The European Association for the Study of Diabetes (EASD) Annual Meeting – press release
· • Reducing ultra-processed food (UPF) intake and being physically active can cut risk of type 2 diabetes, regardless of genetic make-up
· • High prevalence of neurodiversity among young people diagnosed with type 2 diabetes, suggests study of over 6 million people
· • Up to one in three people with type 2 diabetes develop serious heart or kidney disease or die within five years of diagnosis, study of 1.6 million patients suggests
· • New post-hoc analysis shows daily oral weight loss / diabetes medication orforglipron was associated with similar weight reductions for women of different menopausal status
Reducing ultra-processed food (UPF) intake and being physically active can cut risk of type 2 diabetes, regardless of genetic make-up
· Your genes are not your destiny, say study’s authors
Eating a diet low in ultra-processed foods (UPFs) and exercising can cut the risk of type 2 diabetes, even in those with a strong genetic disposition to the condition, new research being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy (Sept 28 – Oct 2) suggests.
The analysis of data on tens of thousands of people in the UK found that those who had a diet low in processed food and did regular moderate to vigorous physical activity were up to 70% less likely to develop the condition.
In those with a strong genetic predisposition, the diet-exercise combination halved the risk of type 2 diabetes.
“Type 2 diabetes is caused by a combination of a person’s genetic susceptibility and their lifestyle,” says Wenxin Xu, of City University of Hong Kong, Hong Kong, China, who led the research.
“In terms of lifestyle, eating more ultra-processed food is associated with a higher risk, whereas physical activity is protective.
“However, whether a lower UPF intake reduces genetic susceptibility hasn’t been clear. Nor have we known whether exercising helps offset the impact of UPFs.
“It is important to find this out because, unlike genetic susceptibility, diet and physical activity can be modified – they are things people can change.”
To find out more, Ms Xu and colleagues at the City University of Hong Kong (Hong Kong and Dongguan) examined data on 56,964 adults in the UK Biobank study (average age 69.5 years, 42.3% male).
Detailed questionnaires provided information on UPF intake at baseline, as defined by the Nova system1. The amount of moderate-to-vigorous physical activity (MVPA) was calculated from activity trackers worn on the wrist for a week. MVPA is exercise that increases heart rate and breathing rate. Examples include brisk walking, cycling, hiking and walking the dog. Sports, housework and gardening jobs that require sustained physical effort are also included. Genetic susceptibility to type 2 diabetes was estimated from genetic data.
During an average follow-up period of 7.8 years, 926 of the participants developed type 2 diabetes.
As expected, eating more UPFs was associated with a higher risk of the condition and, MVPA, a lower risk. Type 2 diabetes risk increased in line with UPF intake. Every 10% (by weight) of an individual’s diet that was made up of UPFs increased their risk of type 2 diabetes by 7%. Meanwhile, the participants who met the World Health Organization (WHO) recommendation of at least 150 minutes of MVPA a week were 39% less likely to develop type 2 diabetes than those who exercised less.
Further analysis indicated that a lower UPF intake and MVPA both partially offset genetic susceptibility to type 2 diabetes.
In those whose genes put them at high risk of type 2 diabetes, a low UPF intake (approximately 11% or less of total food intake by weight came from ultra-processed foods) was associated with a 35% lower likelihood of the condition. Meeting the MVPA recommendations was associated with a 33% lower risk of type 2 diabetes.
The researchers also found that exercise seems to reduce the impact of UPFs, even in those with a strong genetic predisposition to type 2 diabetes. In participants with high UPF intake (approximately 33% or more of total food intake by weight came from ultra-processed foods), meeting WHO recommendations for MVPA was associated with 31% lower risk of type 2 diabetes risk in those with a high genetic risk, 57% in those with an intermediate genetic risk and 58% in those at low genetic risk.
The combination of lower UPF intake and MVPA was associated with even greater protection against the condition. It was linked to a 49% reduction of risk of type 2 diabetes in those whose genes made them highly susceptible to type 2 diabetes, a 70% reduction in those with an intermediate genetic susceptibility and a 59% reduction in those with a low genetic susceptibility.
This highlights the importance of considering lifestyle changes together, rather than in isolation, say the authors. They acknowledge that the findings are observational and so cannot prove cause and effect. However, they are in line with existing advice to eat a healthier diet and stay physically active to prevent or delay the onset of type 2 diabetes.
Ms Xu adds: “Our study indicates that our genes are not our destiny.
