Experts say sustainable weight loss can protect patients from disease directly associated with morbid obesity such as type 2 diabetes.

Obese people who get bariatric surgery are less likely to require medication to control diabetes symptoms afterward, compared to those who don’t get operations to lose weight, a French study suggests.

Researchers examined data on 15,650 obese patients who had weight-loss surgery in France in 2009, including 1,633 people who were on medications to help control diabetes at the time. The surgery recipients were compared to an equal number of similar obese patients who were hospitalized that year but didn’t get bariatric surgery.

Six years later, half of the people who started out on diabetes medication and got bariatric surgery were no longer taking these drugs, compared to 9 percent in the control group that didn’t have the surgery, researchers report in JAMA Surgery.

 “We can hypothesize that sustainable weight loss can protect patients from disease directly associated with morbid obesity such as type 2 diabetes, which is a serious chronic disease that has become more prevalent all around the world,” said lead study author Dr. Jeremie Thereaux of La Cavale Blanche University Hospital and the University of Bretagne Occidentale in Brest, France.

 “Bariatric surgery should be considered as an effective treatment of type 2 diabetes in patients suffering from morbid obesity,” Thereaux said. “However, bariatric surgery is not actually recommended in the U.S. and in Europe as a treatment of type 2 diabetes in less-obese patients, and our study cannot scientifically support this idea.”

Surgical weight loss has gained traction in recent years as a growing number of extremely obese patients turn to this option after failing to lose weight through diet, exercise or medication - strategies that can also manage diabetes. Like all surgery, bariatric operations are not risk free; with these procedures there’s a possibility of malnutrition and repeat operations to adjust, replace or remove a device implanted to aid weight loss.

Among people taking diabetes drugs at the start of the study, the biggest impact on diabetes remission was seen with gastric bypass, which can reduce the size of the stomach from about three pints to roughly the size of a shot glass.

Compared to people who didn’t get weight-loss surgery, patients who had gastric bypass were more than 17 times more likely to discontinue diabetes medications by the end of the study.

With a different weight-loss operation known as a sleeve gastrectomy, which reduces the stomach to the size of a banana, people were more than 7 times more likely to discontinue their diabetes drugs without surgery.

A third type of weight-loss surgery, adjustable gastric banding, which inserts an inflatable silicone device around the top portion of the stomach to help slow and reduce food consumption, was associated with more than four times the likelihood of discontinuing diabetes drugs.

With surgery, people who didn’t take diabetes medications at the start of the study were also less likely to start taking them during the follow-up period. By the end of the study, 1.4 percent of people who got bariatric surgery started taking diabetes drugs, compared with 12 percent of the control group.

The study wasn’t a controlled experiment designed to prove whether or how weight-loss surgery might help people control diabetes symptoms or reduce the need for diabetes medications. Researchers also lacked data on the amount of weight loss and how long people had been living with diabetes, both of which can independently influence whether patients need medications.

Even so, the results add to evidence that surgical weight loss may help manage diabetes, said Dr. Michel Gagner, author of an accompanying editorial and a professor of surgery at the Herbert Wertheim School of Medicine at Florida International University in Miami.

In some parts of the world, weight loss surgery is commonly done to treat diabetes, Gagner said by email.

 “In fact, even patients that are non-obese but have type 2 diabetes can get these operations,” Gagner added. “Having no more diabetes is a big thing, as diabetes attacks small blood vessels and leads to blindness, renal failure on dialysis or need for renal transplant, heart attacks and amputation of limbs.”

Courtesy - Deccan Hearald


According to WHO estimates, India has about 70 million diabetics and is rapidly moving towards becoming the diabetes capital of the world, even though rates of the disease are increasing across the world.

Diabetes may actually be of five types and not just type 1 and type 2 as people know it, suggests new research published in The Lancet Diabetes & Endocrinology journal.

Recasting adult-onset diabetes into five types could help better tailor early treatment for patients, said the research by scientists from Lund University Diabetes Centre, Sweden, and Institute for Molecular Medicine Finland. The five types found had different characteristics, with different complications, and called for different treatment needs.
According to WHO estimates, India has about 70 million diabetics and is rapidly moving towards becoming the diabetes capital of the world, even though rates of the disease are increasing across the world.

