Study reveals type 2 diabetes remission can restore pancreas size and shape

In 2019, research revealed that achieving remission of type 2 diabetes by intensive weight loss can restore the insulin-producing capacity of the pancreas to levels similar to those in people who have never been diagnosed with the condition. Now, new research being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), held online this year, demonstrates for the first time that reversing type 2 diabetes can also restore the pancreas to a normal size and shape.

“Our previous research demonstrated the return to long term normal glucose control, but some experts continue to claim that this is merely ‘well controlled diabetes’ despite our demonstration of a return to normal insulin production by the pancreas. However, our new findings of major change in the size and shape of the pancreas are convincing evidence of return to the normal state”, says Professor Roy Taylor from Newcastle University, UK, who led the research.

He goes on to explain, “Large amounts of insulin cause tissues to grow, or at least maintain their size. Normally, inside the pancreas the amounts of insulin present after a meal are very high. But in type 2 diabetes this does not happen. This new study suggests that achieving remission of type 2 diabetes restores this healthy, direct effect of insulin on the pancreas.”

Affecting 1 in 11 of the world’s adult population (415 million people), and on the rise, type 2 diabetes is caused by too much glucose (a type of sugar) in the blood due to the pancreas not producing enough insulin (a hormone which breaks down glucose into energy in the cells) together with insulin resistance.

Previous imaging studies have shown reduced size and abnormal shape of the pancreas in people with type 2 diabetes. But whether these abnormalities resulted from, rather than led to, the disease state was unknown until now.

In the study, 64 participants from the landmark Diabetes Remission Clinical Trial (DiRECT) and 64 age-, sex-, and weight- matched controls without type 2 diabetes were measured over 2 years for pancreas volume and fat levels, and irregularity of pancreas borders using a special MRI scan. Beta cell function—key to the body’s ability to make and release insulin—was also recorded. Responders (people in remission) were classified as achieving a glycated haemoglobin A1c (HbA1c) level of less than 6.5% and fasting blood glucose of less than 7.0 mmol/l, off all medications.

At the start of the study, average pancreas volume was 20% smaller (64 cm3 vs 80 cm3), and pancreas borders more irregular, in people with diabetes compared with controls without diabetes.

After 5 months of weight loss, pancreas volume was unchanged irrespective of remission (63 cm3 to 64 cm3 for responders and 59 cm3 to 60 cm3 in non-responders). However, after 2 years, the pancreas had grown on average by around one fifth in size (from 63 cm3 to 76 cm3) in responders compared with around a twelfth (from 59 cm3 to 64 cm3) in those who did not.

In addition, responders lost a significant amount of fat from their pancreas (1.6%) compared with non-responders (around 0.5%) over the study period, and achieved normal pancreas borders.

Similarly, only responders showed early and sustained improvement in beta-cell function. After 5 months of weight loss, the amount of insulin being made by responders increased and was maintained at 2 years, but there was no change in non-responders.

“Our findings provide proof of the link between the main tissue of the pancreas which makes digestive juices and the much smaller tissue which makes insulin, and open up possibilities of being able to predict future onset of type 2 diabetes by scanning the pancreas”, says Professor Taylor.

“All our research has been focused on type 2 diabetes which has developed within the last 6 years. Although some people with much longer duration diabetes can achieve remission, it is clear that the insulin producing cells become less and less able to recover as time passes. We need to understand exactly why this is and find ways to restore function in long duration type 2 diabetes.”

He concludes, “Type 2 diabetes is a simple disease occurring when an individual has more fat inside their body than they can cope with. The solution to the huge and growing problem of type 2 diabetes in the population lies in the hands of politicians. Legislation on supply of high calorie foods is essential to change our environment.”

Despite these important findings, the study has some limitations including that follow up was only for 2 years, and the observations were not pre-planned but made in retrospect.