”Even among people with a high genetic susceptibility to type 2 diabetes, lower intake of ultra-processed foods and regular moderate-to-vigorous physical activity were associated with a substantially lower risk of developing the condition.
“While we cannot say that type 2 diabetes can always be avoided, our results suggest that healthy lifestyle choices may help reduce the risk whatever your genetic background.”
Ms Wenxin Xu, City University of Hong Kong, Hong Kong, China. M) +852 6477 8192 E) nicole.xu@my.cityu.edu.hk
Alternative contact: Tony Kirby in the EASD Press Office T) +44 7834 385827 E) tony.kirby@tonykirby.com
References:
1. https://nupens.fsp.usp.br/en/food-classification-nova/
The authors declare no conflicts of interest.
The press release is based on abstract 296 at the Annual Meeting of the European Association for the Study of Diabetes (EASD, Milan, September 28 – October 2). The results of the study form part of a paper that has been accepted by the journal Diabetes. The paper is not yet available but the authors are happy to answer your questions.
High prevalence of neurodiversity among young people diagnosed with type 2 diabetes, suggests study of over 6 million people
· ADHD appears twice as prevalent, and autism more than three times as prevalent, among individuals diagnosed with type 2 diabetes before the age of 20, compared to similarly aged individuals without type 2 diabetes.
· Findings highlight the need for greater focus on tailored and equitable support for people living with both early-onset type 2 diabetes and neurodiversity, to help improve health outcomes.
Embargo: 0001H CEST Milan local time on Sunday 27 September
People with neurodiversity, particularly autism and ADHD (attention-deficit/hyperactivity disorder), may be more likely to be diagnosed with type 2 diabetes (T2D) at younger ages, with particularly high prevalence of neurodiversity observed among individuals diagnosed with T2D before the age of 20, finds an analysis of patient data being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy (September 28–October 2.
With prevalences of ADHD and autism among those aged under 20 years reaching as high as 14% and 5%, respectively, the authors underscore the importance of considering the needs of neurodivergent people when planning clinical services and support for those with early-onset T2D.
“Health systems are failing to fully meet the needs of people living with both early-onset T2D and neurodiversity, both of which are linked to poorer health outcomes,” said lead author Dr Jonathan Goldney from the University of Leicester Diabetes Research Centre and NIHR Biomedical Research Centre, Leicester UK. “Neurodivergent people and those living with early-onset T2D are likely to face unique challenges when navigating busy healthcare environments, communicating with healthcare professionals, and managing their diabetes.
“Providing healthcare for T2D in a suitable way for neurodivergent individuals is critical to making healthcare more accessible for everyone, particularly as more people are being diagnosed with T2D earlier in life.”
Rates of early-onset T2D, defined as diagnosis before the age of 40, are rising and are associated with poorer health outcomes. Challenges engaging with healthcare and the burden of managing diabetes can be compounded by stigma and the competing demands of early adulthood. Being diagnosed with T2D at a younger age also means a longer lifetime exposure to the condition, increasing the risk of serious complications and early death.
To better understand this growing and under-served population, researchers examined the prevalence of neurodiversity (ADHD, autism, dyslexia, and dyspraxia) among 4.2 million individuals newly diagnosed with T2D from the TriNetX US collaborative network [1] between March 2006 and March 2026, who were grouped by age at diagnosis into 10-year age bands.
Each 10-year age group was then matched by age, year of birth, sex, ethnicity and race to 17.1 million individuals without T2D, to account for demographic differences between those with and without T2D. In total, 3.4 million matched pairs aged younger than 80 years were included in the analysis.
Overall, among people both with and without T2D, the prevalence of neurodiversity was highest at younger ages and declined rapidly with increasing age, becoming extremely low beyond the age of 40 years (see figure in notes to editor).
However, both ADHD and autism were consistently more prevalent among people with T2D, with the greatest differences observed at younger ages. For example, ADHD was over twice as prevalent among people diagnosed with T2D before the age of 20 compared to similarly aged individuals without T2D (14.4% vs 6.9%). This difference generally declined with age, with ADHD around 1.4 times more prevalent among people diagnosed with T2D at age 70–79 years (0.25% vs 0.18%).
Similarly, autism was more than three times as prevalent among people diagnosed with T2D before the age of 20 compared to those without T2D (5.72% vs 1.79%). The difference was smaller among those diagnosed at age 70–79 years, in whom autism was 1.24 times higher. However, prevalence of autism was extremely low in the 70–79 years group with or without T2D —less than 0.01% in both groups.
