Across 2384 Indian adults with type 2 diabetes, 31% achieved remission through a comprehensive mobile-based programme combining diet, exercise, stress management, and medical support
Photo by Ketut Subiyanto on Unsplash
Nearly one-third of people with type 2 diabetes (T2D) in an Indian cohort achieved remission through an intensive lifestyle intervention program, according to a new study publishing October 22, 2025, in the open-access journal PLOS One by Pramod Tripathi of Freedom from Diabetes Clinic & Diabetes Research Foundation, India, and colleagues.
Type 2 diabetes affects more than 72 million people in India. While lifestyle interventions have shown promise for diabetes management in Western populations, limited data exists on their effectiveness in India, where genetic and lifestyle factors place the population at higher risk.
In the new study, researchers analysed data from 2384 adults with T2D who enrolled in a one-year online intensive lifestyle intervention programme at the Freedom from Diabetes Clinic in India between May 2021 and August 2023. The intervention, provided by a six-member care team through a mobile application, included a personalised plant-based diet, structured physical activity, group therapy and individual psychological counselling, and medication management.
Overall, 744 participants (31.2%) achieved diabetes remission, defined as maintaining glycated haemoglobin (HbA1c) levels below 48mmol/mol for at least three months without glucose-lowering medications. The remission group showed significantly greater improvements than the non-remission group in weight (8.5% vs 5.2% reduction), body mass index (8.6% vs 5.2% reduction), HbA1c (15.3% vs 12.4% reduction), fasting insulin (26.6% vs 11.4% reduction), and insulin resistance (37.3% vs.19.7% reduction). People under 50 years of age, with higher BMI, no prior medication use, and a shorter duration of diabetes (<6 years) were most likely to achieve remission.
The study was limited by its retrospective design and lack of a control group. Because the programme required a subscription and participants who lacked follow up data were excluded from the analysis, there may have been selection biases. However, the authors conclude that a significant proportion of individuals with T2D can achieve remission through a comprehensive, culturally adapted lifestyle programme.
The authors add: “Our research demonstrates that nearly one-third of individuals with type 2 diabetes can achieve remission through a scientifically designed, culturally tailored, and structured lifestyle intervention. This represents the first large-scale evidence from India highlighting the potential of intensive lifestyle modification in achieving type 2 diabetes remission.”
A new biomarker for mental health called FGF21 offers a window into aging and disease risk
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A long-studied metabolic hormone, FGF21, also acts as a stress hormone – a discovery that helps explain how psychological stress causes metabolic dysregulation and drive physical disease, according to a new study published in Nature Metabolism.
FGF21 (fibroblast growth factor 21) has been researched for over two decades for its role in metabolism, glucose regulation, and diabetes.
“This is the first human evidence that FGF21 responds to mental stress, acting as a hormonal bridge between body and mind,” said senior author Martin Picard, PhD, associate professor of behavioural medicine at Columbia and co-director of the Columbia Science of Health programme. “It integrates psychosocial experiences with systemic metabolic signalling – expanding the neuroendocrine framework beyond traditional stress hormones.”
The study tracked hormonal changes following acute psychological stress in both healthy individuals and patients with mitochondrial disease, a group of genetic disorders that impair cellular energy transformation. In healthy participants, FGF21 levels on average dropped immediately after exposure to a standardised stressor, returning to baseline within 90 minutes – demonstrating a tightly regulated, dynamic hormonal pattern.
In contrast, participants with mitochondria that cannot transform energy normally showed a different pattern: FGF21 levels rose following stress and peaked at 90 minutes, indicating a fundamentally different stress response, likely regulated by mitochondrial biology.
“These results reveal a new axis of vulnerability,” said Mangesh Kurade, lead author on the study at Columbia. “The way our social environment and psychological experiences interact with mitochondrial health may directly shape metabolic outcomes and long-term disease risk.”
To validate their findings, the team analysed data from more than 20 000 participants in the UK Biobank and also drew on data from their ongoing MiSBIE study (Mitochondrial Stress and Biomarkers in Emotion), which investigates how psychosocial variables map onto biological processes.
The results showed that loneliness, childhood neglect, or recent relationship breakdowns including marital separation was linked to higher FGF21, while individuals with stronger social ties and emotional well-being – including frequent social interactions and high couple satisfaction and social support, were associated with lower levels – providing population-level evidence that FGF21 tracks with psychosocial conditions.
“Our findings suggest that the stress hormone and mitochondrial disease biomarker FGF21 signals not just acute stress, but also reflects a person’s social and emotional life over time,” said co-author Michio Hirano, MD, professor of Neurology at Columbia University Irving Medical Center who led the clinical portion of the study.
This cross-validation strengthens the case for FGF21 as a reliable biomarker of how psychological and social environments shape metabolic biology and perhaps also the clinical trajectory of mitochondrial diseases. By identifying FGF21 as both a biological mediator and potential biomarker of psychological stress, the study opens new avenues for research and clinical monitoring.
“This study bridges traditionally separate fields – metabolism and stress biology – suggesting that future precision mental health strategies may benefit from incorporating FGF21 and other biomarkers to monitor metabolic stress vulnerability and therapeutic responses,” said Kurade.
As a hormone once studied strictly within metabolic disease contexts, FGF21 now appears to straddle the boundary between mind and body, offering biological insight into how we age, adapt, and break down under pressure.