Dr. Elizabeth Robertson, Director of Research at Diabetes UK, who funded the study, said: “Our landmark DiRECT trial has revolutionised thinking about type 2 diabetes—we no longer consider it to be a life-long condition for everyone, and know that remission is possible for some people. And we’re continuing to learn more about remission of type 2 diabetes every day. These new findings help to build a clearer picture of the biology behind remission, and how the health of the pancreas can be restored by weight loss.

Source: Read Full Article

Biomarker reveals how aggressive biliary tract cancer is in patients

The cancer called biliary tract cancer (BTC) is not the most widespread form of cancer. In western countries, about 1.6 in 100.000 gets the diagnose every year. It is, however, a very aggressive form of cancer.

The majority of patients with BTC are diagnosed with advanced disease and has an average survival of only 1 year from initiation of chemotherapy. With such narrow survival windows, it is crucial to improve our understanding of the disease.

Now, researchers from Biotech Research & Innovation Centre at the University of Copenhagen and Herlev and Gentofte Hospital along with collaborators from Rigshospitalet and Sygehus Lillebaelt have identified a biomarker that can tell doctors how aggressive a patient’s disease may be.

“We have found a biomarker that reliably predicts how aggressive a patients disease will evolve, which in the future could help doctors in the hospitals make the right decisions about chemotherapy for the benefit of each BTC patient,” says Jesper Andersen, Associate Professor at BRIC.

Biomarkers can used for more than the diagnosis

The researchers measured the levels of two inflammatory proteins and a biomarker commonly used in pancreatic cancer before and during chemotherapy in patients with advanced BTC and found that patients with higher levels of these markers before chemotherapy had a lower survival rate. Especially one protein called IL6 (interleukin-6) proved to be superior to the other markers in predicting those patients at greatest risk of death.

“A common misperception may be that biomarkers are mainly needed to diagnose a specific cancer type, but diverse biomarkers are also needed to guide clinical decision-making throughout each patients’ individual journey. These types of prognostic and predictive biomarkers deserve increased attention, in particular as they are playing important roles in the increasingly individualized management of more common cancer types”, says Jesper Andersen.

There are several markers to predict patients at greatest risk of death, however it was confirmed that the prognostic information provided by measuring IL-6 is not captured by other inflammatory markers already in routine clinical use. For instance, about 10 percent of the population does not express the marker that is normally measured (CA19-9) to predict the patient clinical outcome. Therefore, the course of disease cannot be predicted for these patients using CA19-9, for which IL-6 may be used instead.

Inhibiting IL-6 may improve response to chemotherapy

By inhibiting signaling of the protein IL-6 in a mouse model of human BTC, researchers discovered that the response of mouse tumors to chemotherapy significantly increased.

“Our data suggests that inhibiting IL-6 signaling may extend therapeutic benefit compared to chemotherapy alone. However, this will require careful evaluation in randomized clinical trial settings. Such a trial is currently ongoing at Herlev and Gentofte Hospital and results from this and potential future trials will contribute to our knowledge in regards to the potential of targeting the IL-6 pathway in patients with BTC”, says Jesper Andersen

Large sample size made possible through collaboration

Researchers studying BTC face a data-challenge since only 1.6 per 100,000 of Western populations are diagnosed with BTC annually. This makes it difficult to collect comprehensive amounts of patient data. Therefore, one of the key strengths of this study lies in the patient numbers attained and analyzed in this rare cancer demographic, amounting to 1590 serum samples from 452 patients with advanced BTC.

Furthermore, the study explores advanced BTC patients who represent the majority of patients at diagnosis, while the majority of previous BTC studies published to date have focused on early stage disease.

“It is imperative to increase representation of these patients with the worst prognosis in subsequent studies. These studies should also include longitudinal sampling throughout the patient’s clinical history, as we have done here”, says Jesper Andersen, group leader at BRIC.

The sample size achieved in this study was only made possible through the comprehensive collaboration between Herlev and Gentofte Hospital, Rigshospitalet and Sygehus Lillebaelt in Denmark.

