Diabetics Tips and Solutions!!!: June 2017

Friday, 30 June 2017

According to Research study "texting as good as medication at improving type 2 diabetes management"

Research first to focus on low-income Hispanic community

Date: June 9, 2017
Source: Scripps Health
Summary:: Low-income Hispanics with Type 2 diabetes who received health-related text messages every day for six months saw improvements in their blood sugar levels that equaled those resulting from some glucose-lowering medications, researchers report.

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Dulce Digital clinical trial participant Gloria Favela significantly improved her blood sugar control thanks to text message reminders that arrived while she was busy working as a mural artist.

Credit: Scripps Health

Low-income Hispanics with Type 2 diabetes who received health-related text messages every day for six months saw improvements in their blood sugar levels that equaled those resulting from some glucose-lowering medications, researchers with the Scripps Whittier Diabetes Institute reported today.

The Dulce Digital clinical trial represents the first randomized controlled study to look at the use of text messages to help underserved Hispanics better self-manage their diabetes through glycemic control.
The results were published by Diabetes Care in an online pre-print version of the study, which is scheduled to be published in a future issue of the journal.
      "As a low-cost intervention, we believe text messaging has great potential to improve the management of diabetes, especially among patients who struggle, due to employment, transportation and other barriers, to access health care services," said Athena Philis-Tsimikas, M.D., corporate vice president of Scripps Whittier. "The data from our new study proves that this an effective approach."
Diabetes is a fast-growing epidemic, afflicting 29.1 million Americans and costing more than $245 billion a year, according to the American Diabetes Institute. Hispanics face a higher risk of developing the disease 13.9 p ercent compared with 7.6 percent for non-Hispanic whites.
           The Dulce Digital study was conducted between October 2012 and August 2014 with 126 participants who were recruited from medical clinics operated by Neighborhood Healthcare, a nonprofit community health organization, in the Southern California counties of San Diego and Riverside.
Participants were either uninsured or received coverage through MediCal. A majority of them were middle-aged, female, born in Mexico and reported less than a ninth-grade education.
All participants watched a 15-minute diabetes educational video, received a blood glucose meter and instructions on using it, and were given access to usual care including voluntary visits with a primary care physician, a certified diabetes educator and group diabetes self-management education.
           The 63 participants who were randomly assigned to the study group received two to three short text messages a day at the beginning of the trial, which tapered off slightly over the next six months. Participants used their own cell phones, or were provided one by the researchers, and they each received $12 a month to cover the costs of the study's texts.
On average, each participant received 354 messages over the course of the study. The texts covered a range of educational, motivational and actionable messages. For example:

Use small plates! Portions will look larger and you may feel more satisfied after eating.
It takes a team! Get the support you need -- family, friends and support groups can help you to succeed.
Tick, tock. Take your medication at the same time every day!
Time to check your blood sugar. Please text back your results.

The study focused on hemoglobin A1C, a blood test that measures average blood glucose during the previous two to three months. For people who don't have diabetes, a normal A1C level is below 5.7 percent.
          At the start of the Dulce Digital study, the combined participant groups registered a baseline mean A1C of 9.5 percent. After three months, the mean A1C for the group receiving the texts had improved to 8.5 percent while the control group had a mean A1C of 9.3 percent. At six months, the study group's mean A1C was still 8.5 percent while the control group registered a 9.4 percent mean.
Valley Center, Calif., mural artist Gloria Favela, 48, was one of the study group participants who saw big improvements.
          "As the program continued, my A1C was dropping, and it eventually got to a really healthy level," she said.
Favela said the messages were particularly helpful on days when her attention was focused on painting, not on monitoring her blood sugar or focusing on what she was eating and drinking. "I tend to be very busy," she explained. "I can feel like I've been working on something for 30 minutes, and it will actually be three hours."
During the study, the texts brought the daily management of her health to the forefront with little or no effort on her part, Favela said. "They were nice, gentle reminders. It really worked great for me."
After the trial ended, 96 percent of the study group participants said the text messages helped them to manage their diabetes "a lot." The same amount said they would continue receiving Dulce Digital text messages if given the choice, and 97 percent said they would recommend the program to friends and family members.
           Researchers also found that participants who texted in their blood glucose levels more often had better A1C measures than other study group participants who texted back to the researchers less frequently. They speculated that the increased text volume reflected an overall higher level of engagement and participation in the program.
"Taken together, these findings suggest that, on a wider scale, a simple, low-cost text message-based approach like the one offered through Dulce Digital has the potential to significantly benefit many people who struggle every day to manage their diabetes and maintain their health," Dr. Tsimikas said.

