Diabetes Risk With Breastmilk, Antidepressants, Weight Loss

Some of the latest research advancements in the field of diabetes presented at the European Association for the Study of Diabetes (EASD) virtual meeting included using an osteoporosis drug to prevent diabetes, using insulin resistance to predict a stroke, and gender differences in the REWIND trial of cardiovascular prevention in type 2 diabetes.

More research highlights include the following:

Milk Vs Type 1 Diabetes Risk

Drinking certain milks modified a child's risk for developing type 1 diabetes, according to a systematic review and meta-analysis of 96 studies led by Anna-Maria Lampousi, a PhD candidate at the Karolinska Institutet in Stockholm.

Specifically, kids who drank a lot of cow's milk growing up -- at least 2 servings a day -- saw a higher risk for developing type 1 diabetes (RR 1.78, 95% CI 1.36-2.33, moderate certainty). And each 2-3 portions of cow's milk a day was also tied to a 25% higher risk of islet autoimmunity (RR 1.25, 95% CI 1.06-1.47, moderate certainty).

Kids who had a higher intake of protein, red meat, nitrates, sugar, and sugar-sweetened beverages also saw higher risks for type 1 diabetes.

On the other hand, children who were breastfed for at least 6 to 12 months saw a 61% lower risk for type 1 diabetes versus kids who were breastfed for less than 6 to 12 months (RR 0.39, 95% CI 0.26-0.58, high certainty). Paired with that, kids who were exclusively breastfed for 2 to 3 months or longer also saw this protective benefit against type 1 diabetes (≥2-3 vs <2-3 months: RR 0.69, 95% CI 0.58-0.81, moderate certainty).

Also, kids who had a later introduction to gluten and fruit in childhood had a lower risk for type 1 diabetes. Vitamin D supplementation, as well as higher intake of vitamin A and C were also somewhat protective against type 1 diabetes.

None of the risk factors measured in utero, such as maternal intake of gluten, iron, and vitamin D exposure, were related to childhood type 1 diabetes risk.

"Dietary factors in infancy and childhood may be involved in type 1 diabetes etiology," Lampousi concluded during a presentation of the findings.

Type 2 Diabetes Risk With Antidepressants

Nearly 30% of Scottish adults diagnosed with type 2 diabetes were prescribed an antidepressant within the 4 years prior to diagnosis.

In a cohort of 266,186 adults with type 2 diabetes, 22.5% were prescribed an antidepressant before their diabetes diagnosis, with another 5.3% were prescribed an antipsychotic. Another 6.6% were prescribed both an antidepressant and an antipsychotic.

About one of third of these adults on an antidepressant were prescribed a selective serotonin reuptake inhibitor (SSRI), while another third were prescribed a tricyclic antidepressant. Another 27% were prescribed an antidepressant from multiple subtypes.

As for those prescribed an antipsychotic, the vast majority were on a first-generation agent (80%), while only about 14% were on a second-generation agent.

Looking more closely at these adults prescribed one or more psychiatric drugs prior to their diabetes diagnosis, these patients tended to be of a lower socioeconomic background, to be women, to currently smoke, and to have obesity, hypertension, and high total cholesterol.

Lead study author Charlotte Greene, a PhD candidate at the University of Edinburgh, pointed out during a presentation of the findings that these results only included community prescribing and not in-hospital prescribing, likely underestimating these percentages. She also noted that there was no data on dosage or duration of antidepressant use -- only general prescription data -- limiting some of the findings.

Reversing Heart Risk with Major Weight Loss

Huge weight loss seemed to completely reverse cardiovascular risk for American adults in a study of National Health and Nutrition Examination Survey data spanning from 1999 to 2013.

Adults who formerly had obesity but underwent major weight loss were able to completely attenuate the risk of hypertension and dyslipidemia down to a level comparable to adults who were always at a healthy weight (OR 1.08 and OR 1.13, respectively).

On the other hand, adults who remained obese carried more than three-fold higher odds of developing hypertension and dyslipidemia (OR 3.14 and OR 3.11).

Despite this good news on the reversal of cardiovascular risk, diabetes risk still appeared to somewhat linger even after a massive weight loss. Among adults who formerly had obesity, risk for developing type 2 diabetes was higher than those who were always a healthy weight (OR 2.93) but lower than those currently still obese (OR 7.53).

"The key take away of this study is that weight loss is hard, but important, for cardiovascular health," said lead author Maia Smith, PhD, of St. George's University in Grenada, in a statement. "First of all, it's no surprise that losing weight and keeping it off is hard. Almost everyone in our original sample who had ever had obesity, stayed that way. But don't despair: if you do manage to lose weight, it can not only prevent but reverse significant health problems. The best time to get healthy is 20 years ago; the second best time is now."