Latest from Medical News Today
Medical News Today
2 hours ago
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- Medical News Today
Insulin resistance test may help predict early Alzheimer's cognitive decline rate
There is currently no tool for predicting how quickly early stage Alzheimer's disease will progress. A new study has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The test found that higher insulin resistance indicated quicker deterioration in cognitive estimate that about 69 million people around the world are living with prodromal Alzheimer's disease, or early stage Alzheimer's disease. People in the earliest stage of Alzheimer's disease begin to experience some mild cognitive impairment that may affect their memory and ability to complete tasks and communicate. Past studies show that detecting Alzheimer's disease in its earliest stage allows currently available medications and lifestyle changes to be more effective in helping to slow down disease progression. 'Alzheimer's (disease) begins silently, often decades before symptoms appear, and so detecting risk early is essential to slow or alter the disease course,' Bianca Gumina, MD, a neurology resident for the Neurology Unit in the Department of Clinical and Experimental Sciences at the University of Brescia and for the Neurology Unit in the Department of Continuity of Care and Frailty at ASST Spedali Civili Hospital, both in Italy, told Medical News Today. 'Current tools can diagnose the disease, but they don't always predict how fast it will progress. Identifying individuals at higher risk of rapid decline [c]ould allow for timely, targeted interventions during a critical window when the disease could be still responsive to treatment or changes in (lifestyle),' she is part of the research team for a study recently presented at the European Academy of Neurology (EAN) Congress 2025 that has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The findings of the study are yet to be published in a peer-reviewed TyG Index Test for Alzheimer'sFor this study, researchers analyzed medical records from 315 adults with an average age of about 70 that did not have diabetes. Two hundred of the study participants had received biological confirmation they had Alzheimer's disease. All study participants received insulin resistance assessment using a test called the triglyceride-glucose (TyG) index, with a clinical follow-up three years later. 'The TyG index is a validated marker of insulin resistance, a condition often seen in prediabetes or metabolic syndrome,' Gumina explained. 'It combines triglycerides and fasting blood glucose, two common and non-invasive blood values. (It is) easy to calculate and already available in routine labs.' Higher TyG index results predict quicker cognitive declineAt the study's conclusion, the research team found that when grouping study participants by their TyG index results, those in the highest TyG index group experienced a quicker deterioration in cognitive decline than those with lower TyG index results. 4-fold higher risk'This finding is significant because it highlights a vulnerable window (mild cognitive impairment, the early phase of the disease) when the disease may be especially sensitive to metabolic stress. Patients in this early phase with high TyG levels had a fourfold increased risk of rapid cognitive decline compared to those with lower TyG levels. This suggests that insulin resistance may actively influence how fast Alzheimer's progresses, and identifying this risk early could open new avenues for intervention.'— Bianca Gumina, MD'The TyG index is a low-cost, widely available tool that could be easily integrated into routine clinical practice to flag patients at higher risk of rapid decline,' she continued. 'By identifying these individuals early, clinicians could prioritize them for closer monitoring, lifestyle interventions, or even enrollment in clinical trials, maybe individualizing sub phenotypes of the disease. It also supports the development of metabolic-based treatment strategies, potentially paving the way for therapies targeting insulin resistance to modify disease progression.'As for the next steps in this research, Gumina said the research group is currently exploring whether the TyG index also correlates with neuroimaging biomarkers of brain degeneration. 'The next goal is to integrate metabolic profiling with genetic and imaging data to refine risk models and guide early, personalized interventions,' she added. New potential variable for Alzheimer's progression predictionsMNT spoke with Rehan Aziz, MD, geriatric psychiatrist at Jersey Shore University Medical Center in New Jersey, about this study. Aziz commented that he thought this was a very interesting study involving a new variable to consider when working with patients in the early stages of Alzheimer's dementia, especially as it may predict who is likely to decline faster.'Accurate progression prediction is crucial for multiple reasons,' he explained. 'It empowers families to make informed decisions about care planning, financial arrangements, and how to prioritize quality time together. Clinically, it helps us identify patients who need more intensive monitoring and earlier intervention.''With new disease-modifying treatments like aducanumab and lecanemab becoming available — treatments that carry real risks including brain swelling and bleeding — we urgently need better ways to identify which patients are most likely to benefit from aggressive treatment versus those who might have slower progression,' Aziz continued.'This metabolic marker could help us personalize the risk-benefit calculation for each patient, ensuring we're offering these powerful but potentially risky therapies to those who need them most while protecting slower-progressing patients from unnecessary exposure.'— Rehan Aziz, MDAziz said he'd like to see this study's results validated in larger populations. 'We also need longer follow-up studies to see if this predictive power holds over five to 10 years,' he continued. 'I'm particularly interested in whether interventions targeting insulin resistance — like lifestyle modifications or medications like metformin — could actually slow progression in high-TyG patients. Finally, I'd like to see this integrated with other biomarkers to create a more comprehensive risk stratification tool.' More information on how Alzheimer's progressesMNT also spoke with Peter Gliebus, MD, director of cognitive and behavioral neurology at Marcus Neuroscience Institute, part of Baptist Health South Florida, about this commented that he found the study both fascinating and highly applicable to daily clinical practice. 'As clinicians, we frequently encounter questions from patients and their families, such as, 'How quickly will it worsen?'— and we often don't have a definitive answer,' he explained. 'The prospect that a simple, cost-effective marker like the TyG index could predict progression in Alzheimer's disease is extremely encouraging. It has the potential to bridge an important gap between diagnosis and practical prognosis, which has been a missing element in this field,' he said.'Early-stage Alzheimer's, especially during the mild cognitive impairment stage, exhibits significant variability-some individuals remain stable for years, while others decline rapidly. Identifying those at higher risk of swift decline enables us to customize clinical care and research strategies. It also helps families set clearer expectations and facilitates early, potentially more effective interventions, whether through lifestyle changes, medications or future planning.' — Peter Gliebus, MD'As new treatments are developed, timing and patient stratification will be essential — tools like the TyG index may play a crucial role in that process,' he added.
