Wellness

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A drink a day might be good for diabetics' health, study suggests

By

Serena Gordon, HealthDay News

People who had a bit of alcohol daily had lower levels of a type of blood fat called triglycerides, researchers found. Photo courtesy of HealthDay News

Chinese researchers may deserve a toast for their new findings that suggest light to moderate drinking may be beneficial for people with Type 2 diabetes.

The review found that people who had a bit of alcohol daily had lower levels of a type of blood fat called triglycerides. But alcohol didn't seem to lower blood sugar levels in people who already had Type 2 diabetes, the review found.

The research did show lower levels of insulin and improved insulin resistance in people who drank light to moderate amounts of alcohol, study lead author Yuling Chen said. Chen is a medical student at Southeast University in Nanjing, China.

That finding suggests that "light to moderate alcohol consumption might protect against Type 2 diabetes," Chen said.

RELATED Alcohol taxes don't cover societal costs of excess drinking, study says

But Chen cautioned that you can have too much of a good thing: "High alcohol consumption is reported to be a risk factor for diabetes."

The authors said light to moderate drinking is about 20 grams of alcohol daily. That's about 1.5 cans of beer, a large glass of wine (almost 7 ounces), or a generous shot (1.7 ounces) of distilled spirits.

The American Diabetes Association recommends that people who drink alcohol do so in moderation -- no more than one drink per day for adult women and no more than two drinks per day for adult men.

RELATED Diabetes control has stalled across U.S.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said those are the levels he recommends to his patients with Type 2 diabetes.

"A little alcohol can be good for you, and that's no different in patients with Type 2 diabetes," he said.

One caveat, Zonszein said, is that people with Type 1 diabetes and anyone with Type 2 who is taking insulin or other medications that can cause low blood sugar levels must be more cautious with alcohol. It can sometimes lead to dangerously low levels of blood sugar (hypoglycemia).

RELATED Weight-loss surgery reduces risk of heart disease, death for diabetics

But not all Type 2 diabetes medications are a concern with alcohol. For example, he said, it's OK to have a drink if you're taking a commonly used Type 2 diabetes drug called metformin.

Zonszein shared Chen's concern about too much alcohol. "Excessive drinking is a problem," he said, noting that too much alcohol can raise triglycerides and lead to serious health concerns, such as pancreatitis.

For the new research, Chen and colleagues reviewed 10 previous randomized controlled trials on people with Type 2 diabetes. Those studies had a total of 575 volunteers.

A number of factors related to diabetes and health were measured, including blood sugar control, insulin levels, insulin resistance, cholesterol and triglycerides.

Across the studies, researchers found a drop of nearly 9 milligrams per deciliter (mg/dL) in average triglyceride levels. A normal triglyceride level is less than 150 mg/dL, according to the U.S. National Institutes of Health. A high level of triglycerides is associated with a higher risk of heart disease.

Researchers also saw decreases in insulin levels and in a measure called HOMA-IR that assesses insulin resistance. Chen said these findings suggest "relieved insulin resistance in Type 2 diabetes patients."

The authors are scheduled to present the findings Tuesday at a meeting of the European Association for the Study of Diabetes, in Barcelona, Spain. Findings presented at meetings are typically viewed as preliminary until they've been published in a peer-reviewed journal.

More information

Learn more about alcohol and diabetes from the American Diabetes Association's Diabetes Forecast.

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BARCELONA — Metabolic signs of type 2 diabetes are detectable in the blood of some children as young as 8 years old, according to the results of a large epidemiological study presented here at the European Association for the Study of Diabetes (EASD) 2019 Annual Meeting.

"It's remarkable that we can see signs of adult diabetes in the blood from such a young age — this is about 50 years before it is commonly diagnosed," said lead researcher Joshua Bell, PhD, MRC Integrative Epidemiology Unit, University of Bristol, UK.

Bell and colleagues used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) study to look at the early features of type 2 diabetes in children aged 8 and older.

