those that engage the lower body muscles, is more effective in enhancing glycemic control than a single, longer session of activity. Evidence suggests that these short bursts of activity, often called “exercise snacks,” improve cardiorespiratory fitness and markers of immune function. Learn more in this clip featuring Dr. Martin Gibala.

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  • Plant-based meat substitutes show little effect on cardiometabolic health in people at risk for type 2 diabetes. www.sciencedirect.com
    Diet Metabolism Diabetes Cholesterol Vegetarian

    Plant-based meat substitutes are made from non-meat sources, such as legumes or wheat gluten. They typically mimic the sensory profile of meat products and are popular among those wishing to reduce their animal protein intake for ethical or health reasons. A recent study found that plant-based meat substitutes did not benefit cardiometabolic health in people at risk for type 2 diabetes.

    The study involved 82 adults at risk for type 2 diabetes. Half of the participants ate an animal-based diet, while the others swapped out their usual animal-based foods for plant-based meat substitutes. Researchers assessed their blood lipids (triglycerides, LDL, HDL, and total cholesterol), glycemic control, insulin sensitivity, and blood pressure before and after the eight-week intervention.

    They found that participants who ate the plant-based meat substitutes had higher fiber, sodium, and potassium intake than those who ate animal meat. Their blood lipids showed little improvement, but their diastolic blood pressure decreased, and their insulin sensitivity increased. However, those who ate the animal meat diet had better glycemic control than those on the plant-based diet.

    These findings suggest that plant-based meat substitutes don’t improve cardiometabolic health in people at risk for type 2 diabetes. However, robust evidence demonstrates that high-intensity interval training (HIIT) profoundly affects cardiometabolic health. Learn more in this episode featuring Dr. Martin Gibala.

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  • Evening exercise reduces the risk of early death in people with obesity by 61%, outperforming 33% risk reduction from morning exercise. diabetesjournals.org
    Exercise Obesity Aging Diabetes Mortality

    Although obesity increases the risk of chronic disease and premature death, especially in those who have type 2 diabetes, exercise may counter some of those risks. However, the time of day a person exercises may influence the extent of risk reduction. A recent study found that moderate to vigorous physical activity in the evening reduced the risk of premature death by 61 percent in people with obesity.

    Researchers asked nearly 30,000 adults with obesity, some of whom (3,000) had type 2 diabetes, how often they engaged in moderate to vigorous physical activity (lasting at least three continuous minutes) and whether they did so in the morning, afternoon, or evening. They tracked the participants' health for about eight years.

    They found that engaging in moderate to vigorous physical activity in the evening reduced participants' risk of premature death from all causes by 61 percent. Afternoon exercise reduced the risk by 40 percent, and morning exercise reduced it by 33 percent. Similarly, evening exercise reduced the risk of cardiovascular disease by 36 percent and microvascular disease by 24 percent. They noted similar risk reductions in those who had type 2 diabetes.

    These findings suggest that moderate to vigorous physical activity reduces the risk of chronic disease and premature death in people with obesity (including those with type 2 diabetes), but evening exercise confers the greatest benefit. Learn more about the health benefits of vigorous exercise in this episode featuring Dr. Rhonda Patrick.

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  • Higher vitamin D levels are linked to 18 percent lower dementia risk in older adults with prediabetes. pubmed.ncbi.nlm.nih.gov
    Vitamin D Alzheimer's Diabetes Genetics Dementia

    Lifestyle and nutritional factors influence the risk of dementia, particularly among people with prediabetes – a condition characterized by elevated blood sugar levels that are not high enough to be classified as diabetes. A recent study found that higher vitamin D levels may reduce the risk of developing dementia in older adults with prediabetes.

    Researchers drew on data collected from a large cohort of more than 34,000 older adults enrolled in the UK Biobank, all of whom had prediabetes but did not have dementia at the start of the study. They measured the participants' blood vitamin D levels and monitored them for the development of dementia, including Alzheimer’s disease and vascular dementia, for approximately 12 years. Their analysis also considered genetic variations that could influence the relationship between vitamin D levels and dementia risk.

    They found that participants with higher blood vitamin D levels were 18 percent less likely to develop any type of dementia, with similar findings for Alzheimer’s disease and vascular dementia. The protective effect of vitamin D was particularly robust in participants who did not carry polymorphisms (genetic variants) related to the vitamin D receptor, highlighting a potential interaction between genetics and vitamin D levels in dementia risk.

    These findings suggest that maintaining adequate levels of vitamin D benefits brain health, especially in older adults with prediabetes, a group at elevated risk for dementia. They add to the growing body of evidence supporting the importance of vitamin D for overall health and emphasize the need for further research to understand the mechanisms behind its protective effects on the brain. Learn more about vitamin D in our comprehensive overview article.

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  • What are the optimal time-restricted eating patterns for cardiovascular wellness? pubmed.ncbi.nlm.nih.gov
    Diet Obesity Diabetes Cholesterol Time-Restricted Eating Blood Pressure Cardiovascular

    Time-restricted eating is a dietary pattern that restricts the time during which a person eats to a specific window, such as a “16:8" pattern, where they fast for 16 hours a day and consume food only during the remaining eight hours. Evidence suggests that time-restricted eating improves cognitive function, supports weight loss, and reduces systemic inflammation. Findings from a recent review and meta-analysis suggest that time-restricted eating also reduces the risk of cardiovascular disease.

    Researchers analyzed the findings of 33 studies involving 1,725 participants investigating the effects of time-restricted eating on markers of cardiovascular health. They conducted a sub-group analysis to determine how age, health characteristics, and eating patterns influenced the effects of time-restricted eating.

    They found that the effects of time-restricted eating on cardiovascular disease varied according to a person’s risk factors, age, and when they ate. The table below presents their findings for the optimal time-restricted eating for different groups.

    This meta-analysis and review identifies the optimal time-restricted eating interventions for blood pressure, obesity, lipids, and glucose. It effectively provides a best-practices guide for people interested in implementing time-restricted eating as a lifestyle modification to improve cardiovascular health. Learn more about time-restricted eating in this episode featuring Dr. Satchin Panda.

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  • Daily cinnamon supplementation averaging 2,100 milligrams – roughly a teaspoon – shows promise in managing type 2 diabetes. pubmed.ncbi.nlm.nih.gov
    Diet Diabetes Insulin Resistance Insulin Polyphenol

    Cinnamon is one of the most consumed spices in the world, popular in both sweet and savory dishes in many cuisines. Evidence suggests cinnamon improves lipid profiles and protects against damage induced by oxidative stress. A recent systematic review and meta-analysis found that cinnamon helps maintain healthy blood glucose levels and reduces insulin resistance in people with type 2 diabetes.

    Researchers analyzed the findings of 24 clinical trials investigating the effects of cinnamon supplementation on blood glucose levels. The various trials included more than 1,800 participants from 11 nations.

    The analysis revealed that cinnamon supplementation reduced fasting blood glucose levels, hemoglobin A1c concentrations, and insulin resistance (without lowering insulin) in people with type 2 diabetes. The trials varied in duration from six to 16 weeks, and daily cinnamon doses ranged from 120 to 6,000 milligrams, averaging 2,100 milligrams – roughly a teaspoon.

    These findings suggest that cinnamon improves symptoms of type 2 diabetes and may be a valuable adjunct to traditional therapies. Cinnamon is rich in polyphenols, a broad class of plant bioactive compounds. Learn more about polyphenols in our overview article.

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  • Morning exercise outperforms afternoon workouts in enhancing cardiometabolic health in people with metabolic syndrome. physoc.onlinelibrary.wiley.com
    Exercise Metabolism Diabetes Insulin Metabolic Syndrome Cardiovascular

    The idea that exercise benefits metabolic health is widely accepted. But whether the benefits of exercise are greater depending on when one exercises – morning versus afternoon – is a matter of considerable debate. A recent study shows that morning exercise reduces blood pressure, fasting insulin, and insulin resistance better than afternoon exercise in people with metabolic syndrome.

    Metabolic syndrome is a constellation of conditions characterized by abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoproteins. Having metabolic syndrome increases a person’s risk of cardiovascular disease and type 2 diabetes. Roughly one-third of adults between the ages of 20 and 60 have metabolic syndrome.

    The study involved 139 adults with metabolic syndrome who agreed to participate in three supervised high-intensity interval training sessions every week for 16 weeks. About a third of the participants performed their exercise in the morning, a third did so in the afternoon, and a third didn’t engage in any exercise. Researchers measured the participants' body composition, cardiorespiratory fitness, maximal fat oxidation, blood pressure, and blood metabolites before and after the intervention.

    They found that both exercise groups demonstrated greater body fat loss, reduced waist circumference (nearly an inch), and lower diastolic blood pressure than those who didn’t exercise. However, when comparing the morning exercise group to the afternoon group, they found that morning exercise was more effective at reducing systolic blood pressure (4 percent drop vs. 1 percent), lowering fasting insulin (12 percent drop vs. 5 percent), and decreasing insulin resistance (14 percent drop vs. 4 percent).

    These findings suggest that morning exercise boosts cardiometabolic health better than afternoon exercise. The investigators posited that these effects may be related to circadian rhythms, which influence the body’s response to exercise and dietary intake.

    Finding the time or motivation to exercise in the morning may be challenging for many. Fortunately, most experts agree that some exercise is better than none, as long as it’s not too close to bedtime. Learn more in this clip featuring Dr. Rhonda Patrick.

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  • Dietary AGEs linked to overeating and 30 percent shorter lifespan in worms. www.sciencedaily.com
    Nutrition Diet Aging Diabetes Ketogenic Diet

    Advanced glycation end-products (AGEs) form when the sugars, amino acids, and fats in food encounter heat. The molecules in the foods rearrange, forming brown polymers (a process known as the Maillard reaction) and creating the deep flavors of browned barley in beer, roasted coffee, seared meats, and French fries. A recent study in worms shows that dietary AGEs promote overeating and reduce lifespan by as much as 30 percent in those genetically susceptible.

    Researchers investigated the health effects of AGEs in Caenorhabditis elegans, a type of roundworm often used to model human aging. Specifically, they looked at the effects of dietary AGEs derived from methylglyoxal, a byproduct of glycolysis and lipid peroxidation.

    They found that worms lacking the gene for glyoxalase, an enzyme that protects the body from methylglyoxal-derived AGEs, showed increased appetite when exposed to AGEs. They also found that the methylglyoxal-derived AGE known as MG-H1 influences the production of the neurotransmitter tyramine, ultimately contributing to the harmful effects of AGEs, including increased feeding, decreased lifespan, and neuronal damage.