Medical News Today
a day ago
- Health
- Medical News Today
Alternative to GLP-1 drugs may treat diabetes, weight loss without muscle loss
A new study published by Swedish researchers shared results of the clinical trial of a new drug that aids weight loss in people with type 2 diabetes and obesity. The medication is taken orally and has a different method of activation compared to the popular GLP-1 drugs. The new drug works through skeletal muscle metabolism, which the researchers say preserves muscle mass during weight of people in the United States have type 2 diabetes and/or obesity. Many of the drugs that treat these often cause people to lose muscle mass. Muscle mass loss can cause a loss of strength and slow metabolism. Osteoporosis is also a concern when losing muscle mass, especially in older people. Researchers affiliated with the Karolinska Institute and Stockholm University, both in Sweden, have developed a new drug that treats type 2 diabetes and obesity without impacting muscle recently conducted an initial phase 1 clinical trial to determine how well humans tolerate the drug. The findings appear in the journal alternative aims to preserve muscle massGLP-1 drugs, including the popular semaglutide medications Ozempic and Wegovy, work by reducing hunger signals in the brain and slowing gastric emptying. While these drugs aid in weight loss, some studies have shown that they can reduce lean muscle mass by up to 60%. Swedish researchers developed a new drug in tablet form that activates metabolism in the muscles. In animal trials, it avoided the muscle loss side effect of GLP-1 drugs. Muscle tissue is metabolically active, so it burns more calories at rest than fat. When someone loses muscle during weight loss, this causes their resting metabolic rate to slow, which can make it tough to continue losing weight or maintain weight also helps regulate blood sugar by absorbing glucose from the bloodstream. Losing muscle can make blood sugar harder to control and worsen insulin new drug is based on a beta-2 molecule. Beta-2 medications can cause an increased risk for heart problems, but the researchers say the way they developed the new drug causes 'little or no increase' in cardiac lesions or hypertrophy. After conducting animal trials with the medication, researchers moved to their first trial involving humans to see how well they tolerated the medication. The trial consisted of 48 healthy people and 25 people with type 2 groups took the 2.5 mg tablet once daily for 28 days. The scientists tracked various health metrics from the participants including heart rate and blood tolerate the new drug wellBoth healthy participants and participants with type 2 diabetes were able to tolerate the drug well overall. The researchers noted that a side effect of the drug caused 'a mild and transient reflex-driven increase in heart rate' early in the trial. This side effect did not persist by day 28 of the trial, and the authors said there was no significant difference in the heart rate or blood pressure between the groups. The authors said one participant had a severe adverse event related to the drug. However, the researchers noted that it occurred in 'a patient with preexisting cardiac abnormalities that resolved without complications, and its connection to the study drug remains uncertain.' The participants all had plasma levels consistent with being at a therapeutic level for the medication at the end of the trial. The researchers found this reassuring since it showed that participants were taking the medication as prescribed and validated the heart metrics recorded. Since this phase of the trial was successful, the next step is a longer clinical phase 2 trial. This trial will see how the drug affects people with type 2 diabetes and/or obesity in terms of muscle mass, glucose levels, and insulin weight-loss drug shows promiseMir Ali, MD, a board certified general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center, spoke with Medical News Today about the trial.'This seems to be a promising drug that could be a potential weight loss and diabetes medication,' said Ali, who was not involved in this noted that a clinical trial is needed comparing the medication to the GLP-1 drugs available. 'Often, the real-world results vary significantly from initial studies,' he pointed out. The doctor also touched on why a weight loss drug that does not cause muscle loss is so important:'Preserving muscle mass is important in any kind of weight loss; the goal is to lose fat and not muscle. Losing muscle leads to weakness and a slower metabolic rate; more muscle means more calories are burned, even at rest; therefore, anything that helps preserve muscle is important.'Maria Knöbel, MBBS, medical director of Medical Cert UK, similarly who was not involved in the recent research, also spoke with MNT about the trial results. Knöbel said that, with her patients who lose weight, she has noticed that 'a great decline in musculature levels occurs, and this increases their insulin resistance and further complicates their disease.''The trial of this drug is promising since it is a solution to this issue since it provides a means of losing fat without losing muscles,' she noted. 'The saving of muscle mass with weight loss in these patients would be instrumental to the long-term control of glucose and would lead to better outcomes concerning their diabetes treatment.'
