Category: 8. Health

With nearly half the world’s population at risk, dengue has evolved from a seasonal disease to a global health threat — and Pakistan is in no position to take this lightly. The World Health Organisation (WHO) estimates 100 to 400 million dengue infections every year, a staggering figure that underscores the urgency of preventive measures. Closer to home, Sindh recently reported its first dengue-related death of the year, a grim reminder that the virus continues to claim lives while our public health response lags dangerously behind. The crisis, particularly in Sindh, is rapidly escalating. So far, 295 cases have been reported in the province — with Karachi alone accounting for nearly 260. This spike follows recent rains, which once again exposed the deep dysfunction in local governance. The Karachi Metropolitan Corporation (KMC) admitted it could only drain rainwater from main roads, passing the buck to town municipal corporations for cleaning residential areas. This lack of coordination is a failure that costs lives.

While provinces like Punjab, historically hard-hit, have managed to keep a relatively low case count this season, Sindh stands out for all the wrong reasons. Prevention is the only real defence against dengue, given the absence of a vaccine. Yet in many parts of Sindh, mosquito spraying campaigns are either token or entirely missing. Standing water — a notorious breeding ground for dengue-carrying mosquitoes — remains untouched in many neighbourhoods, often hidden behind mountains of uncollected garbage. The result: an environment primed for disease. The 2022 floods should have been a wake-up call. Displaced communities in Sindh and Balochistan then suffered not just from displacement but from swarms of giant mosquitoes and the diseases they carried. But if there were lessons learned, they’ve long since been shelved. The WHO has laid out clear, actionable guidelines: wear protective clothing, use mosquito nets (especially during daytime sleep), install window screens, apply repellents and ensure proper waste disposal. These are simple measures, yet their successful implementation hinges on robust public education and a functioning civic infrastructure.

It is time our provincial governments treated this as a public health emergency. Awareness campaigns must reach every citizen. Municipal bodies should be empowered with not just mandates but also the budgets needed to clean and sanitise urban and rural areas alike. Trash piles must be cleared, and stagnant water must be drained without delay. The tools are available; what’s missing is political will and coordinated action. While the current numbers remain within a manageable range, complacency now could spiral into an uncontrollable crisis in the coming weeks. Every day of inaction widens the window for the virus to spread further. Pakistan cannot afford another preventable health disaster. All provinces must urgently come together, devise a unified national strategy and act. Dengue may be a mosquito-borne disease, but in Pakistan, it thrives on mismanagement.

Veteran mountaineer Petra Thaller does not easily accept defeat – especially from cancer.

In 2014, the German mother-of-two, then aged 53, was hiking the Carstensz Pyramid – also known as Puncak Jaya – which at 4,884 metres (16,024 feet) is Indonesia’s highest peak.

She found it odd that she felt so tired on the climb. At one point, while crossing a river, she hurt her breast, which immediately swelled up and felt tender and sore.

On her return to Germany, her doctor found five malignant tumours in her breast. Treatment was aggressive: lymph node removal, chemotherapy, a mastectomy and then radiotherapy.

Less than two years later, while still in treatment, two small nodules – diagnosed as “precancerous” – were found in her other breast.

Although no treatment was required at that stage, she felt as if she was back at square one, she says over Zoom from her home in Munich, Germany.

Omega-3 is a healthy fatty acid, which is linked to enhanced brain function and development in all stages of life.Studieshave shown that omega-3 fatty acids increase learning, memory, cognitive well-being, and blood flow in the brain. Omega-3, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are essential fats that build and maintain brain cell membranes. Foods such as fatty fish (salmon, sardines, mackerel), chia seeds, flaxseeds, walnuts, and algal oil (plant-based DHA supplements) are good sources of Omega-3.

Type 5 diabetes is no longer a footnote. On April 9, 2025 the International Diabetes Federation confirmed that chronic undernutrition can seed a very different form of blood‑sugar trouble, giving the condition its own place in the global classification system.

“Malnutrition‑related diabetes has historically been vastly under‑diagnosed and poorly understood,” said Dr. Meredith Hawkins as the vote was announced.

Hawkins is an endocrinologist at Albert Einstein College of Medicine and founding director of the Global Diabetes Institute (GDI).

Why a fifth type matters

Nearly one in nine adults worldwide now lives with some form of diabetes, and more than 250 million people remain unaware of their status, according to the 11th edition of the IDF Diabetes Atlas.

