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Medscape
18 hours ago
- Health
- Medscape
ADA 2025: Progress in Managing Type 1 Diabetes
This transcript has been edited for clarity. The one study that my patients with type 1 diabetes asked me about from the American Diabetes Association meetings was the Vertex study, where stem cell-derived islet cells were given to individuals with type 1 diabetes and followed for a year. They reported on 12 participants, and basically, these little islet cells worked. The problem, of course — and the reason I had to disappoint my patients — is that it didn't work without immunosuppression. These patients required immunosuppression, but in the setting of immunosuppression, the little new islet cells worked. We saw an increase in C-peptide production. Most patients got off of insulin. The patients had no further episodes of severe hypoglycemia, and the patients really were cured, in essence, of their type 1 diabetes — at least the small number of people followed for a year. The downside, of course, is the immunosuppression, and that's where the side effects occurred. I think this was really interesting because it's certainly proof of concept that we can take stem cells, make islet cells, and infuse them into people and have them work. We just have to figure out a way to do it without immunosuppression. The next study that my patients and I found interesting came from the Barbara Davis Center and was done by Dr Halis Akturk and his colleagues. It was looking at the use of semaglutide 1 mg as an adjunct to insulin in people with type 1 diabetes and obesity who are on automated insulin delivery systems. Now, in full disclosure, I do this all the time in my patients who are overweight or obese who wish to try combination therapy off-label with semaglutide, but this is the first randomized controlled trial to show the benefit. This was called the ADJUST-T1D trial. It was a double-blind study. This was a 26-week placebo-controlled study, and they enrolled 72 individuals with type 1 diabetes from four US clinics. They were randomized 1:1 to semaglutide or placebo once weekly while they continued on their usual automated insulin delivery systems. The insulin adjustments were guided by the investigators, along with the patients, looking at time in range, time below range, and other continuous glucose monitoring parameters. These individuals had to have a BMI ≥ 30 and an A1c between 7% and 10% coming into the study. These are fairly typical individuals with type 1 diabetes who are overweight, and they had a baseline A1c of 7.7%. The primary outcome was a composite one, looking at how many people achieved a time in range of > 70%, time below range of < 4%, and ≥ 5% weight loss. This composite endpoint was met in 36% of the participants in the semaglutide group, and this was highly significant compared to the placebo group. In terms of secondary outcomes, there was a reduction in A1c by 0.7% in the semaglutide group compared to 0.3% in the placebo group. Time in range improved. People lost, on average, 18 lb, and there was a reduction in total daily insulin dose. There was no diabetic ketoacidosis, but there were two episodes of severe hypoglycemia in each group. This was really proof of concept, which I think all of us who treat many people with type 1 diabetes and have been using incretin therapy have shown to be beneficial. I think the things we still need to watch for is obviously weight loss that's too fast because I don't think this is good for anybody, and the fact that people will need less insulin, so the insulin doses need to be reduced as people use these agents. Patients on these automated insulin delivery systems tend to do pretty well. I'm often adjusting the carb ratio and maybe the sensitivity depending on the pump, but I found this to be a pretty safe and effective way to do it. I think you just start lower, you go up slowly, and you make sure patients are tolerating the medication. I think patients really see benefit. What's not measured here are the nonglycemic benefits that we know are part of the use of incretin therapies, which I think is important. In my own clinic, I looked at outcomes at 2 years retrospectively, and people had still maintained the weight loss but some of the glycemic improvements waned over time. I think that just goes to show the difficulty of managing people with type 1 diabetes. I think this helps, and I think this was a really good trial. I'm very grateful to the investigators for doing this study. These two presentations highlight some of the progress in how we're thinking about dealing with type 1 diabetes. First, the notion of hopefully, someday having a cure that helps people with type 1 diabetes, having new beta cells that actually work. The second is using some of the drugs that we're now familiar with in terms of their benefits to people with type 2 diabetes in people with type 1 diabetes, and showing that it can be done safely and effectively. This has been Dr Anne Peters for Medscape. Thank you.
