Category: Diabetes 101

According to researchers at the University of Cambridge in the United Kingdom, a rare and serious form of hypoglycemia can be traced back to a hereditary disposition.

The scientists say that the AKT2 gene — or more specifically, mutations in the gene — are responsible for causing this particular type of hypoglycemia, which is serious enough to be considered life-threatening and which deprives the body of the energy it needs to continue functioning normally.

According to the scientists from Cambridge, who published their report in the journal “Science,” there are already cancer drugs in use which are designed to treat a similar process.

Hypoglycemia, or a condition of low blood sugar, can be caused by imbalances between blood sugar levels and insulin, which carries sugar away from the bloodstream and into cells, lowering blood glucose levels. Hypoglycemia typically occurs in individuals who have Type 1 diabetes, when they miss meals, consume alcohol, or inject themselves with too much insulin.

The researchers at the University of Cambridge discovered that one in 100,000 babies is born with a mutation in the AKT2 gene that causes hypoglycemic conditions even when no insulin is present in the blood. In those cases, individuals should exhibit high levels of blood glucose.

Individuals with this mutation must use feeding tubes during periods of sleep to ensure that blood sugar levels do not drop too low. The patient must always be vigilant about maintaining blood sugar levels and ensuring that they don’t dip into dangerous territory, and the condition can be taxing for both the patient and his or her family.

“Fear of low blood sugar has dominated the lives of these patients and their families,” said Dr. Robert Semple, one of the researchers from Cambridge.

In discovering the mutation, the scientists looked at genetic code of three children who had this severe form of hypoglycemia. All of the children exhibited a certain mutation in the ATK2 gene. The mutation causes the ATK2 gene, which functions as an interpreter for insulin, to act as if insulin is always being produced by the pancreas. Blood sugar levels are therefore consistently lowered.

According to Professor Stephen O’Rahilly, lead researcher on the project at Cambridge, there are medications available which target ATK1 and also provide some effect in acting on ATK2. These medications are currently used to treat cancer. Since medications already exist which act on the genes, it may not be long before new treatments are introduced for treating the rare form of hypoglycemia.

“There are actual pills that can be swallowed by humans. There could be a treatment in a year,” said Professor O’Rahilly.

An individual is considered hypoglycemic when his or her blood sugar levels fall below 70mg/dL. If blood sugar levels remain at such a low level for an extended period of time, it can be harmful to the individual. The hormone insulin is normally produced by the beta cells of the pancreas where it works to reduce blood sugar levels, but blood sugar levels can fall too low if too much insulin is produced, exercise is performed at a different time, or alcohol is consumed, among other factors. Hypoglycemia is treated by consuming about 15 grams of carbohydrates and checking blood sugar levels again after about 15 minutes. Hypoglycemia can cause loss of consciousness and even seizures or nervous system damage; as such, it should be treated as quickly as possible, but individuals with low blood sugar should refrain from driving themselves to reach a hospital.

Juvisync, a pill that combines medication for both diabetes and high cholesterol, recently won approval for sale in the U.S. The medication will provide a reduction in both expenses and pill count for users of Januvia and Zocor, both medications developed by Merck & Co., Inc.

Juvisync will be available within a few weeks and will combine Zocor, a statin drug that combats high cholesterol, with Januvia, a Type 2 diabetes medication. Juvisync will be priced about the same as Januvia alone — about $215 for a month’s supply. Generic forms of Zocor cost patients about $30 per month.

The combination pill will likely be attractive to many diabetics who are not currently taking statins, as they will be able to gain the benefits of those medications with little or no extra cost. The American Diabetes Association recommends that diabetics over the age of 40 or who have also been diagnosed with heart disease should take a statin every day.

“This provides a way to simplify their regimen and improve adherence,” says Dr. Susan Spratt of the Duke University Medical Center. According to Spratt, many diabetics already take several pills each day — sometimes six or more — due to the need for different medications for diabetes, high cholesterol, and blood pressure. Taking all of the necessary pills each day can be a chore, and even diabetics who have health insurance can find their medication to be very pricey.

