Diabetes developments – by Simon O’Neill

In a regular blog series, Simon O’Neill, Diabetes UK’s Director of Health Intelligence and Professional Liaison, rounds up the latest diabetes news.

This week Simon rounds up the latest research.

Good bacteria may be good for your blood sugar

A small study has suggested that microbes that live in your gut may play a positive role on your blood sugar levels.

The study involved people without diabetes who were following the DASH diet, which is recommended for people with high blood pressure. The DASH diet is a diet rich in fruits, vegetables, and low fat or non-fat dairy. It also includes mostly whole grains, lean meats, fish and poultry, nuts and beans. It is high fibre and low to moderate in fat. One arm followed the DASH diet alone while the other arm added probiotics from various sources, such as low-fat probiotic yogurt.

Before the study researchers measured the people’s HbA1c, fasting blood sugar levels and blood pressure and no differences were noted. However, after the three month study researchers found similarly lowered blood pressure measurements in both groups but a lower HbA1c in the probiotic arm. The non-probiotic arm had lowered HbA1c by 3.4 per cent (eg from 50mmol/mol to 48 mmol/mol) whereas the arm that used probiotics had lowered it by 8.9 per cent (eg from 50mmol/mol to 45.5 mmol/mol). They also had lower fasting blood sugars compared with the standard group.

The researchers propose that the probiotics help the body produce more butyrate, which may play a role in insulin sensitivity. However, it was a small study and not in people with diabetes, so before you rush out and buy your daily dose of probiotics, more research is needed to confirm the findings.

Gene therapy

A Chinese research team have become the first to inject a person with cells that contain genes edited using the revolutionary CRISPR–Cas9 technique. Although earlier clinical trials have been tried using other techniques, CRISPR-Cas9 is simpler and more efficient than other techniques.

With this technique, scientists remove immune cells from the recipient’s blood and then disable a gene in them using CRISPR–Cas9, which combines a DNA-cutting enzyme with a molecular guide that can be programmed to tell the enzyme precisely where to cut. The disabled gene then codes for the protein PD-1, which normally stops the immune response in the cell which cancers use to proliferate. These cells are then cultured outside the body and injected back in to the patient in large numbers. The hope is that these cells will then be better able to attack the cancerous cells.

Similar studies have just been given approval in the US, with the goal of treating a number of different cancers. At this stage, the trials are really being set up to confirm that the process is safe for the patient and doesn’t have unexpected side effects. But if successful, this is being hailed as a potential breakthrough in gene therapies, which could have wider impacts outside the cancer world.

Sent to bed without any dinner!

A small study has shown that fasting in the evening may lead to improved weight loss and metabolism. The trial followed 11 men and women with a mean BMI of 30.1kg/m2. All participants were followed over 4 days of eating between 8 am and 2pm and 4 days of eating between 8 am and 8 pm. The researchers then tested the impact of both diets on calories burned, fat burned, and appetite. The same number of calories were eaten in both approaches, and to avoid any bias, all participants tried both diets.

The restricted diet didn’t affect how many calories were burned, but it did reduce daily hunger swings and increased fat burning during several hours at night. It also improved metabolic flexibility and led to greater weight loss. The researchers hypothesize that, as many aspects of metabolism function at their best in the morning, eating in better alignment with the body’s circadian clock may positively influence health.

So perhaps being sent to bed without any dinner might not be such a bad thing after all!

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