    These findings suggest that dietary AGEs promote overeating and reduce lifespan by as much as 30 percent in genetically susceptible organisms. Although AGEs are present in the diet, they also form in the body during normal glucose metabolism. However, if high AGE levels accumulate in the tissues and blood, they can become pathogenic, driving many chronic diseases, including diabetes, atherosclerosis, Alzheimer’s disease, macular degeneration, and kidney failure. The body clears excess AGEs via the liver (and possibly the kidney)00462-3/fulltext), but the clearance rate declines with age.

    Evidence suggests that a low carbohydrate diet inhibits AGE formation. The ketogenic diet typically restricts carbohydrate intake to roughly 10 percent or less of one’s calories. Learn more about the ketogenic diet and its health effects in this episode featuring Dr. Dominic D'Agostino.

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  • High-intensity exercise mitigates sleep-induced metabolic disruptions, offering a potential defense against type 2 diabetes. www.sciencedirect.com
    Exercise Metabolism Sleep Diabetes Circadian Rhythm Mitochondria

    Poor sleep negatively affects metabolism, impairing glucose tolerance and increasing the risk of developing type 2 diabetes. Findings from a recent study indicate that HIIT compensates for the harmful effects of sleep loss on glucose tolerance.

    Researchers assigned 24 healthy young men to one of three five-night sleep protocols: normal sleep (eight hours nightly), sleep restriction (four hours nightly), and sleep restriction with HIIT. Researchers collected muscle biopsies to assess muscle protein synthesis before and after the intervention.

    They found that the group with sleep restriction experienced marked reductions in glucose tolerance, mitochondrial respiratory function, and sarcoplasmic protein synthesis. They also experienced altered diurnal skin temperature rhythms. However, sleep-restricted participants who engaged in HIIT did not experience these disturbances.

    The sarcoplasm is the cytoplasm of muscle cells. Sarcoplasmic protein synthesis is crucial for muscle growth, repair, and maintenance, contributing to overall muscle health and function.

    This study was small, but the findings suggest that sleep restriction impairs metabolic function, circadian rhythmicity, and muscle protein synthesis. However, engaging in HIIT during periods of sleep restriction helps counter these effects. Learn more about the benefits of HIIT in this episode featuring Dr. Martin Gibala.

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  • Impairment of associative learning caused by obesity and insulin insensitivity offset by anti-obesity drug liraglutide in recent study www.sciencedaily.com
    Obesity Diabetes Memory

    Associative learning is a psychological process that occurs when two initially unrelated elements, such as objects, sights, sounds, ideas, or behaviors, become linked in the brain. Classic examples include associating pain with touching a hot stove or connecting foodborne illness with eating a particular food. People with obesity and poor insulin sensitivity have impaired associative learning. However, a recent study shows that liraglutide, a drug used to treat type 2 diabetes and obesity, restores associative learning capability in people with obesity.

    The study involved 54 adults, half with normal body weight (high insulin sensitivity) and half with obesity (reduced insulin sensitivity). Researchers gave participants either liraglutide or a placebo in the evening and tested their learning abilities the next morning.

    They found that people with obesity and reduced insulin sensitivity encountered difficulties when attempting to establish connections between sensory signals, and their brain activity related to learning was weaker than in normal-weight individuals. However, just one dose of liraglutide reversed these issues in people with obesity and reduced insulin sensitivity, exhibiting brain activity comparable to that of normal-weight participants, indicating that the drug improved their learning abilities.

    Liraglutide is a glucagon-like peptide 1 receptor agonist (GLP-1RA), a type of drug used to treat type 2 diabetes, overweight, and obesity. GLP-1RA medications work in the pancreas to lower blood glucose levels by promoting the production and release of insulin. They also support beta cells synthesis, growth, and survival while reducing their apoptosis rate.

    These findings suggest that liraglutide, an anti-obesity drug, affects brain activity in people with obesity and reduced insulin sensitivity. This study was small, however, so validating the results requires more research.

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  • Just 30 minutes of reduced-exertion high-intensity training weekly improved sedentary people's aerobic capacity and metabolic health. link.springer.com
    Exercise Metabolism Diabetes Aerobic

    Type 2 diabetes is a metabolic disorder characterized by skeletal muscle insulin resistance. High-intensity interval training (HIIT) improves skeletal muscle insulin sensitivity, but the demanding nature of traditional HIIT sessions can be daunting for people unaccustomed to regular physical activity. A 2012 study found that reduced-exertion high-intensity interval training (REHIT) improved aerobic capacity and metabolic health in people who were sedentary – a risk factor for developing type 2 diabetes.

    The study involved 29 sedentary young adults. Half the participants engaged in three 10-minute REHIT sessions weekly for six weeks. Each session consisted of low-intensity cycling and one or two brief “all-out” sprints lasting between 10 and 20 seconds. The other half of the participants remained sedentary. Researchers assessed the participant’s aerobic capacity (measured as VO2 peak) and insulin sensitivity before and after their respective interventions.

    Ten of the 15 REHIT participants completed all 18 sessions, indicating high compliance. Aerobic capacity increased by 15 percent in males and 12 percent in females. Insulin sensitivity improved by 28 percent in males but not in females. Participants rated their perceived exertion as “hard” or “somewhat hard.”

    Encouraging regular, balanced exercise that includes cardiorespiratory, strength, and flexibility training can optimize health benefits. However, addressing barriers, such as lack of time or access to formal exercise equipment, is crucial to have widespread effects. The findings in this small study suggest that brief, reduced-exertion high-intensity training improves aerobic capacity and metabolic health in sedentary people despite a low time commitment (just 30 minutes per week) and relatively low effort. Learn more about REHIT and how it differs from HIIT and SIT in this clip featuring Dr. Martin Gibala.

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  • "Exercise snacks" – short bursts of activity interspersed throughout the day – boost fitness levels in sedentary adults. pubmed.ncbi.nlm.nih.gov
    Exercise Aging Diabetes Aerobic

    Sedentary behavior is associated with an increased risk of many chronic diseases. Evidence suggests that “exercise snacks” – brief, isolated intervals of vigorous exercise, each lasting less than one minute and typically performed multiple times throughout the day – may counter the harmful effects of sedentary behavior. A 2022 study found that vigorous stair-climbing increased participants' peak oxygen uptake by approximately 5 percent.

    The study involved 24 healthy, sedentary young adults. For six weeks, half of the participants engaged in three bouts of vigorous stair climbing (60 steps in a three-flight stairwell) daily, with one to four hours of rest in between, three days a week. The other half did not participate in any training. Researchers measured the participants' peak oxygen uptake and power output before and after the intervention.

    At the end of the intervention, the stair-climbing participants' peak oxygen uptake had increased by approximately 5 percent, and peak power output increased by 12 percent. Participants maintained a consistent rate of perceived exertion of 5, indicating a “hard” level, and their heart rate remained relatively stable at approximately 85 percent of the age-predicted maximum.

    These findings suggest that integrating brief periods of intense exercise into one’s daily routine can improve cardiorespiratory fitness in sedentary adults. They also align with previous research showing that exercise snacks improve insulin sensitivity in people with insulin resistance.

    A key benefit of exercise snacks is that they eliminate the need for specialized equipment and the scheduling of leisure time for structured exercise. They are easily integrated into everyday activities, whether inserting short bursts of activity between tasks or incorporating them into daily routines at home, work, or school. Exercise snacks can also reduce blood glucose levels in people with type 2 diabetes. Learn more in this clip featuring Dr. Martin Gibala.

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  • Kombucha reduces blood glucose levels by nearly 30 percent. www.frontiersin.org
    Nutrition Gut Diet Microbiome Diabetes

    Kombucha is a fermented beverage made from tea, sugar, bacteria, and yeast. Some evidence suggests that kombucha exerts antimicrobial, antioxidant, detoxifying, and liver-protective effects. A new study has found that kombucha lowers blood glucose levels by nearly 30 percent in people with type 2 diabetes.

    Researchers conducted a small trial involving 12 adults with type 2 diabetes. The participants drank approximately 8 ounces of either kombucha or a placebo beverage daily for four weeks. Eight weeks later, they switched to the other option. During each intervention, they measured their fasting blood glucose levels at the start and after one and four weeks. They completed questionnaires about their overall health, insulin needs, gut health, skin condition, and mental state. The researchers analyzed the kombucha’s microbiota and quantified its fermentation products.

    When the participants drank the kombucha, they experienced a notable drop in average fasting blood glucose levels by the end of the intervention compared to the start (164 versus 116 mg/dL – nearly 30 percent lower). However, the placebo group did not experience the same reduction (162 versus 141 mg/dL – less than 13 percent lower). The microbiota analysis revealed lactic acid bacteria, acetic acid bacteria, and yeast as the dominant components. The primary fermentation products were lactic acid, acetic acid, and ethanol.

    This was a very small study, but the findings suggest that kombucha might have blood glucose-lowering potential for people with diabetes. Learn how consuming fermented foods, such as kombucha, kefir, and others, increases gut microbial diversity and decreases inflammation in this clip from a live Q&A with Dr. Rhonda Patrick.

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  • Higher Vitamin K1 intake reduces type 2 diabetes risk by over 30 percent in a 20-year study. academic.oup.com
    Diet Diabetes Vitamin K

    The role of Vitamin K1 in blood clotting is well established. However, a new study shows that higher vitamin K1 intake may also reduce the risk of type 2 diabetes. People with higher K1 intake were more than 30 percent less likely to develop type 2 diabetes than those with lower intake.

    Researchers tracked the health and dietary intake of nearly 55,000 adults for approximately 20 years. Then they used statistical analysis to identify links between vitamin K1 intake and the risk of type 2 diabetes.

    They found that people with the highest vitamin K1 intake were 31 percent less likely to develop type 2 diabetes than those with the lowest intake, even after considering other risk factors. The association between vitamin K1 intake and reduced diabetes risk was particularly robust in men, smokers, and those who were overweight or sedentary.

    These findings suggest that eating vitamin K1-rich foods reduces the risk of developing type 2 diabetes. They also highlight a potential synergistic effect for the two forms of vitamin K, based on recent research demonstrating vitamin K2’s effects on maintaining glycemic control in people with type 2 diabetes.

    Vitamin K is a fat-soluble vitamin. Naturally occurring forms of vitamin K include phylloquinone (vitamin K1) and a family of molecules called menaquinones (vitamin K2). Vitamin K1 is synthesized by plants and is the major form found in the diet. Vitamin K2 molecules are synthesized by the gut microbiota and found in fermented foods and some animal products (especially liver).