Yahoo
20 hours ago
- Health
- Yahoo
The #1 Breakfast to Help Lower Your A1C, According to Dietitians
Reviewed by Dietitian Katey Davidson, RD, CPT Hemoglobin A1C is a blood test that measures the average amount of glucose (sugar) in your blood over the last three months. 'When blood sugar levels stay elevated over time, it causes A1C to increase,' says Vandana Sheth, RDN, CDCES, FAND. Many factors can contribute to this, but diet plays a large role, including our breakfast choices. The good news is that eating a balanced breakfast, like our Southwest Breakfast Quesadilla, may help lower A1C. Just keep in mind that it can take a few months to lower A1C, so stay patient and consistent. 'Lowering your A1C starts with one key habit: keeping blood sugars steady—and that begins at breakfast,' says Kaitlin Hippley, RDN, LD, CDCES. Keep reading to learn why the Southwest Breakfast Quesadilla is the best breakfast to eat to help lower your A1C. Why the Southwest Breakfast Quesadilla Is the Best Breakfast to Help Lower A1C While there are many breakfasts that can support healthy blood sugar levels, the Southwest Breakfast Quesadilla is a top pick. 'The Southwest Breakfast Quesadilla delivers on all fronts and helps set the tone for the day by keeping blood sugars steady from the start. It's loaded with powerful ingredients like egg, beans, whole-wheat flour tortilla and tomatoes, all working together to support better glucose control and lower A1C results,' says Hippley. Plus, you can prepare it ahead of time or whip it up in the morning. It's High in Protein Although managing your carbohydrate intake is important, packing meals with protein is one of Hippley's top tips for lowering A1C. 'The eggs and beans in this recipe deliver a protein punch of 19 grams, helping to slow the conversion of carbs into glucose and prevent blood sugar spikes,' she says. Protein also keeps you full longer, making you less likely to overeat, and it helps to preserve lean muscle mass—key for boosting insulin sensitivity and supporting blood sugar control. In fact, the American Diabetes Association lists eggs and beans as two of the best protein sources for people with diabetes due to their high protein and fiber content, respectively. It's High in Fiber Speaking of fiber—the Southwest Breakfast Quesadilla is loaded with it. One serving provides a whopping 14 grams of fiber, which is about 50% of your daily fiber needs. Research shows that increasing fiber intake improves blood sugar control in people with type 2 diabetes. 'High fiber intake supports a healthy gut, and when the gut is balanced, insulin is used more efficiently,' says Hippley. 'Fiber also slows the breakdown of carbohydrates, leading to a gradual rise in blood sugar instead of spikes. Fewer spikes and better insulin sensitivity ultimately supports a lower A1C.' It Supports Healthy Weight Loss 'Losing just 5% to 10% of your body weight can help lower your A1C and reduce risk of complications,' says Hippley. While the average breakfast could top 400 calories, this one has just 175 calories and still delivers plenty of protein and fiber to support weight loss and blood-sugar management. That said, weight loss is not always warranted if your A1C is high. You can certainly lower your A1C by changing your diet and increasing exercise, even if your weight doesn't change. However, studies have found that losing just 5% of body weight can help lower A1C. This doesn't mean you have to count calories or restrict your food. Simply changing your habits—like walking more, strength-training and eating balanced meals—may help you lose weight. It May Reduce Cravings Research shows that high-protein breakfasts may reduce food cravings more than high-carbohydrate ones. Breakfasts high in carbohydrates can cause a rapid spike in blood sugar, followed by a quick crash. When this happens, low blood sugar can trigger cravings for more sugar or carbs. 'Avoiding blood sugar crashes in the morning reduces cravings for high-carb foods, large portions and glucose spikes,' says Hippley. Not only that, but starting the day with a balanced meal encourages healthier choices throughout the rest of the day, which ultimately helps lower your A1C, she says. Other Things to Do to Help Lower A1C Starting the day with a balanced breakfast is just one of many ways to support healthy blood sugar. Here are other strategies for lowering A1C: Prioritize Movement: Both cardio and strength training can help reduce A1C. One study found adults with type 2 diabetes who did both aerobic exercise and resistance training each week significantly lowered their A1C levels. The strongest effect was seen with 4.5 hours of moderate-intensity or 2.5 hours of high-intensity exercise per week. If that sounds like a lot, start small—because every bit counts. 'Go on a 10-minute walk after meals,' says Sheth. 