The researches assessed genetic liability in the kids using variants known to be associated with adult diabetes and calculated a genetic risk score, which was cross-referenced with metabolic markers in the blood measured at four time points as the children grew up, until the age of 25. The full article is also available online.


"This was a way of trying to piece together what the disease looks like as it's developing," he told Medscape Medical News.

Specifically, one of the earliest features to change in the blood was metabolism of high-density lipoprotein cholesterol (HDL-C) or "good" cholesterol. Low levels of this marker appeared to be correlated with higher genetic likelihood of developing type 2 diabetes in adulthood, Bell explained

These changes occurred before any alterations in low-density lipoprotein cholesterol (LDL-C) or "bad" cholesterol.

Session moderator Naveed Sattar, MD, from the Institute of Cardiovascular & Medical Sciences at the University of Glasgow, UK, welcomed the work but pointed out that it is unlikely this information would be used clinically, at least at the present time.


"It does add a little bit of new information on what the pathways to diabetes may be — so only of research interest currently — not for the clinic for many years, if ever," he observed.

"We already have good risk scores based on questions and simple measurements of weight or waist...which help signal those at high risk [of diabetes] who should consider getting tested for it," he added.

What Are the Earliest Features of Type 2 Diabetes? How Do They Unfold?

Bell explained that type 2 diabetes takes many years to develop and, based on adult data, it has been established that disease-related changes can occur in the decade or two leading up to diagnosis.


"What we don't know is what the very early beginnings of disease look like," he explained.

Using the ALSPAC data (also known as the cohort of the 90s study), Bell and colleagues genotyped 4765 children for 162 genetic variants of adult type 2 diabetes and also examined lipid measures — including triglycerides as well as a number of amino acids and fatty acids — in blood samples taken at ages 8, 15, 18, and 25 years.

"We wanted to know the effect of that genetic susceptibility on blood markers. How early in life do we see the beginning of disease activity? And how does it unfold?" he told Medscape Medical News.

He acknowledged the findings "are more preclinical than clinical," but stressed they provide some early insight into "what features might be targeted to prevent progression to clinical disease."

Elizabeth Robertson, PhD, director of research at Diabetes UK, said the findings may indeed be of use in years to come.

"In the future, insights like these could mean we're able to spot who is at a higher risk and — most importantly – find ways to intervene to reduce this risk much earlier in a person's life than we're able to today and...potentially prevent more cases of type 2 diabetes from developing at all," she commented.

"Although we can't do anything about our genetic risk, there are things you can do to help lower your risk of developing the condition that include maintaining a healthy weight, eating well, and moving more," she noted.

EASD 2019 Annual Meeting. Presented September 19, 2019. Abstract 81.

Bell has reported no relevant financial relationships.

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Why Diabetes Management May Need to Change for South Asians

Moneeza Siddiqui, PhD

Disclosures
September 19, 2019

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This transcript has been edited for clarity

I'm Dr Moneeza Siddiqui, from the University of Dundee, and I'm here at the European Association for the Study of Diabetes (EASD) 2019 Annual Meeting presenting some results we have from, from the India-Scotland Partnership for Precision Medicine in Diabetes (INSPIRED).

These are first results from INSPIRED. Our aim was to understand how clinical features at the time of diagnosis of type 2 diabetes differed between Asian Indians and White Europeans. These are results from a cross-sectional study of 100,000 individuals from South India and the United Kingdom.

What were your findings?


Essentially what we found were that what are well known to be traditional risk factors for the age of onset of type 2 diabetes, do not appear to predict risk for onset as well in South Asians as they do in white Europeans. Primarily features like obesity, calculated by body mass index, or waist circumference, while strongly associated with the age of onset in white Europeans, very obese white Europeans could develop diabetes quite young, whereas those developing diabetes at the age of 60, or 70, or later, tend to be quite slim.

This effect was completely absent in in South Asians who were generally a lot slimmer than white Europeans when they developed diabetes and never really showed a strong association of increased obesity with early age of onset.

