New medicine can create a new life for diabetes patients -- without needles!

There are approximately 425 million people worldwide with diabetes. Approximately 75 million of these inject themselves with insulin daily. Now they may soon have a new alternative to syringes or insulin pumps. Scientists have found a new way to supply the body with smart insulin.

The new insulin can be eaten by taking a capsule or even better, within a piece chocolate.

Inside these we find tiny nano-carriers to which the insulin is encapsulated. The particles are 1/10,000th the width of a human hair and so small that you cannot even see them under a normal microscope.

"This way of taking insulin is more precise because it delivers the insulin rapidly to the areas of the body that need it most. When you take insulin with a syringe, it is spread throughout the body where it can cause unwanted side effects," explains Professor Peter McCourt at UiT Norway's Arctic University. He is one of the researchers behind the study.

The research was recently published in Nature Nanotechnology.

Delivered to the liver

It was researchers at the University of Sydney and Sydney Local Health District who, in collaboration with UiT, discovered many years ago that it was possible to deliver medicines via nano-carriers to the liver. The method has then been further developed in Australia and in Europe.

Many medicines can be taken by mouth, but until now people have had to inject insulin into the body. McCourt explains that the problem with insulin with a nano-carrier is that it breaks down in the stomach and thus does not get to where it is needed in the body. This has been a major challenge for developing a diabetes medicine that can be taken orally.

But now the researchers have solved this challenge.

"We have created a coating to protect the insulin from being broken down by stomach acid and digestive enzymes on its way through the digestive system, keeping it safe until it reaches its destination, namely the liver," says McCourt, who is a liver biologist.

The coating is then broken down in the liver by enzymes that are active only when the blood sugar levels are high, releasing the insulin where it can then act in the liver, muscle, and fat to remove sugar from the blood.

"This means that when blood sugar is high, there is a rapid release of insulin, and even more importantly, when blood sugar is low, no insulin is released," says Nicholas J. Hunt at the University of Sydney who, together with Victoria Cogger, leads the project.

He explains that this is a more practical and patient-friendly method of managing diabetes because it greatly reduces the risk of a low blood sugar event occurring, namely hypoglycemia and allows for the controlled released of insulin depending on the patient's needs, unlike injections where all the insulin is released in one shot.

Fewer side effects

The new method works similarly to how insulin works in healthy people. The pancreas produces insulin which first passes through the liver where a large portion of it is absorbed and maintains stable blood sugar levels. In the new insulin method, the nano-carrier releases insulin in the liver, where it can be taken up or enter the blood to circulate in the body.

"When you inject insulin under the skin with a syringe, far more of it goes to the muscles and to adipose tissues that would normally happen if it was released from the pancreas, which can lead to the accumulation of fats. It can also lead to hypoglycemia, which can potentially be dangerous for people with diabetes.

With the new method, there will be fewer such side effects.

In addition, you do not need to stab yourself with a needle and you can take the medicine you need in a slightly more discreet way. Also, this form of insulin does not need to be refrigerated.

Tested on baboons

The oral insulin has been tested on nematodes, on mice and rats. And lastly, the medicine has now been tested on baboons in the National Baboon Colony in Australia.

"In order to make the oral insulin palatable we incorporated it into sugar-free chocolate, this approach was well received" says Hunt.

He says that 20 baboons have taken part in this study. When they received the medicine, their blood sugar was lowered.

The baboons were normal, healthy baboons, but the oral insulin have also been tested on mice and rats that actually have diabetes. The mice and rats did not have low blood sugar events (hypoglycemia), gain weight or fat accumulation in the liver overcoming current challenges with injectable and other oral insulins.

What remains now is to test the new method on humans.

Ready for use in 2-3 years

"Trials on humans will start in 2025 led by the spin out company Endo Axiom Pty Ltd. Clinical trials are performed in 3 phases; in the phase I trial we will investigate the safety of the oral insulin and critically look at the incidence of hypoglycemia in healthy and type 1 diabetic patients. Our team is very excited to see if we can reproduce the absent hypoglycemia results seen in baboons in humans as this would be a huge step forward. The experiments follow strict quality requirements and must be carried out in collaboration with physicians to ensure that they are safe for the test subjects" says Hunt.

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Generating power with blood sugar

In type 1 diabetes, the body does not produce insulin. This means that patients have to obtain the hormone externally to regulate their blood sugar levels. Nowadays, this is mostly done via insulin pumps that are attached directly to the body. These devices, as well as other medical applications such as pacemakers, require a reliable energy supply, which at present is met primarily by power from either single-use or rechargeable batteries.

