A landmark study in Lancet Diabetes & Endocrinology identified a T1D subtype in Sub-Saharan African youth and Black Americans lacking islet autoantibodies. This insulin-deficient form isn't autoimmune, urging revised diagnostic, prevention, and treatment strategies.
Did you know? A randomized crossover trial published in August 2025 demonstrated that a DASH diet modified for type 2 diabetes (DASH4D) significantly improved glycemic control. Adults with T2D on the DASH4D regimen experienced greater reductions in mean CGM glucose and increased time in the target range compared to standard U.S. dietary patterns. Improvements were most pronounced in participants with elevated baseline A1C.
Could evidence-based dietary frameworks like DASH4D enhance existing treatment plans for patients with complex metabolic profiles?
Could evidence-based dietary frameworks like DASH4D enhance existing treatment plans for patients with complex metabolic profiles?
Source : https://pubmed.ncbi.nlm.nih.gov/40316731/
This review describes a prolonged research endeavour to test the twin cycle hypothesis that type 2 diabetes is caused by fat-induced dysfunction of the liver and pancreas, guided by the...
This review explores the twin cycle and personal fat threshold hypotheses, demonstrating that weight loss can induce durable remission of type 2 diabetes by reversing liver and pancreas fat dysfunction.
Patient Background: A 75-year-old woman presents with progressive weight loss, generalized weakness, easy bruising, and poorly controlled hypertension. On exam, she has thin skin with ecchymoses, proximal muscle weakness, and hypokalemia (serum potassium 2.9 mmol/L).
Family History: The patient reported no family history of hormonal disorders, malignancy, or pituitary pathology relevant to her presentation.
Assessment and Diagnosis: Evaluation revealed elevated 24-hour urinary free cortisol (UFC), elevated morning (8 am) serum cortisol, and non-suppression on a low-dose dexamethasone suppression test (LDDST), with elevated ACTH. Pituitary MRI was negative, and Ga-68 DOTATATE PET/CT showed no ectopic lesion. Bilateral inferior petrosal sinus sampling (BIPSS) with CRH stimulation confirmed MRI-negative, ACTH-dependent Cushing’s disease, although features such as marked weight loss and hypokalemia initially raised suspicion for ectopic ACTH secretion.
Suggested treatment plan: The patient declined surgery and opted for medical therapy with an adrenal steroidogenesis inhibitor plus a dopamine agonist.
Patient education: The patient was educated on the importance of medication adherence and avoidance of drug–drug interactions. She was specifically advised to avoid concurrent use of gastric acid–reducing agents, which can impair treatment absorption and effectiveness.
Follow-up: Medical therapy led to normalization of UFC, improved potassium levels, blood pressure, and glycemic control, along with a 15-lb weight gain. A relapse occurred after initiation of an acid-suppressing medication, which compromised drug absorption. Discontinuation restored efficacy, with rapid normalization of hormone levels and a 50-lb weight gain, improving mobility and strength.
Dyslipidaemia is a modifiable risk factor for cardiovascular disease (CVD). A large meta-analysis shows that exercise training (ExTr) yields modest but significant improvements across lipid outcomes.
ExTr reduced total cholesterol (−5.9 mg/dL), LDL (−7.2 mg/dL), triglycerides (−8.0 mg/dL), VLDL (−3.9 mg/dL), and increased HDL (+2.1 mg/dL). Combined aerobic training (AT) and resistance training (RT) produced the most consistent lipid improvements. AT alone improved all five markers, while RT primarily raised HDL.
Meta-regression showed dose–response effects: each additional AT session per week was associated with a reduction in TC of −7.7 mg/dL, and longer sessions (>30 minutes) improved HDL. These findings support tailoring exercise to lipid profiles.
ExTr alone may reduce LDL by ~6.3%, corresponding to a potential 4–5% reduction in ASCVD risk. When combined with pharmacologic therapy, total risk reduction may approach 30%.
However, up to 37% of included studies showed no benefit for certain lipid subtypes, underscoring individual variability. Still, 100% of studies reported benefit for VLDL. Exercise should remain a first-line strategy for dyslipidaemia, with tailored prescriptions using AT and RT. AT should be prioritized in cases of hyperlipidaemia.
How will you incorporate these exercise-specific insights into your dyslipidaemia counselling strategies?