Similarly, dyslexia and dyspraxia were more prevalent among younger people. Overall, people with T2D were about twice as likely to have dyslexia as those without T2D, but this didn’t appear to vary in an obvious pattern with age.
The authors speculate that several factors may contribute to the association between neurodivergent conditions and T2D, including lower levels of physical activity, sleep difficulties, medication use, mental health conditions and barriers to accessing healthcare. Factors earlier in life may also play a role. For example, maternal diabetes has been associated with neurodevelopmental outcomes and later cardiometabolic risk in children.
“Our findings by no means suggest that most people with a neurodivergent condition will go on to develop type 2 diabetes,” says Dr Goldney. “However, the higher prevalence of neurodiversity among people diagnosed with T2D earlier in life should be considered when planning services for people with early-onset T2D. Taking neurodiversity into account could help reduce potential barriers to accessing and engaging with healthcare.”
The authors point out that, although the study was large, its observational design means that it cannot establish cause and effect, and the influence of other factors that were not measured cannot be ruled out. The study also relied on anonymised hospital records which may be prone to errors and are not specifically designed for research. They also note that people with neurodivergent conditions may have more frequent contact with healthcare professionals, potentially increasing opportunities for a T2D diagnosis and influencing the findings. Additionally, because the study only included people who had attended hospital, it may not be fully representative of the wider population and could exclude healthier individuals. This may have affected the prevalence estimates, particularly among younger people without T2D.
They add that future studies should explore the factors underlying the association between neurodivergent conditions and T2D, and whether diabetes care that takes neurodiversity into account can improve health outcomes.
For interviews with the report authors, please email Joanna Jones at the NIHR Biomedical Research Centre, Leicester, UK at Joanna.jones51@nhs.net
Alternative contact in the EASD Press Room: Tony Kirby T) + 44(0)7834 385827 E) tony@tonykirby.com
[1] The TriNetX US collaborative network is a large, regularly updated data network containing de-identified patient electronic health record information from healthcare organsiations across the USA, which is broadly generalisable to the US population.
The authors declare no conflicts of interest
The press release is based on short oral Presentation 226 at the Annual Meeting of the European Association for the Study of Diabetes (EASD, Milan, September 28 – October 2). There is no full paper at this stage, but the work has been submitted to a medical journal for publication. The authors are happy to answer your questions.
Up to one in three people with type 2 diabetes develop serious heart or kidney disease or die within five years of diagnosis, study of 1.6 million patients suggests
Findings reinforce the critical importance of early, proactive and comprehensive management of people newly diagnosed with type 2 diabetes
The risk of developing chronic kidney disease (CKD) or heart failure (HF), or dying, following a type 2 diabetes (T2D) diagnosis increases substantially over time, according to new research being presented at the Annual Meeting of The European Association for the Study of Diabetes (EASD) in Milan, Italy (Sept 28 – Oct 2).
The study, which analysed data from more than 1.6 million patients across the USA, found that the combined risk of developing CKD or HF, or dying, was 33% on average within the first five years of a T2D diagnosis, rising to 55% over 10 years.
The researchers say their findings underscore the critical importance of early, proactive and more holistic approaches to the management of type 2 diabetes to help reduce the risk of serious complications.
T2D is projected to become the biggest epidemic disease in the world, affecting an estimated 1.3 billion people by 2050 [1]. It frequently occurs alongside other conditions, including obesity, high blood pressure, HF, CKD and depression, contributing substantially to the global burden of multimorbidity. This causes considerable suffering for people living with T2D and economic stress for many countries, especially low- and middle-income countries.
However, how quickly and in what order people newly diagnosed with T2D develop serious complications such as CKD and HF is not fully understood.
To address these knowledge gaps, researchers analysed real-world data from the CALOR observational study programme [2] to estimate the risk of developing CKD or HF following a new T2D diagnosis, the risk of developing the other complication within five years of the first, and the combined risk of developing CKD or HF, or dying, within five and 10 years of diagnosis.
They included 1,617,508 patients newly diagnosed with T2D between 1st January 2010 and 31st March 2024 from across the USA. The average age of participants at enrolment was 59 years, and 51% were female. Among the 13% of patients who had a body mass index (BMI) recorded, the average (median) was 30.9 kg/m².
Almost three-quarters (72%) of participants were also living with dyslipidaemia (high levels of cholesterol and other fats in the blood), and over two thirds (68%) had high blood pressure.