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  • Supplemental vitamin K2 improves diabetes markers and glycemic control. pubmed.ncbi.nlm.nih.gov
    Metabolism Diabetes Insulin Resistance Vitamin K Insulin

    Vitamin K2 – a form of vitamin K produced in the gut – plays important roles in blood clotting, bone mass maintenance, and blood vessel contractility. But new research shows that supplemental vitamin K2 also improves diabetes markers. People with type 2 diabetes who took supplemental vitamin K2 had better markers of glycemic control than those who took a placebo.

    Researchers performed a three-part study in humans and mice. First, they conducted a randomized controlled trial involving 60 adults who had type 2 diabetes. Half of the participants took vitamin K2 every day for six months, while the other half took a placebo. Then the researchers transplanted gut microbes from vitamin K2-supplemented mice into obese mice. Finally, they analyzed the gut microbial composition and their metabolites in both humans and mice.

    They found that the participants who received supplemental vitamin K2 experienced marked reductions in levels of fasting blood glucose (13.4 percent), insulin (28.3 percent), and HbA1c (7.4 percent), indicating improved glycemic control. Similarly, the mice demonstrated improved glucose tolerance after receiving the gut microbe transplants. Lastly, the researchers found that certain metabolites that play roles in glucose metabolism, including bile acids and short-chain fatty acids, increased in the feces of both groups. Furthermore, they identified a specific type of bacteria that was responsible for producing these metabolites.

    Vitamin K is a fat-soluble vitamin. The body has limited vitamin K storage capacity, so the body recycles it in a vitamin K redox cycle and reuses it multiple times. Naturally occurring forms of vitamin K include phylloquinone (vitamin K1) and a family of molecules called menaquinones (vitamin K2). Vitamin K1 is synthesized by plants and is the major form found in the diet. Vitamin K2 molecules are synthesized by the gut microbiota and found in fermented foods and some animal products (especially liver).

    These findings suggest that vitamin K2 participates in maintaining glycemic control in people with type 2 diabetes. They also underscore the role of the gut microbiota in this process. Learn about other roles for the gut microbiota in this episode featuring Dr. Eran Elinav.

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  • Omega-3s improve metabolic markers in women with gestational diabetes. www.sciencedirect.com
    Diabetes Insulin Resistance Omega-3 Inflammation Pregnancy Insulin

    Omega-3s improve metabolic markers in women with gestational diabetes.

    Gestational diabetes, a form of diabetes that occurs only during pregnancy, carries many health concerns for women, including an increased risk of developing type 2 diabetes in later life. A new study shows that omega-3 fatty acids may improve metabolic markers associated with gestational diabetes. Women who took omega-3s during their pregnancies had healthier blood glucose, triglyceride, and cholesterol levels than those who didn’t.

    Researchers analyzed the findings of six randomized controlled trials that investigated the effects of omega-3s in women with gestational diabetes. The studies included more than 330 pregnant women, and the duration of the various trials was six weeks. Omega-3 doses ranged from 1 to 2 grams per day.

    They found that across the six studies, markers of glucose metabolism (fasting glucose, fasting insulin, and insulin resistance), lipid metabolism (triglycerides and very low-density lipoprotein cholesterol), and inflammation (C-reactive protein) were lower among women who took omega-3s than those who took a placebo. Levels of high-density lipoprotein cholesterol – often referred to as “good” cholesterol – increased.

    This analysis suggests that omega-3 fatty acids, which are perhaps best known for their cardioprotective and neuroprotective properties, positively influence metabolism in pregnant women. It also aligns with the findings of a previous analysis, which found that compared to women who took a placebo, those who took supplemental omega-3s had considerably lower fasting blood sugar levels and insulin resistance. Learn about other health benefits associated with omega-3s in our comprehensive overview article.

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  • Having kidney disease increases the risk of bleeding in the brain. www.ncbi.nlm.nih.gov
    Diabetes Omega-3 Blood-Brain Barrier

    A 2020 study found that kidney disease increases the risk of having tiny brain hemorrhages called microbleeds. People with kidney disease were five times more likely to have microbleeds than those with normal kidney function.

    Researchers studied the effects of kidney disease on cultured brain endothelial cells and in mice. They also tracked the progression of microbleeds in people who had kidney disease or were healthy.

    They found that exposing the cells to urea – a byproduct of protein metabolism that builds up in the blood during kidney disease – damaged the endothelial cells' integrity, compromising their capacity to maintain the blood-brain barrier. The mice with kidney disease had twice as many microbleeds in their brains as healthy mice and showed signs of increased blood-brain barrier permeability. Fifty percent of the people who had kidney disease had microbleeds, whereas just 10 percent of those who were healthy had microbleeds.

    Microbleeds are cerebral microhemorrhages that occur due to cerebral amyloid angiopathy, chronic hypertension, and other vascular conditions. Having a high microbleed count is associated with impaired cognitive function. Microbleeds are a hallmark of cerebral small vessel disease.

    Evidence suggests that omega-3 fatty acids reduce the risk of chronic kidney disease. Omega-3 fatty acids may protect the kidneys by improving endothelial function, reducing blood pressure, and maintaining healthy blood lipids. Learn more about the benefits of omega-3s in our overview article.

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  • Polyphenols found in tea and coffee may reduce the risk of diabetes. pubmed.ncbi.nlm.nih.gov
    Diabetes Insulin Resistance Coffee Green Tea Polyphenol

    Drinking tea and coffee may reduce the risk of developing type 2 diabetes, a 2022 study found. Men that drank a beverage enriched in polyphenols present in tea and coffee had lower blood glucose levels and improved insulin sensitivity than those who drank a placebo.

    Eleven healthy men drank a beverage that contained either polyphenols from tea (catechins) and coffee (chlorogenic acids) or a placebo every day for three weeks. Both beverages provided 119 milligrams of caffeine – a little more than the amount present in one cup of coffee. At the end of the three weeks, they ate a high-fat, high-carbohydrate meal, and then researchers measured their blood glucose, insulin, and other metabolic markers.

    The researchers found that consuming the catechin- and chlorogenic-rich beverage reduced the men’s blood glucose levels when consumed with a high-fat or high-carbohydrate meal. Their insulin sensitivity and levels of hormones involved in glucose metabolism increased, as well.

    Catechins are polyphenolic compounds found in tea, cocoa, and berries. Evidence suggests that catechins ameliorate symptoms associated with diabetes. Chlorogenic acids are polyphenolic compounds found in coffee, apples, and berries. Evidence suggests that chlorogenic acids reduce inflammation, a key player in the pathophysiology of diabetes.

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  • Higher magnesium intake may cut type 2 diabetes risk in half. diabetesjournals.org
    Diabetes Inflammation Magnesium

    Nearly half of all people living in the United States are deficient in magnesium. However, people with higher magnesium intake were nearly half as likely to develop type 2 diabetes than those with lower intake, a 2010 study found. Those with higher magnesium intake also had lower markers of inflammation.

    Researchers conducted a long-term study in nearly 5,000 healthy young adults to investigate the role that lifestyle and other factors play in the risk of developing cardiovascular disease. They quantified their magnesium intake and measured their inflammatory markers.

    They found that those with the highest dietary magnesium intake were 47 percent less likely to develop type 2 diabetes over a 20-year period than those with the lowest intake, even after taking other risk factors into consideration. Levels of inflammatory markers, including C-reactive protein, interleukin-6, and fibrinogen – a protein that participates in clot formation – were lower among those with higher magnesium intake.

    Magnesium is an essential mineral and a cofactor for hundreds of the body’s enzymes. Magnesium deficiency is linked with an increased risk of cardiovascular disease, osteoporosis, and metabolic disorders, including hypertension and type 2 diabetes. Current magnesium intakes among people living in the United States are below recommended levels (400-420 milligrams per day for men and 310-320 milligrams per day for women).

    This study highlights the role dietary magnesium plays in health and underscores the mineral’s importance in the human diet. Dietary sources rich in magnesium include green leafy vegetables, unrefined grains, legumes, beans, and nuts. Try this magnesium-rich smoothie recipe to get more of this essential nutrient in your diet.

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  • Estrogen may improve insulin sensitivity and suppress gluconeogenesis via Foxo1, mouse study suggests. (2019) www.sciencedaily.com
    Hormones Diabetes Estrogen Insulin Blood Sugar

    From the article:

    “Premenopausal women exhibit enhanced insulin sensitivity and reduced incidence of Type 2 diabetes compared with age-equivalent men,” he explained. “But this advantage disappears after menopause with disrupted glucose homeostasis, in part owing to a reduction in circulating estrogen.”

    […]

    “We wanted to understand the mechanism by which estrogen regulates gluconeogenesis by means of interaction with hepatic Foxo1,” he explained. “Foxo1 has an important role in the regulation of glucose production through insulin signaling. It is an important component of insulin-signaling cascades regulating cellular growth, differentiation and metabolism.”

    He said in both male and ovariectomized female control mice, a subcutaneous estrogen implant improved insulin sensitivity and suppressed gluconeogenesis. However, the estrogen had no effect on the liver-specific Foxo1 knockout mice of both sexes.

    “This suggests Foxo1 is required for estrogen to be effective in suppressing gluconeogenesis,” he said.

    “We further demonstrated that estrogen suppresses hepatic glucose production through activation of estrogen receptor signaling, which can be independent of insulin receptor substrates Irs1 and Irs2. This reveals an important mechanism for estrogen in the regulation of glucose homeostasis.”

    Guo said study results support the hypothesis that improvement of glucose homeostasis by estrogen is regulated by hepatic Foxo1-mediated gluconeogenesis rather than by promoting muscle glucose uptake.

    […]

    Guo also noted some foods, such as soybeans, contain a certain amount of phytoestrogens, which can function in a similar way to that of estrogen, regulating bodily glucose metabolism and insulin sensitivity.

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  • A group of international experts takes strong stance on testosterone deficiency treatment. (2016) www.sciencedaily.com
    Cancer Hormones Diabetes Testosterone Prostate Cardiovascular

    From the article:

    After examining the best available scientific evidence, Morgentaler and colleagues – who included experts with specialties in urology, endocrinology, diabetes, internal medicine, and basic science research – agreed on the following:

    – TD [testosterone deficiency] is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health and quality of life.

    – Symptoms and signs of TD occur as a result of low levels of testosterone and may benefit from treatment regardless of whether there is an identified underlying origin.

    – TD is a global public health concern.

    – Testosterone therapy for men with TD is effective, rational, and evidence-based.

    – There is no testosterone concentration threshold that reliably distinguishes those who will respond to treatment from those who will not.

    – There is no scientific basis for any age-specific recommendations against the use of testosterone therapy in adult males.

