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A long-term clinical trial found that metabolic-bariatric surgery led to far higher rates of lasting type 2 diabetes remission than intensive medical and lifestyle management alone.

• Published in Diabetes Care, journal of the American Diabetes Association
• Trial: Alliance of Randomized Trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) — described as the largest, longest-running trial of metabolic surgery for diabetes
• Participants: 262 people with type 2 diabetes — 166 assigned to surgery, 96 to medical/lifestyle management. Median follow-up 11 years, up to 14 years
• Remission rate: 58% for surgery group vs. 3% for medical/lifestyle group. Remission defined as A1C below 6.5% without blood sugar-lowering medication
• Factors linked to remission: Shorter duration of diabetes before treatment, no insulin use, fewer types of blood sugar-lowering medications, and greater weight loss in the first year after treatment
• Factors linked to relapse after remission: Longer history of diabetes and taking more types of diabetes medications before treatment

The question has been whether benefits endure — this study shows they do, and suggests surgery could be offered earlier to the right patients, rather than as a last resort, based on characteristics that predict lasting remission.

New research from the University of Surrey and Université de Lille reveals a genetic link between type 2 diabetes (T2D) and high blood pressure. People with one condition are more likely to develop the other due to shared genetic factors.

The study analyzed over 1,300 genetic variants and identified 5 clusters contributing to the development of both conditions, including metabolic syndrome and impaired pancreatic beta-cell function. This discovery could lead to earlier identification of high-risk individuals and more personalized care.

“Genetic risk is inherited and remains stable throughout life,” says Dr. Vincent Pascat, making it a valuable tool for precision medicine.

When it comes to footwear, people with diabetes need to be particularly cautious. Diabetes can cause nerve damage, known as neuropathy, which can lead to a loss of sensation in the feet. This makes it more difficult for individuals to detect injuries or irritations, increasing the risk of complications like foot ulcers and infections. Given these risks, the question arises: should people with diabetes wear flip flops?

Risks Associated with Flip Flops

Flip flops are a popular choice for warm weather due to their comfort and ease (eg Archies). However, they offer little to no protection for the feet. For people with diabetes, this lack of protection can pose significant risks:

1. Increased risk of injury: Flip flops provide minimal coverage, leaving the feet vulnerable to cuts, scrapes, and other injuries. For someone with diabetes, even a small cut can become a serious issue if not properly cared for.
2. Exposure to foreign objects: Flip flops do not protect the feet from sharp objects, hot surfaces, or other hazards that could cause injury.
3. Poor foot support: Flip flops often lack the arch support and stability that people with diabetes need to prevent foot problems like plantar fasciitis or other structural issues.
4. Increased risk of infection: If an injury occurs while wearing flip flops, the risk of infection is higher due to the open nature of the footwear.

Considerations for People with Diabetes

Given the potential risks, it’s essential for people with diabetes to carefully consider their footwear choices. While flip flops might be comfortable and convenient, they may not be the best option for everyday wear, especially in situations where the feet are more prone to injury.

Alternatives to Flip Flops

For people with diabetes, it’s often recommended to opt for shoes that provide better protection and support. Some alternatives to flip flops include:

1. Closed-toe shoes: Shoes that cover the entire foot can protect against injuries and provide better support.
2. Orthotic shoes: Custom orthotics or shoes designed for people with diabetes can offer additional support and protection.
3. Therapeutic footwear: Specialized footwear designed for people with diabetes can help prevent foot complications and promote healing.

While flip flops might be a comfortable choice for some, people with diabetes should approach wearing them with caution. The risks associated with flip flops, such as increased vulnerability to injury and infection, make them a less-than-ideal choice for everyday wear. Instead, individuals with diabetes should prioritize footwear that offers protection, support, and comfort to help prevent complications and maintain foot health. Consulting with a healthcare provider or podiatrist can provide personalized guidance on the best footwear options for managing diabetes-related foot issues.