Within five years of a first T2D diagnosis, the risk of developing CKD first was more than twice that of developing HF first (19.0% vs 8.3%; see figure in notes to editors).
However, among people who developed HF first, there was a 42% risk of developing CKD within the following five years. Conversely, among those who developed CKD first, there was a 23% risk of developing HF within the following five years.
”Our findings clearly show how the serious complications associated with type 2 diabetes rise sharply over time as the often common combination in patients of obesity, abnormal blood fats, high blood pressure and higher blood sugar damages blood vessels, and vital organs,” said Professor Naveed Sattar of the University of Glasgow, Scotland, UK who co-led the study. ”Our results emphasise the critical importance of detecting and treating type 2 diabetes thoroughly at the earliest opportunity to help reduce the risk of serious complications.”
The study has several limitations, including that it was observational and can’t prove causation and it can’t rule out the probability of selection bias, which is a common limitation of real-world evidence. For example, the influence of race and ethnicity on the risk of developing CKD or HF may have influenced the result
[1] Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 – The Lancet
[2] The CALOR observational study programme is funded by AstraZeneca: https://www.astrazeneca.com/media-centre/articles/astrazeneca-calor-obesity-study.html
Naveed Sattar declares employment/consultancy with AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Carmot Therapeutics, Eli Lilly, Gan & Lee, GlaxoSmithKline, Hanmi Pharmaceuticals, Kailera, Mass Medicines, Menarini-Ricerche, Metsera, Novo Nordisk, Pfizer, Regeneron, Roche, UCB Pharma and Verdiva Bio. Grants; Institutional research funding from AstraZeneca, Boehringer Ingelheim, Novartis and Roche.
The press release is based on oral presentation 32 at the Annual Meeting of the European Association for the Study of Diabetes (EASD, Milan, September 28 – October 2). There is no full paper at this stage, and the work has not yet been submitted to a medical journal for publication. The authors are happy to answer your questions. As it is an oral presentation, there is no poster.
New post-hoc analysis shows daily oral weight loss / diabetes medication orforglipron was associated with similar weight reductions for women of different menopausal statusr
New analyses to be presented at the Annual Meeting of The European Association for the Study of Diabetes (EASD) in Milan, Italy (Sept 28 – Oct 2) show that the new daily oral weight loss / type 2 diabetes medication orforglipron was associated with similar weight loss for women of different ages and at different life stages – premenopausal, experiencing menopause, or post-menopausal. The study is by Dr Hunter Thomas Hoffman, Eli Lilly and Company, Indianapolis, IN, USA – the sponsor of the study and manufacturer of orforglipron – and colleagues.
Obesity, a chronic progressive disease, is exacerbated by oestrogen deficiency during menopause. Orforglipron, an oral small-molecule, non-peptide GLP-1 receptor agonist, was associated with significant body weight (BW) reductions in ATTAIN-1 and -2 studies, one of which looked at people living with overweight or obesity but not diabetes (ATTAIN-1) and the other with both conditions (ATTAIN-2). This additional analysis evaluates orforglipron‘s effect on BW in women by menopausal stage.
Female participants with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related medical condition in ATTAIN-1 and -2 were analysed by menopausal status: pre-, peri-, or post-menopause, with the number of women in each category receiving orforglipron or placebo ranging from 142 to 225. BW, waist circumference (WC), waist-to-height ratio changes and the proportion achieving BW reduction thresholds (≥5%, ≥10%, ≥15%, ≥20%) vs placebo (PBO) were assessed at 72 weeks.
For women given orforglipron, significant and similar reductions in body weight up to 14% were experienced for pre-menopausal, peri-menopausal and post-menopausal women in ATTAIN-1, and in ATTAIN-2. (see results table full abstract)
Significant reductions in waist circumference of up to 12.5 cm were observed across subgroups with orforglipron for both studies. With orforglipron, up to 83% experienced at least 5% body weight reduction vs 30% with placebo. More orforglipron-treated participants experienced a shift to lower waist-to-height ratio categories than placebo.
All of the authors are employees of Eli Lilly, the manufacturer of orforglipron.
The press release is based on short oral presentation 766 at the Annual Meeting of the European Association for the Study of Diabetes (EASD, Milan, 28 Sept – 2 Oct). No full article is available at this stage and the research has not yet been submitted to medical journal for publication. The authors are happy to answer any questions.
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