Most public campaigns focus on type 2 diabetes, yet an estimated 20 to 25 million lean adolescents and young adults in Asia and Africa carry the new diagnosis of type 5, a burden comparable in size to HIV infection in the same regions.

Unlike type 2, type 5 takes hold where food is scarce, not plentiful. That reality undercuts a long‑standing public narrative that ties diabetes exclusively to over‑nutrition.

For governments counting every healthcare dollar, a distinct label matters. Budgets follow labels, and without one, entire populations have slipped through screening and treatment programs designed for very different metabolic problems.

“This is about equity, science, and saving lives,” said Professor Peter Schwarz, president of the IDF, summing up the stakes during the Bangkok congress. 

Early hunger leaves a lasting mark

Decades of animal work show that a low‑protein diet during gestation or adolescence stunts pancreatic growth and the formation of beta cells, the tiny factories that make insulin.

Human epidemiology echoes that biology, linking low birth weight and recurring childhood malnutrition to impaired glucose control later on.

Researchers now group type 5 under severe insulin‑deficient diabetes, a label that captures the core defect: the pancreas never learned to keep up with sugar loads, even though the rest of the body remains sensitive to insulin.

In South India, investigators tracked adults whose body‑mass index averaged just 18.3 kg/m² yet whose blood sugar routinely soared; birth‑weight records, where available, pointed to under‑nutrition in the womb.

Community nutrition programs are therefore viewed not only as anti‑hunger measures but also as long‑range diabetes prevention.

Public‑health economists note a secondary benefit. Feed a girl properly before and during pregnancy, and her children may avoid the same metabolic trap, breaking an expensive inter‑generational cycle of disease.

State‑of‑the‑art euglycemic clamp studies, published in 2022, confirmed that type 5 patients secrete dramatically less insulin than matched controls while showing normal or even heightened insulin sensitivity.

The same work found little visceral fat and modest liver fat, a stark contrast to type 2 profiles. In practical terms, these young adults do not carry the metabolic baggage that fuels insulin resistance in obesity‑driven diabetes.

Autoantibody screens stay negative, ruling out the immune‑mediated beta‑cell destruction that defines type 1 diabetes.

The numbers therefore line up: glucose levels look dangerous, C‑peptide looks scant, but inflammatory markers typical of autoimmunity are absent.

Because the pancreas is small, many experts suspect that oral drugs that nudge the remaining beta cells may help more than high‑dose insulin injections, a strategy that could lower costs and reduce dangerous hypoglycemia in food‑insecure settings.

Diabetes type causes clinical confusion

“Doctors are still unsure how to treat these patients, who often don’t live for more than a year after diagnosis,” Dr. Hawkins warned.

Younger clinicians, trained on the obesity paradigm, may reach for large insulin doses that push already fragile patients into ulcerating hypoglycemia.

Misclassification also skews surveillance data. When a thin teenager in rural Uganda shows up with elevated glucose but no ketosis, the chart often reads “type 1,” obscuring the true epidemiology and directing precious insulin supplies away from those who need them.

A 2025 commentary in the Bangladesh Journal of Endocrinology emphasized the threat: standard insulin regimens carry “potentially fatal consequences” for type 5 patients who are mis‑typed as type 1, because even small dosing errors provoke sharp glucose crashes.

Simple screening cues can help. A BMI below 19 kg/m² in the absence of autoantibodies should prompt consideration of type 5, especially when the history includes prolonged childhood hunger.

Steps for care of diabetes type 5

Two weeks after the Bangkok vote, the IDF launched a dedicated working group to write diagnostic criteria, compile treatment algorithms, and build an international patient registry by 2027.

The panel, co‑chaired by Hawkins and Dr. Nihal Thomas of Christian Medical College in Vellore, India, will test low‑dose insulin, sulfonylureas, and structured nutrition programs in multi‑site trials. Results could reshape essential‑medicine lists in low‑income countries.

Public‑health agencies are already modeling the economic impact. Analysts predict that shifting even half of misdiagnosed cases from insulin vials to oral drugs could save tens of millions of dollars each year, funds that might be redirected to maternal nutrition.

Advocates also press for the inclusion of pancreas‑focused imaging in major nutrition cohorts. Measuring organ size early could identify high‑risk children before glucose spirals out of control.