While type 1 diabetes is generally diagnosed in childhood and caused by the body not producing enough insulin, type 2 occurs when the body cannot produce enough insulin to meet increased demand imposed by obesity and insulin resistance (dearth of hormone receptors), and typically occurs later in life. Most diagnosed cases are type 2 (75-85%).
For the new study, in 14,775 patients across Sweden and Finland, the authors analysed six measurements — age at diagnosis, body mass index, long-term glycaemic control, successful functioning of insulin-producing cells in the pancreas, insulin resistance, and presence of auto-antibodies associated with autoimmune diabetes. They also did genetic analyses, and compared disease progression, treatment, and development of complications for each type.

The authors identified one autoimmune type of diabetes (condition in which the body produced chemicals that destroyed insulin) and four distinct subtypes of type 2 diabetes. Three forms were severe and two mild. Among the severe forms, one group had severe insulin resistance and a significantly higher risk of kidney disease than the other types (affecting 11-17% of patients). Another had relatively young, insulin-deficient individuals with poor metabolic control but no auto-antibodies (9-20%). The remaining severe group was insulin-deficient patients who had auto-antibodies associated with autoimmune diabetes (6-15%), the form called type-1, or latent autoimmune diabetes in adults.

The most common was one of the more moderate forms, seen in the elderly and affecting 39-47% of the patients. The other mild form was mainly seen in obese individuals and affected 18-23% of patients.

All five types were genetically distinct.

“Evidence suggests that early treatment for diabetes is crucial to prevent life-shortening complications. More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop,” said lead author Professor Leif Groop, Lund University Diabetes Centre . “Existing treatment guidelines are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment. This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes.”

The study could not confirm if the five types have different causes, nor if patients’ type changes over time. Future research will be needed to test and refine the five types.

Courtesy - Indian Express

Patients may not be eating nuts due to concerns about the high-fat content and that increasing nut consumption will lead to obesity, which leads to worse outcomes says a study. "The results highlight the importance of emphasising dietary and lifestyle factors in colon cancer survivorship," added a researcher.

People with colon cancer who regularly eat nuts such as almonds, walnuts, hazelnuts, cashews and peanuts may be at significantly lower risk of cancer recurrence and mortality, researchers say. The findings showed that those who regularly consumed at least two, one-ounce servings of nuts each week showed a 42 per cent improvement in disease-free survival and a 57 per cent improvement in overall survival. In patients with stage III colon cancer, recurrence was reduced by nearly half. “These findings are in keeping with several other observational studies that indicate that a slew of healthy behaviours, including increased physical activity, keeping a healthy weight, and lower intake of sugar and sweetened beverages, improve colon cancer outcomes,” said lead author Temidayo Fadelu, postdoctoral student at Dana-Farber Cancer Institute in Boston.

“The results highlight the importance of emphasising dietary and lifestyle factors in colon cancer survivorship,” Fadelu added. The study, published in the Journal of Clinical Oncology, followed 826 participants in a clinical trial for a median of 6.5 years after they were treated with surgery and chemotherapy. Patients may not be eating nuts due to concerns about the high-fat content and that increasing nut consumption will lead to obesity, which leads to worse outcomes. On the contrary, “our studies, and across the scientific literature in general, have found regular consumers of nuts tend to be leaner”, explained Charles S. Fuchs, Director at Yale Cancer Centre in the US.

Many previous studies have reported that nuts also help to reduce insulin resistance. “These studies support the hypothesis that behaviours that make you less insulin resistant, including eating nuts, seem to improve outcomes in colon cancer,” Fuchs said. Nuts also might play a positive role by satisfying hunger with less intake of carbohydrates or other foods associated with poor outcomes, Fuchs noted.


Courtesy - Indian Express


An amateur astronomer from Argentina captured a rare image: one of an exploding star.

Scientists have obtained the first view of the initial burst of light from the explosion of a massive star, thanks to lucky snapshots taken by an amateur astronomer in Argentina. While testing a new camera, Victor Buso captured images of a distant galaxy before and after the supernova’s ‘shock breakout’ – when a supersonic pressure wave from the exploding core of the star hits and heats gas at the star’s surface to a very high temperature, causing it to emit light and rapidly brighten.

To date, no one has been able to capture the ‘first optical light’ from a supernova, since stars explode seemingly at random in the sky, and the light from shock breakout is fleeting. The new data provide important clues to the physical structure of the star just before its catastrophic demise and to the nature of the explosion itself. “Professional astronomers have long been searching for such an event,” said Alex Filippenko, an astronomer at University of California, Berkeley in the US.

