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Celebrated every November 14 since its creation in 1991, World Diabetes Day is an opportunity to raise collective awareness of the condition and, above all, the resources deployed to manage it. Diabetes refers to consistently higher than normal blood sugar levels (hyperglycemia).  Two types of diabetes can be distinguished:

– Type 1, an auto-immune disease characterized by the insufficient production of insulin;

– Type 2, which occurs as the result of the poor use of insulin by the body.

Over half of deaths attributable to hyperglycemia occur before the age of 70. The World Health Organization (WHO) predicts that, in 2030, diabetes will be the 7th leading cause of death worldwide. Source: WHO

Last year, we showcased the research of Eric Renard, head of Inserm Unit 1191 “Determinants and correction of insulin secretion loss in diabetes”, which was working on the development of an artificial pancreas usable in daily life by people with type 1 diabetes.

Read last year’s C dans l’air (in French)

In late 2016, early 2017, studies performed in some thirty patients, along with three from Montpellier, demonstrated the feasibility of a 6-month trial. In addition, the opportunity to use new devices, particularly in Europe, is arising. One such device is an implantable continuous glucose monitoring system, which could be used for up to 6 months, and would replace the current system that requires changing every 7 to 10 days. This ongoing integration work will be consolidated in the first quarter of 2018, and concern three European centers: Montpellier, Padua and Amsterdam. Around 24 patients will be enrolled at each center in order to participate in this study funded by the NIH.

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Osteoporosis continues to remain a poorly understood and often under-diagnosed disease. It is estimated that 39% of women around the age of 65 suffer from osteoporosis, a figure which rises to up to 70% for those aged 80 and over.

Affecting the skeleton, it is characterized by a reduction in bone mass and a deterioration of the internal structure of the bone tissue, which considerably increase the fracture risk.

Each year in France, more than 130,000 women are victims of fractures, often because they are unaware that they have osteoporosis. Therefore, only 20% of them are referred for screening, and then treated.

Although age-related osteoporosis more commonly affects women because of menopause, this does not make it an exclusively female disease. One quarter of all fractures related to fragile bones occur in men.

Consult our press releases (in French):

http://presse.inserm.fr/osteoporose-comment-preserver-lequilibre-entre-formation-et-destruction-de-los/17727/

http://presse.inserm.fr/quand-la-serotonine-tombe-sur-un-os/2500/

Consult our report (in French):

https://www.inserm.fr/thematiques/physiopathologie-metabolisme-nutrition/dossiers-d-information/osteoporose

Osteoporosis: Strategies for prevention and treatment:

http://www.ipubli.inserm.fr/handle/10608/16

©WHO

Organized by the France Alzheimer association, the 24th World Alzheimer’s Day will take place this Thursday, September 21. This year, the Alzheimer’s Village information center will be running for the 5^th time in Paris (Place de la Bataille-de-Stalingrad), from September 21 to 24, 2017. There are currently 900,000 people affected by Alzheimer’s disease, or by a related condition. It is estimated that by 2020, 1.275 million people will be suffering from the disease[1].

In the book “Alzheimer: fatalité ou espoir?” [Alzheimer’s: inevitability or hope?] from the Choc Santé [Health Shock] series produced in partnership by Inserm and Le Muscadier, Francis Eustache provides an overview of past and current advances. He also explains that there are two distinct types of Alzheimer’s disease:

– the familial inherited type (in which the first symptoms appear at the same age from generation to generation, often around the age of 60).

– the sporadic type (which represents the majority of cases, and most often occurs around the age of 85).

From the age of 85, 1 out of every 4 women and 1 out of every 5 men are affected. From the age of 65, the risk of developing Alzheimer’s disease doubles every 5 years[2].

©WHO

Despite this, Alzheimer’s disease should not be seen as an inevitable consequence of aging.

Several Inserm units are currently working on the disease, in search of messages of hope for patients.

Their recent work includes studying immunotherapy as a treatment for the disease. In a paper published in the journal Brain, Inserm research director Nathalie Catier explains that immunotherapy, which has been effective in the case of cancer and autoimmune disease therapies, could also have a major impact on neurodegenerative disease.

Personalized care has a beneficial effect for patients affected by Alzheimer’s disease. This kind of cognitive and social rehabilitation delays the loss of independence, and reduces behavioral problems in people suffering from Alzheimer’s disease. This was demonstrated in a study by Clément Pimouguet, an Inserm researcher from unit 1219, the “Institute of Public Health, Epidemiology and Development”.

Vitamin D may also represent a new avenue in the treatment of Alzheimer’s disease. According to the study by Catherine Féart and Cécilia Samieri, published in Alzheimer’s & Dementia, vitamin D deficiency doubles the risk of developing dementia, and triples the risk of developing Alzheimer’s disease. 

A word of warning however in regard to popular beliefs concerning Alzheimer’s disease. In a paper published on June 22, 2017, Séverine Sabia explains that physical activity does not protect against the onset of dementia. In fact, while longer life expectancy can be explained by improved quality of life, living longer also strongly increases the probability of developing dementia. While many studies suggested until recently that physical activity could have a neuroprotective effect, research by the Inserm team from the Center for Research in Epidemiology and Public Health (CESP) showed that 2 hours 30 minutes of recommended daily activity did not prevent a decline in cognitive function in some patients, in line with individuals affected by dementia who did no exercise.

