BASEL, Switzerland, May 2, 2022 /PRNewswire/ -- Ascensia Diabetes Care, a global diabetes care company, maker of CONTOUR blood glucose monitoring (BGM) system portfolio and distributor of the Eversense continuous glucose monitoring (CGM) system, announces a new study demonstrating that people who use the connected CONTOUR BGM systems (BGMS) and CONTOURDIABETES App (CDA) for at least six months can see a reduced frequency of hypoglycaemic and hyperglycaemic blood glucose readings (BGRs). BGRs in these out-of-target ranges can lead to serious health complications, suggesting a key benefit of using Ascensia's connected CONTOUR BGMS and CDA together (the CDA system). Real-world data from this study were presented at the International Conference on Advanced Technologies & Treatments for Diabetes (ATTD) 2022.

The study, which assessed data from 7,047 CDA system users in Australia, demonstrated a reduction in frequency of BGRs within both hypoglycaemic (low) and hyperglycaemic (high) ranges.After six months, the estimated frequency of BGRs in high and very high ranges in people using the CDA system fell by more than 6.5-times and 5.6-times, respectively, compared to baseline.This decrease was more prominent among users who reported the use of oral antidiabetic medications, at 7.37-times less than baseline.The decrease of BGRs in the low range was modest at 1.2-times in the entire assessed population, and at 1.38-times in CDA system users who were treated with insulin and are more prone to hypoglycaemic events. These data suggest improved glycaemic control when using the CDA system for at least six months and, more generally, a key benefit in using connected BGMS, including apps, to support the management of diabetes.

The majority of CDA system users in the assessed group were people with type 2 diabetes (66.9%), for whom improvement of glycaemic control is associated with the reduced progression of diabetes-related complications[1]. As diabetes apps continue to permeate clinical care, these findings offer the potential to explore how connected BGMS with visibility and accessibility of blood glucose readings can support self-management for people with type 1 and type 2 diabetes.

Frank Held, Head BGM Marketing and Strategy at Ascensia Diabetes Care, said: "We're pleased to see results from the study showcasing that our CDA system is helping people with diabetes to manage their condition. While many diabetes apps support people with diabetes in managing their condition, they don't all provide alerts or guidance for hypoglycaemic or hyperglycaemic events, like theCONTOURDIABETES App does. Failure to properly address these events can result in serious health complications, so it is crucial that monitoring systems and connected apps facilitate the detection of high and low blood glucose levels."

Before this study, there were limited data assessing the impact of diabetes apps in Australia, particularly in a 'real world' setting. In addition, while evidence suggests that there are hundreds of diabetes apps that support people with diabetes in managing their blood glucose, only a third of these apps have alerts or guidance for hypoglycaemic and or hyperglycaemic events[2]. If these events are not addressed, they can become severe and lead to serious complications[3], so it is of utmost importance that monitoring tools help people with diabetes to manage these events.

The poster featuring this research, titled 'Assessment of Blood Glucose Readings of People with Diabetes in Australia who were using the connected CONTOURBGMS and CONTOURDIABETES App,' was presented from a study led by Wendy Mak PhD, Scott Pardo PhD, PStat, and Rimma Shaginian, MD, MPH. ATTD 2022 took place in Barcelona, Spain from April 27-30, 2022.

1.Stratton, IM, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPD 35); prospective observational study. BMJ 2000; 321: 205-412.

2.Lum E, Jimenez G, Huang Z et al (2019) Decision support and alerts of apps for self-management of blood glucose for type 2 diabetes. JAMA 321(15):1530 15301532. https://doi.org/10.1001/jama.2019.1644.

3.Mayo Clinic. 2022. Hyperglycemia in diabetes - Symptoms and causes. [online] Available at: https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631 [Accessed April 2022].

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ASCENSIA DIABETES CARE PRESENTS NEW RESEARCH SHOWING THAT PEOPLE USING THE CONTOUR BLOOD GLUCOSE MONITORING SYSTEM AND APP EXPERIENCE FEWER...

By Will Atwater

Eastern North Carolina has some of the highest rates of diabetes in the state.

There are two forms of diabetes type 1 and type 2. Type 1 diabetes is a genetic disorder in which the immune system destroys insulin producing cells needed to regulate blood sugar levels. Type 2 diabetes occurs when the body is unable to produce enough insulin to regulate blood sugar levels. Factors associated with type 2 diabetes include diet, exercise and environment.

In 2020, the U.S. diabetes average was 10.6 percent, while the North Carolina average was 12.4 percent, according to American Health Rankings 2021 Annual Report. During this same period, the annual County Health Rankings report noted that Columbus County recorded a 19 percent diabetes rate, Pender County was at 15 percent and Brunswick showed a rate of 14 percent. These counties are a part of the lower Cape Fear River Basin.

Thats why its worrisome that a recent study suggests that middle-aged women exposed to forever chemicals may be at a higher risk of contracting the disease.