    – The evidence does not support increased risks of cardiovascular events with testosterone therapy.

    – The evidence does not support increased risk of prostate cancer with testosterone therapy.

    – The evidence supports a major research initiative to explore possible benefits of testosterone therapy for cardiometabolic disease, including diabetes.

    “It will be surprising to those unfamiliar with the literature to learn how weak the evidence is supporting the alleged risks of cardiovascular disease and prostate cancer,” said Michael Zitzmann, MD, vice-chair of the conference and a Professor in the Centre for Reproductive Medicine and Andrology at the University of Muenster in Germany. “Indeed, there is substantial data suggesting there may actually be cardio-protective benefits of testosterone therapy.”

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  • Testosterone therapy reduced the risk of death from 20% to 8.6% in type 2 diabetes patients with low testosterone. (2011) www.sciencedaily.com
    Hormones Diabetes Testosterone Mortality

    From the article:

    Professor Jones' team conducted a six year study of 587 men with type 2 diabetes, splitting them into three groups: those with normal total testosterone levels (above 10.4nmol/L, n=338), those with low testosterone levels (below 10.4nmol/L) that weren’t treated with testosterone replacement therapy (n=182), and those with low testosterone levels treated with testosterone replacement therapy for two years or more during the follow up period (n=58).

    The findings show for the first time that low testosterone puts diabetic men at a significantly increased risk of death (p=0.001 log rank): 36 of the 182 diabetic men with untreated low testosterone died during the six year study, compared to 31 of the 338 men with normal testosterone levels (20% vs 9%). Furthermore, only 5 of the 58 diabetic men that were given testosterone replacement therapy died during the study (8.6%), meaning they showed significantly better survival compared to the non-treated group (p=0.049 log rank).

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  • In older men with low testosterone levels, testosterone replacement therapy improved risk factors for cardiovascular disease and diabetes. (2008) www.sciencedaily.com
    Hormones Diabetes Cholesterol Testosterone Triglycerides Metabolic Syndrome Weight Loss Cardiovascular

    From the article:

    All 95 men in the studies (ages 34 to 69 years) had the metabolic syndrome. To receive this diagnosis, patients must have three of the following five risk factors: increased waist circumference (abdominal fat), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure, and high blood sugar.

    The first study showed that testosterone treatment significantly reduced waist circumference, total cholesterol, LDL (“bad”) cholesterol, triglycerides, and body mass index (a measure of body fat). Treatment also increased “good” cholesterol. Improvements were progressive over 12 months, indicating that benefits may continue past a year, Saad said.

    In the second study, the researchers divided the patient population into three groups by age: less than 57 years, 57 to 63 years, and more than 63 years. They found that the oldest men had similar improvements in metabolic risk factors to the youngest men.

    Additionally, the investigators looked at the degree of testosterone deficiency before treatment. This beginning level of testosterone deficiency did not predict the beneficial outcome, they found. Men whose subnormal testosterone levels were not as low as the others had similar improvements in metabolic risk factors to men with the lowest levels, according to Saad.

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  • Diabetic men with low testosterone had a sixfold higher risk of increased carotid artery thickness and endothelial dysfunction. (2014) www.sciencedaily.com
    Hormones Diabetes Testosterone Cardiovascular

    From the publication:

    The cross-sectional prospective study published in JCEM examined testosterone levels and key atherosclerotic markers, including intimal media thickening of the layers in the carotid artery, the presence of atherosclerotic plaques, function of the endothelial cells that line the heart and blood vessels, and inflammatory markers in 115 men with Type 2 diabetes. The participants were younger than age 70 and had no history of cardiovascular disease. Researchers measured the levels of testosterone in each participant’s blood. Among the participants, more than half of patients with diabetes were found to have low testosterone levels.

    The study found men who had low testosterone and Type 2 diabetes were six times more likely to have increased thickness of the carotid artery and endothelium dysfunction compared to men with normal serum testosterone levels. A total of 54 percent of the men with low testosterone and 10 percent of the men with normal testosterone were found to be at higher risk for vascular disease.

    “We still need to determine whether testosterone is directly involved in the development of atherosclerosis or if it is merely an indicator of advanced disease,” Farias said.

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  • Low testosterone levels may be common and associated with insulin resistance in men with diabetes. (2008) www.sciencedaily.com
    Hormones Diabetes Testosterone

    From the article:

    For this study, researchers conducted a survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after six months. Testosterone levels were measured from blood samples using the Access testosterone assay.

    Previous population-studies found an association of reduced testosterone levels in men and type 2 diabetes, however this is the first study to demonstrate a similar prevalence in individuals with type 1 diabetes.

    This study raises the question of whether testosterone replacement therapy can reduce insulin resistance or symptoms of hypogonadism in men with diabetes. Researchers, however stress that the balance of benefits and risks of such treatment is currently unknown and still to be defined by large and long-term clinical trials. Also, while insulin resistance is associated with testosterone deficiency, there is no evidence that insulin sensitizers are able to elevate testosterone levels in men with diabetes.

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  • Weight loss reduced the prevalence of low testosterone levels in overweight, middle-aged men with prediabetes by 46%. (2012) www.sciencedaily.com
    Obesity Hormones Diabetes Testosterone Weight Loss

    From the article:

    The study population had 891 middle-aged men, with an average age of 54 years. The men were randomly assigned to receive one of three treatments: 293 men to lifestyle modification, 305 to the diabetes drug metformin and 293 to inactive placebo pills. Lifestyle modifications consisted of exercising for 150 minutes a week and eating less fat and fewer calories.

    The results showed that low testosterone levels are common in overweight men with prediabetes, Hayes said. At the beginning of the study, nearly one in four men had low testosterone levels, considered to be below 300 nanograms per deciliter.

    With lifestyle modification, the prevalence of low testosterone levels decreased from about 20 percent to 11 percent after one year, a 46 percent decrease, the authors reported. The prevalence of low testosterone was unchanged in the metformin group (24.8 versus 23.8 percent) and the placebo group (25.6 versus 24.6 percent).

    Men in the lifestyle modification group lost an average of about 17 pounds (7.8 kilograms) over the one-year study, according to the abstract. The increase in testosterone levels in that group correlated with decreasing body weight and waist size.

    “Losing weight not only reduces the risk of prediabetic men progressing to diabetes but also appears to increase their body’s production of testosterone,” Hayes said.

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  • Testosterone therapy increased tissue glucose uptake by 32% in response to insulin in men with type 2 diabetes and low testosterone (2015) www.sciencedaily.com
    Hormones Diabetes Insulin Resistance Testosterone Insulin

    From the article:

    The current study included 94 men with Type 2 diabetes. Prior to being treated, the 44 men in the study with low testosterone levels expressed significantly lower levels of insulin signaling genes and, thus, diminished insulin sensitivity. These men were randomized to receive a testosterone injection or a placebo every week for 24 weeks.

    The study found that while there was no change in body weight, testosterone treatment produced a reduction in total body fat of 3 kilograms (more than six pounds) while increasing muscle mass by the same amount.

    “Most importantly, we saw a dramatic increase in insulin sensitivity, demonstrated by a 32 percent increase in the uptake of glucose by tissues in response to insulin,” Dandona said. At the same time, there was a similar increase in the expression of the major genes that mediate insulin signaling.

    While patients' hemoglobin A1C (HbA1c) levels did not go down, a necessary indicator that testosterone can help control diabetes, Dandona noted that fasting glucose levels had diminished significantly, by 12 milligrams per deciliter. He said that a significant improvement in HbA1c may eventually be seen when longer term studies are carried out.

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  • Patients undergoing testosterone-lowering therapy for prostate cancer had an 88% increased risk of Alzheimer's risk. (2015) www.sciencedaily.com
    Alzheimer's Cancer Hormones Diabetes Testosterone Prostate Cardiovascular

    From the article:

    Using two different methods of statistical analysis, the team showed that the ADT [androgen deprivation therapy] group, compared to the control group, had significantly more Alzheimer’s diagnoses in the years following the initiation of androgen-lowering therapy. By the most sophisticated measure, members of the ADT [androgen deprivation therapy] group were about 88 percent more likely to get Alzheimer’s during the follow-up period.

    The analyses also suggested a “dose-response effect.” The longer individuals underwent ADT the greater their risk of Alzheimer’s disease, they found. The longer-duration ADT patients also had more than double the Alzheimer’s risk of non-ADT controls.

    […]

    How low testosterone would lead to increased Alzheimer’s risk isn’t precisely known, but there is some evidence that testosterone has a general protective effect on brain cells, so that lowering testosterone would leave the brain less able to resist the processes leading to Alzheimer’s dementia. Studies in mice and in humans also have suggested that lower testosterone levels may allow greater production of the Alzheimer’s protein amyloid beta. Moreover, low testosterone may increase Alzheimer’s risk indirectly, by promoting conditions such as diabetes and atherosclerosis that are known to predispose to Alzheimer’s.

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  • In a study, 40% of obese and 50% of obese diabetic participants had low testosterone levels. (2010) www.sciencedaily.com
    Obesity Hormones Diabetes Testosterone

    From the article:

    Results of a study published online ahead of print in the journal Diabetes Care, conducted by University at Buffalo endocrinologists, showed that 40 percent of obese participants involved in the Hypogonadism in Males (HIM) study had lower-than-normal testosterone readings.

    The percentage rose to 50 percent among obese men with diabetes. Results also revealed that as body mass index (BMI) – a relationship of weight-to-height – increased, testosterone levels fell.

    “The effect of diabetes on lowering testosterone levels was similar to that of a weight gain of approximately 20 pounds,” says Sandeep Dhindsa, MD, an endocrinology specialist in the UB Department of Medicine and first author on the study.

    […]

    This is the largest analysis of the association between obesity and low testosterone, and the first to compare prevalence of low testosterone with obesity and diabetes separately and together. The study shows that obesity and diabetes may exert independent influences on testosterone concentrations.

    […]

    UB endocrinologists published a study in Diabetes Care in 2008 showing that more than 50 percent of men between 18 and 35 years old with type 2 diabetes had lower than normal testosterone levels.

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  • Men with low testosterone are at greater risk for developing type 2 diabetes. (2016) www.sciencedaily.com
    Hormones Diabetes Testosterone Insulin

    From the article:

    Doctors have long known that men with low testosterone are at greater risk for developing type 2 diabetes. For the first time, researchers have identified how testosterone helps men regulate blood sugar by triggering key signaling mechanisms in islets, clusters of cells within the pancreas that produce insulin.

    […]

    “Our study shows that testosterone is an anti-diabetic hormone in men. If we can modulate its action without side effects, it is a therapeutic avenue for type 2 diabetes.”

