Diabetic diseases have long been classified as either type 1 or type 2, but the new research conducted in Scandinavia now indicates that such classification is over-simplistic. Published in The Lancet Diabetes & Endocrinology, this study reveals five distinct subtypes of diabetes and opens doors for more nuanced and personalized treatment strategies.

Simply, diabetes is when the glucose present in the blood is too high because of impaired functioning of insulin- a hormone in charge of regulation of glucose in the body. Type 1 diabetes occurs after the immune system attacks cells which produce insulin inside the pancreas, leading to a complete inability to produce this essential hormone. It most often presents with symptoms at young age and needs continuous insulin therapy.

Type 2 diabetes, on the other hand, is characterized by insulin resistance, where the body produces insulin but does not use it effectively. This type is generally linked to obesity, sedentary lifestyles, and genetics and often manifests in adulthood. While these classifications have guided treatment for decades, the new research divides diabetes into five distinct clusters, each with unique characteristics, risks, and management needs.

5 Cluster of Diabetes

1. Severe Autoimmune Diabetes (SAID)

This form of diabetes is very similar to the original concept of type 1 diabetes. This subtype is due to an autoimmune attack that destroys beta cells responsible for insulin production, leaving the body incapable of producing insulin. It usually occurs in younger people and necessitates tight blood sugar control and insulin therapy.

2. Severe Insulin-Deficient Diabetes (SIDD)

The other extreme type, but not autoimmune, is SIDD. This condition generally affects younger, nonobese people whose bodies do not produce enough insulin because the beta cells are damaged. Individuals diagnosed with SIDD are at the highest risk for complications, including blindness. Generally, treatment consists of insulin therapy, possibly combined with other orally taken medication.

3. Severe Insulin-Resistant Diabetes (SIRD)

SIRD is characterized by a significant resistance to insulin, often linked to obesity. People with SIRD struggle to use the insulin their body produces, resulting in poor blood sugar control. This subtype is associated with a higher risk of kidney disease, and current treatment options are less effective, emphasizing the need for new approaches to manage this group.

4. Mild Obesity-Related Diabetes (MOD)

This presents as a milder form of diabetes associated with obesity. Although these patients have some degree of insulin resistance, this is not as marked as it is in SIRD. Lifestyle interventions including weight loss and physical activity are particularly important in managing MOD, combined with conventional medications for diabetes.

5. Mild Age-Related Diabetes (MARD)

The most prevalent subtype, typically occurring in the elderly. It is less severe than other forms of diabetes, with fewer major complications. Lifestyle changes and oral medications, such as metformin, often are used to keep blood glucose levels within normal limits.

Also Read: What Is Type 3 Diabetes? Insulin Resistance In The Brain That Could Trigger Alzheimer’s

What This Means for Diabetes Management

These five subtypes show that diabetes is complex, and one treatment fits all may not be applicable. In type 2 diabetes, metformin is currently the first drug prescribed to the majority of patients, and then other drugs are added if required. It might not be appropriate for all people, particularly for subgroups such as SIRD, who require more intensive therapies on insulin resistance.

Identifying these subtypes will also enable clinicians to direct appropriate treatments based on the specific risk profiles. For example, those classified as SIDD should have an earlier screen and preventive interventions to avoid blindness. In turn, SIRD may require specific interventions for renal protection.

This study represents a step forward, but it also opens up new questions. Researchers are exploring whether factors such as genetic markers or blood pressure measurements could further refine these subtypes. Furthermore, it is unclear whether a patient's classification might change over time, and so treatment plans need to be flexible and adaptive.

Therefore, findings in this field do not herald a need to completely change the type 1 and type 2 diabetes scheme currently in practice; they rather work as a guideline to develop individualized, high-precision and successful treatment systems in the years to come for the millions dealing with diabetes in today's times.

Diabetes is no longer just about type 1 or type 2. Five distinct subtypes have been identified, and the chronic condition's complexity has now opened the door to a new era of personalized care.

Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. The Lancet Diabetes & Endocrinologyl. 2018

Just as your habits say a lot about you, the way you sleep also shows a part of you. Everyone has their own way of sleeping, whether it is sleeping on their belly, or being in the habit of needing space when they sleep etc. However, there's a less common position that's been named after a dinosaur: the "T-rex." Imagine a T-rex with its tiny arms pulled close to its chest; that's the position we're talking about. People who sleep this way bend their wrists and bring their hands near their body. It might look a little funny, but for them, it's the most comfortable way to fall asleep and stay asleep all night long.

Why the T-Rex Position Feels Comfortable

Experts also believe that when you bend your wrists and bring them close, you're actually relaxing some of the muscles in your arms and hands. Think of it like a gentle hug for your own body. When your arms are straight, those muscles are a little tense. However, when you bend them, they relax, which can feel really good, especially when you're trying to fall asleep. While there is no substantial evidence of how the T-rex position affects your behavior, a similar sleeping position, which is the fetal position, is said to be comforting with arms and feet drawn close to chest like a fetus in the womb. The Sleep Foundation tells that over 60% of adults sleep in this position. It was also hypothesized that people who sleep this way are more anxious and emotional.

Does The T-Rex Position Have Any Downsides?