The Importance of taking diabetes medications as prescribed, exercising and managing weight

Study highlights health system's ability to track important factors which can impact better blood sugar control

Date: June 13, 2017
Source: Kaiser Permanente
Summary:: People with diabetes who took their medications at least 80 percent of the time and people who exercised four or more times per week were at lower risk for poorly controlled blood sugar, according to a new study.

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People with diabetes who took their medications at least 80 percent of the time and people who exercised four or more times per week were at lower risk for poorly controlled blood sugar, according to a new study published in the American Journal of Pharmacy Benefits.

The study also finds that people who were clinically obese were at higher risk for poorly controlled blood sugar.
            Poorly controlled blood sugar can lead to complications including kidney disease, retinal damage, heart disease, hospitalization and death, according to the American Diabetes Association.
The ADA estimates that about 29 million Americans have diabetes, and according to the National Health and Nutrition Examination Survey, 21 percent of adults with diabetes have poorly controlled blood sugar.
The study, which included nearly 20,000 patients from Kaiser Permanente in Oregon and Southwest Washington, is novel because researchers were able to track medication adherence using Kaiser Permanente's unique electronic health record system, which includes pharmacy refill data. Many prior studies relied on asking patients if they took their medications, which is less reliable than patients' medical records.
           "Our physicians can look at a patient's electronic medical record and quickly see how often patients are refilling their diabetes, cholesterol and blood pressure medications. If patients are refilling medications when they're supposed to, they're also likely taking them when they're supposed to," said David Mosen, PhD, lead author and investigator at the Kaiser Permanente Center for Health Research. "During office visits we also ask patients if they are exercising and then enter this information into their medical record."
"It's not that people are willfully not taking their medications, they just forget," said Harry Glauber, MD, co-author and endoctrinologist with Kaiser Permanente. "There's so much focus on new drugs and new technologies to improve diabetes care, but our study shows we could likely improve outcomes if we help patients do these three things: take their medications as prescribed, increase their exercise and manage their weight."
               Researchers examined several lifestyle and demographic factors to determine which were most closely associated with poorly controlled blood sugar. They found that members who took their oral diabetes medications at least 80 percent of the time were 46 percent less likely to have poorly controlled blood sugar, compared to those who took their medications less than 80 percent of the time. Members who exercised four or more times a week were 25 percent less likely to have poorly controlled blood sugar, compared to members who exercised three or fewer times per week.
Researchers also found that people who were clinically obese (a body mass index or BMI of 30 or more) were 18 percent more likely to have poorly controlled blood sugar, compared to those who were not obese.
African Americans and other racial and ethnic minorities were also more likely than non-Hispanic whites to have poorly controlled blood sugar. These differences remained even after adjusting for medication adherence and other lifestyle factors, according to the researchers.

Find out The role of vitamin A in diabetes

Date: June 13, 2017
Source: Lund University
Summary:: There has been no known link between diabetes and vitamin A until now. A new study suggests that the vitamin improves the insulin producing ? cell's function.

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There has been no known link between diabetes and vitamin A -- until now. A new study suggests that the vitamin improves the insulin producing β-cell´s function.