    Researchers used specially bred male mice with pancreatic beta cells lacking the receptor to testosterone (the androgen receptor). They fed them a Western diet rich in fats and sugar and tested their response to glucose. The mice without androgen receptors all developed lower insulin secretion, leading to glucose intolerance compared with normal mice in the control group.

    To better understand how testosterone interacted with insulin production within the pancreas, researchers administered testosterone and glucose directly to human islet cells treated with an androgen receptor inhibitor and islets cells harvested from mice without androgen receptors. In both cases the islet cells showed decreased insulin production compared to islet cells whose receptor to testosterone was not inhibited or missing.

    Further experiments in cultured mouse and human islet cells showed the insulin-producing effect of testosterone could be abolished by inhibiting glucagon-like peptide-1 (GLP-1), a hormone the body produces after a meal. The study suggests that testosterone amplifies the islet impact of the hormone, which is currently used as a diabetes treatment.

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  • Low testosterone levels may be associated with chronic disease, even in men 40 years of age and younger. (2018) www.sciencedaily.com
    Hormones Diabetes Cholesterol Depression Testosterone Triglycerides Blood Pressure Arthritis Cardiovascular

    From the aricle:

    Peterson and team then examined prevalence of nine chronic conditions, including type 2 diabetes, arthritis, cardiovascular disease, stroke, pulmonary disease, high triglycerides, hypercholesterolemia, hypertension and clinical depression.

    The researchers studied the prevalence of multimorbidity, or when two or more of the chronic conditions were present, among three age groups (young, middle-aged and older men) with and without testosterone deficiency. They found that low total testosterone [<300 ng/dL] was associated with multimorbidity in all age groups – but it was more prevalent among young and older men with testosterone deficiency.

    “We also found a large dose-response relationship between the age-specific low total testosterone and moderate total testosterone levels and multimorbidity, even after adjusting for obesity and muscle strength capacity,” Peterson says. “Which means that men should be concerned about declining total testosterone, even if it has not reached a level to warrant a clinical diagnosis (<300 ng/dL [10.4 nmol/L]).”

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  • Association of serum interleukin-6 and C-reactive protein in childhood with depression and psychosis in young adult life. (2014) www.sciencedaily.com
    Brain Heart Disease Diabetes Depression Mental Health IL-6 CRP

    From the article:

    Now, researchers have carried out the first ever longitudinal study – a study that follows the same cohort of people over a long period of time – to examine the link between these markers [cytokines such as interleukin-6] in childhood and subsequent mental illness.

    A team of scientists led by the University of Cambridge studied a sample of 4,500 individuals from the Avon Longitudinal Study of Parents and Children – also known as Children of the 90s – taking blood samples at age 9 and following up at age 18 to see if they had experienced episodes of depression or psychosis. The team divided the individuals into three groups, depending on whether their everyday levels of IL-6 were low, medium or high. They found that those children in the ‘high’ group were nearly two times more likely to have experienced depression or psychosis than those in the ‘low’ group.

    […]

    The research indicates that chronic physical illness such as coronary heart disease and type 2 diabetes may share a common mechanism with mental illness. People with depression and schizophrenia are known to have a much higher risk of developing heart disease and diabetes, and elevated levels of IL-6 have previously been shown to increase the risk of heart disease and type 2 diabetes.

    Professor Peter Jones, Head of the Department of Psychiatry and senior author of the study, says: “Inflammation may be a common mechanism that influences both our physical and mental health. It is possible that early life adversity and stress lead to persistent increase in levels of IL-6 and other inflammatory markers in our body, which, in turn, increase the risk of a number of chronic physical and mental illness.”

    […]

    This potential common mechanism could help explain why physical exercise and diet, classic ways of reducing risk of heart disease, for example, are also thought to improve mood and help depression. The group is now planning additional studies to confirm whether inflammation is a common link between chronic physical and mental illness.

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  • Study shows reduced risk of aortic aneurysm (-27%) and aortic dissection (-47%) in patients with type 2 diabetes. (2017) www.eurekalert.org
    Diabetes Aneurysm

    From the article:

    A decrease in short-term risk of aortic aneurysm (dilatation of the aorta, the main artery in the body, with associated symptoms including pain, and a risk for lethal rupture) and of aortic dissection (a tear in the most intimate layer of the artery wall that can block the flow of blood to the heart or abdominal organs) has been noted for patients with T2DM in previous studies.

    […]

    In total, there were 2,878 cases of AA in patients with T2DM and 16,740 in the control group; and 200 cases of AD in the T2D group versus 2,019 in the control. The results indicate that individuals with T2DM have a 28% lower risk of AA and a 47% lower risk of AD compared to the control group. Sub-analyses for AA also indicated a 44% lower risk for thoracic AA, a 25 % risk reduction for abdominal AA, a 21 % lower risk for unspecified AA and unaltered risk reduction for thoraco-abdominal AA among individuals with T2DM compared to control subjects. Due to few cases of AD, it was not possible to perform the same sub-analysis for AD.

    […]

    The authors conclude: “Among patients with T2DM there were significantly decreased risks of AA and AD as well as decreased risk of mortality after an event of AA.” They also suggest that “glycated (sugar) cross-links, created by various mechanisms, in aortic tissue among T2DM patients may play a protective role in progression of aortic disease. More studies are needed to see exactly what is taking place here.”

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  • Peripheral amyloid-beta produced in the liver in type 2 diabetes may be a crucial link to Alzheimer’s disease www.sciencedaily.com
    Brain Alzheimer's Diabetes Neurodegeneration

    Amyloid-beta produced in peripheral tissues provides a link between diabetes and Alzheimer’s disease risk.

    Type 2 diabetes, a metabolic disorder characterized by glucose intolerance and insulin resistance, poses a significant public health concern, affecting roughly 470 million people worldwide. Having type 2 diabetes greatly increases a person’s risk of developing Alzheimer’s disease, but scientists don’t fully understand the mechanisms that drive the increased risk. Findings from a recent study suggest that amyloid-beta produced in tissues outside the brain provides the link between type 2 diabetes and Alzheimer’s disease.

    Amyloid-beta, a toxic peptide produced in the brain, clumps together and forms plaques with age. Its accumulation is a pathological hallmark of Alzheimer’s disease. However, amyloid-beta is produced in peripheral tissues, as well, including those that are sensitive to glucose or insulin, such as the pancreas, adipose tissues, skeletal muscles, and liver. Scientists don’t fully understand the roles peripheral amyloid-beta plays in human health.

    The investigators conducted a three-part experiment in mice, live mouse tissues, and cell cultures. First, they injected mice with glucose after they had fasted for 16 hours to examine the effects of glucose and insulin on blood amyloid-beta levels. They found that the mice experienced a transient increase in blood levels of glucose, insulin, and amyloid-beta. Then they injected amyloid-beta and glucose into mice that can’t produce the protein and found that amyloid-beta suppressed the animals’ insulin response.

    Next, they applied glucose and insulin to live tissues from the pancreas, adipose tissue, skeletal muscle, liver, and kidneys of mice. They found that glucose stimulated the release of amyloid-beta from the pancreas, whereas insulin stimulated its release from adipose tissue, skeletal muscle, and liver tissue. However, when the scientists added glucose along with amyloid-beta to the pancreatic tissue, insulin release was suppressed.

    Finally, they used antibodies that target the amyloid-beta protein to determine where the protein was produced. They found that amyloid-beta was produced and stored in the beta cells of the pancreas and released into circulation when stimulated with glucose.

    These findings suggest that amyloid-beta protein produced in peripheral tissues modulates insulin secretion. They may further provide a mechanism linking type 2 diabetes to Alzheimer’s disease. The investigators posited that high blood glucose and insulin levels that occur in the setting of diabetes increase peripheral amyloid-beta production, altering the balance between brain and peripheral amyloid-beta levels and suppressing the protein’s efflux from the brain. Furthermore, high insulin levels in the brain may impair normal degradation of brain amyloid-beta, increasing the protein’s levels in the brain and driving its accumulation. Learn more about the role of amyloid-beta in Alzheimer’s disease in this clip featuring Dr. Dale Bredesen.

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  • Silencing TLR4 gene can stop process leading to cardiovascular disease in diabetics (animal study) www.sciencedaily.com
    Diabetes Immune System Blood Sugar Toll-Like Receptors Cardiovascular

    TLR4 plays a role in death of heart cells from high blood sugar.

    From the article:

    Researchers writing in BioMed Central’s open access Journal of Translational Medicine carried out a series of in vitro tests which demonstrated that TLR4 plays a critical role in hyperglycaemic cardiac apoptosis, and that silencing the gene using specific small interfering RNA (siRNA) can prevent it.

    […]

    They found that after 7 days of hyperglycemia, the level of TLR4 mRNA in myocardial tissue was significantly elevated, and signs of apoptosis were evident. Silencing TLR4 resulted in suppression of apoptotic cascades. According to Min, “This is the first demonstration of the prevention of cardiac apoptosis in diabetic mice through silencing of the TLR4 gene.”

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  • Cardio exercise increases the production of FGF21 3x more than strength training: a hormone with relevance to metabolic disorders www.sciencedaily.com
    Exercise Obesity Diabetes Aerobic Strength FGF21

    From the article:

    In a new study published in the scientific Journal of Clinical Investigation – Insight, the researchers show that cardio training on an exercise bike causes three times as large an increase in the production of the hormone FGF21 than strength training with weights. FGF21 has a lot of positive effects on metabolism.

    […]

    Endurance training on a bicycle has such a marked effect on the metabolic hormone that we know ought to take a closer look at whether this regulation of FGF21 is directly related to the health-improving effects of cardio exercise. FGF21’s potential as a drug against diabetes, obesity and similar metabolic disorders is currently being tested, so the fact that we are able to increase the production ourselves through training is interesting', Christoffer Clemmensen elaborates.

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  • Higher-than-normal blood sugar blunts some aerobic adaptations resulting from aerobic exercise
    Exercise Diabetes Blood Sugar Aerobic Strength

    From the article:

    Muscle tissue can remodel itself, which is one reason why exercise becomes easier when we do it regularly, Lessard says. Over time, aerobic exercise such as running or swimming can alter muscle fibers to become more efficient at using oxygen during exercise. “We also grow new blood vessels to allow more oxygen to be delivered to the muscle, which helps to increase our aerobic fitness levels,” she says.

    The scientists propose that high levels of blood sugar may prevent muscle remodeling in part by modifying the “extracellular matrix” proteins in the space between the muscle cells, where blood vessels are formed.

