We live in a day and age where very young children also get diagnosed with diabetes, despite being perfectly healthy. Blood sugar control, which is impaired in people with diabetes, is affected by factors like timing of meals relative to sleep and levels of melatonin, a hormone released at night that helps control sleep-wake cycles.
In research published in ‘Diabetes Care’, a team led by investigators at Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH) and the University of Murcia in Spain conducted a clinical trial to look for connections between these two factors. “We decided to test if late eating that usually occurs with elevated melatonin levels results in disturbed blood sugar control,” said senior author Richa Saxena, PhD, a principal investigator at the Center for Genomic Medicine at MGH.
For the randomised crossover study that included 845 adults from Spain, each participant fasted for eight hours and then for the next two evenings had first an early meal and then a late meal relative to their typical bedtime. The investigators also analyzed each participant’s genetic code within the melatonin receptor-1b gene (MTNR1B) because previous research had linked a variant (called the G-allele) in MTNR1B with an elevated risk of type 2 diabetes.
“In natural late eaters, we simulated early and late dinner timing by administering a glucose drink and compared effects on blood sugar control over two hours,” explained Saxena. “We also examined differences between individuals who were carriers or not carriers of the genetic variant in the melatonin receptor.”
The team found that melatonin levels in participants’ blood were 3.5-fold higher after the late dinner. The late dinner timing also resulted in lower insulin levels and higher blood sugar levels. (This connection made sense because insulin acted to decrease blood sugar levels.) In the late dinner timing, participants with the MTNR1B G-allele had higher blood sugar levels than those without this genetic variant.
“We found that late eating disturbed blood sugar control in the whole group. Furthermore, this impaired glucose control was predominantly seen in genetic risk variant carriers, representing about half of the cohort,” said lead author Marta Garaulet, PhD, a professor of physiology and nutrition in the Department of Physiology at the University of Murcia.
Experiments revealed that the high melatonin levels and carbohydrate intake associated with late eating impairs blood sugar control through a defect in insulin secretion.
“Our study results may be important in the effort towards prevention of type 2 diabetes,” said co-senior author Frank A.J.L. Scheer, PhD, MSc, director of the Medical Chronobiology Program at BWH. “Our findings are applicable to about a third of the population in the industrialised world who consume food close to bedtime, as well as other populations who eat at night, including shift workers, or those experiencing jetlag or night eating disorders, as well as those who routinely use melatonin supplements close to food intake.”
The authors noted that for the general population, it may be advisable to abstain from eating for at least a couple of hours before bedtime. “Genotype information for the melatonin receptor variant may further aid in developing personalised behavioral recommendations,” said Saxena. “Notably, our study does not include patients with diabetes, so additional studies are needed to examine the impact of food timing and its link with melatonin and receptor variation in patients with diabetes,” he concluded.
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WORLD IBD DAY CELEBRATED IN PGIMER TO RAISE AWARENESS
May 19 is celebrated across the globe as World IBD day. Inflammatory Bowel diseases (IBD) are chronic inflammatory conditions of the intestine and are of two main types: ulcerative colitis and Crohn’s disease. IBD is increasing in India and this increase is largely driven by changes in the diet and westernization of lifestyle. A recent editorial in Lancet Gastroenterology & Hepatology described South Asia (including India) as a new frontier of IBD. Some studies have shown that IBD is as common in North India as in the western world. Genetics, immune response, and changes in the dietary pattern also play a role in the causation of this disease. IBD can affect any age or gender. Usually, these patients have abdominal pain, diarrhoea, and bleeding in the stools. The diagnosis is often delayed because of the lack of awareness about the disease in the community, lack of access to colonoscopy, and confusion about other diseases like haemorrhoids, abdominal tuberculosis, and cancer.
