Medical Bulletin 30/October/2023

Here are the top medical news of the day:

Is Intermittent fasting safe and effective for Type 2 diabetes? Here is what research says!

Time-restricted eating, also known as intermittent fasting, can help people with Type 2 diabetes lose weight and control their blood sugar levels, according to a new study published in JAMA Network Open by researchers at the University of Illinois Chicago.

Participants who ate only during an eight-hour window between noon and 8 p.m. each day actually lost more weight over six months than participants who were instructed to reduce their calorie intake by 25%. Both groups had similar reductions in long-term blood sugar levels, as measured by a test of hemoglobin A1C, which shows blood sugar levels over the past three months.

The study was conducted at UIC and enrolled 75 participants into three groups: those who followed the time-restricted eating rules, those who reduced calories and a control group. Participants’ weight, waist circumference, blood sugar levels and other health indicators were measured over the course of six months.

Senior author Krista Varady said that participants in the time-restricted eating group had an easier time following the regime than those in the calorie-reducing group. There were no serious adverse events reported during the six-month study. Occurrences of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) did not differ between the diet groups and control groups.

Ref: Effect of Time-Restricted Eating on Weight Loss in Adults With Type 2 Diabetes A Randomized Clinical Trial, JAMA Network Open, DOI 10.1001/jamanetworkopen.2023.39337

Can a simple blood test diagnose bipolar disorder? Highlights from new study

A recent JAMA study conducted in the UK has paved the way for a potential blood test that could significantly improve the diagnosis of bipolar disorder (BD) and distinguish it from major depressive disorder (MDD). Bipolar disorder is often misdiagnosed as major depressive disorder due to overlapping symptoms and the absence of objective diagnostic tools.

The study, which ran from April 2018 to February 2020, aimed to identify a consistent metabolomic biomarker signature in dried blood spots (DBSs) from patients that could differentiate between BD and MDD during depressive episodes.

The study analyzed data from 241 patients with depressive symptoms who had been recently diagnosed with MDD. Of this group, 67 were subsequently diagnosed with BD through the Composite International Diagnostic Interview, while 174 were confirmed as having MDD. The researchers identified a 17-biomarker panel.

When the biomarker data were combined with patient-reported information, the diagnostic performance was significantly improved. The models based on this combined data outperformed those based solely on demographic information and traditional diagnostic tools.

The identified biomarkers were primarily associated with lifetime manic symptoms. They were validated in a separate group of patients who received a new clinical diagnosis of MDD or BD during a one-year follow-up period.

Ref: Tomasik J, Harrison SJ, Rustogi N, et al. Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression. JAMA Psychiatry. Published online October 25, 2023. doi:10.1001/jamapsychiatry.2023.4096

Is Simvastatin Effective in Treating Critically Ill COVID-19 Patients? New Study sheds light

An international, adaptive platform trial aimed at assessing the effectiveness of simvastatin in critically ill COVID-19 patients has concluded that the drug was not superior to a control group in terms of clinical outcomes. Simvastatin, administered at a daily dose of 80 mg, was compared to a control group of critically ill COVID-19 patients who were not receiving statins at baseline.

The primary outcome measure of the study was the number of respiratory and cardiovascular organ support-free days through day 21, evaluated on an ordinal scale that combined in-hospital deaths and days free of organ support in survivors. The study employed a Bayesian hierarchical ordinal model for its analysis.

It was found that the median number of organ support-free days was similar in both groups, with 11 days for the simvastatin group and 7 days for the control group. The analysis yielded a 95.9% posterior probability of no superiority for simvastatin when compared to the control group.

At 90 days, the hazard ratio for survival was in favor of simvastatin, indicating a 91.9% posterior probability of superiority. However, this outcome did not reach statistical significance.

The study reported that serious adverse events, such as elevated levels of liver enzymes and creatine kinase, occurred more frequently in the simvastatin group compared to the control group.

Ref: October 25, 2023 DOI: 10.1056/NEJMoa2309995