Those forever chemicals are per- and polyfluoroalkyl substances (PFAS). Theyre a family of synthetic chemicals that includes more than 4,700 substances, none of which are federally regulated. Theyve been a subject of scrutiny in eastern North Carolina since 2017, when researchers found that the Chemours chemical facility near Fayetteville had been dumping one of the PFAS chemicals known as GenX into the Cape Fear River for decades.

A key point in the findings, published in the journal Diabetologia, is that women who were exposed to a mixture of per- and polyfluoroalkyl substances (PFAS) are at a higher risk of developing diabetes than the women who were exposed to only one of the chemicals.

The studys authors wrote that this finding suggested, a synergistic effect of multiple PFAS on diabetes risk.

Based at the University of Michigan, the researchers tracked a mixed race group of 1,237 women with a median age of 49.4. They followed them for 17 years, from the turn of the century until 2017. Four out of five of the women had at least some college education.

The researchers found that of the overall group studied, Black women who were less educated, less physically active, had a larger energy intake and higher BMI at baseline, were more likely to develop diabetes than the other participants.

PFAS have been manufactured and used by industries worldwide since the 1940s, used in everything from Teflon pans to raincoats to dental floss. They are also used in firefighting foams.

The two most extensively produced and studied, PFOA and PFOS, have been phased out in the U.S., but they dont break down easily and can accumulate in the environment and in human bodies, hence the moniker forever chemicals. There is a growing body of evidence that exposure to PFAS can lead to adverse human health effects.

Although all the health effects of PFAS are still not completely clear, the Centers for Disease Control and Prevention says they are believed to impact the immune system and may reduce antibody responses to vaccines, including those for COVID-19.

Additionally, studies on laboratory animals have found a link between PFAS and liver, kidney, testicular, pancreas and thyroid cancer. Studies also suggest that PFAS can cause high cholesterol, pregnancy problems and immune suppression.

The studys researchers suspect that the molecular structures of different PFAS mimic naturally occurring fatty acids. Those fatty acids trigger receptors in the bodys cells that are sensitive to fat and insulin and control the formation and development of fat cells. Those receptors also exercise control of the bodys fat and blood sugar levels.

If PFAS chemicals are fooling the fat and insulin receptors in cells, that could disrupt their behavior and suggest a possible way that these substances affect diabetes risk.

In other words, there may be environmental factors beyond ones ability to control diet and exercise, for instance, that contribute to diabetes risk factors, the research suggests.

The Lower Cape Fear River Basin, which provides drinking water to Columbus, Pender and Brunswick counties, among others, is contaminated with a class of PFAS known as GenX.

There are more than 257,000 people living in these three counties, which have diabetes rates of 19 percent, 15 percent and 14 percent respectively. In contrast, the states two largest counties, Mecklenburg and Wake, have diabetes rates of 8 percent and 9 percent respectively.

The study may offer insights into certain public health issues in this region.

North Carolina State University epidemiologist Jane Hoppin believes the study though started several years before North Carolina began tracking PFAS has overlap with respect to certain legacy chemicals and is worth attention.

While this is a [study] with older samples, it could be particularly relevant to people in North Carolina because our levels [of exposure] 22 years later, are like this general population sample [from] 20 years ago, she said.

Donald A. McClain, an endocrinologist at Wake Forest University School of Medicine, says that while the Michigan study is compelling, there are likely several other factors that contribute to a diabetes diagnosis, including diet, genetic disposition and environmental factors.

On the other hand, McClain acknowledged this study contributes to a growing body of research that points to the negative effects of human exposure to forever chemicals. He believes it is not too soon to act.

I would not be sad if the political and social response to this [study] was maybe even a little bit ahead of science, he said. If Im suddenly 75 percent sure, do I want to wait 10 years and be 99 percent sure?

And after 10 years, how many people have [been harmed]?

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North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org. (on the web, this can be hyperlinked)

by Will Atwater, North Carolina Health News April 26, 2022

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.

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Possible link between PFAS and diabetes in women - NC Health News - North Carolina Health News

Katrina Donahue, MD, MPH, and Laura Young, MD, PhD, received a grant from the National Institute of Health to increase uptake of diabetes self-management education. The study will focus on two factors: provider and diabetes care and education specialist engagement with patients, and patient peer support.

According to the Centers for Disease Control, over 37.3 million people live with diabetes. The challenges, costs, and complications of living with diabetes can be minimized with proper education. Diabetes Self-Management Education and Support (DSMES) is well known to help persons with diabetes learn to cope with the uncertainties of life with diabetes, yet unfortunately is underutilized in our current health care setting. To address this concern, UNC School of Medicine faculty Katrina Donahue, MD, MPH, and Laura Young, MD, PhD, received a grant from the National Institute of Health to increase uptake of diabetes self-management education.

The study will focus on two barriers to DSMES:

Given the critical importance of self-management to diabetes success and the demonstrated value of DSMES class completion on diabetes outcomes, efforts to increase DSMES use have great potential to reduce the burden of this disease on individuals, states Donahue, faculty in the Department of Family Medicine.

Young, faculty in the Department of Medicine, adds, Making the referral process easy for providers by making it part of their workflow will help make sure patients who live with diabetes get standardized education, and peer support will inspire patients to actively participate.