The researchers initially discovered that insulin-producing beta-cells contain a large quantity of a cell surface receptor for vitamin A.
"There are no unnecessary surface receptors in human cells. They all serve a purpose but which, in many cases, is still unknown and because of that they are called "orphan" receptors. When we discovered that insulin cells have a cell surface expressed receptor for vitamin A, we thought it was important to find out why and what the purpose is of a cell surface receptor interacting with vitamin A mediating a rapid response to vitamin A," explains Albert Salehi, senior researcher at the Lund University Diabetes Centre in Sweden.
            The researchers believe that the purpose, in this particular case, is that vitamin A plays an important role for the development of beta-cells in the early stages of life, but also for a proper function during the remaining life especially during pathophysiological conditions, i.e some inflammatory conditions.
Albert Salehi and his research team, together with their colleagues at the University of Gothenburg, King's College (London) and the Oxford Centre for Diabetes, have mapped 220 different receptors on the surface of the beta cell, whose features are still not fully known. One of the findings is the cell surface expressed receptor for vitamin A.
             In order to study the role of the vitamin in cases of diabetes, the researchers worked with insulin cells from mice and non-diabetic and type 2 diabetic donors. By partially blocking the vitamin A receptor and challenging the cells with sugar, they could see that the cells' ability to secrete insulin deteriorated.
"We saw close to a 30 per cent reduction," says Albert Salehi, adding that impaired cell survival and insulin secretion are key causes of type 2 diabetes.
The same tendency could be seen when comparing insulin cells from type 2 diabetic donors. Cells from patients with type 2 diabetes were less capable of insulin secretion compared with cells from people without diabetes.
              The researchers also saw that the beta-cells' resistance to inflammation decreases in the absence of vitamin A. In case of a complete deficiency, the cells die. The discovery may also be significant for certain types of type 1 diabetes when the beta-cells are not sufficiently developed during the early stages of life.
"In animal experiments it is known that newborn mice need vitamin A to develop their beta-cells in a normal way. Most likely, the same applies to human beings. Children must absorb a sufficient amount of vitamin A through their diet," says Albert Salehi.
Vitamin A is found mainly in offal and dairy products. In Sweden, milk is enriched with vitamin A. There appears to be no vitamin A deficiency in Sweden in people who eat a standard variety of food, but vegetarians perhaps need to be aware of the problem.
                 Too much vitamin A is harmful and can lead to osteoporosis. However, there is no risk of excessive intake through food -- the risk lies in taking dietary supplements. Defects associated with vitamin A deficiency are, among other things, impaired night vision and reduced elasticity in the skin and mucous membranes.
In the event of a diabetes treatment based on the newly found cell surface receptor for vitamin A, Albert Salehi believes that the risk of excessive intake makes the vitamin A itself inappropriate.
"But we're trying to find substances such as small molecules or peptides that are similar to the vitamin A could activate the newly found receptor while lacking the unwanted effects" of vitamin A," he concludes.

Research suggests that Seal oil could help people with type 1 diabetes

Date: June 13, 2017
Source: University Health Network
Summary:: Seal oil has the potential to help promote nerve regeneration in patients with Type 1 diabetes, new research indicates.

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A research team at the Krembil Neuroscience Centre in Toronto has published a paper that suggests seal oil has the potential to help promote nerve regeneration in patients with Type 1 diabetes.

The study found that patients who ingested an omega-3 supplement derived from seal oil twice a day over a 12-month period reported an increase in corneal nerve fibre length. The paper entitled The effects of omega-3 supplementation on neuropathy in type 1 diabetes was published in the June, 2017 issue of Neurology, the medical journal of the American Academy of Neurology.
"Nothing like this has been attempted in humans before," says Dr. Evan Lewis, a neurologist and one of the study's authors. "Results from this trial are a very important step towards a clinical therapy for people with diabetic neuropathy."
             Diabetic neuropathy is a form of nerve damage caused by diabetes. Symptoms vary from patient to patient, but can include tingling, numbness, loss of sensation, a feeling of burning in the hands and feet, constant pain and difficulty walking. There are currently no therapies available for patients that stop or reverse its effects.
"This study is the first to show that targeted nutritional invention can stop and reverse small fibre damage," says Dr. Vera Bril, head of the division of Neurology in the Department of Medicine, and Medical Director of the Ellen Prosserman Centre for Neuromuscular Diseases at UHN, and the study's principal investigator. Other members of the research team included Dr. Bruce Perkins of the Leadership Sinai Centre for Diabetes as well as Dr. Thomas Wolever and Dr. Richard Bazinet, both of the University of Toronto's Department of Nutritional Sciences.
             The study involved 40 patients and focused primarily on corneal nerve fibre length. Located at the front of the eye, the cornea has the highest density of nerves in the body. Damage to these nerves, or loss of corneal nerve fibre length, is considered a biomarker for the progression of Type 1 diabetes. The study did not measure vision recovery.
Researchers investigated the effects of the omega-3 seal oil supplement on nerve structure and found that patients on average experienced a 29 per cent increase in corneal nerve fibre length, which is considered to be representative of small nerve fibre regeneration in other parts of the body.
               "These findings suggest that use of this supplement may have the potential to have a regenerative effect," says Dr Lewis. "Our goal was to collect enough data to power a randomized clinical trial and we believe this study lays the groundwork for that to happen."
The next step for the research team will be to conduct a phase three randomized controlled trial involving a larger group of participants.
Funding for this study was provided by Diabetes Canada and the Banting and Best Diabetes Centre.
"The initial results of this research are very promising and Diabetes Canada looks forward to continued study on the impact of omega-3s on nerve regeneration," said Dr. Jan Hux, Chief Science Officer at Diabetes Canada.

