Current Trends in Diabetes
By: Ashleigh Smith
Date: May 2017
Diabetes is one of the major chronic diseases affecting our society today, with nearly 422 million people around the world living with Diabetes in 20141. In South Africa, the IDF reported 2.3 million South Africans between the ages of 21 and 79 years are living with Diabetes2. We all know at least one person with Diabetes and the shocking thing is that there are people out there who don’t even know they have Diabetes. Due to the burden of Diabetes on the healthcare system a lot of money is going into research within this field. What this means for us is that there are continuous developments and trends in the industry.
BARIATIRC SURGERY & VERY LOW CALORIE DIETS (VLCD)
One of the nutritional or diet trends that have been in the media is the effect of Bariatric Surgery and Very Low Calorie Diets (VLCD) in those with living with Diabetes. Bariatric surgery is an operation that is performed to help individuals with severe obesity and other chronic diseases of lifestyle lose weight. It works by restricting both food intake and decreasing the amount of food absorption from the stomach and intestines3. This enables patients to lose weight and decrease their risk for obesity-related diseases3. This surgery is often dangerous and many of these patients are required to implement strict lifestyle changes that result in rapid weight loss beforehand. To help with this, Bariatric surgery patients are often placed on a Very Low Calorie Diet (VLCD) before and after surgery in order to achieve rapid weight loss4.
A Very Low Calorie Diet (VLCD) is one where energy intake is 1000 calories or less5. To give you an idea of how little this is, the recommended energy intake for the average adult is 2000 calories for women and 2500 calories for men5, however this can be more or less depending on many factors such as age, gender, physical activity or disease state. The VLCD typically involves replacing foods with diet supplements, soups or bars and is followed for a specific period of time e.g. less than 12 weeks5. This is considered an extreme diet and is only done with the help of a doctor and registered dietitian who ensures that the nutritional needs are best met whilst following the diet5.
This VLCD works by reducing the overall size of the liver (through fat loss from the liver), which makes the surgery easier to perform4. Obesity and Type 2 Diabetes are caused by a combination of genetics and lifestyle factors such as physical inactivity and unhealthy eating2. Long term intake of excess energy or calories from food, causes extra carbohydrate to be converted to fatty acids4. As there are more fatty acids around than usual, fat accumulates in the liver which has a knock on affect causing triglyceride levels in your blood rise4. Due to this, excess fat is sent to all the tissues in the body, including your pancreatic cells4. This build-up of fat interferes with the proper functioning of your pancreatic cells, resulting in insulin resistance, where your cells are unable to use the insulin to transport glucose into your cells therefore causing high blood glucose levels (hyperglycaemia)4. This cycle is switched off by severe calorie restriction when following the VLCD, hence why there is a loss of fat from the liver. As a result insulin resistance and blood glucose management improves even before large changes in body weight occur4.
What does the research say? In one study, authors found that after following a VLCD (600 kcal) fasting blood glucose levels normalised after a week and 7 out of the 10 patient’s Diabetes went into remission at the end of the study6. Another study whereby 29 people who had Type 2 Diabetes for varying durations (2.5 – 12.7 years) were put on a VLCD (624–700 kcal)7. After 8 week there was a significant drop in fasting blood glucose levels with 87% of those who had Diabetes for a short duration (<4 years) vs. 50% of those who had diabetes for a longer duration (> 8 years) going into remission and stopping all medication7.
The biggest changes in glycaemic control in individuals living with Diabetes is seen in patients whom have had bariatric surgery, with research showing that rates of diabetes remission were nearly 90% 10 years after bariatric surgery4. According to the America Society of Metabolic and Bariatric Surgery (ASMBS), of 135 000 patients, 90% showed improvements in their type 2 Diabetes by lowering blood glucose levels, reducing the dosage and type of medication required and improving Diabetes-related health problems8.. Seventy eight percent of these individuals went into remission which caused normalised blood glucose levels and eliminated the need for Diabetes medications.8
Both of these methods are showing very promising results in the management of Diabetes, but don’t be fooled they are considered very extreme and not for the faint hearted. Consult with your diabetes health care professional team on effective dietary management of your Diabetes. Visit our website www.futurelife.co.za for more nutrition related articles.
SMART CONTACT LENSES
Researchers from Korea have unveiled a smart contact lens sensor that can be used to help monitor biomarkers for Diabetes Mellitus, intraocular pressure (IOP) and other health conditions9. Although this concept is not new, numerous studies over the last few decades have shown drawbacks to these lenses due to discomfort of product material and opaque nature of the electrodes9,10. The new smart contact lens sensors are very much improved and use electrodes made of highly stretchable and transparent graphene sheets with metal nanowires that measure glucose levels in tear fluid and IOP (fluid pressure inside the eye) 9,10. These smart contact lenses require no separate power source and have a wireless antennae, meaning patients are able to transmit their health information allowing for real-time monitoring of their health conditions9,10.