To our knowledge, this will be the first effectiveness trial of Peer Support in relation to engaging and retaining patients in DSME. We are testing it within primary care clinics, the setting in which most persons with diabetes receive their care, claims Donahue.

I am excited to test out stakeholder informed, team-based population health approaches to further support people with diabetes, states co-investigator Jacquie Halladay, MD, MPH. The studys stakeholders are all a part of the North Carolina Network Consortium (NCNC), a diverse statewide consortium of providers, academic institutions, and patients that work to address pressing questions related to the delivery of primary care health services and the management of primary care problems. NCNC is funded by the NC TraCS Institute, whose data team researchers will work.

With the data gathered from this study, researchers intend to build a larger multi-site study with hopes that engaging providers and educators directly, teamed with peer-support services, will provide a blueprint for diabetes treatment moving forward. As Donahue explains, DSMES has the potential to improve diabetes outcomes significantly, but only to the degree that physician and patient barriers can be overcome.

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Donahue, Young Awarded NIH Grant to Study Diabetes Self-Management Education and Support | Newsroom - UNC Health and UNC School of Medicine

If you are a diabetes patient, then your cup (literally) has to be filled with conscious choices of beverages that do not affect your blood sugar levels. Therefore, you have to always steer clear of sugary drinks, caffeinated concoctions, certain fruit juices and even syrups. However, do you know if teas should be in your diet and how might they impact your health?

While not all teas are good for you, there are a few which may be able to help your health, and keep your diabetes under control. Heres a list of four such teas that you must embrace (with your doctors permission ofcourse) and add some flavour (and colour) to your life, without disturbing the delicate balance of sugar in your blood.

Hibiscus Tea

Black Tea While you cannot dream of adding sugar to your tea if you have diabetes, you can continue to have your English Breakfast or Earl Grey without any worry. These teas fall in the category of black tea which is considered to be good for diabetic patients because it has blood sugar lowering qualities. It is also rich in antioxidants and can reduce the blood sugar in pre-diabetic individuals. According to a study conducted in Thailand, it was found that black tea is a promising anti-diabetic tea which can control the glycemic levels.

Chamomile TeaApart from promoting a good nights sleep, this tea is great for the overall well being of diabetic patients. It not only regulates blood sugar level, but also helps in reducing oxidative stress, which leads to several diabetes related complications. Studies have shown that it also reduces HbA1c and insulin levels in diabetic patients.

Cinnamon TeaCinnamon is a versatile spice and has many uses, but cinnamon tea or any other cinnamon infused drinks are also not devoid of benefits. Studies show that having this tea before taking in sugar solutions, decreases blood sugar levels. According to another study, 6 grams of a cinnamon supplement daily for 40 days is likely to reduce pre-meal glucose levels in non-diabetic patients too. This spice is said to slow down the release of glucose in the blood stream improving cellular glucose, and insulin sensitivity.

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Not all beverages are bad for diabetes patients. Hibiscus tea, cinnamon drinks keep blood sugar in check - Economic Times

People who have been diagnosed with COVID-19 may be at a higher risk of developing the autoimmune disease Type 1 diabetes, according to a study of more than 27 million people across the United States.

Researchers found that patients who were infected with SARS-CoV-2, the coronavirus that causes COVID-19, were 42% more likely to develop Type 1 diabetes than those who did not contract COVID-19 during the study period.

The risk is highest among the youngest of pediatric patients (those under the age of 1 were at an increased risk of 584%) and elevated among older adult patients with COVID-19. The researchers also observed differences across race and ethnicity, with risk of Type 1 diabetes associated with a COVID-19 infection being most pronounced among American Indian/Alaskan Native (130% increased risk), Asian/Pacific Islander (101%), and Black patients (59%).

Trenton Honda, clinical professor and associate dean in the Bouv College of Health Sciences at Northeastern University

Particularly in pediatric populations, [COVID-19] is not usually a life-threatening, oftentimes not serious, condition. But Type 1 diabetes is usually a lifetime illness that requires dramatic amounts of contact with the medical community, increases your risk of death, increases your risk of long-term comorbidity, says Trenton Honda, clinical professor and associate dean in Northeasterns Bouv College of Health Sciences, and a member of the research team led by Fares Qeadan at Loyola University Chicago.

Our interest is really looking at the question, Are there going to be hidden costs, even among those who are not at high risk from COVID itself, because of COVID, later on? Honda says.

The scientists also probed whether patients who had Type 1 diabetes before contracting COVID-19 were more likely to suffer a serious, life-threatening complication called diabetic ketoacidosis after being infected with the virus. They found that those patients who had Type 1 diabetes and then were infected had a 126% increased risk of developing diabetic ketoacidosis compared to those who did not get infected. Their results were published in the journal PLOS One earlier this month.

Honda uses the word association when referring to the increased risk, careful not to say that a COVID-19 infection causes Type 1 diabetes onset.