“We are taking decisive steps to correct this,” said Schwarz, insisting that momentum will continue. Policies built on that momentum will decide whether type 5 becomes another silent killer or a preventable relic of poverty.

The study is published in Diabetes Care.

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A new study has found that leprosy was circulating in Chile some 4,000 years ago, meaning the disease arrived in the Americas much earlier than previously thought.

That’s based on an analysis of ancient bones and teeth by researchers from institutions in Germany, Argentina, and Chile, and it challenges the conventional wisdom that leprosy was a disease introduced by European settlers from the 16th century onwards.

Through a comprehensive study of DNA fragments found in two human skeletons, the researchers were able to match the genetic material to the Mycobacterium lepromatosis pathogen – the less common of two bacteria known to cause leprosy.

“We were initially suspicious, since leprosy is regarded as a colonial-era disease, but more careful evaluation of the DNA revealed the pathogen to be of the lepromatosis form,” says anthropologist Darío Ramirez, from the National University of Córdoba in Argentina.

Related: Experts Warn Leprosy Isn’t Ancient History as Cases Surge in The US

Scientists are still learning about M. lepromatosis, which has only recently been identified. Another bacteria, Mycobacterium leprae, is the dominant strain behind leprosy, and its history and spread has been more clearly mapped to date.

While there’s a scarcity of samples in the Americas, M. leprae has been tracked back for thousands of years across Eurasia, which is part of the reason why researchers have long thought it traveled from Europe across the Atlantic.

Another recent study found traces of M. lepromatosis in remains from Canada and Argentina, stretching back at least a thousand years – again before European settlers showed up. This new find, pushing its arrival back millennia earlier, adds further evidence that we need to rethink the history of leprosy.

“Ancient DNA has become a great tool that allows us to dig deeper into diseases that have had a long history in the Americas,” says anthropologist Kirsten Bos, from the Max Planck Institute for Evolutionary Anthropology in Germany.

“The advanced techniques now used to study ancient pathogen DNA allows us to look beyond the suspects and into other diseases that might not be expected from the context.”

Trying to pick apart this history of disease isn’t easy. Indigenous American peoples would certainly have had afflictions of their own, but they would have also been hit hard by infections imported by colonists – infections their bodies were poorly prepared for.

The researchers are confident that there’s more to the story, in terms of both modern and ancient forms of the disease – especially in regards to M. lepromatosis. Each archaeological dig and clinical test gives experts more genomes to work with, which then further helps our understanding of disease history, spread, and diversification.

Part of the skill needed by researchers is knowing what to look for, which is highlighted by this study – previous work in this area may have missed ancient markers of leprosy, simply because no one thought to look for it.

“This disease was present in Chile as early as 4,000 years ago, and now that we know it was there, we can specifically look for it in other contexts,” says anthropologist Rodrigo Nores, from the National University of Córdoba.

The research has been published in Nature Ecology & Evolution.

The hippocampus is a brain region that is essential for learning and memory and involved in emotion regulation. Back in 2013, Jonas Frisén’s research group at Karolinska Institutet showed in a high-profile study that new neurons can form in the hippocampus of adult humans. The researchers then measured carbon-14 levels in DNA from brain tissue, which made it possible to determine when the cells were formed.

Identifying cells of origin

However, the extent and significance of this formation of new neurons (neurogenesis) are still debated. There has been no clear evidence that the cells that precede new neurons, known as neural progenitor cells, actually exist and divide in adult humans.

“We have now been able to identify these cells of origin, which confirms that there is an ongoing formation of neurons in the hippocampus of the adult brain,” says Jonas Frisén, Professor of Stem Cell Research at the Department of Cell and Molecular Biology, Karolinska Institutet, who led the research.

From 0 to 78 years of age

In the new study, the researchers combined several advanced methods to examine brain tissue from people aged 0 to 78 years from several international biobanks. They used a method called single-nucleus RNA sequencing, which analyses gene activity in individual cell nuclei, and flow cytometry to study cell properties. By combining this with machine learning, they were able to identify different stages of neuronal development, from stem cells to immature neurons, many of which were in the division phase.

To localize these cells, the researchers used two techniques that show where in the tissue different genes are active: RNAscope and Xenium. These methods confirmed that the newly formed cells were located in a specific area of the hippocampus called the dentate gyrus. This area is important for memory formation, learning and cognitive flexibility.

