With diabetes reaching epidemic proportions, the search is on for innovative ways to reduce the burden. Breaking research finds hope in the most surprising of places - chocolate.
Today, there are an estimated 29 million Americans living with diabetes, with the vast majority of cases being type 2 diabetes. Globally, by 2035, there could be 592 million people with diabetes. This is no small problem.
Beyond those Americans who already have a diabetes diagnosis, a further 86 million adults - more than 1 in 3 Americans - have prediabetes, a precursor to the disease. Without intervention (diet and exercise), diabetes is likely to be the next step for these individuals, often within 5 years.
Diabetes is costly in human terms, of course, but it is also a huge financial drain; in 2012, diabetes and its complications accounted for $245 billion in total medical costs and lost work and wages, up from $174 billion just 5 years earlier. The statistics are overwhelming.
Although type 2 diabetes is largely preventable through lifestyle choices, at this point in time, more needs to be done to stem the flow and turn the tide.
Finding potential medical interventions for people at risk of developing type 2 diabetes is more pressing than ever. Research, recently published in The Journal of Nutritional Biochemistry, investigates whether a compound found in cocoa could be useful in the fight.
Diabetes, insulin, and beta cells
At the root of diabetes is the hormone insulin, which is produced, stored, and released by beta cells in the pancreas. Insulin is responsible for controlling and regulating levels of sugar in the blood; it ensures that blood sugar levels never gets so high that they damage blood vessels and organs, or so low that the body cannot function.
People with type 2 diabetes are less sensitive to insulin. This means that the body needs to produce more insulin to achieve the desired regulatory effect.
On top of this reduction in sensitivity to insulin, studies have shown that beta cells' ability to produce and secrete insulin is also hampered; this appears to be due to increased rates of cell death among beta cells. So, not only is the body less reactive to insulin, the cells responsible for creating insulin are reduced in number, further adding to the progression of type 2 diabetes.
Researchers from Brigham Young University (BYU) in Provo, UT, and Virginia Tech in Blacksburg are currently looking at ways of bolstering beta cell performance and potentially delaying or preventing the onset of type 2 diabetes.
Earlier research has shown that beta cells are particularly sensitive to oxidative stress (free radicals); for this reason, the researchers decided to investigate flavanol compounds in cocoa, which are known to have antioxidant powers.
Cocoa compound protects beta cells?
The researchers found that when rats received a high-fat diet that included a cocoa compound, levels of obesity were decreased and the rats' ability to handle increased glucose levels were increased.
Scientists have been investigating flavanols and how they might protect beta cell function for some time. However, the current study is the first to pinpoint the most effective molecule: a flavanol called catechin.
In particular, catechin monomers gave the most positive results; these are single molecules, the smallest of the compounds to be investigated.
Next, the scientists needed to understand how catechin was making improvements; specifically, they wanted to know what was happening within the beta cells. Study author Jeffery Tessem, assistant professor of nutrition, dietetics, and food science at BYU, explains what they found:
"What happens is, it's protecting the cells, it's increasing their ability to deal with oxidative stress. The catechin monomers are making the mitochondria in the beta cells stronger, which produces more ATP (a cell's energy source), which then results in more insulin being released."
Specifically, they saw a jump in the expression of genes that promote both mitochondrial function and the body's response to oxidative stress.
This is the first time a potential mechanism has been described that helps explain how flavanols might improve beta cell function - epicatechin monomers strengthen beta cells' mitochondria, the power houses of the cell.
"These results will help us get closer to using these compounds more effectively in foods or supplements to maintain normal blood glucose control and potentially even delay or prevent the onset of type 2 diabetes."
Co-author Andrew Neilson, assistant professor of food science at Virginia Tech
The authors are quick to be clear - eating sugary, high-fat chocolate will not protect against diabetes. Tessem explains that, "You [would] probably have to eat a lot of cocoa" to get enough epicatechin monomers to make any kind of positive difference.
The results are promising; compounds found in chocolate might mark a new line of research into preventing or treating diabetes, but, sadly, eating chocolate is still not a healthful option.