'This can help your body lower your blood sugar by moving sugar from the blood into the cells more effectively.' Balance Your Plate: Include protein, healthy fats and fiber-rich carbs at meals, says Sheth. This is important not only at breakfast, but also at lunch, dinner and snacks because it helps prevent big swings in your blood sugar. Aim to fill half your plate with nonstarchy vegetables, one quarter with whole grains or other starches, and one quarter with protein. For example, try salmon with broccoli and quinoa, or a turkey burger on a whole-wheat bun with a side salad. Get Your Zzz's: 'Disrupted and poor sleep can affect insulin sensitivity and make it harder to manage blood glucose,' says Sheth. One study found poor-quality sleep and not sleeping enough was associated with a higher A1C in people with prediabetes. Aim for seven to eight hours of good-quality sleep per night and try to go to bed earlier to better align with your circadian rhythm—which helps to regulate blood sugar and insulin response. Research also shows that eating earlier in the day and reducing late-night eating is linked with healthier blood glucose levels., Manage Stress: Stress management is often an afterthought for managing blood sugar, but it's just as important as diet and exercise. When you're stressed, your body releases a stress hormone called cortisol, which raises blood sugar. This response is OK and sometimes needed in the short-term, but chronic stress can keep blood sugar levels elevated, leading to higher A1C levels. Challenge yourself to prioritize stress management as much as you prioritize your diet. Some examples include getting quality sleep, walking daily, meditating or journaling. Consider Supplements: Sheth always recommends focusing on food choices and lifestyle factors first before considering supplements. However, some supplements that may help with lowering A1C and blood sugar include berberine, alpha-lipoic acid and magnesium, she says. For example, some studies have shown berberine to be effective at lowering A1C and fasting glucose, though more research is needed. Probiotics also show promise; one study found that they improved blood sugar control in patients with less severe type 2 diabetes and could be a potential treatment option in this population. Be sure to consult with your health care provider before taking any supplements to ensure safety and avoid any negative side effects. Our Expert Take Lifestyle changes have the power to help lower A1C, and the best place to start is breakfast. The Southwest Breakfast Quesadilla is an ideal choice because it's low in calories and is packed with protein and fiber. Together, this can support healthy blood sugar levels, reduce cravings and may aid weight loss—all of which can contribute to lowering A1C. To further support your A1C, focus on regular exercise, quality sleep and stress management, and consider supplements if they're right for you. Remember, noticeable changes can take a few months, so be patient and give it time. Read the original article on EATINGWELL
Mail & Guardian
a day ago
- Health
- Mail & Guardian
Diabetes is a disease that thrives on inequity
South Africa must treat the conditions that breed diabetes, including by making healthy food affordable. Photo: File It's not every day one finds themselves navigating the buzz of McCormick Place convention centre in downtown Chicago, dwarfed by towering banners, energised scientists and a swirling stream of conversations in a dozen different languages, all united by a single cause: tackling diabetes. For me, attending the 2025 American Diabetes Association (ADA) Scientific Sessions wasn't just about science. It was a reckoning. A moment to understand, reflect and reimagine what this disease means for my country, and for me as a South African woman. I arrived late on Friday, 20 June, after a long-haul flight with cramped legs, airport sandwiches and anticipation. By the time I checked into my hotel, I had missed most of the day's sessions. But there was one I was determined to catch, and I made it just in time. The session was called Social Drivers of Health Needs and Cost. What unfolded in that packed hall was less a session and more a raw, honest confrontation with reality. Dr Jennifer Wallace, the moderator, opened with something that hit me square in the chest: 'If we want to treat diabetes effectively, we cannot ignore the world outside the clinic.' It's a sentiment that resonates deeply in South Africa, where the world outside the clinic, townships, informal settlements and communities living in food deserts, is precisely where the battle against Type 2 diabetes is being lost. Dr Marcus Lee told a story about a patient who managed her insulin levels by eating less. I could immediately picture women back home doing the same, sacrificing meals so their medication lasts longer. Alicia Ramos, a community health navigator, reminded us that for many, the choice is not just between food and medicine, but between survival and wellness. The truth? Type 2 diabetes is no longer a condition we see in sick or older people. It's knocking loudly on the doors of the working class, of families earning just enough to survive but not enough to eat well. Saturday's session, Type 2: From Biology to Behaviour: Is it all in the Family?' took the conversation even deeper. The message was clear: diabetes doesn't just