The other very striking result we had was with regards to blood pressure. It's well known that the metabolic syndrome, which is how diabetes is generally described in white Europeans is associated with not only obesity, but also hypertension. And we definitely see that in our white European population where young onset diabetes is associated with quite high systolic and diastolic hypertension. But this effect was again completely absent in Asian Indians, who in comparison had very normal systolic and diastolic blood pressure -  120/80 being the norm for those diagnosed under the age of 40, which was also quite puzzling.

But finally, the area in which we did see a big difference was in beta cell function. Beta cells are obviously are a marker of insulin secretion. And we could see quite clearly that in those diagnosed young in South Asians, there was a lower beta-cell function that was not evident in white Europeans who were diagnosed at similar ages, suggesting that that's really where the answer lies for Asian Indians.


What other differences did you find?

Actually, what's really striking in our results was that it's pretty well known that South Asians develop diabetes much younger than white Europeans. But in this particular study, in this particular population, we're looking at a 15 year difference in the age of onset on average.

Part of the population level effect that's occurring here is that, aside from the ethnically driven risk, is that Asian Indians in this study are from a private clinic system for the management of type

2 diabetes. So it is possible that we're looking at a slightly more extreme group of people with type 2 diabetes. But it's not uncommon in India, if you have a chronic health condition to seek management in a private specialist facility. What's particularly of note here is that if we are looking at a slightly more extreme kind of, a more aggressive type of type 2 diabetes, what’s even more striking is that is that in spite of that there is lower adiposity and hypertension compared to white Europeans, which is really of note. We did undertake additional analyses, comparing our Asian Indian cohort with a population-level dataset from the same region in India, and noticed an increased BMI and waist circumference in our cohort (who had type 2 diabetes) compared to the local population. This does suggest there is an increase in adiposity in Asian Indians with diabetics, it is just to a much lesser degree than in white Europeans. Our results also suggest that increased adiposity in Asian Indians does predict who will develop diabetes, but not when.


What's the message from your research for primary care?

Obviously, before these findings become incorporated into routine care, there would need to be plenty of clinical trials done to understand first of all, what drugs would best work in South Asians, because clearly what we are starting to see here is that the pathogenesis of the disease is very different. And so I think the same therapies may not work to the same efficacy in these two ethnically different populations.

Based on our findings, there are two main unknows in Asian Indians:

• What specifically is causing the beta-cell failure

• Could we improve our understanding of adiposity in this ethnic group?

We're seeing this across the EASD. Several talks this year have focused on perhaps a different standard of screening for South Asians, whereby they’re screened younger perhaps, should be screened more frequently. Because this is noted both in our study, which is looking at indigenous South Asians, as well as some studies that I have been to today, that have discussed South Asians living in the UK, for example, who, when they are diagnosed with type 2 diabetes, seem to have very high HbA1Cs, which perhaps suggests that they aren’t seeking health care as routinely as white Europeans are or perhaps they aren't being compelled to be screened as often as they should be, given that we already know they are at an increased risk.

So I think the main message for primary care, primary care physicians,would be essentially to just be a little bit more aware that that disease comes on that much sooner in in South Asians, and that early-onset may not necessarily come bundled together with our idea of metabolic syndrome, as in those people may not be quite as obese or as hypertensive as you might think they would be to have risk at that young age. Essentially, what we're looking at is a beta cell issue, so perhaps tailoring medications for that might be the future of primary healthcare for diabetes in South Asians.

Editor's Note: This article was updated after publication to include additional informsation from Moneeza Siddiqui.

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BARCELONA — Use of real-time continuous glucose monitoring (rtCGM) can help improve blood glucose control in people with type 1 diabetes whether they use an insulin pump or multiple daily injections (MDI) of insulin, new research suggests. 

Three-year data from the Comparison of Different Treatment Modalities for Type 1 Diabetes Including Sensor-Augmented Insulin Regimens (COMISAIR) study were presented here at the European Association for the Study of Diabetes (EASD) 2019 Annual Meeting by Jan Šoupal, MD, PhD, Charles University, Prague, Czech Republic.

The results were simultaneously published in Diabetes Care.

