“Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71 percent of all deaths globally.

Diabetes, cardiovascular disease, cancer, and respiratory diseases are the cause of more than 80 percent of premature deaths due to non-communicable diseases. Unhealthy diet, smoking, physical inactivity, and alcohol consumption are the main related risk factors.

Reducing risk factors as well as screening, early diagnosis and timely treatment of non-communicable diseases can reduce a large part of their damage,” he said.

According to global estimates, the number of diabetics in the West Asia and North Africa region will increase by 96 percent over the next 25 years.

In recent decades, the prevalence of diabetes and the number of deaths due to diabetes in the world has increased dramatically, and this increase has been much greater for type 2 diabetes, he said, IRNA reported on Tuesday.

He went on to say that the rate of disabilities caused by diabetes, especially type 2 diabetes, has also increased significantly in the country, so that diabetes is one of the main causes of disability in Iran.

Referring to diabetes as a costly disease in Iran’s health care system, he stated that “more than 8.5 percent of the country’s total health expenditures are spent on matters related to this disease.”

Due to the importance of diabetes, the country’s health care system has adopted several strategies and policies to reduce the burden of the disease, including, collecting data and measuring the burden of the disease at national and transnational levels, the creation of a national action plan for non-communicable diseases, the development of a national diabetes framework, the establishment of a national network of diabetes clinics, the design of a diabetes research roadmap and the national diabetes registration system, he explained.

Referring to the second edition of the National Document for the Prevention and Control of Non-Communicable Diseases, he noted that the document has been updated by various working groups of the Ministry of

Health, in cooperation with the Endocrinology and Institute of Endocrinology and Metabolism of Tehran University of Medical Sciences.

Diabetes burden in Iran

In Iran, 25 percent of people are not aware of their diabetes. The figure is 50 percent in the world and 60 percent in West Asia and North Africa region.

About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.6 million deaths are directly attributed to diabetes each year.

Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. As it is expected that by 2030, 578 million people will develop diabetes, and the number of patients may exceed 700 million by 2045.

In 2019, 4.2 million people died of diabetes. And now, 50 percent of coronavirus patients were diabetic.

About 90 percent of diabetics are diagnosed with type 2 diabetes worldwide. Education, self-care, and following a healthy lifestyle, and using medication are effective in controlling the disease.

Type 2 diabetes is preventable and, in some cases, can be cured early. Lack of access to insulin, failure to early diagnosis of type 1 diabetes leading to diabetic ketoacidosis is a common cause of death in children and adolescents.

Diabetes is a major cause of blindness, kidney failure, heart attack, stroke, and lower limb amputation. A healthy diet, physical activity, and avoiding tobacco use can prevent or delay type 2 diabetes. In addition, diabetes can be treated and its consequences avoided or delayed with medication, regular screening, and treatment for complications.

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A third of deaths from the virus have occurred among individuals with diabetes, which is linked to excess weight and a lack of exercise.

The study by the NHS and Imperial College London also found that those with Type 1 diabetes –which is not linked to obesity – were three and a half times more likely to die, the Daily Mail reported.

The findings provide further evidence that certain groups of patients are at much higher risk of suffering fatal complications.

But they also suggest that lifestyle strongly influences someone’s susceptibility to the virus.

Lead researcher Professor Jonathan Valabhji, the NHS’s national clinical director for diabetes and obesity, analyzed the deaths of 23,804 patients in England from coronavirus between March 1 and May 11.

Professor Valabhji, also a consultant diabetologist at Imperial College Hospitals, found that 31.4 percent had Type 2 diabetes and 1.5 percent had Type 1.

The study also found that patients with Type 2 diabetes doubled their risk again if they were severely obese, with a body mass index (BMI) above 40.

They were twice as likely to die than those patients with the condition who were in the overweight or normal category. Patients with Type 2 diabetes who also had high blood glucose levels because their condition was poorly controlled increased their risk of death by another 60 percent.

Professor Valabhji said: ‘This research shows the extent of the risk of coronavirus for people with diabetes and the different risks for those with Type 1 and Type 2 diabetes. Importantly, it also shows that higher blood glucose levels and obesity further increase the risk in both types of diabetes.

‘This can be worrying news but we would like to reassure people that the NHS is here for anyone with concerns about diabetes – and has put extra measures in place to help people and keep them safe, including online sites to support people to care for themselves, digital consultations, and a dedicated new helpline for advice and support for people treated with insulin.’

The Government is carrying out a major review into whether obesity, ethnicity, and gender increase their chances of dying or becoming severely ill with the virus.

The findings, which are due within the next few weeks, could influence whether these groups are given tailored advice regarding social distancing and working in non-frontline NHS roles.

At least 3.9 million Britons have diabetes and the number has doubled in the past 20 years in line with rising levels of obesity.

Up to 90 percent have Type 2 which usually develops after the age of 40 but is being increasingly seen in children and teenagers.

Bridget Turner, director of policy at Diabetes UK, said: ‘This new data sheds much-needed light on which groups of people with diabetes are more likely to experience poor outcomes if they catch coronavirus.

It also shows that the risk of death for people with diabetes is higher than for people without the condition – with the risk for people with Type 1 being higher than for those with Type 2 – and that a history of higher blood sugar levels, as well as obesity, seem to be contributing factors.

‘It’s very important to remember that the risk of dying from coronavirus – for people with and without diabetes – remains very low and that as cases of coronavirus decline, the risk to every one of catching the disease will reduce in turn.’

It’s become clear that coronavirus attacks the heart as well as the lungs, and one of its harmful effects on a cardiac chamber may predict who dies of the infection, a new study suggests.

Researchers at Mt Sinai University Icahn School of Medicine in New York followed the conditions of 110 hospitalized coronavirus patients and their prior medical records.

