Risk of diabetes with breast milk, antidepressants, weight loss

Some of the latest advances in diabetes research presented at the European Association for the Study of Diabetes (EASD) virtual meeting included the use of an osteoporosis drug to prevent diabetes, l ‘Use of Insulin Resistance to Predict Stroke and Gender Differences in the REWIND Cardiovascular Prevention Trial in Type 2 Diabetes.

Other research highlights include the following:

Milk against the risk of type 1 diabetes

Consuming certain milks altered a child’s risk of developing type 1 diabetes, according to a systematic review and meta-analysis of 96 studies led by Anna-Maria Lampousi, a doctoral student at the Karolinska Institutet in Stockholm.

Specifically, children who drank a lot of cow’s milk as they grew older – at least 2 servings per day – saw a higher risk of developing type 1 diabetes (RR 1.78, 95% CI 1.36-2, 33, moderate certainty). And every 2-3 servings of cow’s milk per day was also linked to a 25% higher risk of islet autoimmunity (RR 1.25, 95% CI 1.06-1.47, moderate certainty) .

Children who consumed more protein, red meat, nitrates, sugar, and sugary drinks were also at higher risk for type 1 diabetes.

On the other hand, children who were breastfed for at least 6 to 12 months had a 61% lower risk of type 1 diabetes compared to children who were breastfed for less than 6 to 12 months (RR 0.39, 95% CI 0.26-0.58, certainty). Along with this, children who were exclusively breastfed for 2-3 months or more also saw this protective benefit against type 1 diabetes (≥2-3 vs.

Additionally, children who were introduced to gluten and fruit later in childhood had a lower risk of type 1 diabetes. Vitamin D supplementation, as well as a higher intake of vitamins A and C were also somewhat protective against type 1 diabetes.

None of the risk factors measured in utero, such as maternal intake of gluten, iron, and vitamin D exposure, were related to the risk of type 1 diabetes in children.

“Dietary factors in infancy and childhood may be involved in the etiology of type 1 diabetes,” Lampousi concluded during a presentation of the results.

Risk of type 2 diabetes with Antidepressants

Almost 30% of Scottish adults diagnosed with type 2 diabetes were prescribed an antidepressant within 4 years of being diagnosed.

In a cohort of 266,186 adults with type 2 diabetes, 22.5% received an antidepressant prior to their diagnosis of diabetes, and 5.3% received an antipsychotic. Another 6.6% were prescribed both an antidepressant and an antipsychotic.

About a third of these adults on antidepressants were prescribed a selective serotonin reuptake inhibitor (SSRI), while another third were prescribed a tricyclic antidepressant. Another 27% were prescribed an antidepressant of several subtypes.

Of those who received an antipsychotic, the vast majority were on a first generation agent (80%), while only about 14% were on a second generation agent.

Looking more closely at those adults who received one or more psychiatric medications prior to their diagnosis of diabetes, these patients tended to be from lower socioeconomic backgrounds, to be female, to currently smoke, and to suffer from diabetes. obesity, hypertension and high total cholesterol.

Lead author of the study, Charlotte Greene, a doctoral candidate at the University of Edinburgh, stressed during a presentation of the results that these results only included community prescribing and not hospital prescribing. , probably underestimating these percentages. She also noted that there were no data on the dosage or duration of antidepressant use – only general prescribing data – limiting some of the results.

Reverse heart risk with major weight loss

Huge weight loss appeared to completely reverse cardiovascular risk in American adults in a study of data from the National Survey of Health and Nutrition covering 1999 to 2013.

Adults who were previously obese but experienced significant weight loss were able to completely reduce the risk of hypertension and dyslipidemia to a level comparable to adults who were still at a healthy weight (OR 1.08 and OR 1.13 , respectively).

On the other hand, adults who remained obese had a more than three times higher risk of developing hypertension and dyslipidemia (OR 3.14 and OR 3.11).

Despite this good news about cardiovascular risk reversal, the risk of diabetes still seemed to persist somewhat even after massive weight loss. Among adults who were previously obese, the risk of developing type 2 diabetes was higher than those who were still at a healthy weight (OR 2.93) but lower than those who are currently still obese (OR 7.53).

“The main takeaway from this study is that losing weight is difficult, but important for cardiovascular health,” said lead author Maia Smith, PhD, of St. George’s University in Granada, in a report. communicated. “First of all, it’s no surprise that it’s hard to lose weight and keep it off. Almost everyone in our initial sample who ever suffered from obesity stayed that way. But don’t despair: if you manage to lose weight, it can not only prevent but reverse important health problems.The best time to be healthy is 20 years ago, the second best time is now.

  • Kristen Monaco is editor-in-chief, specializing in news in endocrinology, psychiatry and nephrology. Based in the New York office, she has been with the company since 2015.

Disclosures

Lampousi’s study was supported by the Swedish Research Council and FORTE.

No author has reported any disclosures.


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