Diabetes News Roundup: November 2018
Highlights include an online diabetes prevention program; sweetened drinks pose greater diabetes risk; and the link between night shifts and T2DM.
A healthy lifestyle plays an important role in preventing the development of type 2 diabetes (T2DM). Three new studies highlight the advantages of promoting a healthy lifestyle: online diabetes prevention programs are as effective as in-person programs for weight loss; sweetened drinks pose greater diabetes risk than other sugary foods; and night shifts plus unhealthy lifestyle raises the risk of T2DM.
Patients Lose Weight in Online Diabetes Prevention Program
Online Diabetes Program Proves Successful in Weight Loss. Authors conducted a large, non-randomized trial of 268 obese or overweight veterans with prediabetes in an online DPP. The 2nd group of 273 veterans were enrolled in an in-person DPP which consisted of 8 to 22 face-to-face sessions that focused on 7% weight loss and at least 150 minutes per session of moderate physical activity. Lastly, 114 veterans were enrolled in Move! which consisted of 8 to 12 face-to-face healthy lifestyle sessions with monthly maintenance sessions and no specified goals given.
Online Diabetes Program Proves Successful in Weight Loss. Patients in the online DPP lost 10.3 lbs at 6 months and 8.8 lbs at 1 year. In a secondary analysis, the same participants who completed ≥1 modules/sessions saw a mean weight loss of 10.6 lbs at 6 months and 9lbs at 1 year. There was no significant difference in weight change between online and in-person DPP. Participants in Move! lost 1.1 lbs at 6 months and 10.6 lbs at 1 year.
Author's Insights. "An intensive, multifaceted online diabetes prevention program intervention may be as effective as in-person diabetes prevention program and help expand reach to those at risk.”
For more information: Moin T, Damschroder LJ, AuYoung M, et al. Results from a trial of an online diabetes prevention program intervention. Am J Prev Med. 2018;55:583-591.
More Evidence Sweetened Drinks Raise Risk of T2DM
Sweetened Drinks Increase Risk of T2DM. In a systemic review and meta-analysis of 155 controlled intervention trials, researchers monitored 5086 patients for up to 12 weeks and assessed the effects of different food sources of fructose on blood glucose levels in people with or without T2DM.
Sweetened Drinks Increase Risk of T2DM. Authors found that when fruit and fruit juice does not provide excess calories, they may have beneficial effects on blood glucose and insulin control, especially in T2DM patients. Foods that add excess "nutrient poor" energy to diet, especially sweetened drinks and fruit juices, seem to have harmful effects. Low glycemic index of fructose vs other carbohydrates and higher fiber content of fruit, may help explain improvements in blood glucose levels by slowing down the release of sugars.
Author's Insights. "These findings might help guide recommendations on important food sources of fructose in the prevention and management of diabetes. Until more information is available, public health professionals should be aware that harmful effects of fructose sugars on blood glucose seem to be mediated by energy and food source.”
For more information: Choo VL, Viguiliouk E, Blanco Mejia S, et al. Food sources of fructose-containing sugars and glycaemic control: systematic review and meta-analysis of controlled intervention studies. BMJ. 2018;363:k4644.
Night Shift Workers with Unhealthy Lifestyle Face Higher Risk of T2DM
Night Shift Workers Face Higher T2DM Risk. Authors of this prospective cohort study extracted data from 2 Nurses' Health Studies that included 143 410 women without T2DM, CVD, or cancer at baseline in order to evaluate the joint association of duration of rotating night shift work and lifestyle factors with T2DM risk.
Night Shift Workers Face Higher T2DM Risk. During follow-up, 10 915 nurses reported a T2DM diagnosis and for every 5 years working rotating night shifts, nurses were 31% more likely to have a T2DM diagnosis. Women who exhibited any 4 unhealthy lifestyle factors and worked rotating night shifts had a 2.83 times higher risk of T2DM diagnosis.
Author's Insights. “These findings suggest that most cases of T2DM could be prevented by adhering to a healthy lifestyle, and the benefits could be greater in rotating night shift workers.” Researchers also suggested that the additional T2DM risk occurs when rotating night shift workers follow unhealthy lifestyle that disrupts sleep, circadian rhythms, hormones, other metabolic pathways, or bacteria balance in gut.
For more information: Shan Z, Li Y, Zong G, et al. Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses. BMJ. 2018;363:k4641.
