I couldn’t find any big breakthroughs this week, but there is plenty of news about less splashy research in every aspect of diabetes.
Not Just Glucose: The Role of Weight Loss in Managing T2D
Excess body weight is considered a key modifiable risk factor for type 2 diabetes, with 90% of people with diabetes classified as overweight or obese. Studies have shown that about 5% weight loss may favorably affect plasma glucose concentration and A1c, and 10% weight loss can lead to diabetes remission in approximately 50% of patients.
Ah, a target I can aim at. Excellent. I’ll let you know how that goes.
tirzepatide
C-peptide and metabolic outcomes in trials of disease modifying therapy in new-onset type 1 diabetes: an individual participant meta-analysis
Metabolic outcomes in type 1 diabetes remain suboptimal. Disease modifying therapy to prevent β-cell loss presents an alternative treatment framework but the effect on metabolic outcomes is unclear. We, therefore, aimed to define the relationship between insulin C-peptide as a marker of β-cell function and metabolic outcomes in new-onset type 1 diabetes.
6 months after treatment, a 24·8% greater C-peptide preservation in positive studies was associated with a 0·55% lower HbA1c (p<0·0001), with differences being detectable as early as 3 months. Cross-sectional analysis, combining positive and negative studies, was consistent with this proportionality: a 55% improvement in C-peptide preservation was associated with 0·64% lower HbA1c (p<0·0001). Higher initial C-peptide levels and greater preservation were associated with greater improvement in HbA1c.
FDA Approves New Type 2 Diabetes Drug Bexagliflozin
The US Food and Drug Administration (FDA) has approved bexagliflozin (Brenzavvy, TheracosBio) for the treatment of adults with type 2 diabetes.
The once-daily 20-mg oral sodium-glucose cotransporter 2 (SGLT2) inhibitor is indicated as an adjunct to diet and exercise to improve glycemic control for those with type 2 diabetes, but not type 1 diabetes. It can be used in adults with an estimated glomerular filtration rate (eGFR) > 30 mL/min/1.73m2.
Approval was based on results from 23 clinical trials with over 5000 participants, including more than 300 patients with stage 3 kidney disease (eGFR < 60 and > 30 mL/min/1.73 m2).
In the phase 3 studies, bexagliflozin significantly reduced A1c and fasting blood glucose at 24 weeks as monotherapy or as add-on to metformin and other glucose-lowering drugs and combinations. It also produced modest reductions in body weight and systolic blood pressure.
New Marker of Cardiovascular Risk Discovered in T2D
A significant quantity of dysfunctional monocytes appears to indicate poor cardiovascular prognosis in patients with type 2 diabetes.
"Predicting these complications in diabetic patients is usually very difficult," Venteclef told the Medscape French edition.
"They are strongly associated with inflammation in these patients. Therefore, we sought to quantify this inflammation in the blood." To do this, his team focused on monocytes, a category of white blood cells circulating in the blood. They measured the blood concentration of monocytes and the subtypes present in patients with type 2 diabetes. "These monocytes are dysfunctional because they have a mitochondrial problem," Venteclef explained.
Special Diabetes Program: Clinical Trials Recruiting Patients & Families
Can a Twice-Daily Pill Delay Progression of Type 1 Diabetes?
A U.S. clinical trial is recruiting adolescents and adults between the ages of 14 and 45 with recently diagnosed type 1 diabetes to evaluate the effectiveness of ladarixin, a treatment that may preserve beta-cell function and delay the progression of type 1 diabetes. The study will also evaluate the drug’s safety.
Identification of Senescence-Associated Biomarkers in Diabetic Glomerulopathy Using Integrated Bioinformatics Analysis
Cellular senescence is thought to play a significant role in the onset and development of diabetic nephropathy. Hub senescence-associated genes were investigated by differential gene analysis and Least Absolute Shrinkage and Selection Operator analysis. Cluster analysis was employed to identify senescence molecular subtypes. The relationship between these genes and the glomerular filtration rate was explored based on the Nephroseq database.
Twelve representative senescence-associated genes (VEGFA, IQGAP2, JUN, PLAT, ETS2, ANG, MMP14, VEGFC, SERPINE2, CXCR2, PTGES, and EGF) were finally identified. Biological changes in immune inflammatory response, cell cycle regulation, metabolic regulation, and immune microenvironment have been observed across different molecular subtypes. Almost all these genes could well predict the occurrence of diabetic glomerulopathy based on receiver operating characteristic analysis and are associated with the glomerular filtration rate. These genes are differently expressed in various kidney diseases.
Identification of the Relationship between Hub Genes and Immune Cell Infiltration in Vascular Endothelial Cells of Proliferative Diabetic Retinopathy Using Bioinformatics Methods
Diabetic retinopathy (DR) is a serious ophthalmopathy that causes blindness, especially in the proliferative stage. [proliferative diabetic retinopathy (PDR)] However, the pathogenesis of its effect on endothelial cells, especially its relationship with immune cell infiltration, remains unclear.
We unearthed the DEGs [differentially expressed genes] and Hub genes of endothelial cells related to the pathogenesis of PDR: EEF1A1, RPL11, and RPS27A, which are highly related to each other and participate in the specific biological process of inflammation-related immune cell infiltration and endothelial cell development, chemotaxis, and proliferation, thus providing new perspectives into the diagnosis of and potential “killing two birds with one stone” targeted therapy for PDR.
Bioinformatic analysis of retinal gene function and expression in diabetic rats
Diabetic retinopathy (DR) is a microvascular complication and is the most common cause of vision impairment and blindness among adults aged 20–74 years.
The aim of the present study was to investigate the changes in retinal gene expression at three time points and assess the underlying molecular mechanisms of diabetic retinopathy (DR) in a streptozotocin (STZ)-induced diabetes rat model.
DEGs at 4 weeks were primarily enriched in retinol metabolism. This may provide a scientific basis for the diagnosis and treatment of DR because DEGs may be used to facilitate the development of novel therapeutic strategies to diagnose and treat DR.
Can a Plant-Based Diet Lower Type 2 Diabetes Risk?
Personal Notes
I have started drinking lots of green tea.
Diabetes: Studies of Green Tea
My appetite is significantly reduced, but it’s too soon to say if I am losing weight.
I am off Ozempic, and I am taking insulin injections only when my glucose spikes, a few times a week. I am still on glipizide twice a day.
When my glucose goes low, I can take glucose tabs and eat various carbs, including steel-cut oat porridge, in measured amounts. A rice bowl of porridge. One or maybe two slices of bread. A bit of fruit. Cookies. Dark chocolate drops, just a few at a time. Candied ginger. I can heartily recommend a slice of ginger with a ginger snap.
The one sore on my butt is still healing, with no scab and no pain any more. Waffle cushions are wonderful. So are getting up and moving around, and various forms of exercise.
And how are you?