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.
 


Jordan charity gathers hotel leftovers to feed poor

Updated 13 June 2018
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Jordan charity gathers hotel leftovers to feed poor

  • A team of volunteers collect unwanted food from lavish Ramadan buffets
  • Bandar Sharif began his ‘Family Kitchen’ initiative 10 years ago

AMMAN: At the end of a lavish Ramadan buffet in the banquet hall of one of Amman’s five-star hotels, a young Jordanian charity worker rushes to gather up left-over food that his team of volunteers will package and redistribute to needy families.
Bandar Sharif began his ‘Family Kitchen’ initiative 10 years ago, angered by the amount of food thrown away by hotels during the Muslim fasting month of Ramadan, traditionally a period when consumption levels double across the region.
“What we do is eliminate this waste, we salvage the food and provide it to people who are in desperate need of it,” said Sharif, a 33-year-old teacher.
His team of volunteers now works all year round to collect unwanted food from large wedding parties, bakeries and restaurants.
This year the initiative has focused on the Palestinian refugee camp of Baqaa, one of the depressed areas in a country that has seen some of the biggest protests in years this month over steep price hikes, which are backed by the International Monetary Fund.
Critics say the price hikes are to blame for rising poverty in Jordan.
Family Kitchen’s initiative this year provides ‘iftar’ meals — eaten by Muslims after sunset during the holy month of Ramadan — to 500 families in the impoverished refugee camp on the outskirts of Amman.
A third of the camp’s 120,000 residents have an income below the national poverty line and around 17 percent are unemployed, the UN refugee body says.
“Our families are very poor, there is a lot of poverty in the community, so they need this support, they need these meals in order to ensure that they have food the next day,” said Kifah Khamis, who runs a charity in the sprawling camp.
One camp resident, Um Thair, a mother of four, said she could not have coped without the meals delivered to her family.
“I was able to save money. During Ramadan I didn’t have to buy a lot of food or shop a lot, we got most of our meals from the charity, we would come everyday and get our iftar meal,” she said.