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Developments in Type 2 Diabetes Management

Findings presented at ENDO 2016 shed some light on developments that could play a role in type 2 diabetes prevention, treatment, and management.

Type 2 diabetes and obesity are epidemics for which effective treatments are increasingly necessary. In light of this, new findings from international research presented at a press conference during the Endocrine Society’s 98th Annual Meeting & Expo (ENDO 2016) shed some light on developments that could play a role in type 2 diabetes prevention, treatment, and management.

Liraglutide, a Diabetes Drug

Liraglutide, a glucagon-like peptide-1 (GLP-1) agonist, has successfully treated diabetes and promoted weight loss-but it unknown why the latter occurs. In her studies, Olivia M. Farr of Beth Israel Deaconess Medical Center, Harvard Medical School, reported that, “A novel finding was that GLP-1 receptors exist in the brain.” Farr and colleagues also found that using liraglutide may impact neural responses to food cues in diabetics because it alters attention-related brain activity.

Prebiotics and Probiotics

The results of a study of intestinal ecology between prediabetic and healthy adolescents by Charikleia Stefanaki of University of Athens Medical School and colleagues indicated a potential role for prebiotics and probiotics in diabetes mellitus prevention, as presented by George Chrousos of University of Athens Medical School. Significantly decreased amounts of Ruminococcus spp. were found in the prediabetic group’s fecal samples. Additionally, the healthy group was 8.5 times less likely to have had taken antibiotics until at least age three.

Ruminococcus spp. plays a key role in the fermentation of dietary-resistant starches (RS) and helps to sustain other beneficial microbiota in the gut. A deficiency of RS-degrading species-possibly due to the increased use of antibiotics at a young age-seems to bring about glucose intolerance due to fewer beneficial microbiota populations, which may lead to unfavorable changes in the gut flora and consequently adolescent prediabetes.

Whey Protein

Daniela Jakubowicz of Wolfson Medical Center, Tel Aviv University, Rehovot, Israel discussed why whey protein should be considered an important adjuvant in managing type 2 diabetes. A study by Jakubowicz and colleagues demonstrated that increasing protein content from 13 g to 36 g at breakfast and eating a medium-sized lunch and small dinner significantly impacted weight loss, overall satiety, HbA1c levels, and overall postprandial glycemia (PPG) in individuals with type 2 diabetes. What’s more, their research indicated that whey protein (a byproduct of cheese production) lowered these four factors more significantly than other protein sources such as soy, eggs, and tuna.

Thyroid Function

Investigations by Layal Chaker of Erasmus Medical Center, Rotterdam, Netherlands and colleagues revealed that low thyroid function (higher thyroid-stimulating hormone [TSH] levels and lower free thyroxine [FT4] levels-the two major laboratory markers of thyroid function) was associated with a higher risk of developing type 2 diabetes, as well as an increased risk of progression from prediabetes to diabetes, even within the normal range of thyroid function.

“Thyroid hormone plays an integral role in metabolism, and therefore is an important control of weight and cholesterol metabolism,” Chaker said. “So we hypothesized that it could be important in the development of diabetes type 2.”

From material presented at The Endocrine Society Annual Meeting 2016, Boston, MA.

OR15-2 GLP-1 Receptors Exist in the Parietal Cortex, Hypothalamus, and Medulla of Human Brains and the GLP-1 Analog Liraglutide Administered in the Context of a Cross-over, Randomized, Placebo-Controlled Trial Alters Brain Activity in Response to Highly Desirable Food Cues in Individuals with Diabetes.

Adolescents with Prediabetes Lack Key Species By Quantitative, Core Gut Microbiome Analysis - a Case-Control Study.

OR12-3 Whey Protein Induces Greater Reduction of Postprandial Glycemia and HbA1c, Weight Loss and Satiety Compared to Other Protein Sources in Type 2 Diabetes.

OR33-2 Thyroid Function and Type 2 Diabetes Risk: A Population-Based Prospective Cohort Study.