At 3 years — the longest duration of any CGM trial — real-time (not flash) CGM was superior to self-monitored blood glucose (SMBG), or fingerstick, testing at least four times daily in reducing HbA1c in patients using both pumps and MDI, with little difference between the two insulin delivery modalities.


Only the rtCGM group had improvements in time-in-range and reduced time below range. Fewer patients using rtCGM experienced severe hypoglycemic episodes. 

"It is not so important how insulin is delivered, but more important is how patients with type 1 diabetes monitor their glucose," Šoupal said during his presentation.

CGM and Whether It Is Real-Time Key to Best Outcomes

Šoupal also said that "CGM and multiple daily injections [of insulin] can be a suitable alternative to treatment with pumps and CGM for some patients," such as those who have achieved good control using that regimen, those who are only willing to accept one device on their bodies, or for reasons of accessibility/affordability.


Patients likely to do better with pump plus CGM regimens include those with the dawn phenomenon (a rise in blood glucose in the early morning) and those who are physically active and can benefit from temporarily lowered basal infusion rates. Patients with hypoglycemic unawareness may be ideal candidates for sensor-augmented pump therapy, he added.

"Individualization of treatment is important. However, according to the results of our trial, in the vast majority of cases, CGM is what makes the difference," Šoupal said.

Asked to comment, Julia Mader, MD, Medical University of Graz, Austria, agreed. "The majority of patients profit from rtCGM whereas the insulin delivery mode is really not that important and should be at the patients' preference. They are equal."

Many of the oIder studies that showed improved glycemic control with insulin pumps were conducted during the time prior to use of insulin analogs, she noted, so that the comparator of twice-daily injections of NPH and Regular insulin versus Regular in the pump is not an accurate reflection of today's modalities. Today, she said, "Multiple daily injection [of insulin] is much better than before.”   

Mader also noted that the "real-time" aspect of CGM is important.

Participants in the current study used either the Dexcom G4 or Medtronic Enlite sensors, not the Abbott Libre (ie, "flash" glucose monitoring or FGM).

In her practice in Austria, where many patients use FGM, many don't achieve HbA1c targets with either pump or injection therapy, she noted. That's probably due in part to the alarm feature of rtCGM but not flash monitoring and that flash monitoring is less accurate in the lower ranges of blood glucose levels. 


"Real-time alarms are better than just having the data...I think that's why patients are more cautious," she said.

Mader also cautioned that in some cases the introduction of CGM or flash glucose monitoring might actually lead to an increase in HbA1c if the main initial effect is reducing hypoglycemic events, which should be explained to patients, she advised.

COMISAIR Study Details

The real-world, nonrandomized study compared changes in HbA1c among 94 patients using one of four treatment regimens: insulin pumps with or without rtCGM (15 and 20 patients, respectively) and MDI with or without rtCGM (12 and 18 patients), and all participants also used SMBG.


All patients were adults with type 1 diabetes of at least 2 years' duration and baseline HbA1c 7.0%-10.0% (53-86 mmol/mol). A total of 88 participants completed all 15 study visits at 3-month intervals over 3 years.

At 3 years, the rtCGM + MDI and rtCGM + insulin pump groups had significantly lower HbA1c levels compared with the MDI and pump groups using SMBG, at HbA1c 7.0% (53 mmol/mol), P = .0002, and 6.9% (52 mmol/mol), P < .0001, versus 8.0% (61 mmol/mol), P = .3574, and 7.7% (61 mmol/mol), P = 1.00. There were no significant differences between the two CGM groups or the two fingerstick groups.   

The proportions of patients who achieved HbA1c < 7% at 3 years were 48% with rtCGM + MDI and 43% with rtCGM + pump, compared to just 9% with SMBG + pump and 16% with SMBG + injections. 

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General Diabetes Facts and Information

What is diabetes?

Diabetes is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream — causing one’s blood glucose (sometimes referred to as blood sugar) to rise too high.