The department of Gastroenterology, PGIMER, Chandigarh celebrated the day to raise awareness about the condition and improve the care and treatment of patients living with IBD. Prof Usha Dutta, Head, Department of Gastroenterology, informed that special lectures were organized where the patients with IBD were educated about the disease, the diagnostic tests, various treatment options, the role of diet, and health maintenance. A quiz was organized where patients were asked questions about their health and the top scorers were given IBD Day Prizes. Prof SK Sinha spoke on the nature and presentation of the disease, Dr. Vishal Sharma spoke about the treatment options of the disease, and Prof Usha Dutta spoke about the diet and lifestyle approaches for IBD. Patients who have inflammatory bowel disease asked questions and doubts about their disease and health, which were answered by experts. The patients were also able to visit stalls that provided patient education material and demonstrated methods to use enema, foam, and suppository therapies, which are a cornerstone in the treatment of this condition . On this occasion an IBD card designed by the Department of Gastroenterology, in association with Colitis and Crohn’s Foundation, India was released. This card will provide a snapshot of the disease state and drug therapies with education material and will help improve various aspects of care including diet, preventive health, and medication. The card is designed with suggestions from other experts from AIIMS, Delhi, DMC, Ludhiana, and SGPGI, Lucknow. The card will be available to clinicians and gastroenterologists across the country for use and will be launched through a web meeting on World IBD day.
ALCOHOL CONSUMPTION MIGHT BE MORE RISKY TO THE HEART
According to a study, levels of alcohol consumption currently considered safe by some countries are linked with the development of heart failure.
The study was published in the journal, ‘Cardiology’. “This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” said study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, Ireland.
“To minimise the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5 percent beer,” he added.
According to the World Health Organization, the European Union is the heaviest-drinking region in the world. While it is well recognised that long-term heavy alcohol use can cause a type of heart failure called alcoholic cardiomyopathy, evidence from Asian populations suggests that lower amounts may also be detrimental.
“As there are genetic and environmental differences between Asian and European populations this study investigated if there was a similar relationship between alcohol and cardiac changes in Europeans at risk of heart failure or with pre-heart failure,” said Dr. Wong.
“The mainstay of treatment for this group is the management of risk factors such as alcohol, so knowledge about safe levels is crucial,” he added.
This was a secondary analysis of the STOP-HF trial. The study included 744 adults over 40 years of age either at risk of developing heart failure due to risk factors (e.g. high blood pressure, diabetes, obesity) or with pre-heart failure (risk factors and heart abnormalities but no symptoms).
The average age was 66.5 years and 53 percent were women. The study excluded former drinkers and heart failure patients with symptoms. Heart function was measured with echocardiography at baseline and follow-up.
The study used the Irish definition of one standard drink (i.e. one unit), which is 10 grams of alcohol. 8 Participants were categorised according to their weekly alcohol intake: 1) none; 2) low (less than seven units; up to one 750 ml bottle of 12.5 percent wine or three-and-a-half 500 ml cans of 4.5 percent beer); 3) moderate (7-14 units; up to two bottles of 12.5 percent wine or seven 500 mL cans of 4.5 percent beer), high (above 14 units; more than two bottles of 12.5 percent wine or seven 500 ml cans of 4.5 percent beer).
The researchers analysed the association between alcohol use and heart health over a median of 5.4 years. The results were reported separately for the at-risk and pre-heart failure groups. In the at-risk group, worsening heart health was defined as progression to pre-heart failure or symptomatic heart failure. For the pre-heart failure group, worsening heart health was defined as deterioration in the squeezing or relaxation functions of the heart or progression to symptomatic heart failure. The analyses were adjusted for factors that can affect heart structure including age, gender, obesity, high blood pressure, diabetes, and vascular disease.
A total of 201 (27 percent) patients reported risk of alcohol while 356 (48 percent) were low users and 187 (25 percent) had moderate or high intake. Compared to the low intake group, those with moderate or high use were younger, more likely to be male, and had a higher body mass index.
In the pre-heart failure group, compared with no alcohol use, moderate or high intake was associated with a 4.5-fold increased risk of worsening heart health. The relationship was also observed when moderate and high levels were analysed separately. In the at-risk group, there was no association between moderate or high alcohol use with progression to pre-heart failure or symptomatic heart failure. No protective associations were found for low alcohol intake.
MANY DENTAL MYTHS AND MISCONCEPTIONS DEBUNKED
Many dental myths and misconceptions exist today, including the usage of braces to make teeth symmetrical. Many people are afraid to use braces in this modern era due to concerns about wires being stuck inside the mouth for an extended period. Technological innovations, on the other hand, have shaped and modified the aligners. Clove Dental’s Chief Clinical Officer, Lt. Gen. Dr. Vimal Arora, who served in the Army Dental Corps for a long time, has debunked common misconceptions about the use of aligners and braces.
Q: When should one visit an orthodontist?
