A ‘paradigm shift’ in the diagnosis of diabetes: study

Updated 02 March 2018
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A ‘paradigm shift’ in the diagnosis of diabetes: study

PARIS: Scientists on Friday unveiled a revised classification for diabetes, one they said could lead to better treatments and help doctors more accurately predict life-threatening complications from the disease.
There are five distinct types of diabetes that can occur in adulthood, rather than the two currently recognized, they reported in The Lancet Diabetes & Endocrinology, a leading medical journal.
The findings are consistent with the growing trend toward “precision medicine,” which takes into account differences between individuals in managing disease.
In the same way that a patient requiring a transfusion must receive the right blood type, diabetes sub-types need different treatments, the study suggested.
Similarly, scientists have also identified distinct kinds of microbiome — the bacterial ecosystem in our digestive tract — that can react differently to the same medication, rendering it more or less effective.
“This is the first step toward personalized treatment of diabetes,” said senior author Leif Groop, an endocrinologist at Lund University in Sweden, adding that the new classification is a “paradigm shift” in how the disease is viewed.
People with diabetes have excessively high blood glucose, or blood sugar, which comes from food.
Some 420 million people around the world today suffer from diabetes, with the number expected to rise to 629 million by 2045, according to the International Diabetes Federation.
Currently, the disease is divided into two sub-types.
With type-1 — generally diagnosed in childhood and accounting for about 10 percent of cases — the body simply doesn’t make insulin, a hormone that helps regulate blood sugar levels.
For type-2, the body makes some insulin but not enough, which means glucose stays in the blood.
This form of the disease correlates highly with obesity and can, over time, lead to blindness, kidney damage, and heart disease or stroke. Acute cases may also require limb amputations.
It has long been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades.
For the study, researchers monitored 13,270 newly diagnosed diabetes patients ranging in age from 18 to 97.
By isolating measurements of insulin resistence, insulin secretion, blood sugar levels, age, and the onset of illness, they distinguished five distinct clusters of the disease — three serious and two milder forms.
Among the severe types, a group of patients with insulin resistence — in which cells are unable to use insulin effectively — was at far higher risk of kidney disease.
“This group has the most to gain from the new diagnostics as they are the ones who are currently most incorrectly treated,” Groop said.
Another group facing serious complications was composed of relatively young, insulin-deficient patients.
The third “severe” group were people with auto-immune diabetes corresponding to the original “type-1” diagnosis.
The two other groups have milder types of the disease including one, which includes about 40 percent of the patients, beset with a form of diabetes related to advanced age.
“This will enable earlier treatment to prevent complications in patients who are most at risk of being affected,” said lead author Emma Ahlqvist, an associate professor at Lund University.
The results were checked against three other studies from Sweden and Finland.
“The outcome exceeded our expectations,” said Groop.
The researchers plan to launch similar studies in China and India.
 


A wellness interlude

The relaxation room at the Pearl Spa. (All images supplied)
Updated 20 September 2018
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A wellness interlude

  • The Pearl Spa offers holistic wellness experiences
  • It is themed around the region's pearling heritage

DUBAI: Few things can give you that instant holiday feeling as much as a spa treat. Of course, it helps if it’s within the tranquil beachside setting of the luxe-Arabesque Four Seasons Resort Dubai at Jumeirah Beach. Walking into its sun-drenched lobby bedecked with fresh floral arrangements puts you into relax mode, with the dial being cranked up higher as soon as you enter Pearl Spa.

Themed around the region’s pearling heritage, the spa doesn’t just nod to the gem in its name but also references it in the opulent yet understated design with mother-of-pearl inlays and pearly finishes throughout.



And if the spa’s decor is impressive, the couples’ suite will wow even the most jaded. A proper hotel-suite sized affair, it has a generous living area with sofas, an outdoor courtyard with a bubbling fountain providing the perfect backdrop, and separate treatment rooms and bathrooms. Once holed up in here, anyone could be forgiven for not trying out the rest of the wet facilities, which include a steam room, sauna, Jacuzzi and a sensory shower.

However, a spa is only as good as its therapists, and in this case they are among the best in town. The signature massage, a 90-minute therapy, combines a variety of strokes and pressures, together with regionally inspired oud, rose and frankincense oil to make for a truly indulgent experience.

The treatment protocol is merely prescriptive, however, as the therapists really take it upon themselves to fix whatever is required — knots were teased out, muscle aches I didn’t know existed eased away, and tensions soothed as the masseuse kneaded, pummeled and stretched, hopping on to the table to maximize the impact of the massage.



I waddled out in an utterly relaxed state, making a mental note that this is one of the best massages anyone can have in Dubai, bar none (and I have tried most).

At the end, herbal teas are served in the private lounge as you are left to ease yourself back into the real world at your own relaxed pace. The quintessentially Four Seasons touch of thoughtfulness punctuates the whole experience, whether it’s in the beauty gear provided in the ladies’ dressing room, or the nuts and dried fruit snacks accompanying the post-treatment snack.

When you combine a superlative treatment such as this with a spa lunch, then it can turn a dusty urban afternoon into a complete retreat like little else can.



Offering a holistic wellness experience, their new spa menu features light and nutritious yet delicious gourmet dishes: Marinated tuna carpaccio with seaweed and cucumber yuzu dressing and sunflower seeds; avocado and Boston lettuce salad with shaved Parmesan and poached apple and perfectly cooked Loch-Fynn salmon with sautéed kale and asparagus; and fresh, mousse-like low-fat mango yoghurt with acai sorbet and granola crumbs. The pre-treatment lunch is usually served in the Pearl Courtyard, but during the hotter months can be taken indoors at the lobby side Shai salon.