Now, a team of researchers led by Martin Fussenegger from the Department of Biosystems Science and Engineering at ETH Zurich in Basel have put a seemingly futuristic idea into practice. They have developed an implantable fuel cell that uses excess blood sugar (glucose) from tissue to generate electrical energy. The researchers have combined the fuel cell with artificial beta cells developed by their group several years ago. These produce insulin at the touch of a button and effectively lower blood glucose levels much like their natural role models in the pancreas.

"Many people, especially in the Western industrialised nations, consume more carbohydrates than they need in everyday life," Fussenegger explains. This, he adds, leads to obesity, diabetes and cardiovascular disease. "This gave us the idea of using this excess metabolic energy to produce electricity to power biomedical devices," he says.

Fuel cell in tea bag format

At the heart of the fuel cell is an anode (electrode) made of copper-based nanoparticles, which Fussenegger's team created specifically for this application. It consists of copper-based nanoparticles and splits glucose into gluconic acid and a proton to generate electricity, which sets an electric circuit in motion.

Wrapped in a nonwoven fabric and coated with alginate, an algae product approved for medical use, the fuel cell resembles a small tea bag that can be implanted under the skin. The alginate soaks up body fluid and allows glucose to pass from the tissue into the fuel cell within.

A diabetes network with its own power supply

In a second step, the researchers coupled the fuel cell with a capsule containing artificial beta cells. These can be stimulated to produce and secrete insulin using electric current or blue LED light. Fussenegger and his colleagues already tested such designer cells some time ago (see ETH News, 8 December 2016).

The system combines sustained power generation and controlled insulin delivery. As soon as the fuel cell registers excess glucose, it starts to generate power. This electrical energy is then used to stimulate the cells to produce and release insulin into the blood. As a result, blood sugar dips to a normal level. Once it falls below a certain threshold value, the production of electricity and insulin stops.

The electrical energy provided by the fuel cell is sufficient not only to stimulate the designer cells but also to enable the implanted system to communicate with external devices such as a smartphone. This allows potential users to adjust the system via a corresponding app. A doctor could also access it remotely and make adjustments. "The new system autonomously regulates insulin and blood glucose levels and could be used to treat diabetes in the future," Fussenegger says.

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Intermittent fasting may reverse type 2 diabetes

After an intermittent fasting diet intervention, patients achieved complete diabetes remission, defined as an HbA1c (average blood sugar) level of less than 6.5% at least one year after stopping diabetes medication, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Intermittent fasting diets have become popular in recent years as an effective weight loss method. With intermittent fasting, you only eat during a specific window of time. Fasting for a certain number of hours each day or eating just one meal a couple of days a week can help your body burn fat. Research shows intermittent fasting can lower your risk of diabetes and heart disease.

"Type 2 diabetes is not necessarily a permanent, lifelong disease. Diabetes remission is possible if patients lose weight by changing their diet and exercise habits," said Dongbo Liu, Ph.D., of Hunan Agricultural University in Changsha, China. "Our research shows an intermittent fasting, Chinese Medical Nutrition Therapy (CMNT), can lead to diabetes remission in people with type 2 diabetes, and these findings could have a major impact on the over 537 million adults worldwide who suffer from the disease."

The researchers conducted a 3-month intermittent fasting diet intervention among 36 people with diabetes and found almost 90% of participants, including those who took blood sugar-lowering agents and insulin, reduced their diabetes medication intake after intermittent fasting. Fifty-five percent of these people experienced diabetes remission, discontinued their diabetes medication and maintained it for at least one year.

The study challenges the conventional view that diabetes remission can only be achieved in those with a shorter diabetes duration (0-6 years). Sixty-five percent of the study participants who achieved diabetes remission had a diabetes duration of more than 6 years (6-11 years).

"Diabetes medications are costly and a barrier for many patients who are trying to effectively manage their diabetes. Our study saw medication costs decrease by 77% in people with diabetes after intermittent fasting," Liu said.

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Why some people are mosquito magnets

It's impossible to hide from a female mosquito -- she will hunt down any member of the human species by tracking our CO2 exhalations, body heat, and body odor. But some of us are distinct "mosquito magnets" who get more than our fair share of bites. Blood type, blood sugar level, consuming garlic or bananas, being a woman, and being a child are all popular theories for why someone might be a preferred snack. Yet for most of them, there is little credible data, says Leslie Vosshall, head of Rockefeller's Laboratory of Neurogenetics and Behavior.