A: Firstly, it is essential to understand the difference between a dentist and an orthodontist. Orthodontists undergo an additional 3 years of training that specialises in the alignment of teeth. Here, one is equipped with better diagnosis and treatment planning, and an orthodontist treats misaligned teeth, crowded teeth, and bite issues (overbite and underbite).
There is no specific age to visit an orthodontist for better-crooked teeth alignment. However, the earlier the better. Whenever you spot both aesthetic and functional issues with your teeth, you must make an appointment to visit an expert.
Q: Does tooth extraction weaken eyesight?
A: This is a common myth that exists. Tooth extraction has no direct connection with eyesight. There are times when eyes are swollen or red when people suffer from toothaches, making people think that teeth and eyes are connected, but this is not true.
Q: What is the difference between braces and aligners?
A: There are traditional and modern treatments related to tooth alignment options. Braces are traditional, whereas aligners are modern alignment options. Braces can be used to treat all crooked teeth cases, whereas aligners can treat only a few. Hence, it is important to consult an orthodontist on what applies to you. As braces are fixed to your teeth, unlike aligners where you have to wear them regularly. Any severity category, be it mild, morbid, or severe, can be taken into consideration to treat any malocclusion.
However, with progression in the healthcare system, we have the option of aligners. We can still manage mild to morbid cases with aligners. However, a lot of advancement is needed to select them for the severe category.
Q: Do braces serve better than aligners.
With technological advancement, aligners are more comfortable, to begin with. There is no change in lifestyle, especially related to your brushing and eating habits. You can do all your activities normally. Incidentally, step-by-step post-treatment results as seen before are not required and there is less human error as hi-tech computers scientifically design most treatments. And importantly, aligners have appeal that is more aesthetic.
Q: Can teeth move back into their original positions after treatment?
A: This is partially true that in orthodontics if teeth are once moved, they will get back to their original positions. If proper measures have been taken after correction, to hold the teeth in their positions and the ideology has been taken care of while doing the treatment, we can minimise the chances of teeth going back to their original positions.
Study details benefits of turmeric compound
According to a new study by the University of California, a compound found in turmeric called Curcumin helps grow engineered blood vessels and tissues.
The findings of the study were published in the journal, ‘ACS Applied Materials & Interfaces. The study indicated that a finding by UC Riverside bioengineers could hasten the development of lab-grown blood vessels and other tissues to replace and regenerate damaged tissues in human patients.
Curcumin has anti-inflammatory and antioxidant properties and is known to suppress angiogenesis in malignant tumors.
The magnetic hydrogels embedded with curcumin-coated nanoparticles promote the secretion of vascular endothelial growth factors.
Curcumin’s possible use for vascular regeneration has been suspected for some time but has not been well studied. Huinan Liu, a bioengineering professor in UCR’s Marlan and Rosemary Bourns College of Engineering, led a project to investigate curcumin’s regenerative properties by coating magnetic iron oxide nanoparticles with the compound and mixing them into a biocompatible hydrogel.
Bioengineers at UC Riverside have now discovered that when delivered through magnetic hydrogels into stem cell cultures this versatile compound paradoxically also promotes the secretion of vascular endothelial growth factor, or VEGF, that helps vascular tissues grow.
When cultured with stem cells derived from bone marrow, the magnetic hydrogel gradually released the curcumin without injuring the cells.
Compared to hydrogels embedded with bare nanoparticles, the group of hydrogels loaded with curcumin-coated nanoparticles showed a higher amount of VEGF secretion.
“Our study shows that curcumin released from magnetic hydrogels promotes the cells to secrete VEGF, which is one of the most critical growth factors to enhance the formation of new blood vessels,” said co-author Changlu Xu, a doctoral candidate in Liu’s group who focused on hydrogel research.
The researchers also took advantage of the nanoparticles’ magnetism to see if they could direct the nanoparticles to desired locations in the body.
They placed some of the curcumin-coated nanoparticles in a tube behind pieces of fresh pig tissue and used a magnet to successfully direct the movement of the nanoparticles.
The achievement suggested the method could eventually be used to deliver curcumin to help heal or regenerate injured tissue.
In fact, the best curcumin supplements contain piperine, and this makes them substantially more effective.