Neurons showing Tau accumulation in mice ©David Blum

David Blum, research director of unit 1172 (Jean Pierre Aubert Research Center), studies the impact the environment may have on Alzheimer’s disease, with a close focus on Tau proteins. David Blum and his group are particularly interested in the effects of caffeine. More broadly, the “Alzheimer’s and Tauopathies” team to which he belongs, led by Luc Buée, is studying the physiological role of Tau protein and the impact of its dysfunction on the brain. In Alzheimer’s disease, Tau protein behaves abnormally, and build-up of diseased proteins leads to memory problems.  

[1] Figures from the France Alzheimer association

[2] “Alzheimer: fatalité ou espoir?” [Alzheimer’s: inevitability or hope?] Choc Santé series, Le Muscadier

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Suicide is the cause of over 800,000 deaths around the world each year according to estimates from the World Health Organization, amounting to one death every 40 seconds. It affects all age groups and all parts of the world[1]. In France, the emergency services handle 220,000 suicide attempts every year[2], and 10,500 individuals take their own lives.

Several risk factors appear to increase suicidal ideation. These include problems with alcohol, drugs, and sexual identity, strong impulsivity, social isolation, and advanced age. Depression is the cause of suicide in 70% of cases. Antoine Pelissolo, an Inserm researcher from Unit 955, “Mondor Institute of Biomedical Research” (IMRB), sought to understand this link between depression and suicide in his book Dépression: s’enfermer ou s’enfuir [Depression: sinking or coping], which was published by Le Muscadier in 2015.

© OMS

Among 15-29 year-olds, suicide is the second leading cause of mortality. A large-scale survey, coordinated by Inserm Unit 1178, “Mental Health and Public Health”, and the Fondation Vallée’s University Research Center, which was carried out in 2013 among 15,235 students aged 13 to 18, also showed that suicide attempts appear to be more common now than in the past: 7.8% of young people have already tried to commit suicide once, and 3.7% more than once. These alarming figures highlight the need for more work on preventing suicidal behavior.

Read the report “Le nouveau visage de nos adolescents [The new face of our adolescents]”

Catherine Jousselme, an Inserm researcher from the “Mental Health and Public Health” Unit, explains that social networks can have both incredibly positive and negative effects: they enable greater self-expression, but also lead to isolation. When adolescents feel down, feeling like they exist and are important help them do better. The depiction of suicide on social networks gives them the impression of “dying a hero”.  Certain measures are now in place to prevent suicide (including censorship on social networks, flagging inappropriate content, and the presence of prevention services on social networks), but educating young people and teaching them the right actions to take remains the best way to combat this plague.

For more information on adolescence and suicide, see the book Ados & Suicide: en parler et se parler [Teens & Suicide: talking to them and to each other] in the Choc Santé [Health Shock] series from Inserm and Le Muscadier.

Unemployment can also be a cause of suicide. This was shown by a study from January 8, 2015, led by the Inserm Epidemiology Center on Medical Causes of Death (CépiDc) and the Paris public hospital system (AP-HP). For further data on deaths due to suicide in France, please contact Grégoire Rey, director of the CépiDc-Inserm.

In the context of suicide prevention, joint research unit 1123–Clinical Epidemiology and Economic Evaluation Applied to Vulnerable Populations (ECEVE) has developed the STOPBLUES application, an interventional and evaluative research program. STOPBLUES enables users to access information (videos of professionals, people with depression, and their friends and family) and complete anonymous self-evaluation questionnaires. A map feature also enables them to find the doctors, specialist mental health care centers, and supportive organizations closest to them. It is a kind of virtual companion, designed to support, inform, and reassure users in difficulty. For further information, please contact Karine Chevreul, the deputy director of ECEVE, or Kathleen Turmaine, Inserm researcher and lead on the STOPBLUES project. The application will be available in November 2017, and a website will also be available.

© STOPBLUES

[1] For more information, see the Inserm collection on this topic

[2] “Dépression: s’enfermer ou s’en sortir” [Depression: sinking or coping], Antoine Pelissolo, Le Muscadier, 2015.

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In 2014, Inserm researcher Jean-Philippe Lachaux launched the ATOL (Attentif à l’écOLe or Attention at School) program, which aims to use neuroscientific knowledge to improve children’s attention span in school. A thousand children from 40 classes, spanning the French equivalents of kindergarten to the 7^th grade, have now benefited from this program, which is funded by the French National Research Agency (ANR).

ATOL is based on the premise that all pupils can develop better attention skills, with benefits lasting into adulthood and professional life. The project thus seeks to develop the attention capacity of 6-18-year-olds through a program that takes place in the form of workshops adapted to each level of schooling, and focuses on three subjects:

– understanding the biological mechanism of attention;

– learning to spot situations where there is a conflict for attention; and

– developing a sense of attention balance.

The ATOL project aims to put attention skills at the heart of schooling in order to improve learning, and the future adult lives of the children involved. Partnerships are now being planned with a number of elementary, middle, and high schools.