This is why Vosshall and Maria Elena De Obaldia, a former postdoc in her lab, set out to explore the leading theory to explain varying mosquito appeal: individual odor variations connected to skin microbiota. They recently demonstrated through a study that fatty acids emanating from the skin may create a heady perfume that mosquitoes can't resist. They published their results in Cell.

"There's a very, very strong association between having large quantities of these fatty acids on your skin and being a mosquito magnet," says Vosshall, the Robin Chemers Neustein Professor at The Rockefeller University and Chief Scientific Officer of the Howard Hughes Medical Institute.

A tournament no one wants to win

In the three-year study, eight participants were asked to wear nylon stockings over their forearms for six hours a day. They repeated this process on multiple days. Over the next few years, the researchers tested the nylons against each other in all possible pairings through a round-robin style "tournament." They used a two-choice olfactometer assay that De Obaldia built, consisting of a plexiglass chamber divided into two tubes, each ending in a box that held a stocking. They placed Aedes Aegypti mosquitoes -- the primary vector species for Zika, dengue, yellow fever, and chikungunya -- in the main chamber and observed as the insects flew down the tubes towards one nylon or the other.

By far the most compelling target for Aedes aegypti was Subject 33, who was four times more attractive to the mosquitoes than the next most-attractive study participant, and an astonishing 100 times more appealing than the least attractive, Subject 19.

The samples in the trials were de-identified, so the experimenters didn't know which participant had worn which nylon. Still, they would notice that something unusual was afoot in any trial involving Subject 33, because insects would swarm towards that sample. "It would be obvious within a few seconds of starting the assay," says De Obaldia. "It's the type of thing that gets me really excited as a scientist. This is something real. This is not splitting hairs. This is a huge effect."

The researchers sorted the participants into high and low attractors, and then asked what differentiated them. They used chemical analysis techniques to identify 50 molecular compounds that were elevated in the sebum (a moisturizing barrier on the skin) of the high-attracting participants. From there, they discovered that mosquito magnets produced carboxylic acids at much higher levels than the less-attractive volunteers. These substances are in the sebum and are used by bacteria on our skin to produce our unique human body odor.

To confirm their findings, Vosshall's team enrolled another 56 people for a validation study. Once again, Subject 33 was the most alluring, and stayed so over time.

"Some subjects were in the study for several years, and we saw that if they were a mosquito magnet, they remained a mosquito magnet," says De Obaldia. "Many things could have changed about the subject or their behaviors over that time, but this was a very stable property of the person."

Even knockouts find us

Humans produce mainly two classes of odors that mosquitoes detect with two different sets of odor receptors: Orco and IR receptors. To see if they could engineer mosquitoes unable to spot humans, the researchers created mutants that were missing one or both of the receptors. Orco mutants remained attracted to humans and able to distinguish between mosquito magnets and low attractors, while IR mutants lost their attraction to humans to a varying degree, but still retained the ability to find us.

These were not the results the scientists were hoping for. "The goal was a mosquito that would lose all attraction to people, or a mosquito that had a weakened attraction to everybody and couldn't discriminate Subject 19 from Subject 33. That would be tremendous," Vosshall says, because it could lead to the development of more effective mosquito repellents. "And yet that was not what we saw. It was frustrating."

These results complement one of Vosshall's recent studies, also published in Cell, which revealed the redundancy of Aedes aegypti's exquisitely complex olfactory system. It's a failsafe that the female mosquito relies on to live and reproduce. Without blood, she can't do either. That's why "she has a backup plan and a backup plan and a backup plan and is tuned to these differences in the skin chemistry of the people she goes after," Vosshall says.

The apparent unbreakability of the mosquito scent tracker makes it difficult to envision a future where we're not the number-one meal on the menu. But one potential avenue is to manipulate our skin microbiomes. It is possible that slathering the skin of a high-appeal person like Subject 33 with sebum and skin bacteria from the skin of a low-appeal person like Subject 19 could provide a mosquito-masking effect.

"We haven't done that experiment," Vosshall notes. "That's a hard experiment. But if that were to work, then you could imagine that by having a dietary or microbiome intervention where you put bacteria on the skin that are able to somehow change how they interact with the sebum, then you could convert someone like Subject 33 into a Subject 19. But that's all very speculative."