Nearly 62 percent of patients with enlarged right ventricles – a chamber of the heart that pumps oxygen-poor blood to the lungs – died, according to an article that’s been accepted to a journal, but not yet published.

It comes as the US coronavirus death toll tops 90,000 and doctors continue to search for clues as to why some patients suffer only minor symptoms and others die of the infection.

Of the 110 patients that the Mt Sinai researchers recruited to their study, 21 ultimately died.

Early data out of China suggested that 19 percent of coronavirus patients had heart issues, and it’s a trend doctors across the US have since noted too.

So often is the case, that many US doctors are putting coronavirus patients on blood thinners as a matter of course, because many have developed potentially deadly clots.

Doctors closely monitor coronavirus patients for signs that their hearts may be under attack from the coronavirus.

All 110 patients in Mt Sina’s study – which has been accepted to the journal JACC: Cardiovascular Imaging, but not yet published – had indicators that suggested their hearts could be struggling and were given echocardiograms (EKGs) to assess their cardiac function.

Thirty percent of the patients given EKGs were already in critical condition, on ventilators to help them breathe.

EKGs revealed that 31 percent of the patients had ‘right ventricular dilation,’ meaning the lower right chamber of each heart was larger than normal.

Enlarged right ventricles are not typically a sign of heart disease itself. Instead, they usually signal that another condition is stressing the heart.

The patients with enlarged right ventricles were no more likely to have other health conditions, out-of-control inflammation or be on blood thinners than were other patients.

What’s more, the researchers did not find higher rates of enlarged left ventricles.

It’s not clear exactly why right ventricle, specifically, seemed to suffer more distress.

The research team suspects that multiple factors contribute to the development of the enlarged right chamber, including low oxygen levels that trigger a tightening of blood vessels, direct damage from the virus, damage from inflammatory immune cells called cytokines, and blood clots.

Scientists believe that coronavirus fights its way into human cells by binding to a receptor called ACE2, which is found most prevalently in the lungs but is also on the surface of blood vessel cells.

Other studies have suggested that the virus’s attacks on the blood vessels can lead to all of the conditions that, in turn, the Mt Sinai researcher think to contribute to the enlargement of the right ventricle.

Forty-one percent of the patients with enlarged right ventricles died of coronavirus, compared to just 11 percent of those whose right ventricles looked normal on the EKG.

EKGs are easy to perform bedside, meaning infected patients don’t have to be transported out of their rooms, potentially exposing other patients and more hospital staff, and the new study suggests that performing the imaging exam might help doctors predict when someone with coronavirus is about to take a turn for the worse.

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The light-switchable cells are designed to compensate for the lower insulin production or reduced insulin response found in diabetic individuals. The study published in ACS Synthetic Biology shows that glucose levels can be controlled in a mouse model of diabetes without pharmacological intervention, Phys reported.

Insulin is a hormone that plays a central role in precisely controlling levels of circulating glucose—the essential fuel used by cells -. Diabetes affects more than 30 million Americans according to the Centers for Disease Control and Prevention (CDC). In type II diabetes—the most common form of the disease—the cells of the body become inefficient at responding to insulin and as a consequence, glucose in circulation can become dangerously high (hyperglycemia) while the pancreas cannot produce enough insulin to compensate. In type I diabetes, the beta cells, which are the only cells in the body that produce insulin, are destroyed by the immune system resulting in a complete lack of the hormone.

Current treatments include the administration of drugs that enhance the production of insulin by pancreatic beta cells, or direct injection of insulin to supplement the naturally produced supply. In both cases, regulation of blood glucose becomes a manual process, with drug or insulin intervention conducted after periodic readings of glucose levels, often leading to spikes and valleys that can have harmful long-term effects.

The researchers sought to develop a new way to amplify insulin production while maintaining the important real-time link between the release of insulin and the concentration of glucose in the bloodstream. They accomplished this by taking advantage of ‘optogenetics’, an approach relying on proteins that change their activity on-demand with light. Pancreatic beta cells were engineered with a gene that encodes a photoactivatable adenylate cyclase (PAC) enzyme. The PAC produces the molecule cyclic adenosine monophosphate (cAMP) when exposed to blue light, which in turn cranks up the glucose-stimulated production of insulin in the beta-cell. Insulin production can increase two- to three-fold, but only when the blood glucose amount is high. At low levels of glucose, insulin production remains low. This avoids a common drawback of diabetes treatments which can overcompensate on insulin exposure and leave the patient with harmful or dangerously low blood sugar (hypoglycemia).

Researchers found that transplanting the engineered pancreatic beta-cells under the skin of diabetic mice led to improved tolerance and regulation of glucose, reduced hyperglycemia, and higher levels of plasma insulin when subjected to illumination with blue light.

“It’s a backward analogy, but we are actually using light to turn on and off a biological switch,” said Emmanuel Tzanakakis, professor of chemical and biological engineering at the School of Engineering at Tufts University and corresponding author of the study. “In this way, we can help in a diabetic context to better control and maintain appropriate levels of glucose without pharmacological intervention. The cells do the work of insulin production naturally and the regulatory circuits within them work the same; we just boost the amount of cAMP transiently in beta cells to get them to make more insulin only when it’s needed.”

The blue light simply flips the switch from normal to boost mode. Such optogenetic approaches utilizing light-activatable proteins for modulating the function of cells are being explored in many biological systems and have fueled efforts toward the development of a new genre of treatments.

“There are several advantages to using light to control treatment,” said Fan Zhang, a graduate student in Tzanakakis’ lab at Tufts and the first author of the study. “Obviously, the response is immediate; and despite the increased secretion of insulin, the amount of oxygen consumed by the cells does not change significantly as our study shows. Oxygen starvation is a common problem in studies involving transplanted pancreatic cells.”

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