Recent studies have uncovered a frightening association between the popular diabetes and weight loss drugs, Ozempic and Wegovy, with a rare eye disorder that may cause blindness.

A study, published in the medical journal JAMA Ophthalmology, reported that individuals on those drugs containing semaglutide have a much larger percentage chance of acquiring NAION, or, more precisely known by its acronym, non-arteritic anterior ischaemic optic neuropathy.

This is defined by a lack of flow through the optic nerve, suddenly damaging one’s vision since that nerve has more than one million strands. NAION is a rare condition, affecting only 2 to 10 people per 100,000. It is the second leading cause of optic nerve blindness, and there is currently no effective cure.

The study revealed that those using semaglutide for diabetes were four times more likely to develop NAION than those not using the drug. Those using it for weight loss had even greater risk-more than seven times higher.

“To be perfectly clear, I would not take my findings and use them to recommend that patients stop taking their medications,” says Dr Rizzo. “Our finding was really the first possible significant negative finding with these drugs. It may just merit extra caution in the consideration between doctors and patients about who may use this medicine.”

According to the study, semaglutide is linked to a seven-fold increased risk of NAION when taken to treat obesity and a four-fold increased risk when used to treat type 2 diabetes.

Among the 710 patients with Type 2 diabetes, semaglutide users had an 8.9% chance of developing NAION, while those on other medicines had a 1.8% chance.

The rate of NAION development was 6.7% for patients administered semaglutide for weight loss and 0.8% for patients on other medicines.

Image used for representation purposes. File

On International Diabetes Day (November 14), there was bitter news for nations of the world. A paper published in the peer-reviewed journal, The Lancet, based on a global study, recorded over 800 million adults living with diabetes, with more than half not receiving treatment.  

Not surprisingly, India had the highest number of diabetics in the world, but surprisingly enough, the number was nearly 100 million more than the numbers revealed as part of the nation-wide Indian Council of Medical Research (ICMR)-INDIAB study last year. Splitting hair over figures apart, there are clear indications that the number of people with diabetes is increasing in India, and investing in the prevention of diabetes, its treatment, and in the prevention of complications, is imperative.  

The study, conducted by the NCD Risk Factor Collaboration (NCD-RisC), along with the World Health Organization (WHO), used data from over 140 million people (18+ years) culled from more than 1,000 studies in different countries.  

According to the study, the total number of adults living with either Type 1 or Type 2 diabetes in the world has surpassed 800 million — over four times the total number in 1990. Of this 800 million, over a quarter (212 million) live in India, with another 148 million in China.

“Our study highlights widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries, where numbers of adults with diabetes are drastically increasing. This is especially concerning as people with diabetes tend to be younger in low-income countries, and in the absence of effective treatment, are at risk of life-long complications, including amputation, heart disease, kidney damage or vision loss, or in some cases, premature death,” senior author Majid Ezzati, of the Imperial College, London, said.

One of the reasons for the huge numbers might be the use of either HbA1c value or fasting glucose, whichever data was available in different nations, explained V. Mohan, chairperson, Madras Diabetes Research Foundation. “The gold standard is fasting blood glucose and two-hour post prandial value after an oral glucose tolerance test (OGTT). This is what we used in the ICMR-INDIAB study. If they went by OGTT values alone, then the number would be half of what was recorded,” Dr. Mohan said. 

“Using HbA1c, they used a single cut-off point to determine diabetes — 6.5 %. Even in those with normal glucose, a small percentage will spill over into the 6.5% HbA1c value, depending on whether individuals are ‘fast’ or ‘normal glycators’. Glycation is influenced by many things, including anaemia, and advancing age. Of course, in a global study, there are limitations about using the data that is already available. The reality is that we need to do something urgent about preventing diabetes and its complications,” he added. 