“Observations of stars in the first moments they begin exploding provide information that cannot be directly obtained in any other way,” said Filippenko, who followed up the discovery with observations that proved critical to a detailed analysis of explosion, called SN 2016gkg. On September 20, 2016, Buso was testing a new camera on his 16-inch telescope by taking a series of short-exposure photographs of the spiral galaxy NGC 613, which is about 80 million light years from Earth and located within the southern constellation Sculptor.

Luckily, he examined these images immediately and noticed a faint point of light quickly brightening near the end of a spiral arm that was not visible in his first set of images. Astronomer Melina Bersten and her colleagues at the Instituto de Astrofisica de La Plata in Argentina soon learned of the serendipitous discovery and realised that Buso had caught a rare event, part of the first hour after light emerges from a massive exploding star. She estimated Buso’s chances of such a discovery, his first supernova, at one in 10 million or perhaps even as low as one in 100 million.

“It’s like winning the cosmic lottery,” said Filippenko. Bersten immediately contacted an international group of astronomers to help conduct additional frequent observations of SN 2016gkg over the next two months, revealing more about the type of star that exploded and the nature of the explosion. Researchers estimated that the initial mass of the star was about 20 times the mass of our Sun, though it lost most of its mass, probably to a companion star, and slimmed down to about 5 solar masses prior to exploding.


Courtesy - Indian Express

A research study shows that social media grealty influences teenagers' lives, including their relationships.

Social media experiences of teenagers may spill over into real life and affect their relationships, a study suggests. According to researchers at University of California, Irvine in the US, a new digital divide appears to be emerging over the types of experiences teens have online.

In the research published in the journal Nature, Professor Candice Odgers analysed data from various existing studies. “The evidence so far suggests that smartphones may serve as mirrors reflecting problems teens already have,” Odgers said. “Those from low-income families said that social media experiences more frequently spilled over into real life, causing more offline fights and problems at school,” said Odgers.

In a 2015 survey by Odgers and colleagues, 10- to 15-year-olds reported high levels of regular internet access regardless of family income: 92 per cent for those from economically disadvantaged homes and 97 per cent for their more affluent peers. The gap in smartphone ownership is even smaller, at 65 per cent and 69 per cent, respectively, researchers said. Other studies reviewed by Odgers indicated the need for additional support from parents, schools or other community organisations for adolescents from economically disadvantaged households, who are more likely to be bullied, solicited and victimised in cyberspace.

They also usually have less parental mediation, guidance and supervision of their online activities, researchers said. “The majority of young people appear to be doing well in the digital age, and many are thriving with the new opportunities that electronic media provides. “But those who are already struggling offline need our help online too,” Odgers said.

“Strategies that encourage parental involvement – as well as partnerships between local governments, technology companies and educational institutions – are key to ensuring that all young people, including the most vulnerable, have positive online experiences,” said Odgers.


Courtesy - Indian Express

Friday, 23 February 2018 03:38

Surgery may affect patients’ memory: study

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Reduced immediate memory scores at the second visit were significantly associated with the number of operations in the preceding nine years. Working memory decline was associated with longer cumulative operations, researchers said.


Patients may score slightly lower on certain memory tests after undergoing surgery, a study suggests.

The study published in the journal Anaesthesia involved 312 participants who had surgery and 652 participants who had not (with an average age in the 50s).

Surgery between tests was associated with a decline in immediate memory by one point out of a possible maximum test score of 30 points, researchers said.

Memory became abnormal in 77 out of 670 participants with initially normal memory comprising 18 per cent of those who had had surgery compared with 10 per cent of those who had not, they said.

“The cognitive changes we report are highly statistically significant in view of the internal normative standards we employ, and the large sample size of the control, or non-surgery, population,” said Kirk Hogan from the University of Wisconsin-Madison in the US.

“However, the cognitive changes after surgery are small – most probably asymptomatic and beneath a person’s awareness,” said Hogan.

No differences in other measures of memory and executive function were observed between participants having and not having surgery.

Reduced immediate memory scores at the second visit were significantly associated with the number of operations in the preceding nine years.

Working memory decline was associated with longer cumulative operations, researchers said.