Source: Read Full Article

New study reveals older adults coped with pandemic best

Adults aged 60 and up have fared better emotionally compared to younger adults (18-39) and middle-aged adults (40-59) amid the COVID-19 pandemic, according to new UBC research published recently in the Journal of Gerontology: Psychological Sciences.

Based on daily diary data collected between mid-March and mid-April of this year, the researchers found that older adults experienced greater emotional well-being and felt less stressed and threatened by the pandemic.

“Our findings provide new evidence that older adults are emotionally resilient despite public discourse often portraying their vulnerability. We also found that younger adults are at greater risk for loneliness and psychological distress during the pandemic,” says Patrick Klaiber, the study’s lead author and a graduate student in the UBC department of psychology.

For the study, the researchers analyzed data from 776 participants aged 18-91, who lived in Canada and the U.S. and completed daily surveys for one week about their stressors, positive events and their emotional well-being during the first several weeks of the pandemic. The time period was selected as it was likely to be the period of greatest disruption and uncertainty as local, provincial and state governments began issuing stay-at-home orders.

Klaiber says the difference in reported stress levels may be a result of age-related stressors and how well the different age groups respond to stress.

“Younger and middle-aged adults are faced with family- and work-related challenges, such as working from home, homeschooling children and unemployment,” says Klaiber. “They are also more likely to experience different types of ongoing non-pandemic stressors than older adults, such as interpersonal conflicts.”

Klaiber adds, “While older adults are faced with stressors such as higher rates of disease contraction, severe complications and mortality from COVID-19, they also possess more coping skills to deal with stress as they are older and wiser.”

The study also reveals older and middle-aged adults experienced more daily positive events—such as remote positive social interactions—in 75 per cent of their daily surveys, which helped increase positive emotions compared to younger adults.

Source: Read Full Article

Gigi Hadid Reveals a Bit of Her Bump & Why You Won't See More

During her pregnancy, Gigi Hadid is learning one of the first harsh rules about motherhood: Some people will care more about your child more than they do about all the other amazing things you create. Case in point, in preparing to promote Gigi Journal Part II, an art book she created with V Magazine, she wound up receiving tons of fan questions about showing off her baby bump, yet again.

“I’m so grateful for the positive comments and the questions and wanting just to know that we’re all good and safe and everything’s going great and I love you guys,” Hadid said on Wednesday in a long Instagram Live post to unveil the book.

“Obviously, I think a lot of people are confused why I’m not sharing more, but I’m pregnant through a pandemic,” she explained. “Obviously, my pregnancy is not the most important thing going on in the world. That’s a reason that I felt that it’s not really something that I need to share apart from with my family and friends. Obviously, a lot of people have lost lives due to coronavirus that was in the beginning of quarantine and still happening. And then we moved obviously into the reemergence of the [Black Lives Matter] movement, and I thought that our presence on social media should be used for that.”

This is a very mature, selfless way of explaining Hadid’s lack of pregnancy updates. Mine would have been more like, “I’ll post if I want to, so mind your own business,” only with more expletives. (Reason #798 Hadid is a social media star and I am not.)

But beyond the fact that the world is on fire and there are more important things to discuss than the shape of one model’s belly, Hadid also does want to maintain a bit of privacy during this very special time.

“I have been taking a lot of pictures of my bump and sending it to friends and family,” she said. “And it’s been really cute and exciting, and I’m trying to document it well because I’ve heard a lot of people say, make sure you don’t miss it. And I will be sharing stuff like that in the future. I just am not rushed to do it, and I feel like right now, I just want to experience it.”

Hadid spends her entire life presenting an image of herself for public consumption, so it’s pretty understanding if she wants a break from all that.

“I just don’t want to worry about waking up every day during my pregnancy and worry about having to like look cute or post something,” she went on.

We’ll always have the Bella twins for pregnancy bump pics.

Still, she made one tiny concession for curious fans who just want to see evidence of the life growing inside her. After she had previously explained about not looking pregnant on Instagram videos taking from the front, she discussed her love of loose, linen clothing, particularly the set from Holiday she was wearing. Then she unbuttoned the bottom of her shirt.