“It is very clear that diabetes has been on the ascending limb in India for two decades. In this context, we need to undertake a war-like effort using mass media to spread awareness about nutrition, physical activity, [and] enacting more legal provisions to regulate carbs (carbohydrates) and sugar content in packaged food. We must educate women since they are prone to obesity post-pregnancy, and have a heightened risk at menopause. We need to cut off the rising trend of obesity with these efforts. A long-term vision for 10 years is required, with a dedicated task force assigned to the task,” Anoop Mishra, chairperson, Fortis CDOC Hospital for Diabetes and Allied Sciences, said.  

“Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable, and improve opportunities to exercise through measures such as subsidies for healthy foods and free, healthy school meals, as well as promoting safe places for walking and exercising, including free entrance to public parks and fitness centres,” Anjana Ranjit, president, Madras Diabetes Research Foundation, who was involved in the ICMR-INDIAB study, said. 

New Delhi:

Researchers have developed a novel computer algorithm that can predict various diseases like diabetes or stroke, just by analysing the colour of the human tongue with 98 per cent accuracy.

The imaging system developed by Middle Technical University (MTU) and the University of South Australia (UniSA) in Australia can diagnose conditions such as diabetes, stroke, anaemia, asthma, liver and gallbladder issues, Covid-19, and other vascular and gastrointestinal diseases.

“The colour, shape, and thickness of the tongue can reveal a litany of health conditions,” said Ali Al-Naji, adjunct Associate Professor at MTU and UniSA.

“Typically, people with diabetes have a yellow tongue; cancer patients a purple tongue with a thick greasy coating; and acute stroke patients present with an unusually shaped red tongue,” he added.

The breakthrough was achieved through a series of experiments using 5,260 images to train machine-learning algorithms to detect tongue colour.

Researchers received 60 tongue images from two teaching hospitals in the Middle East, representing patients with diverse health conditions. The AI model matched tongue colour with the correct disease in nearly all cases.

The paper published in Technologies describes how the system analyses tongue colour to provide real-time diagnoses, demonstrating that AI can advance medical practices significantly.

Al-Naji explained that AI is replicating a 2,000-year-old technique from traditional Chinese medicine, where the tongue’s colour, shape, and thickness are used to diagnose health issues.

For example, people with diabetes typically have a yellow tongue, while cancer patients show a purple tongue with a thick greasy coating. Stroke patients often present with an unusually shaped red tongue. A white tongue can indicate anaemia, severe Covid-19 cases are associated with a deep red tongue, and an indigo or violet tongue suggests vascular or gastrointestinal problems or asthma.

The study used cameras placed 20 centimetres from a patient to capture tongue colour, and the imaging system predicted health conditions in real time.

Co-author UniSA Professor Javaan Chahl noted that this technology could eventually be adapted for use with smartphones, making disease screening more accessible.
 

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

A woman in the US was sentenced on Friday to at least nine years in prison for manslaughter after she fed her diabetic daughter a diet consisting mainly of Mountain Dew. According to the New York Post, her 4-year-old daughter Karmity Hoeb died in January 2022 from complications related to diabetes and severe dental decay.

Prosecutors said Tamara Banks caused her daughter’s death through malnutrition and lack of proper medical care. She often gave the girl bottles of baby formula mixed with the neon-green sugary soda. Many of the girl’s teeth had rotten away at the time of her death, the court heard.

Mountain Dew notably contains 77 grams of sugar, far more than the less than 24 grams recommended by experts, according to the report. The little girl’s father, Christopher Hoeb, 53, also pleaded guilty to involuntary manslaughter and is set to be sentenced on June 11.

NEW: Cincinnati parents Christopher Hoeb and Tamara Banks plead guilty to involuntary manslaughter of their 4 year old daughter.

The child was almost exclusively fed Mountain Dew. They went as far as to mix it in with baby formula.

The parents were originally indicted with… pic.twitter.com/CbaamYxzI6

— Joshua Walker (@RedsRepair95) April 28, 2024

“This is one of the most tragic cases I have ever encountered. This child did not have to die,” Clermont County Assistant Prosecuting Attorney Clay Tharp said.