Not only will the patients benefit from fewer pills to take, but the addition of a daily statin could prevent future costs of hospitalization, according to Spratt.

“Anything to reduce the cost is going to be helpful to patients,” says Spratt. “When you improve medication adherence, you actually lower health care costs because patients don’t end up in the ER or the hospital.”

Merck’s shares rose nearly 3 percent on the day of Juvisync’s announcement, up 19 cents to $31.61 at closing.

Type 2 diabetes is a metabolic disorder in which the body does not produce enough insulin or does not use it correctly. The insulin that is produced is unable to bear the load of transporting glucose out of the bloodstream, so blood sugar levels remain elevated and permanent damage to organs and other tissues can result.

A sizable percentage of patients with Type 2 diabetes also have high cholesterol levels: both conditions are related to being overweight or obese. Those with both Type 2 diabetes and high cholesterol are at elevated risk of stroke, kidney disease, heart disease, and other illnesses, as well as complications commonly associated with diabetes such as nerve damage and vision loss.

Though the dangers of high cholesterol combined with Type 2 diabetes are well-documented, Merck says that up to four million patients with Type 2 diabetes are not receiving statins.

“Perhaps one third of the nation’s eligible patients with type 2 diabetes are not being treated with a statin, so here’s a convenient tool for doctors to target glucose as well as cholesterol levels,” said Dr. Seth Reddy, director of clinical affairs for diabetes at Merck.

Merck will offer Juvisync in six different dosages, which will correspond to the variance in severity of diabetes and cholesterol in patients. Side effects include headache, muscle and stomach pain, stuffy nose, and sore throat. The drug will also revitalize Zocor, which saw its market share reduced when it became available in generic forms as simvastatin in 2006.

A study conducted at the University of Wisconsin-Madison has identified a gene that could increase susceptibility to diabetes in those who carry it. Researchers discovered the gene in obese mice; it controls a protein called tomosyn-2, which decreases insulin production by the pancreas. The findings were published in the journal “PLoS Genetics,” which published by the Public Library of Science.

Beta cells in the pancreas are responsible for making and releasing insulin into the bloodstream, where it removes glucose from the blood and carries it into cells so that it can be used as energy. Type 1 diabetes is characterized by a lack of insulin while Type 2 diabetes causes an individual to be insulin-resistant. Both diseases cause a wide variety of complications, becoming more severe if they go untreated.

Alan Attie of the University of Wisconsin-Madison headed the study. He commented that the discovery of the gene could be an important development but it’s uncertain whether the gene can be targeted by therapeutics to effectively combat diabetes in insulin.

“It’s too early for us to know how relevant this gene will be to human diabetes, but the concept of negative regulation is one of the most interesting things to come out of this study and that very likely applies to humans,” said Attie.

Researchers used obese mice in the study, which require more insulin to lower blood glucose levels than mice of a normal weight — and the same is true of humans.

“If you can produce that extra insulin – and most people do – you’ll be okay,” said Attie. “You will avoid diabetes at the expense of having to produce and maintain a higher insulin level.”

According to Attie, however, being overweight means that the body is less able to produce the extra insulin required to eliminate elevated glucose levels.

“Most of the type 2 diabetes that occurs in humans today would not exist were it not for the obesity epidemic,” he said.

Researchers on the study compared diabetes-susceptible and diabetes-resistant mice. They found that a single amino acid accounted for the destabilization of tomosyn-2 in the diabetes-resistant mice. That one mutation allowed the diabetes-resistant mice to produce additional insulin to meet the increased demands of obesity.

While the onset of diabetes is a complex process and it is unlikely that a single gene could be targeted to elminate the disease altogether, genetic research into diabetes can eventually illuminate the processes and allow researchers to develop therapies that cut off diabetes at the source. Many scientists agree that genetic factors play about a 50 percent role in an individual’s risk of developing diabetes.

“This study shows the power of genetics to discover new mechanisms for a complex disease like type 2 diabetes,” said Sushant Bhatnagar, co-lead author of the study.

“Now we know there are proteins that are negative regulators of insulin secretion,” said Attie. “Very likely they do the same thing in human beta cells, and it motivates us to move forward to try to figure out the mechanisms behind that negative regulation.”