Medical News Today
2 days ago
- Health
- Medical News Today
Can a person donate part of their liver to someone with cirrhosis?
Yes, a person can donate part of their liver to another person with cirrhosis. If someone donates part of their liver to another person, healthcare professionals may refer to them as a living donor. If a person wants to donate part of their liver to someone with cirrhosis, they will need to be able to understand and follow instructions before and after surgery, and be between the ages of 18 and 60 the person donating part of their liver will have an emotional tie to the person receiving the liver transplant, but this is not a necessary requirement to donate the a person who wants to donate part of their liver meets the criteria above, the transplant team will:ask about their medical historydetermine whether their blood type matches the person with cirrhosisdetermine whether they have a similar body size to the person with cirrhosisperform medical tests to work out if they have any major health issuesIf the person is a suitable donor, healthcare professionals may schedule the liver transplant surgery 4 to 6 weeks in advance, but the exact timing is variable depending on the situation. The procedure itself may take up to 12 hours or more, and the surgical team will operate on both the person donating part of their liver and the person with cirrhosis at the same the surgery, the person who has donated part of their liver will typically be able to go home after about a week, while the person who has received the liver transplant will typically be able to go home after about 2 more information about liver donation, people should contact a healthcare professional or visit the Organ Procurement and Transplantation Network or United Network for Organ Sharing more about cirrhosisWhat are the early signs of cirrhosis?Is it possible to reverse cirrhosis?What to know about decompensated cirrhosisWhat is the life expectancy for cirrhosis of the liver?
Medical News Today
2 days ago
- Health
- Medical News Today
What to know about liver cirrhosis and ascites
Liver cirrhosis is the scarring of the liver due to long-term damage. This damage can be caused by:chronic alcohol usehepatitis B or Cfatty liver diseaseother liver conditionsAs scar tissue replaces healthy liver tissue, the liver can no longer function is the accumulation of fluid in the abdominal cavity, causing swelling and discomfort. It's a common complication of cirrhosis. Cirrhosis causes increased pressure in the portal vein (called portal hypertension) and reduces the liver's ability to make proteins like albumin, which help keep fluid in the blood vessels. As a result, fluid leaks out of the blood vessels, collects in the abdomen, and leads to ascites. Symptoms of ascites include: a swollen abdomenweight gainshortness of breath feeling full quicklyfatigue and discomfortDoctors can diagnose ascites with a physical exam, ultrasound, CT scan, or paracentesis, where a needle draws out fluid to test for infection or cancer. Having liver cirrhosis increases the risk of developing liver cancer. Treatments for liver cirrhosis and ascites include: low sodium dietdiuretics paracentesis for large or painful ascitesalbumin infusions in some casesTreating the underlying liver disease is essential. A liver transplant may be needed in severe cases.
Medical News Today
2 days ago
- Health
- Medical News Today
Is the keto diet good for liver cirrhosis?
The ketogenic or keto diet is a high fat, low-carbohydrate eating plan. While some early studies suggest that keto may improve liver function in certain conditions like nonalcoholic fatty liver disease (NAFLD), its effects on advanced liver damage, such as cirrhosis, are less clear and potentially cirrhosis is the final stage of chronic liver damage, where healthy tissue is replaced with scar tissue, impairing liver function. Diet plays a critical role in managing cirrhosis, and healthcare professionals often advise people to follow a balanced diet that supports liver health and prevents further several animal studies suggest that the keto diet may worsen liver injury in the context of fibrosis or cirrhosis. A 2021 study in mice found that a high fat ketogenic diet increased cholesterol buildup in the liver. It also noted that the keto diet increased liver inflammation and markers of findings suggest that in cases of existing liver damage, a keto diet may accelerate liver dysfunction rather than improve in some short-term human studies, results are more promising. A 2020 study showed that a 6-day controlled ketogenic diet in adults with nonalcoholic fatty liver disease showed rapid reductions in liver fat and better insulin resistance. A 2025 review of very-low-calorie keto diets (VLCKD) showed substantial reductions in liver fat, improved insulin sensitivity, and lower liver enzyme levels. However, it noted that long-term safety data, especially in cirrhosis, are still limited. These studies suggest short-term benefits in reducing fat and inflammation in early liver disease, but they involved people with fatty liver before cirrhosis represents advanced, irreversible liver damage. Most keto studies exclude patients with cirrhosis, and animal data warn of possible harm from increased fibrosis and ketogenic diets may help reverse liver fat and early fibrosis, there is no strong evidence supporting their safety or benefit in established with liver disease who is considering a major dietary change like the keto diet should do so only under the close guidance of a hepatologist or clinical nutrition specialist. More research is needed to determine whether this type of diet is safe or effective in cirrhosis management.