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Non-nutritive sweeteners affect human microbiomes and can alter glycemic responses

Since the late 1800s non-nutritive sweeteners have promised to deliver all the sweetness of sugar with none of the calories. They have long been believed to have no effect on the human body, but researchers publishing in the journal Cell on August 19 challenge this notion by finding that these sugar substitutes are not inert, and, in fact, some can alter human consumers' microbiomes in a way that can change their blood sugar levels.

In 2014, senior author Eran Elinav an immunologist and microbiome researcher at the Weizmann Institute of Science and the German National Cancer Center (DKFZ) and his team found that non-nutritive sweeteners affected the microbiomes of mice in ways that could impact their glycemic responses. The team was interested in whether these results would also be found in humans.

To address this important question, the research team carefully screened over 1300 individuals for those who strictly avoid non-nutritive sweeteners in their day-to-day lives, and identified a cohort of 120 individuals. These participants were broken into six groups: two controls and four who ingested well below the FDA daily allowances of either aspartame, saccharin, stevia, or sucralose.

"In subjects consuming the non-nutritive sweeteners, we could identify very distinct changes in the composition and function of gut microbes, and the molecules they secret into peripheral blood. This seemed to suggest that gut microbes in the human body are rather responsive to each of these sweeteners," says Elinav. "When we looked at consumers of non-nutritive sweeteners as groups, we found that two of the non-nutritive sweeteners, saccharin and sucralose, significantly impacted glucose tolerance in healthy adults. Interestingly, changes in the microbes were highly correlated with the alterations noted in people's glycemic responses."

To establish causation, the researchers transferred microbial samples from the study subjects to germ-free mice -- mice that have been raised in completely sterile conditions and have no microbiome of their own.

"The results were quite striking," says Elinav. "In all of the non-nutritive sweetener groups, but in none of the controls, when we transferred into these sterile mice the microbiome of the top responder individuals collected at a time point in which they were consuming the respective non-nutritive sweeteners, the recipient mice developed glycemic alterations that very significantly mirrored those of the donor individuals. In contrast, the bottom responders' microbiomes were mostly unable to elicit such glycemic responses," he adds. "These results suggest that the microbiome changes in response to human consumption of non-nutritive sweetener may, at times, induce glycemic changes in consumers in a highly personalized manner."

Elinav says that he expects the effects of the sweeteners will vary person to person because of the incredibly unique composition of our microbiome. "We need to raise awareness of the fact that non-nutritive sweeteners are not inert to the human body as we originally believed. With that said, the clinical health implications of the changes they may elicit in humans remain unknown and merit future long-term studies."

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Multi-tasking wearable continuously monitors glucose, alcohol, and lactate

Imagine being able to measure your blood sugar levels, know if you've had too much to drink, and track your muscle fatigue during a workout, all in one small device worn on your skin. Engineers at the University of California San Diego have developed a prototype of such a wearable that can continuously monitor several health stats -- glucose, alcohol, and lactate levels -- simultaneously in real-time.

The device is about the size of a stack of six quarters. It is applied to the skin through a Velcro-like patch of microscopic needles, or microneedles, that are each about one-fifth the width of a human hair. Wearing the device is not painful -- the microneedles barely penetrate the surface of the skin to sense biomolecules in interstitial fluid, which is the fluid surrounding the cells beneath the skin. The device can be worn on the upper arm and sends data wirelessly to a custom smartphone app.

Researchers at the UC San Diego Center for Wearable Sensors describe their device in a paper published May 9 in Nature Biomedical Engineering.

"This is like a complete lab on the skin," said center director Joseph Wang, a professor of nanoengineering at UC San Diego and co-corresponding author of the paper. "It is capable of continuously measuring multiple biomarkers at the same time, allowing users to monitor their health and wellness as they perform their daily activities."

Most commercial health monitors, such as continuous glucose monitors for patients with diabetes, only measure one signal. The problem with that, the researchers said, is that it leaves out information that could help people with diabetes, for example, manage their disease more effectively. Monitoring alcohol levels is useful because drinking alcohol can lower glucose levels. Knowing both levels can help people with diabetes prevent their blood sugar from dropping too low after having a drink. Combining information about lactate, which can be monitored during exercise as a biomarker for muscle fatigue, is also useful because physical activity influences the body's ability to regulate glucose.

"With our wearable, people can see the interplay between their glucose spikes or dips with their diet, exercise and drinking of alcoholic beverages. That could add to their quality of life as well," said Farshad Tehrani, a nanoengineering Ph.D. student in Wang's lab and one of the co-first authors of the study.