The researchers disclosed that they had no competing interests that could have affected the results of the study. Attie and his research team bred mice and kept records of results for over a decade to arrive at their findings.

An ancillary study to the Look AHEAD trial found that intensive lifestyle interventions designed to promote weight loss in obese individuals with Type 2 diabetes also helped reduce obstructive sleep apnea in the same patients.

Over the course of the four year study, patients who underwent intensive interventions demonstrated an approximately four point reduction in apnea-hypopnea index. Meanwhile, the control group saw a four-point increase in the same metric, according to Gary Foster Ph.D., with Temple University in Philadelphia. Dr. Foster reported the findings of the study at a meeting of the Obesity Society.

Patients with the more severe obstructive sleep apnea at the beginning of the study also saw the greatest benefit and reported the largest gains. However, Dr. Foster commented that intensive interventions would not be a replacement for other sleep apnea therapy: the patients in the study had a mean apnea-hypopnea index of 20, which means that a four-point reduction would not be enough to eliminate symptoms without the help of other treatments.

“I don’t want to give you the impression that this is an alternative treatment to [continuous positive airway pressure treatment],” said Dr. Foster. “It’s probably a complementary treatment.”

The study, called Sleep AHEAD, was an ancillary of the Look AHEAD trial, which studies the benefits and effectiveness of intensive lifestyle interventions for obese individuals with Type 2 diabetes. The interventions are designed to promote weight loss in those individuals through education and diabetes support.

The Sleep AHEAD study aimed to determine whether the patients’ weight loss would also reduce the severity of sleep-related breathing disorders such as obstructive sleep apnea. It had been previously demonstrated in smaller studies that weight loss did have a positive effect on sleep apnea.

The study participants were given a questionnaire which aided researchers in identifying the severity of each individual’s sleep apnea. Patients who were already receiving treatment for sleep apnea or who had received surgery to treat the condition were not included in the pool of participants; researchers wanted to study patients who were not receiving current treatment for sleep apnea.

In all, 305 patients participated in the study, undergoing polysomnograms at their homes to measure symptoms of sleep apnea. Researchers rated participants on the severity of sleep apnea. Those with an apnea-hypopnea index of 5 or less were classified as free of sleep apnea; a score of 5 to 15 was diagnosed as mild; a score of 15 to 30 was moderate, and a score of 30 or more was severe.

Mean score among the participants was 20.5, with 13.4 percent of patients classified as not having sleep apnea. Participants with mild sleep apnea made up 33.5 percent of the study group while moderate patients made up 30.5 percent and severe patients made up 22.6 percent.

A year into the intensive intervention, patients had lost an average of 24 pounds while patients in a control group did not demonstrate any weight loss. Additionally, patients undergoing lifestyle interventions saw a reduction in apnea-hypopnea index of about six points while control patients had an increase of four points.

Four years into the study, intervention patients were more likely to have seen an improvement in their sleep apnea severity classifications (40 percent versus 15 percent) and were also more likely to experience a remission of symptoms (20 percent versus 3 percent).

Though weight loss seemed to be associated with reduction in sleep apnea, Dr. Foster commented that a healthier lifestyle in general could be more responsible for the positive changes.

“The likely hero, I think, is fitness,” said Dr. Foster, citing that previous research has shown that increased fitness levels even in the absence of weight loss can lead to improved sleep apnea.

New research has demonstrated that a type of sugar extracted from buckwheat, called D-fagomine, could help diabetics keep their blood glucose levels well-managed and may offer prebiotic activity in small doses.

A group of Spanish researchers reported in the journal “British Journal of Nutrition” that ingestion of the sugar along with sucrose or starch resulted in a less-severe blood sugar spike and did not stimulate the secretion of insulin. Data from animal studies also showed that ingestion of the D-fagomine sugar was associated with a reduction in levels of potentially harmful bacteria in the gut and a promotion of beneficial bacteria called Lactobacili.