There are two major types of diabetes. In type 1 (fomerly called juvenile-onset or insulin-dependent) diabetes, the body completely stops producing any insulin, a hormone that enables the body to use glucose found in foods for energy. People with type 1 diabetes must take daily insulin injections to survive. This form of diabetes usually develops in children or young adults, but can occur at any age. Type 2 (formerly called adult-onset or non insulin-dependent) diabetes results when the body doesn’t produce enough insulin and/or is unable to use insulin properly (insulin resistance). This form of diabetes usually occurs in people who are over 40, overweight, and have a family history of diabetes, although today it is increasingly occurring in younger people, particularly adolescents.

How do people know if they have diabetes?

People with diabetes frequently experience certain symptoms. These include:

• being very thirsty
• frequent urination
• weight loss
• increased hunger
• blurry vision
• irritability
• tingling or numbness in the hands or feet
• frequent skin, bladder or gum infections
• wounds that don't heal
• extreme unexplained fatigue

In some cases, there are no symptoms — this happens at times with type 2 diabetes. In this case, people can live for months, even years without knowing they have the disease. This form of diabetes comes on so gradually that symptoms may not even be recognized.

Who gets diabetes?

Diabetes can occur in anyone. However, people who have close relatives with the disease are somewhat more likely to develop it. Other risk factors include obesity, high cholesterol, high blood pressure, and physical inactivity. The risk of developing diabetes also increases as people grow older. People who are over 40 and overweight are more likely to develop diabetes, although the incidence of type 2 diabetes in adolescents is growing. Diabetes is more common among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop full-blown diabetes later in life.

How is diabetes treated?

There are certain things that everyone who has diabetes, whether type 1 or type 2, needs to do to be healthy. They need to have a meal (eating) plan. They need to pay attention to how much physical activity they engage in, because physical activity can help the body use insulin better so it can convert glucose into energy for cells. Everyone with type 1 diabetes, and some people with type 2 diabetes, also need to take insulin injections. Some people with type 2 diabetes take pills called "oral agents" which help their bodies produce more insulin and/or use the insulin it is producing better. Some people with type 2 diabetes can manage their disease without medication by appropriate meal planning and adequate physical activity.

Everyone who has diabetes should be seen at least once every six months by a diabetes specialist (an endocrinologist or a diabetologist). He or she should also be seen periodically by other members of a diabetes treatment team, including a diabetes nurse educator, and a dietitian who will help develop a meal plan for the individual. Ideally, one should also see an exercise physiologist for help in developing a physical activity plan, and, perhaps, a social worker, psychologist or other mental health professional for help with the stresses and challenges of living with a chronic disease. Everyone who has diabetes should have regular eye exams (once a year) by an eye doctor expert in diabetes eye care to make sure that any eye problems associated with diabetes are caught early and treated before they become serious.

Also, people with diabetes need to learn how to monitor their blood glucose. Daily testing will help determine how well their meal plan, activity plan, and medication are working to keep blood glucose levels in a normal range.

What other problems can diabetes cause?

Your healthcare team will encourage you to follow your meal plan and exercise program, use your medications and monitor your blood glucose regularly to keep your blood glucose in as normal a range as possible as much of the time as possible. Why is this so important? Because poorly managed diabetes can lead to a host of long-term complications — among these are heart attacks, strokes, blindness, kidney failure, and blood vessel disease that may require an amputation, nerve damage, and impotence in men.

But happily, a nationwide study completed over a 10-year period showed that if people keep their blood glucose as close to normal as possible, they can reduce their risk of developing some of these complications by 50 percent or more.

Can diabetes be prevented?

Maybe someday. Type 2 diabetes is the most common type of diabetes, yet we still do not understand it completely. Recent research does suggest, however, that there are some things one can do to prevent this form of diabetes. Studies show that lifestyle changes can prevent or delay the onset of type 2 diabetes in those adults who are at high risk of getting the disease. Modest weight loss (5-10% of body weight) and modest physical activity (30 minutes a day) are recommended goals.

Find more information about diabetes in What You Need to Know about Diabetes –

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What can I eat if I've been diagnosed with Type 2 diabetes? I've just been diagnosed with Type 2 diabetes. I'm flabbergasted to say the least. Now what? Do I ever get to eat a decent meal again? I'm in deep despair.