Research findings shows that Post-ICU glucose management may improve outcomes in critical patients

Date: June 20, 2017
Source: Stamford Health
Summary:: Monitoring and maintaining glucose levels of critically ill patients after admission from ICU, to general care through their discharge from the hospital may have positive impact on outcomes.

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Monitoring and maintaining glucose levels of critically ill patients after admission from ICU through general care and discharge from the hospital may have positive impact on outcomes, according to findings published in the July 7, 2017 issue of the journal Mayo Clinic Proceedings.

"Our research suggests that the glucose blood level of critical patients transferred back to general care matters -- specifically control of dysglycemia (hyper, hypo and glucose variability) -- which were all independently associated with mortality in patients without diabetes," said James Krinsley, MD, Director of Critical Care at Stamford Hospital and Clinical Professor of Medicine, Columbia University College of Physicians. "The data also suggests that patients should have blood glucose targets based on their personal characteristics rather than a 'one-size-fits-all' approach as current guidelines state."
The article, "Glucose control, diabetes status and mortality in critically ill patients: the continuum from ICU admission to hospital discharge," supports the importance of glucose control throughout the entire period of care for critically ill patients -- and suggest that the current blood glucose target range may not be appropriate for patients without diabetes.
In collaboration with Stanley Nasraway, MD, Director, Surgical Intensive Care Unit and Professor, Tufts University School of Medicine in Boston, Dr. Krinsley conducted a retrospective investigation of the relationship between mean blood glucose, hypoglycemia, high glucose variability, diabetes and mortality among nearly 6,400 ICU patients with five or more blood glucose tests and nearly 4,500 ICU survivors admitted at two academic medical centers between July 2010 and December 2014.
"Our investigation, in combination with other recent literature, suggests that for people without diabetes, a target glucose level of 80-14 mg/dL is strongly associated with best prospects for survival," added Dr. Krinsley. "We believe this study is the first to report on the association of glucose control with mortality in a cohort of critically ill patients spanning the entire continuum of hospitalization."
The data suggests that broader glucose control protocols, from admission to the ICU through discharge, may result in greater survivability for the critical-care patient. For patients without diabetes, it appears a blood glucose range of 80-140 mg/dL as a mean glucose level, is strongly associated with survival, both in the ICU and on the general floor. However, there was no clear relationship between blood glucose level and mortality for patients with diabetes in the ICU or the floor. The next step would be to institute randomized controlled trials to see if protocols for glucose control instituted in general care floors lead to better outcomes.

Specific diabetes medications is being recommended to protect bone health

Date: June 21, 2017
Source: Endocrine Society
Summary:: Type 2 diabetes (T2D) and osteoporosis often coexist in patients, but managing both conditions can be a challenge. A comprehensive review highlights the most effective treatment options for treating these conditions together.

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Type 2 diabetes (T2D) and osteoporosis often coexist in patients, but managing both conditions can be a challenge. A comprehensive review published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism highlights the most effective treatment options for treating these conditions together.

            Previous research has focused on the management of T2D and osteoporosis as separate diseases. However, several studies have shown that fracture risk is increasing in people with T2D. T2D directly affects bone metabolism and strength. Certain diabetes medications affect bone metabolism, and an association exists between diabetic complications and the risk for falls and subsequent fractures.
"Metformin, sulfonylureas, DPP-4 inhibitors and GLP1 receptor agonists -- medications for T2D -- should be the preferred treatment for T2D in patients who also have osteoporosis," said the study's first author, Stavroula A. Paschou, M.D., Ph.D., of the National and Kapodistrian University of Athens in Athens, Greece.
            Paschou's team prefers these medications because they can help protect bone health. Studies show that Metformin has beneficial effects on bone formation and bone mineral density. Positive or neutral effects have been seen in bone metabolism with the use of DPP-4 inhibitors and GLP1 receptor agonists.
On the other hand, thiazolidinediones (TZDs) and canagliflozin should be avoided while other SGLT2 inhibitors are less well-validated options. Insulin should be used with caution and with careful measures to avoid hypoglycemia.
            To determine the most effective treatment options, the researchers systematically reviewed past human studies and guidelines to develop recommendations for the most appropriate joint treatment approaches for diabetes and osteoporosis.
A manual search of key journals and abstracts from the major annual meetings in the fields of diabetes, osteoporosis and endocrinology was also conducted. Researchers gave special attention to studies and guidelines focused on the management of patients with T2D and osteoporosis.
Paschou's team adopted a grading system introduced by the American College of Physicians. Each recommendation received two grades, one for strength (strong, weak or insufficient), and another for the quality of evidence (high, moderate or low) that supported the specific recommendation.
Based on the recommendations, researchers explain that insulin therapy is the preferred method for achieving glycemic control in patients who are hospitalized with T2D and fractures.
           Paschou's team found no evidence of any detrimental effects of osteoporosis medications on glucose metabolism, but a possible beneficial effect with the use of bisphosphonates -- medications used to help prevent the loss of bone mass and treat osteoporosis. They recommend no changes to the treatment of osteoporosis because of the presence of T2D.
Researchers also note that avoiding strict targets for blood glucose levels is important for jointly managing T2D and osteoporosis for the fear of hypoglycemia, falls and fractures.
"A healthy diet and physical exercise are very important for the prevention and treatment of both conditions," Paschou said.