“OK, there’s my belly, y’all,” she said, revealing the top of her bump and leaving the rest out of view of the camera. “It’s there. It’s just that from the front, it’s different. … I’m taking my time with sharing my pregnancy, and you guys will see it when you see it.”

With that, she continued on with her original purpose, to show off Gigi’s Journal. Because, for real, can we please let a mom-to-be also have her career?

If Gigi and Zayn don’t have a name picked out yet, maybe they can get inspo from these wacky celebrity baby names.

Source: Read Full Article

Pregnant Nikki Bella Reveals Environmental Parenting Decision Ahead of Baby

Doing their part! Pregnant Nikki Bella and Artem Chigvintsev want to help the environment by using cloth diapers when their first child arrives.

Everything We Know Pregnant Nikki Bella Has Said About Starting a Family

“I think when we hear about cloth diapers we all freak out right?” the reality star, 36, said on the Wednesday, July 1, “Total Bellas Podcast” episode. “Like, it seems nasty. But when I saw Brie [Bella] doing it with [her daughter], Birdie, it was the easiest, non-nasty thing ever.”

Brie, also 36, chimed in, “Who would’ve thought my bougie sister would use cloth diapers?”

Nikki Bella and Brie Bella’s Baby Bump Album: See Pics From the Twin Sisters’ Pregnancies

Nikki said that she and the Dancing With the Stars pro, 38, realized that they could take “steps in making the environment better.”

She explained, “We still want to focus and help with Black Lives Matter, we want to help with the change in getting everyone to register to vote and being as a part of it as you can this year, but let’s not forget about our environmental issues because it’s easy to forget. For me, I’ve realized that I keep making more and more steps of being environmentally friendly and it feels really good.”

The California native announced in January that she and the Russian dancer are expecting their first child. Brie, who welcomed Birdie, 3, with husband Daniel Bryan in 2017, is also pregnant. The Total Bellas stars are due within two weeks of each other.

“We have the exact same symptoms,” Brie exclusively told Us Weekly in April. “We were so nauseous our first trimester and I was never sick with Birdie ever. [Nikki and I had] morning sickness all day long. We felt like we had car sickness. [It was] really bizarre.”

Celebrity Pregnancy Announcements of 2020

Nikki went on to tell Us at the time that everything in her pregnancy felt “so new.” She revealed, “I guess I just didn’t realize how all these body changes would feel. I don’t just mean outer, but inner. There are days I really get rocked and exhausted and my body’s going through so much. … It’s just in this shock. It’s just tough.”

For access to all our exclusive celebrity videos and interviews – Subscribe on YouTube!

Source: Read Full Article

Diet, gut microbes affect effectiveness of cancer treatment, research reveals

What we eat can affect the outcome of chemotherapy—and likely many other medical treatments—because of ripple effects that begin in our gut, new research from the University of Virginia suggests.

Scientists found that diet can cause microbes in the gut to trigger changes in the host’s response to a chemotherapy drug. Common components of our daily diets (for example, amino acids) could either increase or decrease both the effectiveness and toxicity of the drugs used for cancer treatment, the researchers found.

The discovery opens an important new avenue of medical research. It could have major implications for predicting the right dose and better controlling the side effects of chemotherapy, the researchers report. The finding also may help explain differences seen in patient responses to chemotherapy that have baffled doctors until now.

“The first time we observed that changing the microbe or adding a single amino acid to the diet could transform an innocuous dose of the drug into a highly toxic one, we couldn’t believe our eyes,” said Eyleen O’Rourke of UVA’s College of Arts & Sciences, the School of Medicine’s Department of Cell Biology and the Robert M. Berne Cardiovascular Research Center. “Understanding, with molecular resolution, what was going on took sieving through hundreds of microbe and host genes. The answer was an astonishingly complex network of interactions between diet, microbe, drug and host.”