Reader Question • 837 votes

A

When people receive a diabetes diagnosis, they’re often told to eliminate sugar-sweetened soda and desserts from their diet. But people can work with a diabetes educator to develop an eating plan that includes these and other favorite foods, albeit in limited amounts, said Maggie Powers president-elect of health care and education for the American Diabetes Association.

“It’s a matter of give-and-take,” Dr. Powers said. “If somebody wants [sugar-sweetened] soda, we don’t encourage that, because a little bit gives you a lot of carbohydrates.” But, she said, “If you say that you have to have a brownie every Sunday before you go to bed, I’d say, ‘You typically have a snack of 30 grams of carbohydrates, such as a large apple or banana; you can have a brownie instead.’ ”

The concern is that too many carbohydrate-laden snacks will displace nutritious carbohydrates like fruits, vegetables, cereals and whole grains, and dried beans such as chickpeas, kidney beans or lentils. A can of Mountain Dew, which has 46 grams of carbohydrates, would displace two pieces of bread (26 grams) and a small apple (21 grams).

Dr. Powers, a clinician and scientist with the International Diabetes Center at Park Nicollet in Minneapolis, teaches a carbohydrate management method that distributes carbs throughout the day, taking food intake, exercise, diabetes medications and insulin production into account. The food plan is adjusted based on glucose test results.

Carbohydrate goals will vary, but many women aim for 35 to 40 grams of carbohydrates per meal, whereas men may aim for 45 to 60 grams per meal. “What we’re trying to do is manage the amount of sugar in your blood throughout the day,” Dr. Powers said.

If you need help creating a food plan that works for you, she suggested, ask your physician for a referral to a diabetes education program.

Do you have a health question? Submit your question to Ask Well.

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In Switzerland, more than 400,000 people suffer from type 2 diabetes, a serious metabolic disorder that is constantly increasing. Obesity, by promoting the resistance to the action of insulin – one of the hormones that regulate blood sugar levels – is a major risk factor. However, insulin imbalance may not be the only cause of the onset of diabetes. Indeed, researchers at the University of Geneva (UNIGE) have highlighted another mechanism: indeed, the liver appears to have the ability to produce a significant amount of glucose outside of any hormonal signal. In patients with excess liver fat, this overproduction of glucose could lead to type 2 diabetes, regardless of hormonal circuits. These results, published by the Journal of Biological Chemistry, highlight a novel re-reading of the origin of diabetes in overweight patients.

Blood sugar levels are mainly regulated by two antagonistic hormones: insulin, which lowers blood glucose level, and glucagon, which increases it. The liver plays an essential role in regulating blood glucose levels by producing and redistributing glucose under the influence of these two hormones. Overweight people therefore face two threats: on the one hand, the risk of developing insulin resistance, which is a precursor to type 2 diabetes, and on the other hand, an accumulation of fat in liver cells, which is known as “fatty liver” syndrome. This accumulation of lipids indeed induces an alteration in the morphology and structure of mitochondria, the cells energy plants.

“Do these alterations have an effect on mitochondrial function? Is there a link between liver cell mitochondria, obesity and diabetes? To find out, we focused on a protein called OPA1 which, in its “long” form, in other words its non-degraded form, has the function of maintaining the structure of mitochondria,” explains Pierre Maechler, professor at the Department of Cell Physiology and Metabolism and at the Diabetes Faculty Centre of the UNIGE Faculty of Medicine, who led this work.

No glucose production without OPA1 protein

Scientists inactivated the OPA1 function in mice to be able to analyze the exact role of mitochondria. “The liver of mice that do not have the long form of OPA1 loses its ability to produce sugar in just a few weeks,” says Lingzi Li, a doctoral student in Professor Maechler’s laboratory and the first author of the study. “Liver cell mitochondria then show an altered morphology, confirming their importance in sugar metabolism.”