run in our blood. It runs in our habits, our kitchens and our cultures. In South Africa, many of us grow up eating pap, vetkoek, sugary tea, deep-fried carbs and processed meats. These aren't indulgences. They're affordable staples. They have a high-calorie count and they don't break the bank. When healthier options cost twice as much or simply aren't available, how can we realistically expect people to choose better? The session unpacked how family history and intergenerational behaviour create cycles that are hard to break. But what stood out to me was the shift in tone. This wasn't about blaming families for bad choices. It was about compassion, care and giving people the tools and environments they need to choose health. Back home that means school programmes, public health campaigns and food subsidies. But, I thought, are we doing enough to combat the crisis? Or is our inherent socio-economic system jeopardising the problem? Later that day, a quieter ePoster session titled Obesity-Associated Diabetes and Cancer Risk offered a chilling insight: Type 2 diabetes is tied not only to heart disease, but also to several cancers, especially in women. As someone who has watched family members battle both diabetes and cancer, this hit hard. It's another layer of urgency for prevention and early screening, especially in women's health initiatives. In a session, aptly named Are You What You Eat?, the spotlight turned to nutrition. But rather than scolding or moralising, the speakers reframed the conversation. People aren't unhealthy because they don't care. They're unhealthy because they don't have options. One poster presented data showing measurable improvements in insulin sensitivity from small upgrades in food quality, such as switching to whole grains or reducing sodium. But even those small steps can be unattainable luxuries in under-resourced communities. Junk food is cheaper than a tomato and provides more energy per serving, so with a limited income, why would I choose the tomato? We're treating diet like a choice, but it's often dictated by economics. By Sunday, the most emotional session of the conference, Rising Risks, Real Solutions: Tackling Childhood Type 2 Diabetes and Obesity, laid bare a terrifying trend. More children are getting Type 2 diabetes, and earlier. It's aggressive, fast-moving and robs young people of a healthy adulthood. South Africa isn't immune from this; we're on the front lines. The success stories came from schools with integrated nutrition and mental health programmes. This kind of holistic care could transform South African schools. I wondered how much we could change if our health and education systems worked in tandem (on the ground in communities) and how much this synergy could change how we approach diabetes in the future. The final sessions I attended on Monday were visionary. They explored how hunger signals are regulated in the brain, how muscle mass affects metabolism and how next-gen drugs are not just managing, but potentially reversing diabetes. The promise? Therapies that promote weight loss, cardiovascular protection and even remission. The problem? Access. I learnt a lot about the various medicines on the market, but just because they exist, doesn't mean they're readily available. In South Africa, even metformin can be out of reach for some. GLP-1 therapies such as semaglutide are available (technically), but are they accessible to the majority? That's where Danish pharmaceutical multinational Novo Nordisk and others like it have a crucial role to play. Novo Nordisk has been pioneering research and partnerships for more than 25 years to improve the lives of people with diabetes and obesity. This symposium made me think about equity in a different light. Equity isn't just about distribution, it's about systems, partnerships and policies that bring the future to those who need it most. And equity is about having choice and the option to choose. Being denied options is being denied agency. What I took from ADA 2025 wasn't just knowledge, it was clarity. Type 2 diabetes is no longer a niche concern or an affluent disease. It's a social epidemic, shaped as much by economics as by biology. South Africa must act: boldly and collaboratively. From health policies to supermarket aisles, from school lunchboxes to transport infrastructure. If we want to treat diabetes, we must treat the conditions that breed it. That means making healthy food accessible. That means reimbursing community health workers. That means equipping clinics with tools to screen not only glucose levels, but social risk. The shift isn't just from control to cure. It's from treatment to transformation. I arrived in Johannesburg jetlagged and overloaded with information, but I returned with purpose. Diabetes is not a disease that exists in isolation, it is something proliferated by our socio-economic systems. And if we don't change our systems, diabetes will continue to become more and more of a concern. In the end, health isn't just about science. It's about justice. Katie Mohamed is the chief executive of BrandFusion, W-Suite and ChangeHub.