PANCREATIC ISLET CELL TRANSPLANTATION
There is new exciting research happening in the field of pancreatic islet cells transplantation11. Researchers have created the first successful tissue-engineered “mini pancreas” that has provided long-term insulin independence in a patient with type 1 Diabetes11. Previously insulin-producing cells had been implanted in the liver but the new research uses the Omentum, which is an apron-like tissue covering abdominal organs. The reason for its success is that it has same blood supply and physiological drainage characteristics as the pancreas and is easily accessed with minimally invasive surgery11. The results thus far have shown that the Omentum appears to be a viable site for islet cell implantation11. This breakthrough surgery will allow many patients to live without the need for insulin injections after receiving a transplant of donor cells. Many patients who have received islet transplants have been insulin independent for more than a decade11.
AUGMENTED REALITY SMARTPHONE APP
Researchers from the Queensland University of Technology (QUT) are developing a mobile phone app that uses Augmented Reality (AR) to help people with type 2 Diabetes and high blood pressure manage their medication12. AR “turns the environment around you into a digital interface by placing virtual objects in the real world, in real-time13.” The reason behind this app is that “A person with Diabetes sometimes has to take, on average, eight medications at the same time including blood sugar-lowering medications, cholesterol-lowering medications, aspirin, anti-depressants/anxiolytics or medications for weight management. AR brings the possibility of using your smartphone to give information on specific medications in a form that is appropriate to each person’s level of understanding in a convenient and timely way” says head researcher Dr Alireza Ahmadvand13. The app will also give people the opportunity to call or message credible diabetes helplines, should they have a question about their medication or side effects13. Their aim is to decrease the complexity and increase medication compliance in people living with both type 2 Diabetes and high blood pressure in order to improve the understanding of their conditions13.
So, there you have it, some of the Diabetic trends making waves in the Diabetic community. At FUTURELIFE® we have a variety of products suitable for those living with Diabetes. Try our FUTURELIFE® High Energy, High Protein and ZERO Smart food™ products, all of which can be had as a meal, shake and smoothie, as well as our FUTURELIFE® Smart Drink™ and FUTURELIFE® Smart Bread™, also low GI and endorsed by Diabetes South Africa (DSA). Visit our website www.futurelife.co.za for more interesting articles, recipes and meals to help you manage your diabetes.
Bariatric Surgery & VLCD have been proven to cause Diabetic remission in certain patients which causes normalised blood glucose levels and eliminates the need for Diabetes medications.
Smart Contact Lens: Researchers from Korea have unveiled a smart contact lens sensor using new materials that measure glucose levels in tear fluid and fluid pressure inside the eye. This allows patients to transmit their health information allowing for real-time monitoring of their health conditions.
Pancreatic islet cell transplantation: This breakthrough is the first successful tissue-engineered “mini pancreas” that has achieved long-term insulin independence in a patient with type 1 Diabetes.
Augmented Reality Smartphone app: This allow the possibility of using your smartphone to give information on specific medications for type 2 Diabetes and high blood pressure in a form that is appropriate to each person’s level of understanding in a convenient and timely way.
- World Health Organisations. Global report on Diabetes (2016). Available at: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf (Accessed 24th May 2017)
- International Diabetes Federation. (2016) IDF Atlas seventh edition (2015) available at: http://www.diabetesatlas.org/resources/2015-atlas.html (Accessed 24th May 2017)
- News medical Life Science. Bariatric surgery. Available at: http://www.news-medical.net/health/What-is-Bariatric-Surgery.aspx (Accessed 24th May 2017)
- South African Journal of Clinical Nutrition. (2016) The Use of Very Low Calorie Diets in the Management of Type 2 Diabetes Mellitus. Available at: http://www.tandfonline.com/doi/full/10.1080/16070658.2016.1216514# (Accessed 24th May 2017)
- co.uk. Very Low Calorie Diet. Available at: http://www.diabetes.co.uk/diet/very-low-calorie-diet.html (Accessed 24th May 2017)
- Springer Link. (2011) Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol available at:https://link.springer.com/article/10.1007/s00125-011-2204-7(Accessed 25th May 2017)
- Wiley Online Library. (2015) Restoring normoglycaemia by use of a very low calorie diet in long- and short-duration Type 2 diabetes. Available at: http://onlinelibrary.wiley.com/doi/10.1111/dme.12722/full (Accessed 25th May 2017)
- American Society for Metabolic and Bariatric Surgery. Surgery for Diabetes. Available at: https://asmbs.org/patients/surgery-for-diabetes. (Accessed 25th May 2017)
- Science daily. (2017) Smart contact lens sensor’ for diabetic and glaucoma diagnosis Available at: https://www.sciencedaily.com/releases/2017/05/170504093231.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fdiabetes+%28Diabetes+News+–+ScienceDaily%29 Accessed: (25th May 2017)
- Nature comminications. (2016) Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics. Available at: https://www.nature.com/articles/ncomms14997 (Accessed 25th May 2017)
- Science Daily. (2017) Novel tissue-engineered islet transplant achieves insulin independence in type 1 diabetes. Available at: sciencedaily.com/releases/2017/05/170511083806.htm>. (Accessed 25th May 2017)
- co.uk. (2017) Smartphone app set to help people with type 2 diabetes and high blood pressure. Available at: https://www.diabetes.co.uk/news/2017/may/smartphone-app-set-to-help-people-with-type-2-diabetes-and-high-blood-pressure-90396668.html (Accessed 26th May 2017)
- How Augmented reality really works. Available at: http://www.augment.com/how-augmented-reality-works/ (Accessed 26th May 2017)