Medical Bulletin 06/August/2025 - Video

Here are the top medical news for the day:

This Brain Hormone May Control Blood Sugar Without Insulin

An analysis published in The Journal of Clinical Investigation has revealed new insights into how the hormone leptin might be used to manage diabetic ketoacidosis (DKA), a serious and potentially fatal complication of type 1 diabetes. The research, based on over a decade of findings including work from UW Medicine, shows that leptin may help regulate blood sugar levels even in the absence of insulin—challenging long-standing beliefs in diabetes care.

Diabetic ketoacidosis occurs when the body lacks insulin and begins breaking down fat for energy, leading to a dangerous buildup of glucose and ketoacids in the bloodstream. Traditionally, insulin has been the only effective treatment. However, this new analysis points to the brain—and specifically, the hormone leptin—as a key regulator in this process.

Leptin, produced by fat cells and transported to the brain, plays a role in controlling appetite and energy balance. According to senior author Dr. Michael Schwartz, professor of medicine at the University of Washington School of Medicine, when insulin is absent, "the brain gets the message that the body is out of fuel, even if it's not. This information is being communicated in part by a low blood level of the hormone leptin."

Schwartz and his team first explored this idea in 2011 by injecting leptin directly into the brains of rats and mice with type 1 diabetes. Surprisingly, within four days, their blood sugar and ketone levels normalized, despite having virtually no insulin. "I think the most amazing thing is that the blood sugars just didn't come down, but that the levels stayed down," said Schwartz.

At the time, the discovery was largely overlooked. Now, with a deeper understanding of the mechanism, Schwartz plans to seek FDA approval for human trials. If successful, this could lead to a paradigm shift in how type 1 diabetes is treated—potentially without insulin.

The findings suggest the brain, not just the pancreas, could be a key target in future diabetes therapies, offering hope for millions worldwide.

Reference: https://newsroom.uw.edu/news-releases/brain-might-become-target-of-new-type-1-diabetes-treatments

Adults Born Preterm Face Higher Risk of Chronic Diseases: Study Finds

The longest-running U.S. study on preterm birth has found that being born early can have lasting health consequences well into adulthood—affecting everything from heart health to mental wellbeing. The findings, published in the Journal of the American Medical Association (JAMA), highlight the urgent need to include birth history in adult medical records and develop long-term clinical guidelines for individuals born preterm.

The research, led by University of Rhode Island College of Nursing Professor Amy D’Agata, continues work that began in the 1980s with a cohort of infants born preterm at Women & Infants Hospital. The longitudinal study has followed 215 participants, including both preterm (born between 22 to 36 weeks of gestation) and full-term infants.

As these individuals approach their 40s, the data reveal clear health disparities between those born preterm and their full-term peers. According to D’Agata, preterm individuals are showing higher rates of high blood pressure, elevated cholesterol, abdominal fat, and reduced bone density. Psychologically, they are more prone to internalizing stress, which manifests as higher levels of anxiety and depression.

“Preterm birth is not just a neonatal issue. It, in fact, is a lifelong condition,” said D’Agata. “We are now realizing that there is a very strong link between what happens to you early in life and later health outcomes.”

One critical finding is the lack of birth history documentation in adult healthcare. Many clinicians are unaware if a patient was born preterm, making it harder to assess risk for chronic conditions. D’Agata is calling for birth history to be a standard part of adult medical intake and for targeted screening guidelines to be developed.

“We believe a paradigm shift is needed in health care that recognizes preterm birth as a chronic condition requiring lifelong monitoring and support,” she emphasized.

This research is helping reshape how medicine views early birth—not as a one-time event, but a factor with lifelong implications.

Reference: D’Agata AL, Eaton C, Smith T, et al. Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years. JAMA Netw Open. 2025;8(7):e2522599. doi:10.1001/jamanetworkopen.2025.22599

Study Reveals Social Factors that May Triple the Risk of Long Covid

A new nationwide study led by investigators at Mass General Brigham has revealed that social risk factors such as financial hardship, food insecurity, and limited access to healthcare are significantly associated with a higher risk of developing long COVID. The findings, published in the Annals of Internal Medicine, offer vital insights into the long-term impact of the COVID-19 pandemic and underscore the need to address social determinants of health in efforts to combat long COVID.

Long COVID refers to a broad spectrum of symptoms that persist for three months or more following a SARS-CoV-2 infection. While scientific understanding of the condition has grown through the National Institutes of Health’s RECOVER (Researching COVID to Enhance Recovery) Initiative, the influence of social factors has remained less clear—until now.

To better understand this relationship, researchers analyzed data from 3,700 participants in the RECOVER-Adult cohort. These individuals had contracted COVID-19 during the Omicron

variant surge and completed comprehensive surveys at the time of infection and again six months later to assess for long COVID symptoms. Participants came from 33 states, Washington, D.C., and Puerto Rico, and enrolled between October 2021 and November 2023.

The researchers assessed four major categories of social risk: economic instability, education and language barriers, healthcare access and quality, and lack of community support. They also used ZIP code-level data to measure factors like household crowding.

After accounting for variables such as vaccination status, hospitalization, age, sex, and race, the study found that nearly all individual-level social risk factors were strongly associated with a two- to three-fold increase in the likelihood of developing long COVID. Living in more crowded areas further raised the risk. The burden of these risk factors was higher among racially and ethnically minoritized groups, but their impact on long COVID risk was consistent across all racial categories.

"While rates of COVID-19 have decreased, long COVID is a chronic disease that many people still suffer from," said senior author Dr. Elizabeth Karlson. "Future interventions must address these factors to effectively reduce adverse outcomes among people with high burden of social risk factors."

Researchers plan to expand the study to assess whether these trends hold for children and explore long COVID symptoms lasting a year or more.

References: Candace H. Feldman, Leah Santacroce, Ingrid V. Bassett, et al. Social Determinants of Health and Risk for Long COVID in the U.S. RECOVER-Adult Cohort. Ann Intern Med. [Epub 29 July 2025]. doi:10.7326/ANNALS-24-01971