Medical Bulletin 11/December/2023

Here are the top medical news of the day:

World-first trial offers new hope for type 1 diabetes

Up until insulin’s discovery more than 100 years ago, type 1 diabetes was a fatal condition. Despite insulin’s life-saving role, the therapy itself is potentially dangerous if too much or too little is administered, and the condition still comes with long-term complications, including heart attack and stroke, vision impairment, kidney disease and nerve damage.  

Researchers at St Vincent’s Institute of Medical Research (SVI) in Melbourne have shown that a commonly prescribed rheumatoid arthritis drug can suppress the progression of type 1 diabetes. 

The world-first human trial, published today in the New England Journal of Medicine and led by SVI’s Professor Thomas Kay, showed that a drug called baricitinib can safely and effectively preserve the body’s own insulin production and suppress the progression of type 1 diabetes in people who initiated treatment within 100 days of diagnosis.   

“When type 1 diabetes is first diagnosed there is a substantial number of insulin-producing cells still present. We wanted to see whether we could protect further destruction of these cells by the immune system. We showed that baricitinib is safe and effective at slowing the progression of type 1 diabetes in people who have been recently diagnosed,” said Professor Kay. 

This ground-breaking research shows promise as the first disease-modifying treatment of its kind for type 1 diabetes that can be delivered as a tablet. 

“We are very optimistic that this treatment will become clinically available. This would be a huge step-change in how type 1 diabetes is managed and we believe it shows promise as a fundamental improvement in the ability to control type 1 diabetes,” said Professor Helen Thomas, preclinical lead on the trial.

Reference: World-first trial offers new hope for type 1 diabetes; New England Journal of Medicine; DOI: 10.1056/NEJMoa2306691

Working night shifts causes sleep disorders in more than half of workers

Sleep is critical for daytime and neurocognitive functioning, as well as physical and mental health. When people work shifts – in 2015, 21% of workers in the European Union did – their circadian sleep-wake rhythms are commonly disrupted. Now, researchers in the Netherlands have investigated the relationship between different shift working patterns, sociodemographic factors, and sleep disorders.

“We showed that compared to working regular shifts during daytime hours, working other shift types is associated with a higher occurrence of disordered sleep, particularly in rotating and regular night shift work,” said Dr Marike Lancel, a researcher at GGZ Drenthe’s Mental Health Institute and senior author of the study published in Frontiers in Psychiatry. “Of note, 51% of people working nights scored positive for at least one sleep disorder.”

“There is a lot of evidence that shift work reduces the quality of sleep. However, little is known about the influence of different types of shifts on the prevalence of various sleep disorders, and how this may vary depending on demographic characteristics,” Lancel continued.

To fill these gaps, the researchers recruited more than 37,000 participants who provided demographic information, indicating their shift work patterns (regular morning, evening, night, or switching between shifts).

They also completed a questionnaire screening for six common sleep disorder categories: insomnia, hypersomnia, parasomnia, sleep-related breathing disorders, sleep related movement disorders, and circadian rhythm sleep-wake disorders.

The responses suggested that working regular night shifts was the most debilitating condition concerning sleep. Half of the night shift workers reported to sleep less than six within 24 hours, 51% reported one sleep disorder, and 26% reported two or more sleep disorders.

Reference: Working night shifts causes sleep disorders in more than half of workers; Frontiers in Psychiatry; DOI:10.3389/fpsyt.2023.1233640

Meat-free burgers can be made tastier, juicier and more digestible finds study

An unresolved challenge for plant-based meat analogs (PBMAs) is their lack of juiciness. Saturated fats significantly contribute to the juiciness of PBMAs, but there are concerns about the undesirable health effects related to saturated fats; thus, demand for their replacement with vegetable unsaturated oils has increased.

In this study, researchers in PLOS ONE aimed to develop better consumer-acceptable methods using protein-glutaminase (PG) to improve the juiciness of PBMA patties to meet clean-label trends.

They found no significant difference between the visual surface of control and PG-treated textured vegetable proteins (TVPs). However, the microstructure of PG-treated TVP had a more rounded shape than that of the control TVP as observed under a scanning electron microscope. After grilling process, the PBMA patties composed of PG-treated TVP showed significantly higher liquid-holding capacities (a juiciness indicator) than the control patties.

This suggested that PG treatment could potentially produce PBMA patties with increased juiciness. Interestingly, after the PG-treated TVP underwent the wash process, we found that PG treatment of TVP easily reduced the various beany off-flavor compounds by 58–85%.

Moreover, the results of the in vitro protein digestion test showed that the amounts of free amino nitrogen released from PBMA patties composed of PG-treated TVP were 1.5- and 1.7-fold higher than those from control patties in the gastric and intestinal phases, respectively. These findings indicate that PG treatment of TVP could enhance the physical, sensory, and nutritional properties of PBMA patties and meet the clean-label requirements.

Reference: Meat-free burgers could be made tastier, juicier and more digestible by protein-glutaminase treatment; PLoS ONE, DOI:10.1371/journal.pone.0294637