“This is about more than a single hormone,” said Picard, who is also associate professor at the Columbia Butler Aging Center. “It’s about understanding how our lived experience – our relationships, our stress, our resilience – gets translated into biology. A more accurate, holistic picture of human health is emerging. It’s an exciting time for science and medicine.”
Study participant Sheila Irvine training with the device. Credit: Moorfields Eye Hospital
After being treated with an electronic eye implant paired with augmented-reality glasses, people with sight loss have recovered reading vision, reports a trial involving a UCL and Moorfields clinical researcher.
The results of the European clinical trial, published in The New England Journal of Medicine, showed 84% of participants were able to read letters, numbers and words using prosthetic vision through an eye that had previously lost its sight due to the untreatable progressive eye condition, geographic atrophy with dry age-related macular degeneration (AMD).
Those treated with the device could also read, on average, five lines of a vision chart; some participants could not even see the chart before their surgery.
The trial, with 38 patients in 17 hospital sites across five countries, was testing a pioneering device called PRIMA, with Moorfields Eye Hospital being the sole UK site. All patients had lost complete sight in their eye before receiving the implant.
Dry AMD is a slow deterioration of the cells of the macula over many years, as the light-sensitive retinal cells die off. For most people with dry AMD, they can experience a slight loss of central vision. Through a process known as geographic atrophy (GA), it can progress to full sight loss in the eye, as the cells die and the central macula melts away. There is currently no treatment for GA, which affects 5 million people globally. All participants in this trial had lost the central sight of the eye being tested, leaving only limited peripheral vision.
This revolutionary new implant is the first ever device to enable people to read letters, numbers and words through an eye that had lost its sight.
Mr Mahi Muqit, associate professor in the UCL Institute of Ophthalmology and senior vitreoretinal consultant at Moorfields Eye Hospital, who led the UK arm of the trial, said: “In the history of artificial vision, this represents a new era. Blind patients are actually able to have meaningful central vision restoration, which has never been done before.
“Getting back the ability to read is a major improvement in their quality of life, lifts their mood and helps to restore their confidence and independence. The PRIMA chip operation can safely be performed by any trained vitreoretinal surgeon in under two hours – that is key for allowing all blind patients to have access to this new medical therapy for GA in dry AMD.”
The procedure involves a vitrectomy, where the eye’s vitreous jelly is removed from between the lens and the retina, and the surgeon inserts the ultra-thin microchip, which is shaped like a SIM card and just 2mm x 2mm. This is inserted under the centre of a patient’s retina, by creating a trapdoor into which the chip is posted. The patient uses augmented-reality glasses, containing a video camera that is connected to a small computer, with a zoom feature, attached to their waistband.
Around a month or so after the operation, once the eye has settled, the new chip is activated. The video camera in the glasses projects the visual scene as an infra-red beam directly across the chip to activate the device. Artificial intelligence (AI) algorithms through the pocket computer process this information, which is then converted into an electrical signal. This signal passes through the retinal and optical nerve cells into the brain, where it is interpreted as vision. The patient uses their glasses to focus and scan across the main object in the projected image from the video camera, using the zoom feature to enlarge the text. Each patient goes through an intensive rehabilitation programme over several months to learn to interpret these signals and start reading again.
No significant decline in existing peripheral vison was observed in trial participants.
These findings pave the way for seeking approval to market this new device.
Sheila Irvine, one of Moorfields’ patients on the trial who was diagnosed with age-related macular degeneration, said: “I wanted to take part in research to help future generations, and my optician suggested I get in touch with Moorfields. Before receiving the implant, it was like having two black discs in my eyes, with the outside distorted.
“I was an avid bookworm, and I wanted that back. I was nervous, excited, all those things. There was no pain during the operation, but you’re still aware of what’s happening. It’s a new way of looking through your eyes, and it was dead exciting when I began seeing a letter. It’s not simple, learning to read again, but the more hours I put in, the more I pick up.
“The team at Moorfields has given me challenges, like ‘Look at your prescription’, which is always tiny. I like stretching myself, trying to look at the little writing on tins, doing crosswords.
“It’s made a big difference. Reading takes you into another world, I’m definitely more optimistic now.”
The global trial was led by Dr Frank Holz of the University of Bonn, with participants from the UK, France, Italy and the Netherlands.
The PRIMA System device used in this operation is being developed by Science Corporation (science.xyz), which develops brain-computer interfaces and neural engineering.
Mr Muqit added: “My feeling is that the door is open for medical devices in this area, because there is no treatment currently licensed for dry AMD – it doesn’t exist.
“I think it’s something that, in future, could be used to treat multiple eye conditions.”
More about the device:
The device is a novel wireless subretinal photovoltaic implant paired with specialised glasses that project near-infrared light to the implant, which acts like a miniature solar panel.
It is 30 micrometres/microns (0.03mm) thick, about half the thickness of a human hair.
A zoom feature gives patients the ability to magnify letters. It is implanted in the subretinal layer, under the retinal cells that have died. Until the glasses and waistband computer are turned on, the implant has no visual stimulus or signal to pass through to the brain.
In addition to practising their reading and attending regular training, patients on the trial were encouraged to explore ways of using the device. Sheila chose to learn to do puzzles and crosswords while one of the French patients used them to help navigate the Paris Metro – both tasks being more complex than reading alone.