Surprising link between blood sugar, brain cancer found

Diabetes raises risk for many cancers, but not most common malignant brain tumor

Date: May 3, 2017
Source: Ohio State University
Summary:: New research further illuminates the surprising relationship between blood sugar and brain tumors and could begin to shed light on how certain cancers develop.

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Glioma is one of the most common types of cancerous tumors originating in the brain.

Credit: © ibreakstock / Fotolia

New research further illuminates the surprising relationship between blood sugar and brain tumors and could begin to shed light on how certain cancers develop.

While many cancers are more common among those with diabetes, cancerous brain tumors called gliomas are less common among those with elevated blood sugar and diabetes, a study from The Ohio State University has found.
            The discovery builds on previous Ohio State research showing that high blood sugar appears to reduce a person's risk of a noncancerous brain tumor called meningioma. Both studies were led by Judith Schwartzbaum, an associate professor of epidemiology and a researcher in Ohio State's Comprehensive Cancer Center. The new glioma study appears in the journal Scientific Reports.
"Diabetes and elevated blood sugar increase the risk of cancer at several sites including the colon, breast and bladder. But in this case, these rare malignant brain tumors are more common among people who have normal levels of blood glucose than those with high blood sugar or diabetes," Schwartzbaum said.
"Our research raises questions that, when answered, will lead to a better understanding of the mechanisms involved in glioma development," she said.
           Glioma is one of the most common types of cancerous tumors originating in the brain. It begins in the cells that surround nerve cells and help them function. The disease is typically diagnosed in middle age. At present, there is no treatment that ensures long-term survival, but several potential options are being studied.
The Scientific Reports paper included data from two large long-term studies. One, called AMORIS, included 528,580 Swedes. The second, Me-Can, consisted of 269,365 Austrians and Swedes. In all, 812 participants developed gliomas.
Schwartzbaum and her collaborators evaluated blood sugar and diabetes data and its relationship to subsequent development of brain cancer and found that those with elevated blood sugar and diabetes had a lower risk of developing glioma.
            "This really prompts the question, 'Why is the association between blood glucose levels and brain cancer the opposite of that for several other cancerous tumors?" she said.
The researchers found that this relationship was strongest within a year of cancer diagnosis.
"This may suggest that the tumor itself affects blood glucose levels or that elevated blood sugar or diabetes may paradoxically be associated with a protective factor that reduces brain tumor risk," Schwartzbaum said.
"For example, insulin-like growth factor is associated with glioma recurrence and is found in lower levels in people with diabetes than those who don't have the disease."
           The brain accounts for only about 2 percent of body weight, but consumes about 20 percent of the body's available glucose, Schwartzbaum said.
The body of research on restrictive diets and their effect on brain cancer development has shown mixed results and more work is needed to determine if there's something about the sugar/tumor relationship that can be modified in a way that's beneficial to brain cancer patients, she said.

Potential mechanism for BCG vaccine reversal of type 1 diabetes

Data presented at American Diabetes Association meeting describes increase in immune cells that control autoimmunity

Date: June 10, 2017
Source: Massachusetts General Hospital
Summary:: Interim results from a FDA-approved clinical trial testing the generic vaccine bacillus Calmette-Guérin to reverse advanced type 1 diabetes demonstrate a potential new mechanism by which the BCG vaccine may restore the proper immune response to the insulin-secreting islet cells of the pancreas.

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Scientists have documented reversal of advanced type 1 diabetes in mice and subsequently completed a successful phase I human clinical trial of BCG vaccination.

