Medical Bulletin 17/ April/ 2025 - Video

A newly recognised form of diabetes—Type 5 diabetes—was officially announced this week at the World Congress of Diabetes 2025 in Bangkok by Prof Peter Schwarz, President of the International Diabetes Federation. Distinct from Type 1 and Type 2, Type 5 diabetes primarily affects underweight individuals who have no family history of diabetes and display atypical symptoms.

Unlike Type 2 diabetes, which involves insulin resistance, those with Type 5 are insulin deficient but not insulin resistant, indicating a fundamentally different physiological profile. The condition was first observed in the 1960s in Jamaica and referred to as J-type diabetes. It was recognised by the World Health Organization in 1985 but removed from classification in 1998 due to insufficient evidence.

However, new research published in 2022 by Dr Nihal Thomas and Dr Riddhi Dasgupta of Christian Medical College, Vellore, in collaboration with Prof Meredith Hawkins of Albert Einstein College of Medicine, has confirmed its distinct nature. Their study, published in Diabetes Care, laid the scientific foundation for its reclassification. In response, a global task force will be established to further investigate the condition, aiming to improve diagnosis and treatment, particularly in low-BMI populations where the condition may be more prevalent.

Reference: https://idf2025.org/

New research from the University of Waterloo suggests increasing the ratio of dietary potassium to sodium intake may be more effective for lowering blood pressure than simply reducing sodium intake.

High blood pressure affects over 30 per cent of adults globally. It's the leading cause of coronary heart disease and stroke and may also lead to other afflictions like chronic kidney disease, heart failure, irregular heartbeats, and dementia.

Potassium and sodium are both electrolytes -- substances that help the body send electrical signals to contract muscles, affect the amount of water in your body and perform other essential functions.

The researchers developed a mathematical model that successfully identifies how the ratio of potassium to sodium impacts the body. The model also identifies how sex differences affect the relationship between potassium and blood pressure.

The study found that men develop high blood pressure more easily than pre-menopausal women, but men are also more likely to respond positively to an increased ratio of potassium to sodium.

"Early humans ate lots of fruits and vegetables, and as a result, our body's regulatory systems may have evolved to work best with a high potassium, low sodium diet," said Melissa Stadt, a PhD candidate in Waterloo's Department of Applied Mathematics and the lead author of the study.

"Today, western diets tend to be much higher in sodium and lower in potassium. That may explain why high blood pressure is found mainly in industrialized societies, not in isolated societies."

The researchers emphasize that mathematical models like the one used in this study allow these kinds of experiments to identify how different factors impact the body quickly, cheaply, and ethically.

Reference: https://uwaterloo.ca/news/media/high-blood-pressure-eat-more-bananas

Complications during pregnancy (or adverse pregnancy outcomes), like gestational diabetes and newly developed high blood pressure, act as nature’s stress test and may uncover an individual’s risk for heart disease later in life, according to new research published in the journal of the American College of Cardiology. The study also highlights how weight management before pregnancy may not only improve maternal health but also reduce future cardiovascular disease risk.

For the study, researchers tracked 4,269 pregnant women across nine countries, following up on outcomes over 10 to 14 years. They looked at measurements for blood pressure, triglycerides, fasting glucose, and hemoglobin A1c, comparing participants with overweight or obesity with those who had normal BMI. Secondary outcomes included incidence of hypertension or diabetes at the midlife follow-up.

They found that adverse pregnancy outcomes contributed significantly to the link between pre-pregnancy overweight or obesity and cardiovascular risk factors in midlife. In addition, different types of complications affect different health risks. Specifically, gestational diabetes enhanced risk for higher glucose and hemoglobin A1c, while hypertensive disorders contributed to risk for high blood pressure in midlife.

Jaclyn Borrowman, PhD, a researcher at Northwestern University and lead author of the study noted that, even though these pregnancy complications helped explain the link between pre-pregnancy weight and heart disease risk, they didn’t account for most of the connection—other factors are also involved.

“The study highlights the significance of adverse pregnancy outcomes as a risk-enhancing factor for cardiovascular disease,” Borrowman said. “Our results also suggest that prioritizing weight management among those considering pregnancy may promote both maternal and future cardiovascular health.”

Reference: Pre-Pregnancy Adiposity, Adverse Pregnancy Outcomes, and Cardiovascular Disease Risk in Midlife was published in 2025, in JACC.