How diet affects outcomes

Doctors have long appreciated the importance of nutrition on human health, but the new discovery highlights how what we eat affects not just us, but the microorganisms within us.

The changes that diet triggers on the microorganisms can increase the toxicity of a chemotherapeutic drug up to 100-fold, the researchers found using the new lab model they created with roundworms. “The same dose of the drug that does nothing on the control diet kills the [roundworm] if a milligram of the amino acid serine is added to the diet,” said Wenfan Ke, a graduate student and lead author of a new scientific paper outlining the findings.

Further, different diet and microbe combinations change how the host responds to chemotherapy. “The data show that single dietary changes can shift the microbe’s metabolism and, consequently, change or even revert the host response to a drug,” the researchers report in their paper published in Nature Communications.

Source: Read Full Article

How does the brain link events to form a memory? Study reveals unexpected mental processes

A woman walking down the street hears a bang. Several moments later she discovers her boyfriend, who had been walking ahead of her, has been shot. A month later, the woman checks into the emergency room. The noises made by garbage trucks, she says, are causing panic attacks. Her brain had formed a deep, lasting connection between loud sounds and the devastating sight she witnessed.

This story, relayed by clinical psychiatrist and co-author of a new study Mohsin Ahmed, MD, Ph.D., is a powerful example of the brain’s powerful ability to remember and connect events separated in time. And now, in that new study in mice published today in Neuron, scientists at Columbia’s Zuckerman Institute have shed light on how the brain can form such enduring links.

The scientists uncovered a surprising mechanism by which the hippocampus, a brain region critical for memory, builds bridges across time: by firing off bursts of activity that seem random, but in fact make up a complex pattern that, over time, help the brain learn associations. By revealing the underlying circuitry behind associative learning, the findings lay the foundation for a better understanding of anxiety and trauma- and stressor-related disorders, such as panic and post-traumatic stress disorders, in which a seemingly neutral event can elicit a negative response.

“We know that the hippocampus is important in forms of learning that involve linking two events that happen even up to 10 to 30 seconds apart,” said Attila Losonczy, MD, Ph.D., a principal investigator at Columbia’s Mortimer B. Zuckerman Mind Brain Behavior Institute and the paper’s co-senior author. “This ability is a key to survival, but the mechanisms behind it have proven elusive. With today’s study in mice, we have mapped the complex calculations the brain undertakes in order to link distinct events that are separated in time.”

The hippocampus—a small, seahorse-shaped region buried deep in the brain—is an important headquarters for learning and memory. Previous experiments in mice showed that disruption to the hippocampus leaves the animals with trouble learning to associate two events separated by tens of seconds.

“The prevailing view has been that cells in the hippocampus keep up a level of persistent activity to associate such events,” said Dr. Ahmed, an assistant professor of clinical psychiatry at Columbia’s Vagelos College of Physicians and Surgeons, and co-first author of today’s study. “Turning these cells off would thus disrupt learning.”

To test this traditional view, the researchers imaged parts of the hippocampus of mice as the animals were exposed to two different stimuli: a neutral sound followed by a small but unpleasant puff of air. A fifteen-second delay separated the two events. The scientists repeated this experiment across several trials. Over time, the mice learned to associate the tone with the soon-to-follow puff of air. Using advanced two-photon microscopy and functional calcium imaging, they recorded the activity of thousands of neurons, a type of brain cell, in the animals’ hippocampus simultaneously over the course of each trial for many days.

“With this approach, we could mimic, albeit in a simpler way, the process our own brains undergo when we learn to connect two events,” said Dr. Losonczy, who is also a professor of neuroscience at Columbia’s Vagelos College of Physicians and Surgeons.

To make sense of the information they collected, the researchers teamed up with computational neuroscientists who develop powerful mathematical tools to analyze vast amounts of experimental data.

