[Vol 32] Medi-Scene: Your Weekly Health News Update

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MediScene Vol 32

1. Study: Type-2 diabetes has four variations

According to a new study, type 2 diabetes can be further categorised into 4 subtypes in Indians. These dissimilarities will help doctors cut down on medications for some patients and help them prescribe drugs to prevent complications such as blindness, kidney or nerve damage in some others. The India-Scotland Partnership for Precision Medicine in Diabetes (INSPIRED) study, published in the BMJ Open Diabetes Research and Care recently, classified type 2 diabetes in Indians into four distinct clusters — SIDD (Severe Insulin Deficient Diabetes), IROD (Insulin Resistant Obese Diabetes), CIRDD (Combined Insulin Resistant and Deficient Diabetes) and MARD (Mild Age-Related Diabetes). A group of researchers examined nearly 20,000 case sheets of patients with Type 2 diabetes from Dr Mohan’s Diabetes Speciality Centre in association with the University of Dundee, School of Medicine, Scotland to categorise patients into four clusters, two of which were unique to Indians – IROD and CIRDD. Diabetologist Dr R M Anjana, the first author of the study said, “Until now, we have been treating all type 2 diabetes the same. The study shows different clusters of type 2 diabetes in Indians.”  Senior diabetologist Dr V Mohan said, “This research helps doctors predict the risk of complications and focus on individuals with the highest risk of developing complications.” Dr Colin Palmer from the Department of Pharmacogenomics, School of Medicine, University of Dundee, said “Recognizing subtypes might help doctors more specifically choose medication for their patients instead of going with the standard ones.”

2. Cancer treatments may accelerate aging in young patients

Data from new research examines the effects of cancer treatment on the aging process and finds that the expression of a gene associated with aging is higher in young patients with cancer after treatment with chemotherapy and in young cancer survivors who are frail. Previous research has shown that a protein called p16INK4a, which slows cell division, is produced at higher levels by cells as a person ages. The team first analyzed cells from 60 survivors and compared them with cells from 29 age-matched individuals without a history of cancer. Expression of the gene that codes for p16INK4a was higher in survivors than in controls, representing a 25-year age acceleration. Dr. Smitherman in an interview said, “Higher expression of p16INK4a in peripheral blood lymphocytes has been described in older adults following chemotherapy, but prior to this study, not in young adult survivors. This study is important as we try to understand the biological mechanisms underlying the manifestations of early aging in this population. Additionally, expression of p16INK4a may prove useful as a measure to study treatments aimed at mitigating the early aging effects of cancer treatment.”

3. Govt: 69% of coronavirus patients in India are men

Health Ministry data shows that the majority of the Covid-19 deaths in the country are among men who account for 69% of the total 58,390 deaths recorded so far. The age-wise distribution remains largely unchanged from that reported in the beginning of the month with those above 60 years now contributing 51% of all deaths so far. Those in the relatively younger age band of 45-60 years are contributing 36%, as compared to 37% on Aug 4 and 32% on July 9. Just 1% of deaths were of people below 17 years, another 1% was among the 18-25 age group and 11% were aged between 26-44 age groups. Indian Council of Medical Research director general Dr Balram Bhargava said that the results of the sero survey conducted in containment zones is in the process of publication and is likely to appear this week in the Indian Journal of Medical Research.

4. What to know about sodium restriction in heart failure

Sodium restriction has been the foundation of self-care for patients with heart failure (HF), given the significance of fluid balance in HF and the potential contribution of dietary sodium to fluid overload. Heart failure, particularly HF with reduced ejection fraction, is characterized by an activation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) as a compensatory response to maintain cardiac output through increased sodium and water retention. However, the long-term effects of this neurohormonal activation contribute to the progression of HF. The ACCF/AHA guidelines recommend moderate sodium restriction in patients with symptomatic HF (class IIa, level C). In accordance with the 2012 AHA recommendations, ACCF/AHA guidelines advise limiting dietary sodium intake to < 1500 mg/d for the general population. Epidemiologic evidence on the effects of sodium restriction on clinical outcomes in patients with HF has shown mixed results. An observational study that assessed sodium intake of ambulatory patients with HF over a mean period of 3 years suggests that patients with a sodium intake > 2800 mg/d are at greater risk for an acute HF event compared with patients with lower sodium intakes. A recent systematic review of nine studies and 479 unique participants found limited evidence of clinical improvement in outpatients with HF who followed a reduced-sodium diet, and the findings were inconclusive for inpatients with HF.

