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

Updated 02 March 2018

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.
 


Baby Talk: How to deal with fears of first time parents

Updated 09 December 2019

Baby Talk: How to deal with fears of first time parents

  • Babies are totally dependent on their parents and care-givers for all their needs
  • Learning is on the job, but you can be prepared

DUBAI: It is natural for a first time mom (and dad) to have fears and worries about the responsibility of their brand new little baby. Babies are tiny, they are vulnerable, and they are totally dependent on their parents and care-givers for all their needs. This can seem overwhelming, and as each baby is different, it is not possible to provide a text-book of answers with each new arrival. Learning is on the job, but you can be prepared.

Common worries of first time parents:

  • Recognizing your baby’s cries

At first your baby’s cries may sound similar to you but soon you will learn to recognize the difference between a hungry cry for feed, a cry of discomfort for a diaper change or other discomfort, or a more serious discomfort such as colic or something else. An unusually high pitched cry can mean illness. You will soon not only know what your baby wants but also recognize your baby’s cry among other babies.

  • Going out of the home with your baby

It can be scary leaving the house for the first time with your new baby; the outside world can seem hazardous and contact with other people give risk to sources of infection. It is perfectly natural to feel this way but important to remember that the benefits or getting out and about with your baby will outweigh the risk with planning and preparation. Take sensible precautions with safety when you are out and ensure you have everything with you that you need including a cell phone for emergencies. Strangers may wish to admire your baby but it is reasonable to not allow others outside immediate family and friends handle your baby. Keep your first trips out short until you feel more comfortable and take someone with you if that helps you build confidence.

(Shutterstock)
  • Waking your sleeping baby

New parents are often frightened to make a noise during their baby’s nap times in case they wake. Naturally you have finally got your baby to sleep and will not want to wake them. It is best to carry out general house chores and conversations as usual because babies are used to noise from within the womb. Background noise of TV, vacuum cleaner, chatting or fans should not be avoided and your baby will become accustomed to sleeping through such noise. Loud and sudden noises will wake a sleeping baby but they should not wake because of usual household noise and there is certainly no need to tiptoe around a sleeping baby.

  • Putting baby down to sleep while they are crying

It is emotionally hard to put your baby in their crib whilst they are crying, particularly if they double their efforts as soon as you have laid them down. However it is also not idea to be in a situation where you cannot put your baby down to sleep for hours whilst you rock and sooth them, exhausting yourself and also possibly your baby. Babies can become overtired and if you have taken care of feeding, changing and winding and your baby is still fussing and crying they may need to sleep and will soon settle if you allow them to cry on their own a short while. The more used a baby is to settling themselves the better for baby and parents. Be brave and try to leave them briefly whilst close at hand and see if they settle by themselves. It is not wise to leave a baby to cry for too long and always seek medical advice if you have any concerns.

  • Handing over the baby care

One of the hardest things for a new mom to do is hand her baby over to another to care for in her absence, sometimes even if the person is her husband and she is only gone for a short time. This is natural and does not mean that you do not trust the person it means that you are programmed to be present for your baby at all times! However it is very important in modern society that you are able to leave your baby with your partner, trusted family members and friends. It is important that your baby leans to be soothed by others than yourself. It will become easier with time. Remember it is not important that your baby is wearing the outfit you would have chosen or if things have not been tidied away like you would have done, the important things is that you were able to have time away from your baby and that your baby is safe on your return.

This article was first published on babyarabia.com.