Medical Bulletin 05/Jul/2025 - Video

Here are the top medical news for the day:

Can Lifestyle Changes Really Prevent Diabetes?

In a study published in The Lancet Diabetes & Endocrinology, researchers report that lifestyle modifications remain more effective than medication in preventing the onset of Type 2 diabetes in at-risk individuals.

The findings come from the Diabetes Prevention Program (DPP), a large randomized trial launched in 1996 to compare the effects of the drug metformin with those of an intensive lifestyle intervention, including healthy diet and regular exercise. The trial enrolled 3,234 prediabetic adults at 30 institutions across 22 U.S. states. Researchers found that, while both strategies significantly reduced the risk of developing Type 2 diabetes, the lifestyle intervention showed superior long-term results.

The latest follow-up, called the Diabetes Prevention Program Outcomes Study (DPPOS), involved researchers like Vallabh “Raj” Shah, professor emeritus at The University of New Mexico School of Medicine. According to Shah, “The data suggests that those people who didn't get diabetes also didn't get diabetes after 22 years.”

Initially, the lifestyle changes led to a 58% reduction in diabetes incidence after three years, compared to 31% with metformin. Over the full 22-year span, the lifestyle group saw a 24% reduction in diabetes onset, and the metformin group saw a 17% reduction, compared to placebo. Participants in the lifestyle arm also remained diabetes-free for a median of 3.5 years longer than those in the placebo group, while those on metformin extended that timeline by 2.5 years.

“Within three years, they had to stop the study because lifestyle was better than metformin,” Shah emphasized. “That means lifestyle, which everybody is banking on, is more effective – that is the news.”

Reference: Long-term effects and effect heterogeneity of lifestyle and metformin interventions on type 2 diabetes incidence over 21 years in the US Diabetes Prevention Program randomised clinical trial, Knowler, William CAbbas, Caroline et al. The Lancet Diabetes & Endocrinology, Volume 13, Issue 6, 469 – 481

How COVID-19 Pandemic Increased Mental Health Issues, Malaria, and Heart Disease

Disruptions in healthcare services during the COVID-19 pandemic led to significant increases in illness and death from non-COVID causes such as mental health conditions, malaria in young children, and cardiovascular disease in older adults, according to a new study published in The BMJ.

During the pandemic, many healthcare systems were strained or shut down, interrupting routine care and management for chronic and infectious diseases. To better understand the global fallout, researchers in China analyzed data from the Global Burden of Disease Study 2021. They simulated the burden of 174 health conditions across 204 countries and territories for the years 2020 and 2021, focusing on measures such as incidence, prevalence, mortality, and disability-adjusted life years (DALYs).

Mental health disorders saw one of the sharpest increases. New cases of depressive disorders rose by 23% in 5-14 year-olds, the study found. DALY rates for depressive and anxiety disorders increased by 12% and 14% respectively, with particularly high rates among females. Similarly, age-standardised incidence and prevalence rates for depressive disorders rose by 14% and 10%, while anxiety disorders saw a 15% rise.

Malaria deaths among children under five surged by 14%, and overall age-standardised DALY rates for malaria increased by 12%. Cardiovascular conditions such as ischaemic heart disease and stroke also recorded significant increases, particularly among those aged 70 and above.

The researchers noted that their findings may be limited by inconsistent data quality, underreporting, and diagnostic delays. Nonetheless, the breadth of the analysis offers crucial insights into the pandemic’s broader impact.

They concluded: “These findings underscore the urgent need to strengthen health system resilience, enhance integrated surveillance, and adopt syndemic-informed strategies to support equitable preparedness for future public health emergencies.”

Reference: Chen C, Zhou W, Cui Y, Cao K, Chen M, Qu R et al. Global, regional, and national characteristics of the main causes of increased disease burden due to the covid-19 pandemic: time-series modelling analysis of global burden of disease study 2021 BMJ 2025; 390 :e083868 doi:10.1136/bmj-2024-083868

Early Infections and Obesity in Boys May Reduce Key Male Hormone

Early childhood obesity and common infections like chickenpox may increase the risk of chronic diseases later in life, according to new research published in the journal Andrology. Scientists from the University of Nottingham’s School of Biosciences have found that such early-life health factors are linked to reduced levels of the testis hormone biomarker, insulin-like peptide 3 (INSL3), in men by their mid-twenties a change that could forecast future health complications.

The study builds on previous work demonstrating that INSL3 is a powerful predictor of long-term male health. INSL3 levels are stable in adulthood and reflect the testes' ability to produce testosterone a hormone vital not only for reproductive function but also for maintaining general health, including bone strength, cardiovascular function, and metabolic health.

In the new study, researchers examined data from the “Children of the Nineties” (Avon Longitudinal Study of Parents and Children), a large UK birth cohort initiated by the University of Bristol. The team measured INSL3 levels in 24-year-old men and matched them against a wide array of clinical and lifestyle data collected since birth.

They discovered that while most early-life factors had little or no influence on adult INSL3 levels, being overweight as a child or experiencing certain infections in infancy — such as chickenpox — were associated with a 10–15% reduction in INSL3. This decline potentially increases the risk of adult-onset conditions such as diabetes, cardiovascular disease, and even sexual dysfunction.

Dr. Ravinder Anand-Ivell, lead author of the study, said: “There is a clear link between certain health factors in childhood at a time before puberty when the testes are still developing and later men’s health as they age.”

“By using this new biomarker INSL3 as well as having this childhood health information allows us now to be able to predict those men at risk and thus consider appropriate preventative measures before disease sets in,” Dr. Anand-Ivell concluded.

Reference: Ivell R, Tilumcu B, Alhujaili W, Anand-Ivell R. Maternal, childhood and adolescent influences on Leydig cell functional capacity and circulating INSL3 concentration in young adults: Importance of childhood infections and body mass index. Andrology. 2025; 1-11. https://doi.org/10.1111/andr.70091

Could Your Saliva Predict Diabetes Risk?

A new Cornell University study brings additional clarity to the relationship between Type 2 diabetes and genes that express a salivary enzyme that breaks down starch.

It was previously known that people with more copies of the genes that express salivary amylase (called AMY1) produce more salivary amylase enzyme. The new paper, published in PLOS One, supports the idea that having more copies of the AMY1 gene may be protective against Type 2 diabetes, though additional long-term studies are needed to prove the theory.

If researchers do eventually prove a clear association between AMY1 copy number and diabetes, it could lead to genetically testing people at birth to predict their susceptibility.

Researchers collected measurements from study participants of amylase activity very early in the morning after fasting and in the evening. They found that morning readings were much lower than they were in the evenings.

When they compared participants, they found that salivary amylase activity was higher for each additional copy of AMY1 in those with Type 2 diabetes or prediabetes, compared to those without either.

The findings have led Angela Poole, assistant professor of molecular nutrition, to suspect that a higher copy number of AMY1 genes may be protective, though more study is needed to verify it.

Since amylase breaks down starch into sugars, common sense would suggest that a higher AMY1 copy number would increase blood glucose and be detrimental to people with Type 2 diabetes. Poole suspects that during chewing of starch, the body senses the glucose, and it causes people with a higher AMY1 copy number to release insulin sooner, leading to a protective effect. Gut microbes may also play a role.

“I suspect that people with a lower copy number are at higher risk for Type 2 diabetes,” Poole said. But she added, it also depends on how much starch they eat.

Reference: Devarakonda SLS, Ren J, Poole AC (2025) The association between salivary amylase gene copy number and enzyme activity with type 2 diabetes status. PLoS One 20(7): e0324660. https://doi.org/10.1371/journal.pone.0324660