    Adapting to aerobic exercise as though it were strength training:

    The scientists found that these JNK pathway signals were getting crossed in the hyperglycemic mice, by activating pathways associated with strength training, even though the mice were performing aerobic exercise. “As a result, the muscles of hyperglycemic animals have bigger fibers and fewer blood vessels, which is more typical of strength training, rather than aerobic training,” Lessard says.

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  • Long-term weight-loss reduces cancer risk in adults with obesity and type 2 diabetes. www.sciencedaily.com
    Cancer Obesity Diabetes

    Obesity and type 2 diabetes cause perturbations in metabolism and immunity that increase the risk of cancer. Bariatric surgery is the most effective intervention for substantial and enduring weight loss in those with obesity and has been shown to [reverse type 2 diabetes](​​https://pubmed.ncbi.nlm.nih.gov/33485454/) and reduce cancer risk. Findings of a recent report demonstrate a lower risk of cancer in patients with obesity and diabetes up to 31 years following bariatric surgery.

    Weight gain occurs when the body stores excess calories in the form of fat in adipose tissue depots around the body. As the amount of energy stored increases, the body’s tolerance for glucose and other fuels decreases, leading to insulin resistance and type 2 diabetes. The high circulating levels of glucose, insulin, insulin-like growth factors, and inflammatory proteins observed in type 2 diabetes increase cancer cell proliferation and suppress apoptosis (programmed cell death). Reducing energy stores through bariatric surgery or other weight-loss therapies restores insulin sensitivity and reduces cancer risk.

    The authors collected data from an ongoing trial with over 4,000 participants investigating the long-term effects of bariatric surgery in adults with obesity and type 2 diabetes. At their baseline visit, participants underwent a physical exam, gave a blood sample, and completed questionnaires regarding health and lifestyle factors. Participants chose to undergo bariatric surgery or receive conventional obesity treatment during the years of 1987 and 2001. They continue to provide additional questionnaire data and blood samples as the study remains ongoing. The investigators followed participants in the current sample for an average of 21 years.

    Participants who chose to undergo bariatric surgery lost an average of 60 pounds two years after the baseline visit, compared to just 7 pounds in participants who received standard obesity treatment. These levels of weight loss remained stable 10 years after the baseline visit. At two years follow-up, 70 percent of participants who underwent surgery had diabetes remission, compared to 34 percent at 10 years follow-up. Bariatric surgery reduced cancer risk by 48 percent in women and 37 percent in the whole group. Participants who underwent surgery and maintained diabetes remission after 10 years had 55 percent reduction in cancer risk compared to participants with diabetes at 10 years follow-up. Participants who did not undergo surgery but achieved diabetes remission had an even greater risk reduction of 60 percent at 10 years follow-up.

    These findings support long-term weight-loss, including bariatric surgery, as a strategy to reduce type 2 diabetes and cancer risk among adults with obesity.

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  • Allulose reduces blood sugar and insulin levels. drc.bmj.com
    Diabetes Sugar Insulin Blood Sugar

    Foods with a high glycemic index, such as sugar-sweetened soft drinks, desserts, and white bread products, contain sugars that are rapidly absorbed into the bloodstream, causing hyperglycemia (high blood glucose). Regular consumption of high glycemic foods may lead to insulin resistance, type 2 diabetes, and obesity. Low-calorie sweeteners (i.e., artificial sweeteners) such as allulose have a low glycemic index and can be used in place of sugar to reduce the intake of calories and high-glycemic carbohydrates; however, the effects of allulose in addition to sugar require further investigation. Findings published in a new report show that allulose significantly reduces glucose and insulin levels following sugar consumption.

    Allulose is a rare sugar that can be found in small amounts in some fruits and grains and is sold as a low-calorie sweetener. Allulose is an epimer of fructose, meaning its chemical structure is very similar to fructose, giving it a nearly identical taste and texture; however, allulose provides only 0.4 calories per gram, compared to 4 calories per gram of fructose. A meta-analysis of previous research found that small doses of allulose improved glucose and insulin regulation; however, additional randomized controlled trials are needed, especially in Western populations and in people without type 2 diabetes.

    The researchers recruited 30 participants (average age, 33 years) without type 2 diabetes and asked them to follow an individualized diet plan that provided 50 to 65 percent of calories from carbohydrates for up to eight weeks. Participants completed five study visits with one to two weeks between visits. At each visit, the researchers gave participants a beverage containing 50 grams of fructose (the amount in about 16 ounces of sugar-sweetened soda) with escalating doses of allulose (0, 2.5, 5, 7.5, or 10 grams). They measured glucose and insulin levels in the blood 0, 30, 60, 90, and 120 minutes after beverage consumption.

    Allulose consumption reduced plasma glucose levels among participants in a dose-dependent manner, meaning as the dose of allulose increased from 0 to 10 grams, glucose levels at each time point decreased. The relationship between allulose and lower glucose levels was statistically significant at the 30-minute time point when either 7.5 or 10 grams of allulose was added to the fructose beverage. Compared to consuming a fructose beverage with no added allulose, the 10-gram dose of allulose also significantly decreased insulin levels 30 minutes after beverage consumption.

    These findings demonstrate that allulose decreased glucose and insulin levels when added to a high-sugar beverage in healthy young people without diabetes. The authors suggested that future studies explore more of the mechanisms underlying these results.

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  • Maternal diabetes causes birth defects by increasing cellular aging. apple.news
    Brain Aging Diabetes Pregnancy

    Neural tube defects (e.g., spina bifida, hydranencephaly) are a group of birth defects caused by incomplete development of the outer layers of the brain or spinal cord. Prenatal folate supplementation prevents an estimated 70 percent of neural tube defects, but additional therapies are needed. A recent report describes the relationship between maternal diabetes and abnormal cell aging in the fetal nervous system in mice.

    Previous research has demonstrated a relationship between maternal diabetes and the incidence of neural tube defects in mice; however, the mechanisms that drive this relationship are unknown. High blood glucose levels cause oxidative damage and promote cellular senescence, a state in which cells are not metabolically active and do not reproduce. Aging cells accumulate damage over time and become senescent. In adults, an excess of senescent cells can promote inflammation and disease. In the developing fetus, senescence is vital for tissue remodeling and the building of limbs and organs. However, inappropriate senescence may lead to abnormal development.

    The investigators used multiple mouse models in their study. In a first experiment, they used a strain of mice that develop diabetes and compared them to wild-type mice that are not predisposed to any disease. They injected pregnant females from both groups with either rapamycin, a compound that slows cellular aging by inhibiting the enzyme mTOR, or a placebo. In a second experiment, they used diabetic and non-diabetic strains of knockout mice, whose genomes do not contain the gene FoxO3a, a regulator of aging that may slow cellular senescence.

    Maternal diabetes increased the abundance of biomarkers of cellular senescence and DNA damage in the lining of the brain in offspring. Pregnant diabetic mice that were exposed to rapamycin had offspring with lower levels of senescence biomarkers and fewer neural tube defects compared to placebo. Offspring from FoxO3a knockout mice experienced the same decrease in senescence biomarkers and neural tube defect rates as rapamycin-treated mice.

    These results elucidate the mechanisms by which maternal diabetes can cause birth defects through metabolic changes that accelerate aging. Learn more about the role of cellular senescence in aging in this episode featuring Dr. Judith Campisi.

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  • Antioxidant-rich moringa and amaranth leaf powders decrease oxidative stress and improve metabolic health. www.ncbi.nlm.nih.gov
    Diabetes Moringa

    During the process of menopause, the ovaries produce less estrogen, leading to several physiological changes that include the end of reproductive life. Lower estrogen levels in post-menopausal females may decrease the body’s antioxidant enzymes because estrogen has known antioxidant properties. In a recent report, a group of researchers tested the effects of drumstick (Moringa oleifera) and amaranth (Amaranthus tricolor) leaf supplements on antioxidant capacity in post-menopausal females.

    Much of the bodily damage that comes with aging is caused by oxygen radicals, but many foods and supplements contain antioxidant compounds that protect the body. Drumstick leaves contain a number of antioxidant compounds including the isothiocyanate called moringin, which is similar to sulforaphane found in some cruciferous vegetables. Amaranth leaves contain a number of antioxidant compounds as well as other beneficial nutrients, such as magnesium, folic acid, and dietary fiber.

    The investigators enrolled 90 post-menopausal females and allocated them to one of three groups. One group received 7 grams of drumstick leaf powder for three months, another received 9 grams of amaranth leaf powder for three months, and the third group received no intervention. The investigators measured antioxidant enzymes, glucose, and malondialdehyde, a marker of oxidative stress, in the participants’s blood.

    The authors found that the drumstick leaf and amaranth leaf powders increased retinol by 9 percent and 5 percent (respectively) and increased vitamin C by 44 percent and 6 percent (respectively). The drumstick leaf and amaranth leaf powders decreased malondialdehyde by 16 percent and 10 percent (respectively) and decreased fasting glucose levels by 14 percent and 10 percent (respectively).

    These results suggest that drumstick and amaranth leaf supplements improve antioxidant capacity and reduce oxidative stress in postmenopausal females while also improving metabolic health.

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  • Sulforaphane improves blood glucose control in obese people with type 2 diabetes. stm.sciencemag.org
    Nutrition Diabetes Sulforaphane NRF2 Metformin Glucoraphanin

    Type 2 diabetes is a progressive metabolic disorder characterized by high blood glucose levels and insulin resistance. Long-term complications from poorly controlled type 2 diabetes include heart disease, stroke, and kidney failure, among others. Findings from a 2017 study demonstrated that sulforaphane reduces glucose production in the liver and improves blood glucose control. Glucose is the body’s primary metabolic fuel. In the fasted state, the body can produce glucose via gluconeogenesis, a highly conserved pathway that occurs primarily in the liver. Increased liver gluconeogenesis among people with type 2 diabetes is a major contributor to high blood glucose and subsequent disease complications.

    The authors of the study investigated the effects of sulforaphane in several rodent models of type 2 diabetes and found that sulforaphane ameliorated many of the hallmark characteristics of the disease. Then they assessed sulforaphane’s effects in 97 people with type 2 diabetes. Sixty of the participants had well-regulated disease, but 37 had poorly regulated disease. Of those with poorly regulated disease, 17 had obesity. Nearly all of the participants took metformin, a common blood glucose-lowering drug.

    Participants received either an oral placebo or glucoraphanin-rich broccoli sprout extract every day for 12 weeks. The authors of the study measured the participants' fasting blood glucose and HbA1c (a measure of long-term blood glucose control) levels and assessed their glucose tolerance prior to and after the intervention.