Microneedles merged with electronics

The wearable consists of a microneedle patch connected to a case of electronics. Different enzymes on the tips of the microneedles react with glucose, alcohol and lactate in interstitial fluid. These reactions generate small electric currents, which are analyzed by electronic sensors and communicated wirelessly to an app that the researchers developed. The results are displayed in real time on a smartphone.

An advantage of using microneedles is that they directly sample the interstitial fluid, and research has shown that biochemical levels measured in that fluid correlate well with levels in blood.

"We're starting at a really good place with this technology in terms of clinical validity and relevance," said Patrick Mercier, a professor of electrical and computer engineering at UC San Diego and co-corresponding author of the paper. "That lowers the barriers to clinical translation."

The microneedle patch, which is disposable, can be detached from the electronic case for easy replacement. The electronic case, which is reusable, houses the battery, electronic sensors, wireless transmitter and other electronic components. The device can be recharged on any wireless charging pad used for phones and smartwatches.

Integrating all these components together into one small, wireless wearable was one of the team's biggest challenges. It also required some clever design and engineering to combine the reusable electronics, which must stay dry, with the microneedle patch, which gets exposed to biological fluid.

"The beauty of this is that it is a fully integrated system that someone can wear without being tethered to benchtop equipment," said Mercier, who is also the co-director of the UC San Diego Center for Wearable Sensors.

Testing

The wearable was tested on five volunteers, who wore the device on their upper arm, while exercising, eating a meal, and drinking a glass of wine. The device was used to continuously monitor the volunteers' glucose levels simultaneously with either their alcohol or lactate levels. The glucose, alcohol and lactate measurements taken by the device closely matched the measurements taken respectively by a commercial blood glucose monitor, Breathalyzer, and blood lactate measurements performed in the lab.

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Eating whole grains linked to smaller increases in waist size, blood pressure, blood sugar

Middle- to older-aged adults who ate at least three servings of whole grains daily had smaller increases in waist size, blood pressure, and blood sugar levels over time compared to those who ate less than one-half serving per day, according to new research.

Published July 13, 2021, in the Journal of Nutrition, the study by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University examined how whole- and refined-grain intake over time impacted five risk factors of heart disease: Waist size, blood pressure, blood sugar, triglyceride, and HDL ("good") cholesterol.

Using data from the Framingham Heart Study Offspring Cohort, which began in the 1970s to assess long-term risk factors of heart disease, the new research examined health outcomes associated with whole- and refined-grain consumption over a median of 18 years. The 3,100 participants from the cohort were mostly white and, on average, in their mid-50s at the start of data collection.

The research team compared changes in the five risk factors, over four-year intervals, across four categories of reported whole grain intake, ranging from less than a half serving per day to three or more servings per day. According to the Dietary Guidelines for Americans 2020-2025, the recommended amount of whole grains is three or more servings daily. An example of a serving is one slice of whole-grain bread, a half cup of rolled oats cereal, or a half cup of brown rice.

The results showed that for each four-year interval:
 

• Waist size increased by an average of over 1 inch in the low intake participants, versus about ½ inch in the high intake participants.
   
• Even after accounting for changes in waist size, average increases in blood sugar levels and systolic blood pressure were greater in low intake participants compared to high intake participants.

The researchers also studied the five risk factors across four categories of refined-grain intake, ranging from less than two servings per day to more than four servings per day. Lower refined-grain intake led to a lower average increase in waist size and a greater mean decline in triglyceride levels for each four-year period.

"Our findings suggest that eating whole-grain foods as part of a healthy diet delivers health benefits beyond just helping us lose or maintain weight as we age. In fact, these data suggest that people who eat more whole grains are better able to maintain their blood sugar and blood pressure over time. Managing these risk factors as we age may help to protect against heart disease," said Nicola McKeown, senior and corresponding author and a scientist on the Nutritional Epidemiology Team at the USDA HNRCA.

"There are several reasons that whole grains may work to help people maintain waist size and reduce increases in the other risk factors. The presence of dietary fiber in whole grains can have a satiating effect, and the magnesium, potassium, and antioxidants may contribute to lowering blood pressure. Soluble fiber in particular may have a beneficial effect on post-meal blood sugar spikes," said Caleigh Sawicki. Sawicki did this work as part of her doctoral dissertation while a student at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University and while working with the Nutritional Epidemiology Team at the USDA HNRCA.