“Based on all this evidence, d-fagomine may be used as a dietary ingredient or functional food component to reduce the health risks associated with an excessive intake of fast-digestible carbohydrates, or an excess of potentially pathogenic bacteria,” wrote the study’s authors.

The D-fagomine sugar is currently under development by Bioglane, a Barcelona-based biopharmaceutical company associated with the Spanish Research Council (CSIC). Bioglane funded the study into the properties of d-fagomine. Bioglance has previously reported that is has developed enzymatic processes that can be used to produce natural iminosugars on a large scale suitable for commercial use. It has focused on developing D-fagomine up to this point and has scaled up its production of the sugar under the name FDA-GMP. Bioglane was formed in 2007 and is also associated with the Genoma Espana Foundation and Caja Navarra. The company is devoted to finding new iminosugars that would allow humans to eat carbohydrate-rich diets without the negative effects sometimes associated with them.

D-fagomine is an iminosugar that occurs naturally in buckwheat grain and traditional buckwheat-based foods, according to Bioglane. The compound was first isolated in 1974 and is usually considered to be a glucose analog.

In the new study, lab rats were fed a combination of D-fagomine along with either starch or sucrose. The results of the experiments showed that the rats taking D-fagomine demonstrated lower levels of blood glucose, depending on the size of the dose. When they were given a dose of 1 to 2 milligrams per kilogram of body weight along with one gram of sucrose, they showed a 20 percent reduction in blood glucose levels after the meal. The maximum blood glucose level took longer to occur as well. According to the researchers, insulin levels also decreased along with the decrease in blood glucose.

The researchers also noted in their report that D-fagomine had significant prebiotic effects, preventing certain harmful bacteria from adhering to mucus membranes in the gut of test animals while having a positive effect on good bacteria.

“We also disclose here an activity of D-fagomine that had never been suggested before: the modulation of bacterial adhesion. We observed that D-fagomine selectively agglutinated potentially deleterious Enterobacteriaceae and prevented their adhesion to pig intestinal mucosa,” they reported. “The adhesion of Lactobacillus spp. was promoted by D-fagomine while that of Bifidobacterium spp. was not affected.”

However, they reported that additional research would be necessary to determine if D-fagomine could provide prebiotic health benefits from long-term use: “As the intestinal microbiota clearly influences the physiological status of the gut and even the health of the whole organism, further studies will determine whether this activity of D-fagomine results in long-term effects related to the reduction of health risk factors,” they said.

The research team was affiliated with Bioglane, Institut de Quimica Avancada de Catalunya, CSIC, Barcelona Science Park, the Universitat de Barcelona, and the Universitat Autonoma de Barcelona.

A team of scientists reported on October 5 that they had successfully utilized cloning technology to create embryonic stem cells that contained genetic information from specific individuals. The success of the project could mark an important step in the development of stem cell cloning techniques, which could be used to treat diseases since they are not rejected by the patient’s body.

The cells produced in the experiment were genetically abnormal and would not be suitable for use in humans, say the researchers. But the discovery could still pave the way for future cloning techniques that could heal a variety of terminal illnesses.

The use of embryonic stem cells is controversial throughout several fields, including ethics, morality, and politics. Scientists paid women to donate eggs, which were used in the research. The study created concern about the exploitation of women for research and the health risk involved in donating eggs. The researchers used the eggs to produce and destroy embryos, from which the stem cells were extracted. The research caused controversy because scientists grew mutant human embryos specifically for use in the extraction of stem cells.

“They have created human embryos. They are abnormal, but they are still human embryos,” says Daniel P. Sulmasy, professor of medicine and ethics at the University of Chicago. “Anyone who is opposed to the deliberate creation and destruction of human embryos, as I am, would be opposed to this research.”

However, other scientists, bioethicists, and advocates of embryonic stem cell research praised the scientists for their meticulous attention to detail and for the advances in the fields of medicine that the research could bring.

“I think it will teach us a lot of how to control the generation of all the different cell types that we would like to study and use for therapy,” says Lawrence Goldstein, director of the stem cell research program at the University of California at San Diego. “I think it’s a really exciting development,” Goldstein continued.