The case came to light when the girl suffered a “serious medical issue” in January 2022. Her symptoms worsened as the days progressed and her mother only called 911 after she turned blue and stopped breathing, the Cincinnati Inquirer reported. 

First responders were able to revive the child for a short time before taking her to the hospital, where doctors performed scans that showed she was brain dead. An autopsy showed that she died from a diabetes-related brain injury and being fed a sugary drink through a bottle that dissolved her teeth. She was never taken to the dentist, the paper reported.

Prosecutors also pointed out Banks has several other grown children who were treated poorly in her custody, including a son who fell into a coma at 4 years old from previously undiagnosed diabetes.

However, Banks regularly refilled her prescriptions and even had doctors visit her apartment to ensure that her medical needs were met.

“It’s hard to be a good parent but you expect at least mediocre parents, everybody should expect that. Not knowing what to do is not an excuse, the judge said during Friday’s hearing. 

Under Ohio state law, Banks could serve as much as 13 and a half years if the Department of Rehabilitation and Correction decides to extend her sentence based on behaviour while jailed.

New Delhi:

On the hottest days, risk of hospitalisation for people with metabolic disorders such as those of sugar and blood pressure, and obesity, almost doubled as compared to days recording comfortable temperatures, a new study has found.

The research analysing hospital admissions related to high temperatures during summer over more than a decade in Spain found that extreme heat impacted people with these conditions the most.

“There are a number of reasons to explain this. For example, in people with obesity, heat loss responses work less efficiently, as body fat acts as an insulator, making them more susceptible to heat disorders,” said Hicham Achebak, a researcher at the Barcelona Institute for Global Health.

Higher levels of air pollution further appeared to worsen the risk of hospital admission for people with these conditions, including diabetes, the researchers said.

The study also found that on hotter days, men showed a higher risk of hospital admission due to injuries, while women showed a higher risk of hospitalisation from infectious, hormonal and metabolic, respiratory or urinary diseases.

“Under conditions of heat stress, the body activates cutaneous vasodilation (more blood flows to skin) and sweat production in order to lose heat. The subsequent reactions can affect people differently depending on a series of factors, such as age, sex or pre-existing health conditions,” explained Achebak, corresponding author of the study published in the journal Environmental Health Perspectives.

“We know, for example, that women have a higher temperature threshold above which sweating mechanisms are activated and are more susceptible to the effects of heat,” he said.

The researchers analysed data of more than 11.2 million emergency hospital admissions between 2006 and 2019 from 48 provinces in mainland Spain and the Balearic Islands, an archipelago off eastern Spain in the Mediterranean.

Using statistical methods of analysis, the team estimated how temperatures affected the different causes of hospitalisation for summer (June to September) and by province. They also considered daily average temperatures and relative humidity, along with air pollutant levels, including those of PM2.5.

High temperatures were found to have “a generalised impact on cause-specific hospitalisations.” Children under a year and adults older than 85 years were the most vulnerable, even as heat heightened the risk of hospitalisation across all age groups, the researchers said.

“The underlying mechanisms by which heat triggers adverse health outcomes remain unclear, but they seem to be related to how our body regulates its own temperature,” said Achebak.

Other conditions that increased an individual’s risk of hospitalisation because of extreme heat were those of kidney, including failure and stones, and urinary tract infection, the researchers found.

Heat was also found to raise the risk of hospitalisation in people with sepsis, in which chemicals released in the blood to fight infections trigger inflammation throughout the body.
 

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Higher consumption of most ultra-processed foods is linked to a slightly higher risk of death, with ready-to-eat meat, poultry, and seafood based products, sugary drinks, dairy based desserts, and highly processed breakfast foods showing the strongest associations, finds a 30-year U.S. observational study. The results were published in the journal The BMJ.

The researchers say not all ultra-processed food products should be universally restricted, but that their findings “provide support for limiting consumption of certain types of ultra-processed food for long term health”. Mounting evidence links ultra-processed foods to higher risks of obesity, heart disease, diabetes and bowel cancer, but few long term studies have examined links to all causes and cause specific deaths, especially due to cancer.