Hope for new treatments

The results show that the progenitors of adult neurons are similar to those of mice, pigs and monkeys, but that there are some differences in which genes are active. There were also large variations between individuals – some adult humans had many neural progenitor cells, others hardly any at all.

“This gives us an important piece of the puzzle in understanding how the human brain works and changes during life,” explains Jonas Frisén. “Our research may also have implications for the development of regenerative treatments that stimulate neurogenesis in neurodegenerative and psychiatric disorders.”

The study was conducted in close collaboration with Ionut Dumitru, Marta Paterlini and other researchers at Karolinska Institutet, as well as researchers at Chalmers University of Technology in Sweden.

The research was funded by the Swedish Research Council, the European Research Council (ERC), the Swedish Cancer Society, the Knut and Alice Wallenberg Foundation, the Swedish Foundation for Strategic Research, the StratRegen programme, the EMBO Long-Term Fellowship, Marie Sklodowska-Curie Actions and SciLifeLab. Jonas Frisén is a consultant for the company 10x Genomics. See the scientific article for a complete list of potential conflicts of interest.

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If your daily routine involves an energizing cup of coffee, you may want to rethink what you choose to put in it.

Drinking coffee has been linked to a lower risk of death. The catch is, mortality risk based on coffee consumption changes with the amount of sweeteners and saturated fat added, according to a study from the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University.

“Coffee is among the most-consumed beverages in the world, and with nearly half of American adults reporting drinking at least one cup per day, it’s important for us to know what it might mean for health,” Fang Fang Zhang, senior author of the study, said.

“The health benefits of coffee might be attributable to its bioactive compounds, but our results suggest that the addition of sugar and saturated fat may reduce the mortality benefits.”

The study found that drinking black coffee and coffee with low levels of added sugar and saturated fat were associated with a 14% lower risk of all-cause mortality as compared to no coffee consumption.

But for coffee with high amounts of added sugar and saturated fat, results varied.

The study analyzed data from the National Health and Nutrition Examination Survey from 1999 to 2018 and National Death Index Mortality Data.

Among the studied 46,332 U.S. adults aged 20 or over, 7,074 people have died. Those deaths were then cross-referenced against coffee consumption, according to reports.

The researchers found that people who drink coffee showed a lower risk of all-cause mortality, but when more than a little sugar and saturated fat was added, the risks were heightened.

While limited in scope, the study suggests that drinking caffeinated coffee could help you live longer, while decaffeinated coffee drinkers saw no difference in mortality rates. And taking sugar, milk and cream in your coffee could increase mortality.

“Few studies have examined how coffee additives could impact the link between coffee consumption and mortality risk, and our study is among the first to quantify how much sweetener and saturated fat are being added,” researcher Bingjie Zhou said.

“Our results align with the Dietary Guidelines for Americans which recommend limiting added sugar and saturated fat.”

The second quarter of 2025 brought a steady stream of momentum in cardiology, with developments spanning early-stage innovation, late-phase trial results, and new FDA approvals. This quarter’s recap includes 3 key regulatory milestones—including a major hypertension approval and a fast-tracked gene editing therapy—as well as 3 headline-making trial readouts that challenged, confirmed, or extended the evidence base in high-risk populations.

Rounding it out, Don’t Miss a Beat delivered 3 episodes from the frontlines of ACC, Heart in Diabetes, and beyond—offering expert commentary on treatment sequencing, cardiorenal strategies, and emerging approaches in ATTR-CM. Here’s a look at what mattered most this past quarter in cardiovascular care.

FDA News in Cardiology

FDA Grants Fast Track Designation to VERVE-102 Gene Therapy

On April 11, 2025, the FDA awarded Fast Track designation to Verve Therapeutics’ VERVE-102 gene editing medicine to lower low-density lipoprotein cholesterol (LDL-C) levels in individuals with hyperlipidemia and high cardiovascular risk. The regulatory agency cleared the Investigational New Drug (IND) application for VERVE-102 in March 2025, when the company provided interim data from the dose–escalation part of the Phase 1b Heart-2 trial.