Those who support embryonic stem cell research feel that it is one of the most promising fields of biomedical research. Embryonic stem cells are thought to have the ability to become any type of cell, tissue, or organ in the body. Such cells could be used to regrow defective organs such as kidneys, hearts, and livers, and new research could result in a cure for several serious diseases such as diabetes, paralysis, and Alzheimer’s disease. However, stem cell research is not without its opponents: scientists must grow and eventually destroy embryos to extract the stem cells, and some opponents believe that destroying an embryo is equivalent to ending a life.

Stem cells were first isolated in 1998 and researchers have been working ever since to create new stem cells that could be used to generate new tissue such as organs or even limbs. Since stem cells would contain the DNA of the individual who is receiving the treatment, the patient’s body would not reject the new tissue.

“Therapeutic cloning,” as it is sometimes called, is the process that was used to clone the sheep Dolly in 1996. The process implants genes from an adult individual into an egg that has been stripped of its own genetic material. Scientists then use other genetic processes to stimulate the egg to grow into an embryo with the new genetic information, which allows scientists to extract the embryonic stem cells.

A team of United States-based scientists are hopeful that new research on a natural chemical found in body cells could set the stage for the development of a vitamin-like pill that could prevent diabetes or perhaps even reverse the disease completely.

The chemical is called nicotinamide mononucleotide (also known as NMN) and it serves an important purpose in the way body cells utilize energy. The U.S.-based researchers tested the compound by injecting diabetic mice with it. After the injections, the mice showed normalized blood glucose levels in addition to lowered triglyceride blood fat and cholesterol levels.

The next step for the research team is to develop a method of administering the NMN compound to mice directly through their drinking water instead of through injections. In the future, the team’s long-term goal is to develop a “nutriceutical” pill, similar to a normal daily vitamin, that can be taken to reverse or prevent Type 2 diabetes.

“Once we can get a grade of NMN that humans can take, we would really like to launch a pilot human study,” said Dr. Shin-ichiro Imai, M.D., Ph.D., from the Washington University School of Medicine in St. Louis; Dr. Imai also headed the study. Since mice share a similar genetic code with humans, medications meant for human use are often tested on mice first. However, even when a medication appears safe when used on mice, it must be extensively tested on humans as well before being approved for prescription and sale. According to Dr. Imai, the effect of NMN was “remarkable,” and it was more pronounced in female mice: “After giving NMN, glucose tolerance goes completely back to normal in female diabetic mice,” said Dr. Imai.

The researchers triggered the onset of Type 2 diabetes in the mice by feeding a high-fat diet to young, otherwise healthy mice. All of the mice displayed decreased levels of a molecule called NAD, which is responsible for extracting energy from nutrients in food and turning it into a form that cells can use to operate. In mice as well as humans, NAD is derived from NMN and is created by cells through a series of metabolic reactions.

One important effect of NAD is the activation of SIRT1, a protein that has been the subject of much study and which has been demonstrated to encourage well-functioning metabolism throughout the body and to increase insulin sensitivity. SIRT1 — or NAD-dependent deacetylase sirtuin-1 — is encoded by a gene also called SIRT1. Since NAD is toxic when administered directly to organisms such as mice and humans, researchers injected mice with NMN instead, which leads to an increase in NAD levels. After they were treated with the compound, the mice displayed significantly improved glucose response. NMN is produced naturally by the body but its levels decrease as the individual ages. High-fat diets also discourage the production of NMN.

According to Dr. Imai, NMN exhibits very similar behavior in mice and humans. However, the further testing will be required before it can be determined whether a lack of the compound is equally responsible for Type 2 diabetes in humans. “Whether this mechanism is equally compromised in human patients with Type 2 diabetes is something we have to check,” said Dr. Imai. “We have plans to do this in the very near future.”

A study published in the October issue of the journal “Diabetes Care” has demonstrated that, in patients with Type 1 diabetes who receive intensive insulin therapy through the use of a pump, a new algorithm based on the food insulin index is more effective at improving acute postprandial glycemia — or blood sugar levels after a meal — than a carbohydrate counting plan.