“The results await confirmation both in follow-up investigations in our own population sample after more surgeries in aging participants, and by other investigators with other population samples,” said Hogan.

He noted that it is too early to recommend any changes in clinical practice regarding prevention, diagnosis, management, and prognosis of cognitive changes after surgery.


Courtesy - Indian Express



Courtesy - Indian Express


A big tummy with thin thighs is equal to high risk of diabetes and a slim tummy with big thighs is equal to low risk of diabetes. Sir Ganga Ram Hospital has come out with a new study that can help predict diabetes. Find out more here.

According to International Diabetes Federation, there were over 72 million cases of diabetes in India in 2017. The number of Indians suffering from this malicious disease is expected to cross the 100 million mark by 2030. A large part of this epidemic spreading so rampantly can be attributed to the rising obesity.

Sir Ganga Ram Hospital along with Motilal Nehru Medical College of Allahabad, has recently discovered a “simple and cost-effective screening tool” to identify people at high risk of Type 2 diabetes.

According to the study, “Big tummy with thin thighs is equal to high risk of diabetes and slim tummy with big thighs is equal to low risk of diabetes.”

Why do big thighs protect one from diabetes and not a big tummy?

The fat on the thighs called the subcutaneous fat sits under the skin and is not very harmful. On the other hand, a big tummy means one has visceral fat that surrounds the organs. It is a “deep-rooted” fat that changes that way the body functions.

“If two people are overweight, the one having subcutaneous fat is less likely to have diabetes than the one with visceral fat,” says Dr Tejal Lathia, consultant, endocrinologist, Hiranandani Hospital Vashi. However, it does not mean that a person with subcutaneous fat storage cannot develop diabetes, she added.

When should you get checked for diabetes?

People over 40 years of age should get checked for the disease. Those who are younger are likely to develop it if they have a family history of diabetes, are overweight, have a sedentary lifestyle or suffer from hypertension. The other signs to watch out for are:

* If the Body Mass Index (BMI) is more than 23, one is likely to get diabetes.

* A person having a history of gestational diabetes, which means that a pregnant woman without diabetes develops high blood sugar during her carrying period, is a sign of diabetes.

* Giving birth to a baby weighing more than four kilos is also a sign, according to Dr Monika Sharma, Consultant, Endocrinology, Indraprastha Apollo Hospitals, Delhi.

What difference has the study made?

The study has made it easier to predict who can or cannot develop diabetes in the future. Dr Atul Gogia, co-author and senior consultant, Department of Medicine, Sir Ganga Ram Hospital, said: “Our study found that diabetics had significantly greater waist circumference than non-diabetics. Also, diabetics had lesser thigh circumference than non-diabetics.

“We found Waist Thigh Ratio (WTR) of 2.3 as a cut-off point as a predictor of diabetes. Simply put, a person having Waist Thigh Ratio (WTR) less than 2.3 will be at low risk of diabetes and may not require further investigation.”

The waist circumference is often used as a parameter for diagnosing diabetes. Dr V Mohan, who is the chairman and Chief of Diabetology at Dr. Mohan’s Diabetes Specialities Centre, a WHO Collaborating Centre for Noncommunicable Diseases Prevention, uses a scoring system which screens the patient’s weight, family history, age and waist circumference.

Why are Indians more prone to have diabetes?

A carb-heavy diet with little protein and high sugar content makes Indians more likely to have diabetes.

The study has made it easier to predict diabetes effectively and inexpensively and this screening can help in further treating the disease.

New research into polar ice has shown that bacteria can survive deeper into ice sheets, raising the possibility of life in our solar systems' distant, icy planets.

For the first time, scientists have discovered living bacteria in polar ice and snow – an environment once considered sterile – altering perceptions about which planets in the universe could sustain alien life. The research also shows that humans may be having an even greater impact on levels of carbon dioxide (CO2) in Earth’s atmosphere than accepted evidence from climate history studies of ice cores suggests.

Gases captured and sealed in snow as it compresses into ice can provide researchers with snapshots of Earth’s atmosphere going back hundreds of thousands of years. Climate scientists use ice core samples to look at prehistoric levels of CO2 in the atmosphere so they can be compared with current levels in an industrial age. This analysis of ice cores relies on the assumption that there is limited biological activity altering the environment in the snow during its transition into ice.