We are the first study in the U.S. population in a really, really big national dataset to be able to say that people who got COVID appear to be at higher risk of developing Type 1 diabetes, although were not able to say that COVID caused that increased risk. It could be any number of things, he says. To establish that causal connection, Honda says, researchers would need to do a randomized controlled trial. Instead, the team looked at the anonymized data of more than 27 million people who came into contact with hospital medical care across the U.S. from December 2019 through the end of July 2021.

Theres other evidence that links COVID-19 infection to increased risk of being diagnosed with Type 1 diabetes. SARS-CoV-2 is not the first virus to be associated with an increased risk of Type 1 diabetes onset. It has also been linked to several viral infections such as mumps, rubella, cytomegalovirus, and Epstien-Barr virus.

It all comes down to the pancreas.

All of the cells in your body rely on sugar (glucose) for fuel, Honda explains. But some cells require prompting by a hormone called insulin in order to absorb glucose from the blood. Insulin is produced by the pancreas in response to changes in blood sugar.

Type 2 diabetes is typically an issue of insulin resistance developing in those cells that require it. But Type 1 diabetes is an autoimmune disease, Honda explains. Essentially your body produces antibodies and immune cells that go in and destroy the cells that produce insulin. So you end up with this precipitously low insulin level over time. And what that means is that the cells in our body that need insulin to get sugar into them stop using sugar and they start using fats. And by doing so, they change the entire metabolism of the body and institute an acidotic state that ultimately is fatal.

Before what Honda calls one of the greatest moments in all of medical history when insulin was purified from pigs, Type 1 diabetes was a death sentence. Now, its a lifelong disease that is survivable with glucose monitoring and insulin injections.

With other viruses, scientists think that the way the virus invades the cells in the pancreas causes them to spontaneously die, Honda explains. And when they die, the immune system mobilizes to destroy those dead cells. The idea, he says, is that this might foster the development of an autoimmune response to those cellsand it could get out of control and continue attacking those vital insulin-producing cells in the pancreas.

This is the way that other viruses are presumed to lead to Type 1 diabetes, Honda says. So thats the logic behind this study.

This study focused on COVID-19 cases in the absence of vaccines. Honda says the next big question is to determine whether immunization against SARS-CoV-2 is linked to any further or minimized risk of Type 1 diabetes.

The research team also aims to study associations between 40 other autoimmune diseases and COVID-19 infections.

If we think about just the burden of disease that COVID causes, its quite possible that the immediate disease is going to have a much, much smaller impact, particularly on people who are at low risk from the disease itself, Honda says. And we might end up with a huge number of lifelong disorders that developfrom the exposure to COVID.

For media inquiries, please contact Marirose Sartoretto at m.sartoretto@northeastern.edu or 617-373-5718.

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Study finds link between COVID-19 infections and Type 1 diabetes - Northeastern University

Abbott, CamDiab and Ypsomed Unveil New Automated Insulin Delivery Partnership for People with Diabetes

BARCELONA, Spain, April 27, 2022 /PRNewswire/ -- Abbott (NYSE: ABT), CamDiab and Ypsomed today announced that they are partnering to develop and commercialize an integrated automated insulin delivery (AID) system to help lessen the burden of round-the-clock diabetes management for people with diabetes. The initial focus of the partnership will be in European countries.

The new integrated AID system is being designed to connect Abbott's FreeStyle Libre 3 sensor, the world's smallest1 and most accurate2,3 continuous glucose monitoring sensor with readings every minute, to CamDiab's CamAPS FX mobile app, which connects with Ypsomed's mylife YpsoPump creating a smart, automated process to deliver insulin based on real-time glucose data. The connected, smart wearable solution is designed to continuously monitor a person's glucose levels and automatically adjust and deliver the right amount of insulin at the right time, removing the guesswork of insulin dosing.

"Our goal is to make diabetes care as easy as possible, which is why Abbott continues to expand its team of insulin delivery partners, digital coaching and technology leaders," said Jared Watkin, senior vice president of Abbott's diabetes care business. "We want to deliver new advanced solutions that simplify and make it possible for people to spend less time thinking about diabetes and more time living."

"Poor glucose control leads to an increased risk of diabetes complications such as blindness, and heart and kidney disease. We want to help people with diabetes better manage their glucose through advanced technology. Our CamAPS FX, already approved in Europe, is a highly adaptive algorithm that when integrated with Abbott's sensor is being designed to communicate with Ypsomed's insulin pump to provide the optimal insulin dose, lifting the burden of managing a condition that is relentlessly unpredictable day and night," said Roman Hovorka, director of CamDiab Ltd.

"We are convinced that major challenges of society can only be addressed through partnerships. We are therefore proud to expand our partners and connectivity to offer more freedom of choice in managing diabetes. When combined our mylifeYpsoPump with the FreeStyleLibre 3 system and CamAPS FX advanced adaptive hybrid closed-loop app, we will be able to deliver an additional compact and lightweight AID system that is discreet and simple to use," said Simon Michel, chief executive officer of Ypsomed.

The companies intend to complete development by end of 2022 with commercial availability expected thereafter.

About AbbottAbbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 113,000 colleagues serve people in more than 160 countries.

Connect with us at http://www.abbott.com, on LinkedIn at http://www.linkedin.com/company/abbott-/, on Facebook at http://www.facebook.com/Abbott and on Twitter @AbbottNews.

About CamDiabCamDiab Ltd is a digital health and personalized medicine company focused on the design, development, and commercialization of its world leading, interoperable CamAPS FX closed loop app. The CamAPS FX is designed to use adaptive, self-learning control algorithm, linked to a compatible continuous glucose monitoring device and a compatible insulin pump, to autonomously compute and direct insulin delivery to maintain tight glycaemic control. Since its founding in 2019, its mission has been to help people with type 1 diabetes and their families live better lives. For further information, visit http://www.camdiab.com or follow CamDiab Ltd and its products on Facebook, LinkedIn, and Twitter @CamAPS_FX.

About YpsomedYpsomed is the leading developer and manufacturer of injection and infusion systems for self-medication and a renowned diabetes specialist with over 35 years' experience. As a leader in innovation and technology, it is a preferred partner of pharmaceutical and biotech companies for pens, autoinjectors, pump systems and software solutions for administering liquid medications. Ypsomed presents and markets its product portfolios under the umbrella brands mylifeDiabetescare directly to patients or via pharmacies and hospitals as well as under YDSYpsomed Delivery Systems in business-to-business operations with pharmaceutical companies. The company is headquartered in Burgdorf, Switzerland, and has a global network of production facilities, subsidiaries and distribution partners employing a staff of around 1,900 employees worldwide. http://www.ypsomed.com

1 Among patient-applied sensors. Data on file, Abbott Diabetes Care.2 FreeStyle Libre 3 User Manual.3 Data on file. Abbott Diabetes Care, Inc. Comparison based on publicly available information.

SOURCE Abbott

For further information: Abbott Media: Anita de Groot, anita.degroot@abbott.com, +31 (0)88 82 22 643, Samantha Thai, samantha.thai@abbott.com, +1 510-239-2765, Abbott Financial: Mike Comilla, mike.comilla@abbott.com, +1 202-213-5129, Ypsomed Media: Thomas Kutt, thomas.kutt@ypsomed.com, +41 34 424 35 55

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Abbott, CamDiab and Ypsomed Unveil New Automated Insulin Delivery Partnership for People with Diabetes - Press Releases

Seattles Benaroya Research Institute (BRI) has landed $17.1 million in funding to assess why respiratory infections hit some people particularly hard, to explore new ways of treating type 1 diabetes, and other efforts.

The institution announced the funding, from the U.S. National Institutes of Health, on Thursday.

The study of respiratory infections will be powered with a $11.4 million grant for five years. Researchers will assess why children with asthma, allergies or obesity are particularly vulnerable to severe respiratory infections. They will also ask why adults with chronic inflammatory or autoimmune diseases are at increased risk of severe effects from such infections.

BRI investigators Carmen Mikacenic andMatt Altman will lead the multi-institution study, which will profile how patients respond to infection at the molecular and cellular level. Questions include which immune cells are activated, and how proteins, genes and other cellular molecules respond to infection.

Ultimately, researchers may be able to correlate such information with clinical outcomes and identify potential therapies. They will share their data with the Human Immunology Project Consortium, a network of researchers characterizing the immune system.

This research will help contribute to a baseline understanding of how the immune system responds to infection in these understudied populations, said Mikacenic in a press release.

A second, $3.9 million grant, will use human cells and mouse models to investigate new ways to treat type 1 diabetes, which results from autoimmune destruction of insulin-producing cells in the pancreas. Researchers will engineer protective regulatory T cells to target the insulin-producing cells, preventing their destruction and promoting their health.

The four-year diabetes project will be led by BRI researchers Eddie James and Jane Buckner, who is the institutions president, as well as Seattle Childrens Research Institute researcher David Rawlings. Rawlings is a co-founder of preclinical biotech company Gentibio, which is also developing regulatory T cell therapies for type 1 diabetes and other autoimmune and inflammatory conditions.

The new studies will take the approach further, targeting the pancreatic cells only when they are stressed, and delivering molecular cargo directly into them support their health.

We aim to uncover ways to promote healthy islet function and protection, said Buckner in the press release, referring to groups of insulin producing cells.

Four other BRI projects received about $475,000 each from the NIH, including studies on multiple sclerosis, autoimmunity, Crohns disease, and lung fibrosis in COVID-19. BRI is known for its focus on diseases of the immune system.

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Studies on respiratory infections, type 1 diabetes, boosted with $17M to Benaroya Research Institute - GeekWire

Thiazolidinediones may change metabolic patterns and contribute to weight gain.

The likelihood of developing type 2 diabetes is increasing at an alarming rate, along with the average daily intake of simple carbohydrates. Consequently, insulin is released to counteract the surge in blood sugar; however, over time, the body grows resistant to its own insulin and blood glucose levels remain elevated.

