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Type 2 diabetes mellitus is associated with an increased risk of cognitive decline and dementia. Observational data suggest that hyperglycaemia, hypertension and dyslipidaemia might be involved in the causal pathway underlying this link, but data from the ACCORD MIND investigators challenge these findings. Why are the findings of observational and intervention studies so disconnected?
A new study highlights the complexities of anti-TSH-receptor antibody function and the differences between adult and paediatric patients with Graves disease, adding to the controversy regarding the possible role of these antibodies in the development of ophthalmopathy.
Research published in Cell has shed light on the reorganization of circadian rhythm by nutrients. Mice fed a high-fat diet displayed extensive reprogramming of the hepatic clock with profound effects on key metabolic pathways. These changes involved repression of the Clock–Bmal1 network and PPARγ-regulated induction of a novel gene set.
A genetic analysis of patients with permanent neonatal diabetes mellitus has revealed functional conservation of transcription factors critical for β-cell development in both mouse and man. This finding supports the use of mice for modelling human disease but also highlights the need for additional human-specific studies of β-cell function.
A new trial has shown that targeting a blood glucose level of 4.0–7.0 mmol/l in critically ill children has some benefits, including a reduced incidence of kidney failure, shortened duration of hospital stay and lowered health-care costs. However, the chosen short-term primary end point was unaffected, which limits the applicability of the findings.
Prediction of fracture risk is increasingly used to guide clinical use of antiosteoporosis drugs. Data from a large primary care prospective study in 10 countries has now been used to generate an empirical composite 5-year fracture risk model based on clinical data (excluding BMD). This model performed better than current widely used models.
Increased infiltration of adipose tissue macrophages (ATMs) and their subsequent inflammatory effects are implicated in the development of insulin resistance among individuals with obesity. Interestingly, new data published in Cell Metabolism suggest that ATMs might also have important noninflammatory roles in lipid trafficking and its metabolic consequences.
Iodine from the diet is fundamental for brain development. Via milk, infants receive 40–45% of the iodine in their mother's diet during breastfeeding; however, it is unclear to what extent depot iodine supplements (that is, iodized oil) given to iodine-deficient breastfeeding mothers compares with direct supplementation of the infants.
New US guidelines for the management of overweight and obesity have disregarded robust evidence from intervention trials demonstrating the importance of dietary factors for weight control and disease prevention. This omission implies that diet composition does not matter, a stance that is potentially counterproductive for prevention and treatment strategies.
Limited options for clinical management of patients with juvenile-onset diabetes mellitus call for a novel therapeutic paradigm. Two innovative studies support endoplasmic reticulum as an emerging target for combating both autoimmune and heritable forms of this disease.