FDA Accepts NDA Submission for Oral Semaglutide 25 mg

On May 2, 2025, Novo Nordisk announced the FDA accepted its NDA for a once-daily 25 mg oral formulation of semaglutide (Wegovy) for chronic weight management in adults with obesity or overweight. Based on Phase 3 OASIS 4 trial results, the pill showed significant efficacy in reducing weight in patients with at least one comorbidity. According to Novo Nordisk, this could become the first oral GLP-1 therapy approved for obesity treatment. The drug also aims to reduce cardiovascular risk in patients with established heart disease. The FDA decision is expected in Q4 2025.

FDA Approves Triple Combination Drug GMRx2 (Widaplik) for Hypertension Treatment

On June 9, 2025, the FDA approved GMRx2 (Widaplik), the first single-pill triple combination therapy—telmisartan, amlodipine, and indapamide—approved for initial treatment of hypertension in adults likely needing multiple drugs. Based on positive results from 2 phase 3 trials and the VERONICA study, Widaplik demonstrated superior blood pressure control and good tolerability. According to George Medicines, the pill’s design aligns with global guidelines recommending early use of combination therapy. A US launch is expected in Q4 2025.

Trial Updates

VERVE-102 Safely Cuts LDL-C Levels in Early Phase 1b Results

On April 14, 2025, Verve Therapeutics announced data from their phase 1b Heart-2 trial of VERVE-102 for the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) and/or premature coronary artery disease (CAD). A single infusion of the in vivo gene editing medicine achieved dose-dependent reductions in blood PCSK9 and LDL-C, with a mean LDL-C reduction of ≥50% and a maximum decrease of nearly 70% at the highest dose.

Phase 3 Trial Results Announced for Sotatercept-csrk in Pulmonary Arterial Hypertension

On June 23, 2025, Merck announced positive topline results from the Phase 3 HYPERION trial, showing sotatercept-csrk (WINREVAIR) significantly reduced time to clinical worsening in newly diagnosed PAH patients at intermediate or high risk. Based on a composite primary endpoint, the trial met its goal, with additional benefits seen in walking distance, NT-proBNP levels, and functional class. According to Merck, these findings extend sotatercept’s evidence base to earlier-stage patients, building on prior success in advanced PAH. On July 02, 2025, Merck announced the FDA’s acceptance of their BLA for a label expansion, which was granted Priority Review.

ACHIEVE: Spironolactone Fails to Reduce Cardiovascular Risk in Dialysis Patients

On June 6, 2025, results from the ACHIEVE trial presented at ERA 2025 showed that spironolactone did not significantly reduce cardiovascular death or heart failure hospitalization in dialysis patients. Based on data from over 2,500 participants, the primary outcome occurred in 20.5% of the spironolactone group vs. 21.6% in the placebo group (HR 0.92; P = .35). According to investigators, the findings challenge earlier studies suggesting large cardioprotective benefits. Additionally, spironolactone was associated with a higher rate of severe hyperkalemia, occurring in 6.6% of patients.

Don’t Miss a Beat

During the second quarter of 2025, Don’t Miss a Beat released a trio of episodes, including a pair of in-person episodes from the floor at the American College of Cardiology and the Heart in Diabetes meeting. Check out our episode summaries below!

Treatment Sequencing in New Era of Heart Failure Management

In this episode recorded at ACC 2025, the hosts examine the expanding treatment landscape for HFpEF, advocating for early combination therapy using SGLT2 inhibitors, MRAs, and incretin-based drugs to improve outcomes. They debate rapid versus risk-based implementation, highlight phenotyping for tailored care, and discuss upcoming trials and the promise of fixed-dose combinations to enhance adherence.

CONFIDENCE Trial and Combination T2D, CKD Therapy at Heart in Diabetes 2025

In this episode, the hosts review findings from the CONFIDENCE trial showing that combination therapy with finerenone and empagliflozin significantly outperformed either drug alone in reducing albuminuria in patients with CKD and type 2 diabetes. They discuss the trial’s design, safety profile, and implications for rapid implementation strategies and future fixed-dose combination treatments in cardiorenal care.

Don’t Miss a Beat: Navigating the ATTR-CM Care Landscape, With Ahmad Masri, MD

In this episode, the hosts and their guest discuss major advances in treating transthyretin amyloid cardiomyopathy, highlighting FDA-approved agents like tafamidis, acoramidis, and vutrisiran, while examining challenges such as residual risk, late-stage symptom limitations, and lack of head-to-head data. They also explore future strategies including amyloid-clearing therapies and early intervention trials like ACT-EARLY, which could shift the focus toward prevention in high-risk patients.