This onset of type 2 diabetes is often treated using the class of medications known as thiazolidinediones. These compounds activate the fat cell protein peroxisome proliferator-activated receptor gamma (PPARgamma), which is endogenously existent in 2 forms, PPARgamma1 and PPARgamma2. However, they are notoriously known for changing metabolic patterns and contributing to weight gain.

In a study conducted at the Perelman School of Medicine at University of Pennsylvania, senior author Mitchell Lazar, MD, PhD and his team uncovered the differences between the downstream actions of both PPARgamma forms.1

The study involved limiting the amount of PPARgamma1 or PPARgamma2 proteins in 2 separate groups of mice to notify the significance of activating only 1 subtype.

The administration of thiazolidinediones led to anti-diabetic effects in both groups of mice, but only the group with PPARgamma1 deficiency did not gain weight.1

According to Lazar,1 in this group, the PPARgamma protein is largely present as PPARgamma2, which initiated a different downstream gene activity that did not adversely change metabolic patterns. Lazar and his team are eager to explore methods in using thiazolidinediones to selectively activate PPARgamma2 to allow anti-diabetic benefits without the risk of weight gain.

Previous studies regarding PPARgamma1 and PPARgamma2 show that PPARgamma2 is primarily present in adipose tissue to downregulate the expression of fat proteins, such as TNF-alpha, that are linked to obesity.2 A study conducted by the Royal Pharmaceutical Society indicates an increase in fatty acid reuptake and formation of high-density cholesterol following selective activation.

The subsequent decrease in free fatty acids, low density lipoprotein, and triglycerides reduce the likelihood of gaining weight that is typically associated with thiazolidinediones. Due to insulin resistivity, metabolic hormones like adiponectin and leptin are dysregulated, contributing to increased food intake and fat storage.

PPARgamma2 agonists increase selective adipocyte expression to increase secretion of adiponectin and thereby increase insulin sensitivity. As Saraf et. al outlines,2 the alteration in gene activity by PPARgamma2 activation allows for both glucose disposal and regulation of adipocyte expression in insulin-sensitive polypeptides.

A closer look at the differences between PPARgamma1 and PPARgamma2 differentiates their gene pathways; PPARgamma2 has a polymorphic Pro12Ala variant.2 This isoform is the key difference in preventing weight gain through reducing high fat-feeding and improving adipocyte metabolism.

In this way, PPARgamma2 allows for greater adipocyte regulation that is typically absent in type 2 diabetes. Selective activation of PPARgamma2 fat protein can potentially decrease adverse metabolic effects related to thiazolidinediones.

References

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Activating Protein Subtype May Lower Common Adverse Effects Associated with Thiazolidinedione Medications for Diabetes - Pharmacy Times

Tucker Pillsbury is in love. The details are none of our business, of course, but under his stage name, Role Model, he's got an awful lot to say about it.

On Role Model's first studio album, RX, there's plenty of discussion to be hadabout love, about pain, about sin, about forgiveness. And the man behind an album containing tracks like "die for my b**ch," "masturbation song" and "stripclub music" is feeling pensive about life's biggest questions.

Ahead of live shows at Coachella and the kick-off of his first world tour, Role Model sat down with Newsweek to catch us up on where he's at and where he's going.

When we're speaking, your album, RX, came out just a few days ago. How are you feeling?

I'm good. I finally got to digest it a little bit. But then we just yesterday jumped straight back into rehearsals. So now I'm like, back off my phone and playing the music live and looking forward to getting on stage again.

Are you sort of feeling disbelief about the thing being done? I know when I'm working in a creative space, there's a point at which I have to force myself to let it go. Have you reached that point? Or would you still be messing with it if you were able to?

I thought I would cry when it came out! I thought I was gonna have this emotional thing. But maybe it was because my friends all flew out here for the release and everything. And so I was like, with people the whole time, and I think I didn't really get to digest the whole thing until the next day.

But it feels incredible. I mean, it was two years in the making. And it's my first album after being signed to a label for, I don't even know, three years? So it's been more than a long time coming. And I'm happy that I waited and happy that we did it the way we did it.

Did this production feel different than your past work in some way?

For sure. I love my old music. And I love performing it of course, but I [re-]listened to those songs and I'm like... what am I even talking about? Like, there's no cohesive story or like, there's themes and stuff, but it's spill of consciousness.

Whereas when we started this album, I really wanted every song on this album to feel complete, like a complete thought, a complete story. I wanted to be so picky about every word that we put in.

So that was really good. And then also just learning how to use my voice... five-part, six-part harmonies, which I [have] never been able to do in my life. I'm not that musical.

So yeah, I hope it feels like a step up and in every way, hopefully.

You tweeted that you think this album is going to be "insane" live. It is such an intimate and personal albumat times you're whispering into the microphone. Do you change the way you think about the music when you're thinking of performing it in front of a crowd like Coachella?

100 percent. These shows, I always say it's pop music, played like rock music, performed like rap music. When you come to the shows I want the energy of a rap show.

Those lyrics that I'm whispering into the mic are now being yelled. Like, screamed. I love the energy. I love jumping around and it's hard to whisper and be like jumping up and down at the same time.