    Sulforaphane administration improved fasting blood glucose and HbA1c levels in the obese participants who had poorly regulated type 2 diabetes. Sulforaphane mediated these effects via Nrf2 activity and subsequent reduced expression of enzymes that promote glucose production in the liver.

    These findings suggest that sulforaphane ameliorates some of the hallmark characteristics of diabetes in humans. The mechanisms by which sulforaphane mediates these effects differ from those of metformin, suggesting that the two could work in a complementary manner to improve blood glucose control in obese people with type 2 diabetes.

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  • Alterations in brain blood use contribute to motor deficits in type 2 diabetes in women. www.sciencedaily.com
    Diabetes

    People with type 2 diabetes often experience sensory and motor deficits. These deficits have been attributed to peripheral nerve damage that commonly occurs with the condition. Findings from a new study suggest that changes in brain blood use contribute to sensory and motor deficits associated with type 2 diabetes.

    Poor blood glucose control and insulin resistance – the hallmarks of type 2 diabetes – contribute to micro- and macrovascular changes in blood vessels. These changes promote a wide range of complications that affect multiple organ systems, including cardiovascular, neurological, and musculoskeletal systems, contributing to sensory and motor deficits. Postmenopausal women appear to be at greater risk of these complications.

    The study involved 42 postmenopausal women over the age of 60 years who had type 2 diabetes. The authors of the study measured the participants' blood pressure, cholesterol, and HbA1C levels (a measure of long-term blood glucose control) and assessed the women for peripheral nerve damage. The participants underwent testing to evaluate the strength and tactile sensation in their dominant hand. Then they performed a series of exercises with the same hand while undergoing functional near-infrared spectroscopy, a type of imaging technology, to assess oxygenated and unoxygenated blood use by the brain

    The spectroscopy data revealed that the women with motor deficits exhibited reduced oxygenated blood use in their brains. Sensory deficits were not associated with these changes, however. These data suggest that motor deficits associated with type 2 diabetes in postmenopausal women are related to altered blood use in the brain. Further research in men and other age groups is needed to confirm these findings.

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  • Gut microbiota altered in type 2 diabetes. www.eurekalert.org
    Microbiome Diabetes Metformin

    Type 2 diabetes affects more than 400 million people worldwide. Some studies have demonstrated that the microbes that inhabit the human gut contribute to the pathophysiology of type 2 diabetes, but the use of anti-diabetes drugs like metformin may have confounded the results due to their impact on the gut. Findings from a new study suggest that the overall makeup of the gut microbial population in people with type 2 diabetes is altered.

    The authors of the study profiled the microbiota of two groups of participants with varying degrees of glucose tolerance, ranging from normal to impaired (prediabetes) to having untreated type 2 diabetes. One group included 189 people who had isolated impaired fasting glucose, 178 who had isolated impaired glucose tolerance, 75 who had combined glucose intolerance, and 46 who had type 2 diabetes but had not begun treatment. A second group included 523 people with normal glucose tolerance, 226 at low risk for developing type 2 diabetes, and 297 at high risk.

    They found that the composition of the gut microbiota among the participants with any degree of glucose intolerance differed markedly from that of the participants with normal glucose tolerance. The participants with prediabetes and diabetes were more likely to have fewer butyrate-producing bacteria in their guts. Butyrate is a short-chain fatty acid produced during bacterial fermentation in the human colon. It has wide-ranging effects on human physiology. The authors also noted that the composition of the gut microbiota can serve as a biomarker for diabetes.

    These findings suggest that altering the gut microbiota could serve as a means to prevent the development of type 2 diabetes.

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  • Consumption of dairy products – especially high fat products – linked to lower risk of developing diabetes and high blood pressure. www.eurekalert.org
    Diabetes Blood Pressure Dairy

    Metabolic syndrome is a constellation of disorders that includes high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol and triglyceride levels. Having metabolic syndrome increases a person’s risk for developing cardiovascular disease, diabetes, and premature death. An estimated one billion people worldwide have metabolic syndrome. Findings from a new study indicate that dairy product intake is associated with a lower prevalence of metabolic syndrome and its complications.

    Dairy products comprise a wide range of foods derived from the milk of cows, sheep, goats, and others. They provide protein, carbohydrates, fats, vitamins, and minerals. Full-fat dairy products are high in saturated fat. The nutritional benefits of dairy products are hotly debated.

    The study drew on data from the Prospective Urban Rural Epidemiology study, which involved participants between the ages of 35 and 70 years living in Africa, Asia, Europe, and North and South America. The authors of the study first conducted a cross-sectional analysis involving nearly 113,000 people to determine whether there was an association between dairy intake and prevalence of metabolic syndrome. The participants completed food frequency questionnaires that provided information about their dietary intake, including dairy products.

    Analysis of the questionnaires revealed that people who consumed two or more servings of dairy products per day were 24 percent less likely to have metabolic syndrome. If they consumed two or more servings of high fat dairy products (instead of low fat) per day, they were 28 percent less likely to have metabolic syndrome.

    The study authors also conducted a prospective analysis to determine whether there was an association between dairy intake and the incidence of hypertension and diabetes. They reviewed data from nearly 190,000 participants. People who consumed three or more servings of dairy products per day were as much as 14 percent less likely to develop the two conditions. The associations were stronger when the people consumed full fat dairy products (instead of low fat).

    High fat dairy products include full fat milk, full fat yogurt, and cheese. Cheese, in particular, contains spermidine, a compound that serves as a calorie restriction mimetic, capable of inducing autophagy even in the setting of sufficient nutrient intake. Watch this clip with autophagy expert Dr. Guido Kroemer in which he describes this phenomenon.

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  • Blood glucose control among people with type 2 diabetes influences COVID-19-related mortality. www.sciencedaily.com
    Diabetes COVID-19

    Type 2 diabetes is a metabolic disorder characterized by high blood glucose and insulin resistance. Poor blood glucose control is associated with many diabetes-related complications and death. Findings from a new study indicate that blood glucose control influences outcomes in COVID-19.

    The most common symptoms of infection from SARS-CoV2, the virus responsible for COVID-19, include fever, cough, shortness of breath, and other respiratory system involvement. Recent evidence suggests that SARS-CoV2 can attack other organ systems, as well. People with preexisting health conditions such as diabetes are at higher risk of severe illness and even death with COVID-19.

    The retrospective, multi-centered study reviewed 7,337 cases of COVID-19 patients in Hubei Province, China. Of these cases, 952 patients had type 2 diabetes.

    The review indicated that patients with type 2 diabetes were more likely to have preexisting hypertension, coronary heart disease, cerebrovascular disease, and kidney dysfunction than patients without diabetes. They were also more likely to report having fatigue and difficulty breathing associated with COVID-19.

    In addition, COVID-19 patients with type 2 diabetes required more intensive care than patients without diabetes. For example, they had a higher need for antibiotics and other drugs and often required respiratory interventions such as oxygen and various types of ventilation. The mortality rate among COVID-19 patients was considerably higher among people with type 2 diabetes. In particular, 7.8 percent of patients with type 2 diabetes died compared to 2.7 percent of patients without diabetes.

    The authors of the study identified blood glucose control as a primary risk factor for severe illness and death among type 2 diabetes patients. Well-controlled blood glucose was associated with considerably lower mortality during hospitalization.

    These findings shed light on the association between type 2 diabetes and COVID-19 severity and death and underscore the need for educating high-risk patients, especially those with type 2 diabetes, on the importance of maintaining blood glucose control.

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  • Vitamin C supplementation restores lifespan in mice with Werner's syndrome (an advanced aging phenotype) www.sciencedaily.com
    Aging Diabetes Vitamin C Inflammation

    From the article:

    Scientists treated both normal mice and mice with a mutation in the gene responsible for Werner’s syndrome (WRN gene) with vitamin C in drinking water. Before treatment, the mice with a mutated WRN gene were fat, diabetic, and developing heart disease and cancer. After treatment, the mutant mice were as healthy as the normal mice and lived a normal lifespan. Vitamin C also improved how the mice stored and burned fat, decreased tissue inflammation and decreased oxidative stress in the WRN mice.

    From actual publication, rather than press release:

    Daily ascorbate supplementation allowed [Werner mice] to recover a normal mean life span and healthy aging. Although the number of animals used in each cohort was not big enough for a statistical testing on maximum life span, ascorbate treatment did prevent the appearance of Werner syndrome characteristic redox imbalance and related genomic damage. It also prevented the liver proinflammatory status observed in [Werner mice].

    What’s someone unexpected about the fact that additional vitamin C restoring mean lifespan is the fact that Werner syndrome is associated with higher-than-usual ascorbate status rather than reduced, so supplementing with vitamin C being beneficial may be somewhat counter to expectation:

    Interestingly, blood ascorbate levels increased with phenotypic progression in [Werner mice]. Ascorbate being protective, it is possible that the retention of vitamin C is a defense mechanism to counterbalance the age‐dependent rise in oxidative stress. We cannot rule out, however, the possibility that the increased ascorbate levels observed in [Werner mice] are due to a modification in ascorbate metabolism only specific to these mice.

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  • Sulforaphane from broccoli sprout extract improves fasting glucose and HbA1c in obese patients with dysregulated type 2 diabetes. www.sciencedaily.com
    Diabetes Sulforaphane Insulin Isothiocyanates Blood Sugar NRF2

    Type 2 diabetes is a metabolic disorder characterized by high blood sugar and insulin resistance. Long-term complications from poorly controlled type 2 diabetes include heart disease, stroke, diabetic retinopathy (and subsequent blindness), kidney failure, and diminished peripheral blood flow, which may lead to amputations. An estimated 500 million people worldwide are living with type 2 diabetes. A 2017 study suggests that sulforaphane may be beneficial in treating the symptoms of type 2 diabetes.

    Sulforaphane is an isothiocyanate compound derived from cruciferous vegetables such as broccoli, Brussels sprouts, and mustard. Sulforaphane is produced when the cruciferous plant is damaged by insects or eaten by humans. The compound activates cytoprotective mechanisms within cells in a hormetic-type response and has demonstrated beneficial effects against several chronic health conditions, including autism, cancer, cardiovascular disease, and others.

    The authors of the study identified sulforaphane out of more than 3,800 drugs and natural products as a potential therapeutic for type 2 diabetes based on statistical analysis that showed that sulforaphane’s protective effects (called a drug signature) had the potential to counteract diabetes’ harmful effects (called a disease signature).

    They then conducted a randomized double-blind placebo-controlled study involving 97 adults with type 2 diabetes. All the participants were of Scandinavian ethnicity and had diabetes for less than 10 years. Sixty of the participants had well-controlled diabetes; the remaining 37 had poorly controlled diabetes. Of those with poorly controlled diabetes, 17 were obese, and 20 were not obese.