The greatest contributor to whole-grain intake among participants was whole-wheat breads and ready-to-eat whole-grain breakfast cereals. The refined grains came mostly from pasta and white bread. The difference in health benefits between whole and refined grains may stem from the fact that whole grains are less processed than refined grains. Whole grains have a fiber-rich outer layer and an inner germ layer packed with B vitamins, antioxidants, and small amounts of healthy fats. Milling whole grains removes these nutrient-dense components, leaving only the starch-packed refined grain behind.

"The average American consumes about five servings of refined grains daily, much more than is recommended, so it's important to think about ways to replace refined grains with whole grains throughout your day. For example, you might consider a bowl of whole-grain cereal instead of a white flour bagel for breakfast and replacing refined-grain snacks, entrees, and side dishes with whole-grain options. Small incremental changes in your diet to increase whole-grain intake will make a difference over time," McKeown said.

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Why some of us are hungry all the time

 New research shows that people who experience big dips in blood sugar levels, several hours after eating, end up feeling hungrier and consuming hundreds more calories during the day than others.

A study published today in Nature Metabolism, from PREDICT, the largest ongoing nutritional research program in the world that looks at responses to food in real life settings, the research team from King's College London and health science company ZOE (including scientists from Harvard Medical School, Harvard T.H. Chan School of Public Health, Massachusetts General Hospital, the University of Nottingham, Leeds University, and Lund University in Sweden) found why some people struggle to lose weight, even on calorie-controlled diets, and highlight the importance of understanding personal metabolism when it comes to diet and health.

The research team collected detailed data about blood sugar responses and other markers of health from 1,070 people after eating standardized breakfasts and freely chosen meals over a two-week period, adding up to more than 8,000 breakfasts and 70,000 meals in total. The standard breakfasts were based on muffins containing the same amount of calories but varying in composition in terms of carbohydrates, protein, fat and fibre. Participants also carried out a fasting blood sugar response test (oral glucose tolerance test), to measure how well their body processes sugar.

Participants wore stick-on continuous glucose monitors (CGMs) to measure their blood sugar levels over the entire duration of the study, as well as a wearable device to monitor activity and sleep. They also recorded levels of hunger and alertness using a phone app, along with exactly when and what they ate over the day.

Previous studies looking at blood sugar after eating have focused on the way that levels rise and fall in the first two hours after a meal, known as a blood sugar peak. However, after analyzing the data, the PREDICT team noticed that some people experienced significant 'sugar dips' 2-4 hours after this initial peak, where their blood sugar levels fell rapidly below baseline before coming back up.

Big dippers had a 9% increase in hunger, and waited around half an hour less, on average, before their next meal than little dippers, even though they ate exactly the same meals.

Big dippers also ate 75 more calories in the 3-4 hours after breakfast and around 312 calories more over the whole day than little dippers. This kind of pattern could potentially turn into 20 pounds of weight gain over a year.

Dr Sarah Berry from King's College London said, "It has long been suspected that blood sugar levels play an important role in controlling hunger, but the results from previous studies have been inconclusive. We've now shown that sugar dips are a better predictor of hunger and subsequent calorie intake than the initial blood sugar peak response after eating, changing how we think about the relationship between blood sugar levels and the food we eat."

Professor Ana Valdes from the School of Medicine at the University of Nottingham, who led the study team, said: "Many people struggle to lose weight and keep it off, and just a few hundred extra calories every day can add up to several pounds of weight gain over a year. Our discovery that the size of sugar dips after eating has such a big impact on hunger and appetite has great potential for helping people understand and control their weight and long-term health."

Comparing what happens when participants eat the same test meals revealed large variations in blood sugar responses between people. The researchers also found no correlation between age, bodyweight or BMI and being a big or little dipper, although males had slightly larger dips than females on average.

There was also some variability in the size of the dips experienced by each person in response to eating the same meals on different days, suggesting that whether you're a dipper or not depends on individual differences in metabolism, as well as the day-to-day effects of meal choices and activity levels.

Choosing foods that work together with your unique biology could help people feel fuller for longer and eat less overall.

Lead author on the study, Patrick Wyatt from ZOE, notes, "This study shows how wearable technology can provide valuable insights to help people understand their unique biology and take control of their nutrition and health. By demonstrating the importance of sugar dips, our study paves the way for data-driven, personalized guidance for those seeking to manage their hunger and calorie intake in a way that works with rather than against their body."

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