In addition, animal and cellular studies suggest that curcumin may block the action of free radicals and may stimulate the action of other antioxidants. Further clinical studies are needed in humans to confirm these benefits
LONG-TERM FOLLOW UP REDUCES TYPE 2 DIABETES RISK
Though type 2 diabetes is an inherited disease, habits can affect the risk of getting it. Obesity due to fatty and high-calorie foods, often in combination with limited activity, increases the risk considerably.
A new study at NTNU (The Norwegian University of Science and Technology) and St. Olav’s Hospital Centre of Obesity has followed people in the risk group for five years. Participants were offered organized physical activity and courses on the diet. “We’re seeing that follow-up from the health services in Norwegian municipalities over a long period can help reduce the risk of developing diabetes 2 and improve people’s health,” says researcher Ingrid Sordal Folling at NTNU’s Department of Health and Nursing.
Folling works in the Centre for Obesity Research, Surgical Clinic at St. Olavs Hospital in Trondheim. The study results have been published in the British Medical Journal.Taking action helpWorldwide, 350 million people have type 2 diabetes.
HEART FAILURE AWARENESS MONTH 2022: CONTROL HEART FAILURE WITH HELPFUL TIPS
Taking care of one’s heart is crucial, especially if one is suffering from heart failure. Heart failure is the inability of the heart to pump blood efficiently, as seen by shortness of breath, fast heartbeat, and exhaustion. Heart Failure Awareness Month in 2022 is a fantastic time to promote awareness about the issue while also providing simple advice to help heart failure patients live better and happier lives.
Heart failure is a chronic illness that can be adequately controlled with the right treatment and care. Heart failure patients can greatly benefit from regular interactions with their cardiologists, adherence to prescribed treatment plans, and adopting a healthy lifestyle. Dr. K Sarat Chandra, Senior Cardiologist at Apollo Spectra Hospital, Hyderabad, former Editor, Indian Heart Journal, and former President, Cardiological Society of India said, “In India, heart failure is an increasing problem and the reasons for this are the high prevalence of diabetes, hypertension, chronic kidney disease, and heart attack. Very often we see younger people coming with these conditions. To prevent these problems, we need to improve our lifestyle, do regular exercise, stop smoking and limit alcohol intake. Also control blood sugar, blood pressure, and cholesterol. Regarding heart failure, several new treatments have come into practice and early treatment will benefit our patients.”
Here are a few tips for all heart failure patients:
Talk to your cardiologist
It is good to have regular conversations with your cardiologist. Report new or worsening symptoms you observe immediately. These timely check-ups will help you keep track of your progress and get the right advice at the right time.
Check your salt consumption
Inadequate blood flow to the kidneys causes the body to retain water and fluids which leads to swollen legs, abdomen, and ankles, increased urination, and weight gain. High salt consumption is known to cause extra fluid build-up in your body and worsens heart failure. Therefore, keep your salt intake in check by lowering salt levels in your meals, replacing salt with herbs and spices, or choosing ‘low-salt’ or preferably ‘no salt added’ when buying canned or frozen foods.
Track your fluid intake
Drinking a lot of fluids can worsen your heart failure. It is advisable to limit beverages like tea, juice, and soft drinks, as well as foods with high water content like soups, watermelon, or even ice cream! Quick weight gain can be a sign of fluid build-up in your body.
Stick to the prescribed treatment
Staying on top of taking your medications as prescribed is crucial for effective heart failure management. Use reminders or alarms to never miss a dose or an appointment! If you live alone, paste sticky notes on your cabinets or refrigerator as an easy reminder.
According to Prof. (Dr.) Sundeep Mishra, former Professor of Cardiology Department of AIIMS and presently Vice-Chancellor (President) of NIMS University, “With the increasing burden of Heart Failure in India, especially in the younger population, it is necessary to recognize it – as a public health priority. The key reason for the rise in heart failure cases is the growing dependency on a sedentary lifestyle, higher consumption of salt, sugar, and fat in the diet, and rising stress levels. Although, heart failure can be still managed better by regular treatment and regular conversations with a cardiologist and a holistic treatment plan can help one manage the condition better.”
Heart failure is a serious chronic condition where the heart cannot pump enough blood to support the needs of other organs in the body. The most common causes of heart failure include coronary heart disease, myocardial infarction (heart attack), congenital heart defects, or damaged heart valves. Symptoms include breathlessness, fatigue and swollen limbs. it is the most frequent cause the age of 65.
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