Medical Bulletin 31/ March/ 2025 - Video

Wearable mobile health technology could help people with Type 2 Diabetes (T2D) to stick to exercise regimes that help them to keep the condition under control, a new study reveals

Researchers studied the behaviour of recently-diagnosed T2D patients as they followed a home-based physical activity programme – some of whom wore a smartwatch paired with a health app on their smartphone.

They discovered that MOTIVATE-T2D participants were more likely to start and maintain purposeful exercise at if they had the support of wearable technology- the study successfully recruited 125 participants with an 82% retention rate after 12 months.

Publishing their findings in BMJ Open, an international group of researchers revealed a range of potential clinical benefits among participants including improvements in blood sugar levels and systolic blood pressure.

Researchers found that, as well as the encouraging data for blood sugar and systolic blood pressure, the programme could help to lower cholesterol and improve quality of life.

The programme saw participants gradually increasing purposeful exercise of moderate-to-vigorous intensity – aiming for a target of 150 minutes per week by the end of 6 months and supported by an exercise specialist-led behavioural counselling service delivered virtually.

MOTIVATE-T2D used biofeedback and data sharing to support the development of personalised physical activity programmes. Wearable technologies included a smartwatch, featuring a 3D accelerometer and optical heart rate monitor, synced with an online coaching platform for the exercise specialist and web/smartphone app for participants.

Ref: Hesketh K, Low J, Andrews R, et al. Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): a decentralised feasibility randomised controlled trial delivered across the UK and Canada; BMJ Open 2025;15:e092260. doi: 10.1136/bmjopen-2024-092260

Vaping during pregnancy is becoming more common, but its impact on early human development is not well understood. A new study by scientists at the University of California, Riverside, now reports that the flavor chemical menthol used in electronic cigarettes could pose risks to a developing baby.

The study, published in STEM CELLS Translational Medicine, used human embryonic stem cells, or hESCs, to characterize early stages of embryonic development and examined how low concentrations of menthol affect important cellular processes.

The researchers found the concentration of menthol in the blood of pregnant women who vape is enough to activate stress-related channels called Transient Receptor Potential channels in the hESCs.

Transient Receptor Potential channels are a large family of ion channels located in the membranes of many different cell types, including in reproductive tissues and embryos. They are involved in a wide range of sensory and physiological processes, including detecting heat, cold, pain, pressure, taste, and smell.

The researchers found that one of the channels, the TRPA1 channel, was activated by nanomolar concentrations of menthol, which their exposure model predicts would be in the blood of pregnant women who vape and would reach the embryo.

A senior researcher said the findings highlight the need for more research on how vaping during pregnancy may harm embryonic and fetal development and point to possible dangers of using mentholated electronic cigarettes.

The use of e-cigarettes by pregnant women should be discouraged until the effects on their embryos of flavor chemicals, such as menthol, are fully understood.

Ref: Etemadi S. Menthol, a Consumer Product Additive, Adversely Effects Human Embryonic Cells via Activation of TRPM8 and TRPA1 Channels; Stem Cells Translational Medicine: 10.1093/stcltm/szae099.

For women with early-stage breast cancer, breast-conserving therapy (BCT) including radiation therapy (RT) leads to progressive reduction in breast size over time, reports a study in the Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Breast-conserving therapy – consisting of limited surgery (lumpectomy) and RT – is the preferred treatment for many women with early-stage breast cancer. It offers survival rates similar to those of mastectomy, with more favorable physical, psychological, and quality of life outcomes.

However, RT has adverse effects on breast tissue, including breast shrinkage due to radiation-induced tissue atrophy and fibrosis. While this long-term side effect is well-recognized, there are few data on the extent or time course of breast volume loss after BCT.

The authors measured changes in breast volume in 113 patients who underwent BCT/RT for early-stage (T1) breast cancer between 2005 and 2023. Measurements were made using mammograms obtained before and after BCT and up to five years later. The researchers also examined the impact of initial breast size and other factors on volume loss.

Reflecting the size of the tumor, breast volume decreased by an average of 9.2% after lumpectomy. Breast volume continued to decrease over time, even after the immediate side effects of radiation resolved. After one year, the average decline in breast volume was 19.3%, in addition to the tissue removed at surgery.

Women with larger breasts and relatively smaller tumor volumes (measuring less than 10% of breast volume) had greater total breast shrinkage: 29.5%, compared to 21.7% for those with smaller breasts. Other factors associated with greater volume loss included smoking, diabetes, and receiving cytotoxic chemotherapy in addition to RT.

The study provides new evidence on breast shrinkage after BCT. Expected breast shrinkage is approximately 20% within the first year, progressing to about 26% by five years. Especially with the growing emphasis on patient satisfaction in evaluating the outcomes of breast cancer treatment, the findings highlight the need to discuss long-term changes in breast volume in patients receiving undergoing BCT/RT.

The authors discuss key areas for further research, including the effects of different treatment techniques on breast volume changes and the need for more objective approaches to measuring breast volume.

Ref: Becker, Miriam, Reese, McKay et al. A Quantitative Evaluation of the Effects of Radiation Therapy on the Postsurgical Breast. Plastic and Reconstructive Surgery 155(4):p 595-605, April 2025. | DOI: 10.1097/PRS.0000000000011732