“We expected to see repetitive, continuous neural activity that persisted during the fifteen-second gap, an indication of the hippocampus at work linking the auditory tone and the air puff,” said computational neuroscientist Stefano Fusi, Ph.D., a principal investigator at Columbia’s Zuckerman Institute and the paper’s co-senior author. “But when we began to analyze the data, we saw no such activity.”

Instead, the neural activity recorded during the fifteen-second time gap was sparse. Only a small number of neurons fired, and they did so seemingly at random. This sporadic activity looked distinctly different from the continuous activity that the brain displays during other learning and memory tasks, like memorizing a phone number.

“The activity appears to come in fits and bursts at intermittent and random time periods throughout the task,” said James Priestley, a doctoral candidate co-mentored by Drs. Losonczy and Fusi at Columbia’s Zuckerman Institute and the paper’s co-first author. “To understand activity, we had to shift the way we analyzed data and use tools designed to make sense of random processes.”

Ultimately, the researchers discovered a pattern in the randomness: a style of mental computing that seems to be a remarkably efficient way that neurons store information. Instead of communicating with each other constantly, the neurons save energy—perhaps by encoding information in the connections between cells, called synapses, rather than through the electrical activity of the cells.

“We were happy to see that the brain doesn’t maintain ongoing activity over all these seconds because, metabolically, that’s not the most efficient way to store information,” said Dr. Fusi, who is also a professor of neuroscience at Columbia’s Vagelos College of Physicians and Surgeons. “The brain seems to have a more efficient way to build this bridge, which we suspect may involve changing the strength of the synapses.”

In addition to helping to map the circuitry involved in associative learning, these findings also provide a starting point to more deeply explore disorders involving dysfunctions in associative memory, such as panic and pos-ttraumatic stress disorder.

“While our study does not explicitly model the clinical syndromes of either of these disorders, it can be immensely informative,” said Dr. Ahmed, who is also a member of the Losonczy lab at Columbia’s Zuckerman Institute. “For example, it can help us to model some aspects of what may be happening in the brain when patients experience a fearful association between two events that would, to someone else, not elicit fright or panic.”

Source: Read Full Article

Jill Duggar Reveals Son Samuel, 2, Has 'Strong Allergies to Dust'

Better safe than sorry! Jill Dillard (née Duggar) is taking precautions after finding out about her 2-year-old son Samuel’s allergy.

“Stuffies in the freezer! We recently found out Sam has strong allergies to dust!” the Counting On alum, 28, captioned a Wednesday, April 29, Instagram picture of her freezer full of stuffed animals. “ Both of the boys love their stuffies so when the allergist mentioned they could be contributing to collection of dust it made total sense!”

The former reality star, who also shares 5-year-old Israel with her husband, Derick Dillard, went on to write, “In addition to being better at washing bedding and vacuuming at least once a week (I know, we still have carpet), the allergist recommended freezing anything that’s tough to wash at least once a month for 48-72 hours to hopefully kill the dust mites! I usually bag them up to keep moisture off of them and contain them a little.”

The 19 Kids and Counting alum asked her social media followers for advice and received plenty of tips, from “allergy-reducing pillow covers” to “high” dryer settings.

She and Derick, 31, tied the knot in June 2014 in Arkansas and welcomed Israel and Samuel in 2015 and 2017, respectively. Earlier this month, the law student hinted at their future family plans.

“We’ll see,” Derick said on the “First Class Fatherhood” podcast when asked whether he and Jill were planning on adding another baby to their brood. “We’re just kind of enjoying life.”

The Oklahoma State University graduate went on to say that baby No. 3 is “not definite.”

The former TLC personalities starred on the first five seasons of Counting On before the network’s September 2017 announcement that Derick had been cut from the cast following transphobic tweets. “His statements do not reflect the views of the network,” the statement read at the time.

Derick responded via Twitter, writing, “For the record, I was never fired. I just felt it best for my family to cut ties months ago, as we are heading in a different direction.”

For access to all our exclusive celebrity videos and interviews – Subscribe on YouTube!

Source: Read Full Article