The study was headed by Jiansong Bao of the University of Sydney in Australia. Bao’s research team compared the effectiveness of a new food insulin index (FII) algorithm, which is used to estimate the dose of insulin that should be given at mealtimes, with counting carbs. The study consisted of 28 adult participants who had been diagnosed with Type 1 diabetes and were users of insulin pumps.

Study participants randomly ate two breakfast meals over the course of three consecutive days. The two separate meals were similar in factors such as total energy, fiber, glycemic index, and calculated insulin demand, but one meal had approximately twice the carbohydrate content of the other meal. For the meal with higher carbohydrate content, the proper insulin dose for the participants was determined by counting the amount of carbohydrates in the meal — 75g. On the other two mornings, participants received the less carb-heavy meal (41g carbohydrate) and used the new FII algorithm to determine proper insulin dosage. Researchers used continuous glucose monitors to determine postprandial blood sugar levels in the participants for the three hours following the meals.

Upon analyzing the results, the researchers discovered that the new FII algorithm had a significant effect in decreasing peak glucose excursion and glucose incremental area under the curve for the three hours after a meal. Participants spent significantly more time after a meal in normal blood glucose ranges when using the FII algorithm, although hypoglycemia was not significantly different between the two groups.

“An insulin algorithm based on physiological insulin demand evoked by foods in healthy subjects may be a useful tool for estimating mealtime insulin dose in patients with type 1 diabetes,” wrote the authors of the study.

Carbohydrate counting is a popular method of ensuring that insulin levels remain under control in both Type 1 and Type 2 diabetics, who must plan their meals to avoid excessive intake of carbohydrate in a single meal. Foods containing carbohydrates increase blood glucose levels, which can prove dangerous for diabetics. By planning their meals carefully and setting a maximum amount of carbohydrate in a single meal, diabetics can ensure that their blood sugar levels will remain well-managed. Most diabetics are advised to start at about 45-50 grams of carbohydrate per meal, though the number varies according to the plan of treatment and the severity of the disease. Doctors can help diabetics establish guidelines for the amount of carbohydrate they should be consuming at every meal.

Not only are diabetics advised to count carbohydrates to better manage blood glucose levels, but they can also use food nutrition labels to determine the total number of calories in the food and to avoid undesirable ingredients such as trans fats and saturated fats. Such fats are especially harmful to patients with heart disease or who are at risk for heart disease; doctors also advise against the consumption of excessive sodium, especially in those who are already hypertensive.

A recent randomized trial showed that increasing the intensity of weight loss interventions only in patients who do not succeed in reaching their goals may be an effective alternative to typical approaches.

According to John Jakicic, Ph.D., with the University of Pittsburgh, the findings did not demonstrate a significant difference in the number of patients who achieved a 10 percent reduction in weight after 18 months between a group that received stepped care and a group that received normal treatment (26 percent versus 32 percent). The two groups also reported similar average weight loss — 5.8 percent loss for the stepped care group versus 6.8% for the normal care group. “So the stepped-care approach may present an effective alternative to standard behavioral weight loss interventions,” said Jakicic.

Jakicic continued to note that 30 to 40 percent of the patients who received stepped care stayed at the first two steps, involving monthly group meetings, lessons mailed to the patients weekly, feedback from doctors on a weight loss diary that the patients completed, and one phone call every month.

Behavioral interventions that promote lifestyle changes have been previously shown to be effective in helping patients lose weight. However, the intensity of the intervention generally remains the same whether or not the patients are responding to the treatment.

Stepped approaches use feedback from the patient’s success with the program to determine its intensity. When a patient does not respond to the intervention, the intensity of the approach is increased. These types of intervention had not been previously compared to standard behavioral interventions for weight loss through the use of a randomized trial.

Jakicic and his team designed the Step Up study, an investigation of 364 overweight and obese men and women that randomly assigned stepped care or standard intervention to each participant. The participants’ mean age was 42.2 and mean body mass index was 33kg/m2. A significant majority of the participants were female (82.7 percent).

Both the standard and stepped care groups were given dietary goals intended to reduce total calorie intake as well as fat intake. Participants were also given targets for engaging in physical activity, increasing in duration to 300 minutes of moderate-to-vigorous exercise each week.