To address this knowledge gap, researchers tracked the long-term health of 74,563 female registered nurses from 11 States in the Nurses’ Health Study (1984-2018) and 39,501 male health professionals from all 50 U.S. states in the Health Professionals Follow-up Study (1986-2018) with no history of cancer, cardiovascular diseases, or diabetes at study enrolment.

Every two years participants provided information on their health and lifestyle habits, and every four years they completed a detailed food questionnaire. Overall dietary quality was also assessed using the Alternative Healthy Eating Index-2010 (AHEI) score. During an average 34-year follow-up period, the researchers identified 48,193 deaths, including 13,557 deaths due to cancer, 11,416 deaths due to cardiovascular diseases, 3,926 deaths due to respiratory diseases, and 6,343 deaths due to neurodegenerative diseases.

Compared with participants in the lowest quarter of ultra-processed food intake (average three servings per day), those in the highest quarter (average seven servings per day) had a 4% higher risk of total deaths and a 9% higher risk of other deaths, including an 8% higher risk of neurodegenerative deaths.

No associations were found for deaths due to cardiovascular diseases, cancer, or respiratory diseases. In absolute numbers, the rate of death from any cause among participants in the lowest and highest quarter of ultra-processed food intake was 1,472 and 1,536 per 100,000 person years, respectively.

The association between ultra-processed food intake and death varied across specific food groups, with meat, poultry, and seafood based ready-to-eat products showing the strongest and most consistent associations, followed by sugar sweetened and artificially sweetened beverages, dairy based desserts, and ultra-processed breakfast food. The association was less pronounced after overall dietary quality was taken into account, suggesting that dietary quality has a stronger influence on long term health than ultra-processed food consumption, note the authors.

A bottle of Ranbaxy Laboratories Ltd.’s atorvastatin calcium tablets arranged for a photograph, February 20, 2014.
| Photo Credit: Dhiraj Singh/Bloomberg

Administering ursodeoxycholic acid (UDCA) can stave off the tendency of statins to induce glucose intolerance and diabetes, a study by a group of researchers in China has found.

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Statins are prescribed to people with a high risk of cardiovascular disease. They work by blocking the activity of an enzyme involved in the metabolic pathway that produces LDL, or “bad”, cholesterol. Statins are on the World Health Organisation’s list of essential medicines and among the most sold drugs worldwide.

However, many studies have found statins could increase the risk of developing diabetes. “It has been known for a few years now that statins can induce glucose intolerance and even frank diabetes in some people,” V. Mohan, chairman of the Madras Diabetes Research Foundation, said over phone to The Hindu.

He added that doctors have continued to prescribe them because statins’ benefits “far outweigh the risk”.

Nonetheless, the mechanism by which statins have this effect has been unclear.

In the study, published in the February edition of Cell Metabolism, the researchers reported one mechanism through which statins could increase glucose intolerance, involving UDCA, a bile acid.

The team recruited 30 people with atorvastatin and 10 without and tracked their metabolism for four months. They reported that the faeces of those taking atorvastatin had a reduced abundance of bacteria of the genus Clostridium and that these individuals had “altered serum and faecal bile acid profiles” as well.

The gut microbiome is a community of bacteria in the gut in a symbiotic relationship with the body. The researchers found that the Clostridium-deficient microbiome inhibited enzymes called hydroxysteroid dehydrogenases and lowered UDCA.

They also verified an idea that “the decreased Clostridium-rich microbiota might influence bile acid synthesis and excretion and impair glucose metabolism” in a 12-week study of mice.

To check the role of UDCA, they recruited five participants on statins and administered 10-13 mg/kg (of body weight) of UDCA per day. After two months, they found the individuals’ HbA1C levels, among others, were “substantially decreased”.

They concluded that “UDCA restored impaired glucose homeostasis without limiting the lipid-lowering effect of statin”.

Dr. Mohan called the finding “good news” and “a new angle” but also said the underlying hypothesis will have to be tested in randomised clinical trials.