I would love to hear you talk a little bit about your influences on this record. I will say that there's one that comes to mind for me immediately, and that is Mac Miller. Particularly on "If Jesus Saves," I very much hear "Divine Feminine," that era of Mac's work.

And I know that Mac is, of course, really, really instrumental in your career. Was he on your mind? Were there other artists that you were looking to for inspiration?

I think, inevitably, Mac is always going to be an influence, even if you can't hear it in the songs. Almost every time I'm in the studio, it's one of those things where you ask yourself if he would hate this, or if he would be, like, bobbing his head to it. And I always do that.

Even outside of music, there's stuff where I weirdly check in with him. That sounds like I'm super spiritual. But it's like, he's one of those people where his approval was everything. If he was like, going like this [head nod and smile] while you're playing a song... Yeah, he's a huge influence.

And like every other artist in the world right now, what I listen to is so all over the place. I think everyone is that way now, because we're just exposed to everything. So like, I'm listening to Drake and Rihanna, and then Neil Young, Van Morrison, and Kacey Musgraves, and Mac. It's all over the place. So no matter what that's gonna seep its way into my music.

The only thing I really tried to keep cohesive is the lyrics and the way I talk. I want people to be like, "Oh, yeah, that's a Role Model song." Because who would else be like talking about touching themselves to a loved one like me?

There's an interesting spiritual and religious undercurrent to RX. You're clearly working on making sense of a lot.

I'm not a religious person, but I just think using all these religious visuals [is] not a new thing, I know every artist is doing it. I just felt like for my personal story... there were just a lot of easy connections that I was finding with the way someone is on their knees, a breaking point, finding God, an epiphany or a miracle. I sound dramatic. But like that's genuinely what it felt like. I had never experienced falling in love. So it hit me like a train. And it really did feel like a drug or something heavenly.

And I have no idea what that feels like to find God or anything, but I just think there's connections there. And so there's religious metaphors throughout the album. I think I probably said "Jesus" a little too much in the whole album.

Has that given you trouble at all?

Um, honestly, yeah, I lost some followers with that "If Jesus Saves" song. In the beginning. But I think once the album came out, I think people maybe understand a bit more. Life is funny. And people are kind of understanding the message, which is good.

You are kicking off a world tour on the 13th of April, and then we will be at Coachella. How are you feeling about that? A world tour is kind of a big deal.

I know. I'm trying not to think about it too hard. I'm so excited to get on the road obviously. And like, Coachella is incredible. All the festivals are incredible, but I'm trying not to think about the fact that I'm going to be gone that long.

But I can't wait, and I miss just hearing people in the crowd. It's just very inclusive, and it's like we're all kind of doing it together. It's my favorite thing in the world.

You've talked a lot about being diabetic, and how being on the road is exhausting. It's exhausting for a lot of people who don't have to deal with that. So what would you say to a little diabetic kid who was thinking about getting into music? Is it too much? Is it manageable?

[pauses] How do I say this? It's hell. Like, it feels incredible, once you get to a point where [you're] like, wow, I'm doing it! If I stopped now, like, there's no example to be set for kids.

Honestly, diabetes is the scariest part of touring. I'm not concerned about forgetting lyrics anymore. I'm not concerned about like, us having technical issues on stage. It's more like, okay, how am I going to survive for these two months? I do everything very independently. It's like, hard to teach people in a short amount of time everything that goes into it, but yeah, it's a lot.

But I would say to any kid with diabetes: please don't let that limit you. When I was a kid, I remember going home to my doctor and my endocrinologist. And she was like, asking me how I'm doing and what I'm doing and what I'm interested in, college and everything. And I told her, I was really interested in music all of a sudden, and I was very passionate about it at the time.

She basically told me that I should probably find a more secure job, because it's a very expensive disease. And I remember driving home crying my eyes out. That wrecked me. But once you can kind of digest that and think about that and think about the person that just said that to your face and where they are? All you want to do is just prove them wrong.

So I guess I have a little bit of competitiveness in me. But yeah, I would just say to any kid, no matter what anyone says to you... you have the whole world in your hand.

Last question: what was the last song you had stuck in your head?

Wow. Oh, that new Jack Harlow song. It's the hook.

Newsweek's continuing Coachella coverage can be found online at newsweek.com and on On Beat, available wherever you get your podcasts.

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Role Model on Checking in With Mac Miller and Touring With Diabetes - Newsweek

Newswise BOSTON An estimated 25 percent of people older than 65 have type 2 diabetes, a condition in which the body cannot produce enough insulin to effectively manage blood sugar. Insulin plays an important role in the brain, and people with prediabetes and diabetes are at increased risk of Alzheimer's disease and cognitive decline. Delivering insulin to the brain intranasally atomized and sprayed through the nose has been shown to improve verbal memory and has emerged as a potential treatment for cognitive decline in the elderly.