The stepped care group also attended a group session every month throughout the duration of the study and received weekly mailed lessons. They also kept diaries on their progress and received feedback from doctors on those diaries. Participants who failed to achieve their goals — 5 percent of the participants at three months, 7 percent at six months, and 10 percent at nine months — were contacted more frequently by researchers and saw the intensity of their interventions increased. The more high-intensity measures included two phone calls per month instead of one, two individual sessions per month to discuss weight loss, and meal replacements provided to the participants.

Participants in both the standard and stepped care groups lost weight. However, absolute weight loss was significantly higher in the standard care group for the first six months (22 pounds versus 17.6 pounds). For each follow-up beginning at six months from baseline, however, participants did not exhibit a significant difference in weight loss between the two groups.

According to Jakicic, more research is needed to determine the effectiveness of stepped care interventions. Factors that need to be addressed include: the effectiveness of each of the steps as compared to other steps; who responded to the stepped care approach; the possible effect of diet and physical activity; and different approaches that may be more useful in stepped care.

A new study warns that eating food too quickly more than doubles an individual’s chance of developing impaired glucose tolerance, also known as pre-diabetes and the precursor to Type 2 diabetes. It appears that eating quickly is the only mechanical eating practice that can promote the onset of pre-diabetes; people who engaged in snacking and eating late at night were not an increased risk of developing the disease. The study appeared in the journal “Diabetes Research and Clinical Practice” and was conducted at the Institute of Clinical Medicine at the University of Tsukuba.

The Japanese study found that eating food quickly was the only eating pattern that caused a significant increase in risk of developing pre-diabetes. The results were adjusted for factors that may have skewed the results, including age, sex, weight, smoking, alcohol, blood pressure, cholesterol, and whether the individual had a family history of diabetes.

The investigation followed 172 Japanese men and women who were diagnosed as healthy at the beginning of the study for three years. They were asked to self-report various aspects of their eating habits, such as whether they were fast eaters, ate late at night, snacked frequently, skipped meals, or ate out frequently. Throughout the three-year period of the study, 39 participants developed impaired glucose tolerance and two of those went on to develop Type 2 diabetes.

Scientists aren’t sure exactly why eating faster makes an individual more likely to develop pre-diabetes and Type 2 diabetes, but one hypothesis states that eating rapidly results in higher postprandial blood glucose levels — the level of sugar in the blood after a meal. Some doctors also speculate that eating too quickly results in an overall increase in the amount of calories eaten since it takes about 20 minutes for the brain to receive the signal that the stomach is full; thus, those who eat quickly will consume more calories before realizing that they’re finished eating.

Previous research has also confirmed that eating quickly results in increased weight gain, which is associated with pre-diabetes and Type 2 diabetes. One study presented to the North American Association for the Study of Obesity found that overweight men and women consumed fewer calories overall when they slowed their eating pace. Another study conducted in Japan found that among 1,700 young women, eating slowly resulted in feelings of fullness occurring sooner, which meant that the women consumed fewer calories throughout the meal. Additionally, a recent study conducted in New Zealand found that women who were fast eaters were at an increased risk of obesity.

It is thought that there are 2.8 million people throughout the United Kingdom with undiagnosed Type 2 diabetes. The disease reduces or eliminates the body’s ability to produce insulin, which helps shuttle sugar in the bloodstream into cells to be used as energy. Since a Type 2 diabetic’s body does not produce enough insulin on its own, diabetics require insulin supplements in the form of injections or other delivery methods.

Impaired glucose tolerance (IGT), or pre-diabetes, is a sign that the individual will soon develop diabetes if blood sugar levels are not more tightly controlled. In pre-diabetes, those blood glucose levels are elevated, but not high enough to cause diabetes.

Preventative measures such as a healthy diet and regular exercise can help those with pre-diabetes keep their glucose levels under control so that they do not develop Type 2 diabetes. However, 40 to 50 percent of individuals with pre-diabetes will be diagnosed with Type 2 diabetes within ten years.