    After undergoing blood tests to check their fasting blood sugar and HbA1c (a measure of long-term blood sugar control) and taking an oral glucose challenge, the participants took either a placebo or powdered broccoli sprout extract (containing 150 µmol sulforaphane per dose) every day for 12 weeks.

    At the end of the study period, the blood tests and the oral glucose challenge were repeated. The participants who took broccoli sprout extract and whose diabetes was well-controlled experienced no changes in their fasting blood sugar or HbA1c levels. The participants who were heaviest and had poorly controlled diabetes saw the greatest benefits from the broccoli sprout extract. After 12 weeks of treatment, obese participants’ fasting blood sugar levels and HbA1c levels decreased, but the participants who received a placebo experienced slightly increased blood sugar and HbA1c levels.

    The researchers also measured the amount of sulforaphane in the participants’ blood and noted that the levels varied from person to person. The higher the blood concentration, however, the greater the change in the participants’ fasting blood sugar.

    Although very few of the participants experienced any negative effects after taking the broccoli sprout extracts, the authors of the study cautioned against prescribing it to patients because more testing needs to be done to understand how sulforaphane works and who would benefit most from it.

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  • Obesity can break down our protective blood brain barrier resulting in problems with learning and memory: overactivity of adenosine in obesity www.sciencedaily.com
    Brain Alzheimer's Obesity Diabetes Coffee Insulin Blood Sugar Blood-Brain Barrier Lipopolysaccharide

    Diet-induced insulin resistance caused blood vessels to become leaky which impaired blood and oxygen flow to a brain region involved in learning and memory (animal evidence).

    Obesity and insulin resistance are associated with a leaky blood-brain barrier. This new animal study found that a high-sugar combined with a high-fat diet caused shrinkage of the tight junctions between endothelial cells that make up the blood-brain barrier and actual holes in those cells.

    Obesity is known to increase toll-like receptor activation through a variety of mechanisms. One of the mechanisms is through through associated increases of circulating of lipopolysaccharide. Another mechanism is the leaking of fatty acids from fatty acids, triggering toll-like receptors through the recognition of damage-associated molecular patterns (DAMPs). (See “obesity” section of toll-like receptor article.)

    Furthermore, LPS challenge in animal studies induces microglia in the brain to attack and damage the blood-brain barrier.

    Blocking adenosine may play a role in preventing impairment of the blood-brain barrier by diet-induced obesity

    However, adenosine, which helps us sleep and helps regulate our blood pressure and is blocked by caffeine may play a role in preventing some of the damaging effects obesity has on the blood-brain barrier, which promotes dementia.

    From the article:

    They knew that chronic activation of the receptor Adora2a [an adenosine receptor] on the endothelial cells that line this important barrier in our brain can let factors from the blood enter the brain and affect the function of our neurons.

    Now Medical College of Georgia scientists have shown that when they block Adora2a in a model of diet-induced obesity, this important barrier function is maintained.

    […]

    In the brain, adenosine is a neurotransmitter that helps us sleep and helps regulate our blood pressure; in the body it’s also a component of the cell fuel adenosine triphosphate, or ATP. Adenosine also activates receptors Adora1a and Adora2a on endothelial cells, which normally supports healthy relationships between brain activity and blood flow.

    Problems arise with chronic activation, particularly in the brain, which is what happens with obesity, says Stranahan.

    People who have obesity and diabetes have higher rates of cognitive impairment as they age and most of the related structural changes are in the hippocampus, a center of learning and memory and Stranahan’s focus of study. Fat is a source of inflammation and there is evidence that reducing chronic inflammation in the brain helps prevent obesity-related memory loss.

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  • Long-term reduction in hyperglycemia in advanced type 1 diabetes: the value of induced aerobic glycolysis with BCG vaccinations www.nature.com
    Diabetes Blood Sugar Aerobic Autoimmunity

    Mycobacterium are among the oldest co-evolutionary partners of humans. The attenuated Mycobacterium bovis Bacillus Calmette Guérin (BCG) strain has been administered globally for 100 years as a vaccine against tuberculosis. BCG also shows promise as treatment for numerous inflammatory and autoimmune diseases. Here, we report on a randomized 8-year long prospective examination of type 1 diabetic subjects with long-term disease who received two doses of the BCG vaccine. After year 3, BCG lowered hemoglobin A1c to near normal levels for the next 5 years. The BCG impact on blood sugars appeared to be driven by a novel systemic and blood sugar lowering mechanism in diabetes. We observe a systemic shift in glucose metabolism from oxidative phosphorylation to aerobic glycolysis, a state of high glucose utilization. Confirmation is gained by metabolomics, mRNAseq, and functional assays of cellular glucose uptake after BCG vaccinations. To prove BCG could induce a systemic change to promote accelerated glucose utilization and impact blood sugars, murine data demonstrated reduced blood sugars and aerobic induction in non-autoimmune mice made chemically diabetic. BCG via epigenetics also resets six central T-regulatory genes for genetic re-programming of tolerance. These findings set the stage for further testing of a known safe vaccine therapy for improved blood sugar control through changes in metabolism and durability with epigenetic changes even in advanced Type 1 diabetes.

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  • Type 1 Diabetes Diets and Excercise
    Exercise Diabetes Blood Sugar

    Hey everyone,

    I am a type 1 diabetic in my early 20’s and wanted to reach out to this community for any helpful info on type 1 nutrition and exercise. A few months ago I had an epiphany and realized it was time to get on top of my health. Over the past few months I have lost almost 30 pounds now only weighing 190, and getting my HbA1c to 7. While there is always conversations about type 2 diabetes, the same cannot be said for type 1. Specifically I want to know how excercise effects blood sugar in T1’s. For my whole life my blood sugar has always gone extremely low during workouts. Know I often find my blood sugar raising after workouts.
    I am also curious what diets/lifestyles you all think would be most successful for type 1’s. I have followed a fairly low carb diet and cut out breads and refined sugars. I have really tried to intermitten fast, but it can be difficult due to low blood sugars. Any other tips and suggestions would be fantastic. Thanks, Jacob

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  • How Air Pollution Causes Diabetes - The Atlantic www.theatlantic.com
    Diabetes Pollution

    The particles examined in this study are known as PM2.5, or particulate matter that’s 2.5 micrometers big—30 times smaller than a human hair. They are emitted by various types of industry and fuel burning, but in the United States, the biggest source of PM2.5 is cars, says Ziyad Al-Aly, the study’s senior author and an assistant professor of medicine at Washington University at St. Louis. When there’s lots of PM2.5 in the air, the air might look smoggy or hazy. In lighter concentrations, the particles are invisible.

    The study, published in The Lancet Planetary Health, linked data from 1.7 million American veterans who had been followed for a median of 8.5 years with air data from the EPA and NASA. It also aggregated past international research on diabetes and air pollution to devise a model to estimate diabetes risk based on the level of pollution, and it used the Global Burden of Disease study to estimate how many years of healthy life were lost due to this air-pollution-induced diabetes. Globally, 8.2 million years of healthy life were lost in 2016 to pollution-linked diabetes, it showed.

    https://www.thelancet.com/journals/lanpla/article/PIIS2542-5196(18)30140-2/fulltext

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  • Exercise causes acute elevation of IL-6 which reduces postprandial blood glucose levels and insulin secretion by delaying gastric emptying. www.cell.com
    Exercise Diabetes Inflammation Insulin IL-6

    Exercise causes acute elevation of IL-6 which reduces postprandial blood glucose levels and insulin secretion by delaying gastric emptying in men with type 2 diabetes.

    IL-6 is a cytokine with both negative and positive effects. Chronic elevation of IL-6 reflects ongoing inflammation and is linked to type 2 diabetes and atherosclerosis. In contrast, acute elevation of IL-6 from exercise inhibits inflammatory cytokines and stimulates the production of anti-inflammatory cytokines in humans.

    To learn more about the role of exercise-induced IL-6, the postprandial inflammatory response and their effects on the brain…check out my interview with Dr. Charles Raison. This episode has a timeline, transcript, summary, and glossary to help find and understand the talking points.

    Charles Raison, MD podcast: https://www.foundmyfitness.com/episodes/charles-raison

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  • Type 2 diabetics given broccoli sprout extract containing 150 μmol sulforaphane for 12 weeks lowered blood glucose levels by 10% compared to placebo. www.newscientist.com
    Diet Diabetes Insulin Resistance Sulforaphane Insulin NRF2 Metformin

    Broccoli sprout extract reduced HbA1c by 7.04% in obese patients with dysregulated type 2 diabetes. It has been demonstrated that a 1% decrease of HbA1c corresponds to 37% reduced risk of microvascular complications.

    Sulforaphane reduces glucose by suppressing liver enzymes that otherwise stimulate the production of glucose.

    In animals, sulforaphane also attenuated exaggerated glucose production and glucose intolerance by a magnitude similar to that of metformin.

    Further investigations showed that while both metformin and sulphoraphane cut blood glucose, they do it in different ways. Metformin makes cells more sensitive to insulin, so they sponge more surplus glucose out of the bloodstream. Sulphoraphane reduces glucose by suppressing liver enzymes that otherwise stimulate the production of glucose. For this reason, Rosengren thinks the broccoli extract is complementary to metformin, not competitive."

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  • Unraveling Alzheimer’s: Making Sense of the Relationship between Diabetes and Alzheimer’s Disease1 www.drperlmutter.com
    Alzheimer's Diabetes Insulin Resistance Insulin

    Abstract. Numerous studies have documented a strong association between diabetes and Alzheimer’s disease (AD). The nature of the relationship, however, has remained a puzzle, in part because of seemingly incongruent findings. For example, some studies have concluded that insulin deficiency is primarily at fault, suggesting that intranasal insulin or inhibiting the insulin-degrading enzyme (IDE) could be beneficial. Other research has concluded that hyperinsulinemia is to blame, which implies that intranasal insulin or the inhibition of IDE would exacerbate the disease. Such antithetical conclusions pose a serious obstacle to making progress on treatments. However, careful integration of multiple strands of research, with attention to the methods used in different studies, makes it possible to disentangle the research on AD. This integration suggests that there is an important relationship between insulin, IDE, and AD that yields multiple pathways to AD depending on the where deficiency or excess in the cycle occurs. I review evidence for each of these pathways here. The results suggest that avoiding excess insulin, and supporting robust IDE levels, could be important ways of preventing and lessening the impact of AD. I also describe what further tests need to be conducted to verify the arguments made in the paper, and their implications for treating AD

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