5. Study: Stress & anxiety over concern for family’s health on a rise

As coronavirus cases continue to rise in India, a month-long research conducted by Sangath found that stress and depression are also being reported. Notably, fear about family members contracting the virus has emerged as a bigger worry compared to the fear of suffering from Covid-19. Between June 11 and July 10, Sangath’s addictions research group, through a survey, reached out to around 673 individuals in Goa, Karnataka, Maharashtra and Delhi. The study found that 83% of the respondents reported feeling moderate to high levels of stress, and almost 30% reported symptoms associated with depression. Urvita Bhatia, Research Fellow, Sangath said, “The study will run during and post the pandemic to capture short and long term mental health and social outcomes. We will repeat assessments at 3,6,9,12 months post pandemic too.” Though 98% of the respondents reported that they are Covid-19 free, 38% of them said that they are worried about family members contracting Covid-19. Sangath said in the preliminary results that, “Respondents report feeling least in control of their physical and mental health, and their future plans. They reported the greatest feelings of control over their relationships with their partners and families.”

6. Early Parkinson’ symptoms inversely linked to healthy diets

New research conducted on over 47,000 participants suggests that endearment to dietary patterns that emphasize vegetables, fruits, nuts, and grains, such as in the Mediterranean diet, is inversely associated with prodromal features of Parkinson’s disease (PD), including constipation, excessive daytime sleepiness, and symptoms of depression. A growing body of evidence suggests that the gut and enteric nervous system may be involved in the pathogenesis of PD, noted lead author Samantha A. Molsberry, PhD, a postdoctoral research fellow at Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Dr Samantha told a leading medical news that, “following a healthy dietary pattern may influence risk for PD or prodromal PD features “by protecting against α-synuclein aggregation in the gut or by otherwise promoting gut health in a manner protective against degeneration in the enteric nervous system or CNS.Healthy diets include foods that are high in antioxidant and anti-inflammatory compounds. Therefore, diet patterns may reduce risk of Parkinson’s disease or prodromal Parkinson’s disease features by preventing oxidative stress and neuroinflammation. However, our study differs from their investigation in that we were able to use prospectively measured diet information that has been regularly collected in our cohorts since the 1980s, which minimizes the chance of reverse causation explaining our results. While we found similar results as Maraki et al. with respect to the Mediterranean diet pattern, we also found similarly strong associations between the Alternative Healthy Eating Index and prodromal features of Parkinson’s disease. This will allow us to further investigate whether certain behaviors and lifestyle choices, such as adherence to a healthy diet, are associated with whether an individual with prodromal features of Parkinson’s disease goes on to develop Parkinson’s disease and how quickly he or she does so.”

Reference link:

  1. https://health.economictimes.indiatimes.com/news/diagnostics/type-2-diabetes-has-four-variations-shows-study/77691429
  2. https://health.economictimes.indiatimes.com/news/industry/cancer-its-treatment-may-accelerate-the-aging-process-in-young-patients/77715191
  3. https://health.economictimes.indiatimes.com/news/industry/69-of-covid-victims-in-india-are-men-govt/77754130
  4. https://www.medscape.com/viewarticle/934673
  5. https://health.economictimes.indiatimes.com/news/industry/stress-anxiety-on-the-rise-over-concern-for-familys-health-study/77716585
  6. https://www.medscape.com/viewarticle/936125

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