The research, published in the Journal of the Royal Society Interface, revealed that the composition of small samples of gas trapped in the ice may have been affected by bacteria that remain active in snow while it is being compressed into ice – a process that can last decades. “As microbial activity and its influence on its local environment has never been taken into account when looking at ice-core gas samples it could provide a moderate source of error in climate history interpretations,” said Kelly Redeker from the University of York in the UK.

“Respiration by bacteria may have slightly increased levels of CO2 in pockets of air trapped within polar ice caps meaning that before human activity CO2 levels may have been even lower than previously thought,” said Redeker. “In addition, the fact that we have observed metabolically active bacteria in the most pristine ice and snow is a sign of life proliferating in environments where you wouldn’t expect it to exist,” he said.

“This suggests we may be able to broaden our horizons when it comes to thinking about which planets are capable of sustaining life,” he added. Research conducted in laboratories has previously shown that bacteria can stay alive at extremely cold temperatures, but this study is the first time that bacteria have been observed altering the polar snow environment in situ.

The researchers looked at snow in is natural state, and in other areas they sterilised it using UV sterilising lamps. When they compared the results the team found unexpected levels of methyl iodide – a gas known to be produced by marine bacteria – in the untouched snow. Researchers also detected the presence of gases at part-per-trillion levels, one million times less concentrated than atmospheric CO2 concentrations.

The results of the study also suggest that life can be sustained even in remote, cold, nutrient poor environments, offering a new perspective on whether the frozen planets of the universe could support microorganisms.


Courtesy - Indian Express

Adding a daily serving of green, leafy vegetables to your diet may be a simple way to foster your brain health. In people who ate the most of green, leafy vegetables brain ageing slowed by 11 years.

Eating one to two servings of salad with spinach, lettuce and kale daily may keep your brain 11 years younger as well as prevent dementia, according to a study.

The study found that people who ate at least one serving of green, leafy vegetables a day had a slower rate of decline on tests of memory and thinking skills than people who never or rarely ate these vegetables.

In people who ate the most of green, leafy vegetables brain ageing slowed by 11 years.

“Adding a daily serving of green, leafy vegetables to your diet may be a simple way to foster your brain health,” said Martha Clare Morris, from the Rush University in Chicago.

“Projections show sharp increases in the percentage of people with dementia as the oldest age groups continue to grow in number, so effective strategies to prevent dementia are critical,” Morris added.

The study, published in the journal Neurology, involved 960 people with an average age of 81 who did not have dementia and were followed for an average of 4.7 years.

Over 10 years of follow-up, the rate of decline for those who ate the most leafy greens was slower by 0.05 standardised units per year than the rate for those who ate the least leafy greens. This difference was equivalent to being 11 years younger in age.

The results remained valid after accounting for other factors that could affect brain health such as smoking, high blood pressure, obesity, education level and amount of physical and cognitive activities, the researchers said.

Courtesy - Indian Express

A study suggests that there might be something about helping strangers that impacts one's moral identity or perceptions of self in a more significant way than helping friends or family members, although these are beneficial behaviours as well

Lending a helping hand to strangers can help teenagers improve self esteem and boost confidence, suggests new research. While adolescents who exhibited pro-social behaviour — such as helping, sharing and comforting — towards strangers had higher self-esteem a year later, the same was not true for those in the study who exhibited pro-social behaviour solely to friends and family, found the research published in the Journal of Adolescence.

“This study helps us to understand that young people who help those with whom they do not have a relationship report feeling better about themselves over time,” said study co-author Laura Padilla-Walker, Professor at Brigham Young University in the US.

“Given the importance of self-esteem during the teen years, this is an important finding. It suggests there might be something about helping strangers that impacts one’s moral identity or perceptions of self in a more significant way than helping friends or family members, although these are beneficial behaviours as well,” Padilla-Walker said.

In the study, researchers looked at 681 adolescents, 11-14 years old, in two US cities. The participants responded to 10 statements such as “I feel useless at times” or “I am satisfied with myself” to assess self-esteem. “Not all helping is created equal, and we’re finding that pro-social behaviour toward strangers is protective in a variety of ways that is unique from other types of helping,” Padilla-Walker said.

Another important finding was that the link between pro-social behaviour and self-esteem was over a one-year time period and present across all three age lags in the study.

Courtesy - Indian Express

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