Yahoo
5 days ago
- Business
- Yahoo
Abbott lowers sales forecast on diagnostics decline, US funding cuts
This story was originally published on MedTech Dive. To receive daily news and insights, subscribe to our free daily MedTech Dive newsletter. By the numbers Q2 revenue: $11.14 billion 7.4% increase year over year Medical device sales: $5.37 billion 13.4% increase year over year Diagnostics sales: $2.17 billion 1% decrease year over year Abbott lowered its sales forecast for the year, citing a drop in diagnostic testing. CEO Robert Ford told investors on Thursday that the company is seeing a drop-off in COVID-19 testing sales, challenges in China's core laboratory market and a reduction in U.S. foreign aid funding for HIV testing, with a combined impact of more than $1 billion. The company reduced its 2025 organic sales growth forecast to a range of 6% to 7%, from the previous forecast of 7.5% to 8.5% shared in the first quarter. 'Even with that billion dollars, we're still forecasting high single-digit growth and absorbing the impact of tariffs,' Ford said. The company now expects 'just under $200 million' of impact from tariffs. CFO Phil Boudreau said the amount was down from previous estimates, when the company had outlined 'a few hundred million' in tariff costs. Discussing how the company plans to mitigate tariffs, Ford said that Abbott plans to open a new cardiovascular manufacturing facility in Georgia in 2028. 'Once tariffs get set in place, they're very difficult to walk away from,' the CEO said, 'so we have to think medium term, but also long term.' Growth in medical devices, diabetes A bright spot for Abbott was its medical device segment, which grew by more than 13% to $5.37 billion in sales. The company's diabetes segment grew by more than 20% to $1.98 billion. Analysts asked about Abbott's plans for a dual analyte sensor that would provide glucose and ketone readings. The company recently showcased the device during the American Diabetes Association's Scientific Sessions. Ford declined to provide a timeline or pricing details for the planned device. BTIG analyst Marie Thibault wrote in June that Abbott's management expects a launch sometime next year. The company is also partnering with insulin pump companies, including Tandem, Sequel Med Tech and Beta Bionics, to support the new sensor. 'I think this is going to be a real next-level, significant change in the CGM market,' Ford said, specifically for intensive insulin users. Abbott's electrophysiology business, with the company's new Volt pulsed field ablation device to treat cardiac arrhythmias, grew by 11.5% to $700 million. Recommended Reading 'We are not rolling over': J&J electrophysiology unit rebounds amid PFA rivalry Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Kuwait Times
7 days ago
- Health
- Kuwait Times
Dasman Diabetes Institute (DDI) represents Kuwait at 85th ADA conference
KUWAIT: Dasman Diabetes Institute (DDI) participated in the 85th annual Scientific Session of the American Diabetes Association (ADA), held in Chicago, representing Kuwait in one of the world's leading events on diabetes research. DDI Acting Director General Dr. Faisal Al-Refaei stated that the institute's participation was the largest of its kind from the Arab region, featuring several scientific presentations and research posters from the institute's research team. Al-Rifai added that many research projects of common interest were also discussed during the meetings held on the sidelines of the conference between the institute - affiliated to the Kuwait Foundation for the Advancement of Sciences (KFAS) - and some of the prestigious international bodies and universities participating. The initiative is part of the institute's broader strategy to expand international collaboration in advanced diabetes research, in line with efforts to combat the disease and its complications through scientific studies. — KUNA