Interim results from a FDA-approved clinical trial testing the generic vaccine bacillus Calmette-Guérin (BCG) to reverse advanced type 1 diabetes are being presented at the 75th Scientific Sessions of the American Diabetes Association. The data demonstrate a potential new mechanism by which the BCG vaccine may restore the proper immune response to the insulin-secreting islet cells of the pancreas. Presented by Denise Faustman, MD, PhD, director of the Massachusetts General Hospital Immunobiology Laboratory and principal investigator of the trial, the findings suggest that BCG may induce a permanent increase in expression of genes that restore the beneficial regulatory T cells (Tregs) that prevent the immune system from attacking the body's own tissue. The results are being presented on Saturday, June 10.

            "Many groups are looking at the ability of BCG vaccination to reverse autoimmunity," says Faustman, who is an associate professor of Medicine at Harvard Medical School. "We and other global efforts have known for some time that restoring beneficial Treg cells might halt the abnormal self-reactivity in type 1 diabetes and other autoimmune diseases, but therapies to restore this immune balance have not achieved long-lasting results. The discovery that BCG restores Tregs through epigenetics -- a process that modulates whether or not genes are expressed -- is exciting. This now provides a better idea of how BCG vaccination appears to work by powerfully modulating Treg induction and resetting the immune system to halt the underlying cause of the disease."
          Type 1 diabetes is an autoimmune disease characterized by the destruction of islets by autoreactive T cells, which mistakenly attack islets as if they were an infection. Tregs are the immune system's "brakes" that normally prevent misdirected attacks against tissues without dampening the entire system. Several research groups have suggested methods for introducing or expanding Tregs in patients with type 1 diabetes, but to date no therapies have been approved.
          Best known for its role in tuberculosis prevention, the BCG vaccine is based on a harmless strain of bacteria related the one that causes tuberculosis. A generic drug with over 100 years of clinical use and safety data, BCG is currently approved by the FDA for vaccination against tuberculosis and for the treatment of bladder cancer. Multiple international studies are currently investigating the potential of repeat BCG vaccinations to prevent and reverse autoimmune diseases including type 1 diabetes and multiple sclerosis.
"BCG is interesting because it brings into play so many areas of immunology that we as a community have been looking at for decades, including Tregs and the hygiene hypothesis," says Faustman. "Repeat BCG vaccination appears to permanently turn on signature Treg genes, and the vaccine's beneficial effect on host immune response recapitulates decades of human co-evolution with myocbacteria, a relationship that has been lost with modern eating and living habits. It is incredible that a safe and inexpensive vaccine may be the key to stopping these terrible diseases."
          Faustman's research team was the first group to document reversal of advanced type 1 diabetes in mice and subsequently completed a successful phase I human clinical trial of BCG vaccination. The five-year, 150-person, phase II trial is investigating whether repeat BCG vaccination can clinically improve type 1 diabetes in adults with existing disease and is almost fully enrolled. Details on the trial and enrollment are available at: https://clinicaltrials.gov/ct2/show/NCT02081326.
Long-term follow-up data from the phase I trial will be published later this year. The phase II trial is entirely funded by private philanthropy from individuals and family foundations.

Is it possible that broccoli could be a secret weapon against diabetes? Why not Find out:

Date: June 14, 2017
Source: American Association for the Advancement of Science
Summary:: Concentrated broccoli sprout extract may help type 2 diabetes patients manage their blood sugar, according to a new study.

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Broccoli sprouts.

Concentrated broccoli sprout extract may help type 2 diabetes patients manage their blood sugar, according to a new study.

The findings could offer a much needed alternative to address the condition, which has become a worldwide epidemic.
             Type 2 diabetes afflicts more than 300 million people globally, and as many as 15% of those patients cannot take the first-line therapy metformin because of kidney damage risks. Seeking a more viable path forward, Annika Axelsson and colleagues used a computational approach to identify compounds that might counter the disease-associated gene expression changes associated with type 2 diabetes.
             The researchers constructed a signature for type 2 diabetes based on 50 genes, then used publically available expression datasets to screen 3,852 compounds for drugs that potentially reverse disease. The most promising chemical -- sulforaphane, a naturally occurring compound found in cruciferous vegetables -- tamped down glucose production by liver cells growing in culture, and shifted liver gene expression away from a diseased state in diabetic rats.
            When the researchers gave concentrated broccoli sprout extracts to 97 human type 2 diabetes patients in a 12-week randomized placebo-controlled trial, obese participants who entered the study with dysregulated disease demonstrated significantly decreased fasting blood glucose levels compared to controls.
The authors say developing gene signatures to investigate large public repositories of gene expression data could be a valuable strategy to rapidly identify clinically relevant compounds.