An unexpected discovery on the liver

To refine their analysis, Pierre Maechler and colleagues reintroduced a functional OPA1 protein in mice in which it had previously been deleted. “And the mitochondria have regained their normal morphology, but not their activity,” the scientists say. “In this area too, shape does not dictate function! It is not enough for mitochondria to appear normal for them to function properly.”

However, the greatest surprise was yet to come. “By observing controls, i.e. healthy mice in which OPA1 had been introduced in its long form, we discovered that, when equipped with these “super-mitochondria”, they generated more glucose than necessary, and their liver produced sugar without any hormonal call,” enthuses Pierre Maechler. This study therefore undermines the long-held belief that the production of glucose by the liver necessarily depends on external stimuli.

This is the first time that glucose production by the liver has been observed independently of an external signal, and particularly hormonal. This finding may explain the development of type 2 diabetes in patients with a “fatty liver” syndrome, apart from any apparent insulin imbalance. To confirm this, UNIGE researchers are now considering modifying the morphology of liver cell mitochondria in overweight mice to see if this overproduction of glucose can trigger abnormally high blood sugar levels and therefore diabetes.

Reference: Lingzi et al. 2019. In vivo stabilization of OPA1 in hepatocytes potentiates mitochondrial respiration and gluconeogenesis in a prohibitin-dependent way. Journal of Biological Chemistry. DOI: 10.1074/jbc.RA119.007601. 

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

[Cakers3]

@cherry   Thank you for taking the time to post.

My annual bloodwork showed pre-diabetes when my hypothyroidism popped up. Also my cholesterol had shot up.  Once the thyroid was taken care of the pre-diabetes and cholesterol went away.

Amazing how one little gland can cause so much disruption.

[cherry]

@Cakers3  I am so happy for you..That thyroid is  little, but it is mighty

[cherry]

New European research has found that individuals with low levels of vitamin D may have a higher risk of an early death, particularly if they have diabetes.

Carried out by researchers at the Medical University of Vienna, Austria, the new study looked at data gathered from 78,581 patients with an average age of 51 who had blood tests taken to measure the levels of 25-hydroxyvitamin D (25D), more commonly known as vitamin D.

A vitamin D level of 50 nmol/L, which is the commonly used cut-off value for vitamin D deficiency, was used in the study as a reference value for comparing other vitamin D levels. The researchers defined a high level of vitamin D at 90 nmol/L and a low level at 10 nmol/L.

The researchers then matched this data with the Austrian national register of deaths to see how many participants died in the follow-up period, which for some participants lasted for nearly 20 years.

The findings, presented at this year's Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain, showed that vitamin D levels of 10 nmol/L or less were associated with a 2 to 3-fold increase in risk of death. The association was particularly strong for patients aged 45 to 60 years, who had a 2.9 times increased risk.

In contrast, high levels of vitamin D, set at 90 nmol/L or greater, were associated with a 30 to 40 percent reduced risk in all-cause mortality. Once again, the effect was strongest among those who were 45 to 60 years of age, who showed a 40 percent reduction in risk.

However, the researchers failed to find a statistically significant association between vitamin D levels and mortality in patients over the age of 75.

When looking at specific causes of death, the strongest associations were not between vitamin D and cardiovascular disease or cancer, a finding which surprised the authors. Instead, vitamin D was strongly associated with a risk of death from diabetes, with participants in the vitamin D deficient group (less than or equal to 50 nmol/L) showing a 4.4 times higher risk of death from the disease than participants whose vitamin D was above 50 nmol/L.

The researchers also found no evidence that higher vitamin D levels above 100 nmol/L increased the risk of death, despite concerns that vitamin D at higher levels can have a negative effect.

"Our survival data from a large cohort, covering all age groups, from a population with minimal vitamin D supplementation at old age, confirm a strong association of vitamin D deficiency (under 50 nmol/L) with increased mortality. This association is most pronounced in the younger and middle-aged groups and for causes of deaths other than cancer and cardiovascular disease, especially diabetes," concluded the researchers, adding that, "Our findings strengthen the rationale for widespread vitamin D supplementation to prevent premature mortality, emphasize the need for it early in life and mitigate concerns about a possible negative effect at higher levels."