Medical Bulletin 15/January/2026

Diabetes already triples heart disease risk. Air pollution makes it far worse by triggering body-wide inflammation that damages blood vessels and fat metabolism. The study measured Inflammatory Lipid Ratio (ILR)—a blood marker showing how pollution amplifies this deadly combo in diabetics.

Researchers used China's Health and Retirement Longitudinal Study (CHARLS), following adults 45+ from 2011-2015. They split participants into four groups: no diabetes/no heart disease, no diabetes/new heart disease, diabetes/no heart disease, diabetes/new heart disease. Diabetes followed American Diabetes Association standards; heart disease included heart attacks, angina, strokes, and heart failure (self-reported).

Key findings:

• 13.8% of diabetics got cardiovascular disease vs. 8.5% of non-diabetics

• Each jump in PM10 pollution raised heart disease risk 28% in diabetics

• PM1, PM2.5, and ozone increased risk 19-26%

• Diabetics' inflamed bodies react worse to pollution than healthy people

With 90 million diabetics and winter smog choking cities, this study screams urgency. Delhi/Chennai research already links PM2.5 to higher Type 2 diabetes rates. Older diabetics need special protection—cleaner air, anti-inflammatory diets, and tighter blood sugar control.

Researchers call for "tailored therapies" addressing diabetics' unique pollution vulnerability. Masks, air purifiers, and staying indoors during peak pollution help. Doctors should prioritize heart protection for diabetic patients in polluted areas.

Air pollution doesn't just bother diabetics—it turns chronic inflammation into cardiovascular disaster. Clean air isn't optional; it's survival for India's 90 million diabetics breathing toxic winter smog.

REFERENCE: Yan, C., Chen, G., Jing, Y. et al. Association between air pollution and cardiovascular disease risk in middle-aged and elderly individuals with diabetes: inflammatory lipid ratio accelerate this progression. Diabetol Metab Syndr 17, 65 (2025). https://doi.org/10.1186/s13098-025-01638-3

Short-Term Calorie Restriction Diet Eases Crohn’s Disease Symptoms Effectively, Study Finds

Starving your gut for 5 days a month could heal Crohn's disease. A groundbreaking Stanford Medicine trial proves a calorie-restricted "fasting mimicking diet" dramatically cuts inflammation and symptoms in mild-to-moderate Crohn's patients—better than standard care alone. Published in Nature Medicine, this first-of-its-kind national study gives doctors concrete dietary advice they've long struggled to provide.

Affecting 1 million Americans, Crohn's causes debilitating gut inflammation, diarrhea, cramps, pain, and weight loss. Steroids work but cause serious side effects. Patients desperately ask, "What should I eat?"—yet no large trials existed. This study tested if extreme calorie cuts could calm the overactive immune system driving Crohn's.

Researchers enrolled 97 patients nationwide in a randomized controlled trial. 65 followed the fasting mimicking diet (FMD): 5 days/month eating just 700-1,100 plant-based calories, then normal eating for 25 days. 32 controls ate normally while continuing standard medications. All tracked symptoms and provided stool/blood samples for inflammation markers over 3 months.

Stunning results:

• 67% of FMD group saw major symptom improvement vs. <50% controls

• Fecal calprotectin (gut inflammation marker) dropped significantly in FMD group

• Inflammatory lipids and immune molecules decreased in FMD patients' blood

• Benefits appeared after just one FMD cycle

• Mild side effects (fatigue, headache) but no serious problems

Extreme calorie restriction reduces inflammatory signals while starving harmful gut bacteria. FMD mimics water fasting benefits without total starvation. Researchers now study microbiome shifts explaining these gains.

FMD offers a safe, drug-free option reducing steroid reliance. Patients alternate normal eating with brief "reset" periods. Future trials test longer use and ulcerative colitis. Doctors finally have data beyond, "Avoid trigger foods."

Crohn's patients don't need endless pills—5 hungry days monthly might heal their gut. This simple dietary hack could transform inflammatory bowel disease treatment worldwide.

REFERENCE: Kulkarni, C., et al. (2026). A fasting-mimicking diet in patients with mild-to-moderate Crohn’s disease: a randomized controlled trial. Nature Medicine. doi: 10.1038/s41591-025-04173-w. https://www.nature.com/articles/s41591-025-04173-w

Preclinical Study Unveils Promising New Drug Candidate for Severe Liver Fibrosis Treatment

A single pill could reverse liver scarring and prevent cancer. McMaster University researchers have discovered a promising drug candidate, EVT0185, that not only stops but actually heals dangerous liver fibrosis—the scar tissue buildup that leads to liver cancer. Published in Cell Metabolism (Jan 2026), these preclinical studies fill a massive gap: Canada has zero approved drugs for MASH (metabolic dysfunction-associated steatohepatitis), the obesity/diabetes-driven liver disease affecting millions.

MASH creates fat buildup that scars the liver, often progressing to cancer, heart attacks, strokes, or transplant. Current treatments? Just diet and exercise recommendations that rarely reverse damage. Two new US/EU drugs help only 33% of patients. EVT0185 changes everything.

Led by Dr. Greg Steinberg (McMaster professor, Espervita co-founder), international teams used advanced disease models mimicking human MASH. They tracked the drug's effects on liver tissue, blood markers, and metabolic health across multiple animal systems.

EVT0185 simultaneously blocks two enzymes controlling fat production and fat burning. This creates Steinberg's "carbon release valve"—excess fat and harmful buildup flush out via urine instead of scarring the liver.

Key Findings:

• Reversed existing fibrosis (unlike current treatments)

• Controlled blood sugar levels

• Lowered cholesterol significantly

• Destroyed liver fat accumulation

• Potential to prevent liver cancer

Think of your liver as a clogged drain. EVT0185 unclogs it by stopping fat factories (ACLY) and fat storage (ACSS2), then flushes debris through urine. No surgery, no transplant—just one pill.

Targets the root cause in obesity/diabetes patients where MASH explodes. Could prevent cancer, diabetes complications, and heart disease simultaneously. Human trials needed, but preclinical data screams potential blockbuster.

Human trials imminent. If successful, EVT0185 becomes first-in-class MASH reversal therapy. For millions with fatty liver disease, one pill might replace years of ineffective lifestyle advice and looming transplant lists.

REFERENCE: Pastena, F. D., et al. (2026). Dual inhibition of ACLY and ACSS2 by EVT0185 reduces steatosis, hepatic stellate cell activation, and fibrosis in mouse models of MASH. Cell Metabolism DOI: 10.1016/j.cmet.2025.11.015. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(25)00529-7