Now, a team of scientists at Beth Israel Deaconess Medical Center (BIDMC) have assessed the long-term effects of intranasal insulin (INI) on cognition and on gait in people with and without type 2 diabetes mellitus. MemAID, a phase 2 randomized controlled clinical trial, provided evidence that intranasal insulin increased the walking speed, increased cerebral blood flow and decreased plasma insulin in participants with type 2 diabetes, while it improved decision making and verbal memory in trial participants without the disease and those with pre-diabetes. The findings, published in the Journal of Neurology, suggest intranasal insulin should be further tested for its possible utility as a treatment for type 2 diabetes as well as a treatment for age-related functional decline.

Walking speed is an important clinical predictor of well-being in the elderly that correlates with cognitive decline, hospitalizations, disability and death, said corresponding author Vera Novak, MD, PhD, of the Department of Neurology at BIDMC and an associate professor of neurology at Harvard Medical School. At baseline, participants with diabetes walked slower and had worse cognition than the participants without diabetes, who served as a clinical reference for normal aging population.

Novak and colleagues at BIDMC and BWH enrolled 223 participants ages 50 to 85-years-old with and without diabetes, and assessed their normal and dual task walking speeds, attention, memory and executive function and mood using a battery of validated tests. Half of the participants with diabetes (n=51) and half without diabetes (n=58) were treated with insulin, delivered intranasally via an electronic atomizer once daily. A double blinded trial, the other participants were given an inactive placebo (sterile saline) that was also delivered intranasally.

After 24-weeks of treatment participants with diabetes who received INI had faster walking speeds during treatment and post-treatment than participants with diabetes who received placebo. The INI-treated participants with diabetes also demonstrated increased cerebral blood flow in the frontal lobe, and lower plasma insulin and insulin resistance compared to the placebo group, while the INI-treated participants without diabetes showed improved decision making and verbal memory. Combined, the INI-treated participants both with and without type 2 diabetes demonstrated faster walking and better executive functioning and memory, with those with pre-diabetes showing the most marked improvements in decision making and verbal memory.

The consistency of the trends in the data showing better performance on walking speed and cognition for INI-treated participants, especially in those with pre-diabetes, carries great implication for potential early intervention using INI in this population to prevent or slow down the progression toward Alzheimer Diseases related dementias, said Long Ngo, PhD, senior author of the study and co-director of Biostatistics Division of General Medicine at BIDMC , as well as associate professor of medicine and biostatistics at Harvard Medical School, and Harvard T.H. Chan School of Public Health. With 96 million adult Americans, and increasing number of younger people having pre-diabetes, this finding on the beneficial effect of INI deserves more attention and definitive confirmation in a larger trial.

The treatment was not associated with any serious or moderate adverse events.Intranasal insulin treatment was safe in participants with type 2 diabetes treated with subcutaneous insulins.

Co-authors included Christos S. Mantzoros, MD, Dsc, Vasileios Lioutas, MD, Stephanie Buss, MD, Faizan Khan, MD, and Laura Aponte Becerra, MD, of BIDMC; Peter Novak, MD, PhD Site Principal Investigator of Brigham and Womens Hospital; Regina McGlinchey PhD- Site Principal Investigator, and Catherine B. Fortier, PhD, of VA Boston Healthcare System and Harvard Medical School; and Weiying Dai, PhD, of State University of New York, Binghamton.

Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIIDDK) under award number R01DK103902, FDA IND 107690) and with support from Harvard Catalyst - The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health award UL1TR002541) and financial contributions from Harvard University and its affiliated academic health care centers. This research study was supported with a study drug from Novo Nordisk, Inc., through an independent ISS grant (ISS-001063) toNovak. Safety sub-study was supported with CGM monitoring devices and supplies from Medtronic Inc., through an independent grant NERP 15-031 to V. Novak. Novo Nordisk, Inc., and Medtronic, Inc., reviewed the manuscript, but had no participation in data analysis, manuscript preparation or submission decision.

Novak, McGlinchey, Fortier, Dai, Khan and Aponte Becerra report no disclosures relevant to the manuscript. Mantzoros provided consultations for Coherus, AltrixBio, California Walnut Commission, Genfit, Regeneron, Ansh, Amgen, Intercept and Aegerion. Mantzoros has provided educational services through Elsevier, CMHC, TMIOA (all unrelated to this project since 2015 through 2020). Mantzoros provided consultations for Novo Nordisk, Inc., on Obesity Advisory Board, and has received grant support through BIDMC which could be considered as related to this project, given that Novo Nordisk, Inc. provided medication. Ngo provided consultation to the Radiological Society, the Journal of Cardiovascular Magnetic Resonance, Five Island Consulting LLC, and to Vinmec Inc. between 2015 and 2020. For a full list of disclosures, please read the study at the Journal of Neurology.

About Beth Israel Deaconess Medical Center Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding.

BIDMC is the official hospital of the Boston Red Sox. For more information, visitwww.bidmc.org.

Beth Israel Deaconess Medical Center is a part of Beth Israel Lahey Health, a health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,800 physicians and 36,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.

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Insulin Spray Improved Gait, Cognitive Function in Patients with and Without Type 2 Diabetes, Clinical Trial Shows - Newswise