Sleeping with your wrists bent all night can cause problems. Mayo Clinic explains that your wrists have nerves, arteries, and tendons running through them, and when you bend them for too long, you put pressure on these delicate structures. This pressure can lead to aches and pains in your wrists and even your elbows. You might also feel numbness or tingling in your hands. If you keep sleeping this way night after night, you could develop conditions like carpal tunnel syndrome or tendonitis, which are painful and can make it hard to use your hands. So, while it's comfy, it's important to be aware of the potential issues.

Managing the T-Rex Sleeping Habit

Completely eliminating a comfortable sleeping position can be challenging. Instead, focus on mitigating the potential problems. Here are some strategies as per WebMD

Sleep Aids

Using a body pillow can provide a sense of security and reduce the need to tuck your arms tightly. Weighted blankets can help alleviate anxiety and promote relaxation, potentially lessening the urge for the T-rex position.

Stress Management

Practicing meditation and deep breathing techniques can help manage stress and reduce the likelihood of reverting to the T-rex position. Taking a few minutes to relax and breathe deeply before bed can make a big difference. These practices can help you unwind and prepare for a restful night.

Stretching

Regularly stretching your wrists and arms in the opposite direction of the bent position each morning can help alleviate pain and numbness. Simple stretches, like rotating your wrists or extending your arms, can help improve flexibility and reduce discomfort. Doing these stretches regularly can prevent long-term problems and keep your wrists healthy and strong.

World Autism Awareness Day commemorates the period set aside to develop insight and promote solutions for those with autism spectrum disorder (ASD). Although the classic therapies of applied behavior analysis (ABA), speech therapy, and occupational therapy have been the standard intervention for autism, there has been an increasing interest in a different method: play therapy. Advoctates purport that play therapy stimulates a child's intrinsic method of acquiring knowledge, supporting communication, interpersonal skills, and emotional balance more effectively than can often be provided by mainstream interventions. Is play therapy the secret ingredient of autism intervention?

Autism Spectrum Disorder (ASD) impacts a child's capacity to communicate, socialize, and use imaginative play. Compared to neurotypical children, autistic children tend to have difficulties with pretend play and usually have a strong interest in particular activities. With these difficulties in mind, therapeutic interventions that address their needs are highly important. One of these interventions is play therapy, which is a structured but fun means of helping autistic children acquire vital life skills.

Play is the language of children, being a universal way of communication and learning. The Association for Play Therapy (APT) describes play therapy as the "systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development." (APT, 2021).

In autistic children, play therapy provides a fun and organized setting to understand feelings, rehearse social interactions, and improve communication. A professional therapist helps the child progress through play-based strategies that promote self-expression and establish healthy relationships with parents, siblings, and friends.

Why Play Therapy Works for Autistic Children?

Play therapy is especially effective for children with ASD because it works within their natural learning and interaction style. It offers a low-stress, safe space in which children can:

• Learn social skills like turn-taking and understanding nonverbal communication.
• Enhance communication through verbal and nonverbal interaction.
• Learn to regulate emotions in order to cope with frustration and anxiety.
• Develop problem-solving and cognitive flexibility.
• Decrease anxiety and build confidence in social situations.

Because autistic children tend to interact with play differently—e.g., becoming fixated on the components of a toy instead of the object as a whole or having difficulty with pretend play—therapists employ systematic methods to enable them to connect with their environment and the individuals in it.

Types of Play Therapy for Autism

Play therapy involves a variety of methods adapted to a child's individual needs. Some of the most useful types for autistic children are:

Child-Centered Play Therapy (CCPT)

CCPT emphasizes establishing a nonjudgmental and accepting environment in which children are able to express themselves spontaneously. The therapist becomes the facilitator, with the child selecting activities of play while being treated with empathy and acceptance. This creates an atmosphere of safety and trust, with children able to explore their emotions and build up social skills organically.

Structured Play Therapy

Unlike CCPT, structured play therapy involves specific activities designed to target particular developmental goals. These sessions help autistic children develop essential skills in a step-by-step manner, ensuring they feel comfortable and supported.

Cognitive Behavioral Play Therapy (CBPT)

CBPT is an integration of cognitive behavioral therapy (CBT) with play therapy to assist children in identifying and managing their emotions. CBPT is particularly beneficial for children experiencing anxiety, frustration, or challenges with the adaptation to new circumstances.

Benefits of Play Therapy for Children with Autism

Enhanced Communication Skills

Play therapy allows autistic children to exercise verbal and nonverbal communication. By means of spoken language, gestures, or interactive stories, children become more at ease with self-expression.

Increased Social Interaction

Through play with a guide, children exercise basic social skills like turn-taking, sharing, and reading body language. These social skills enable them to develop more positive relationships with family members and peers.

Emotional Regulation and Coping Strategies

Play therapy provides a secure environment where children can experiment and learn to deal with their feelings. Therapists can demonstrate skills like deep breathing or the use of a "calm-down" toy to assist children in dealing with frustration and stress.

Problem-Solving and Cognitive Flexibility

Structured play activities encourage children to think creatively, adapt to new scenarios, and develop planning skills. This can be particularly helpful in improving their ability to adjust to changing routines or social expectations.

Reduced Anxiety and Increased Confidence

By providing a playful and interactive setting, play therapy makes autistic children less apprehensive about social interactions and new experiences. Gradually, this increases their confidence and readiness to interact with the world around them.

Play Therapy Activities for Autistic Children

Including therapeutic play activities at home can further increase the advantages of professional play therapy. Some ideas include:

Gross Motor Games

Obstacle Course: Create an indoor obstacle course with pillows, chairs, and painter's tape. Have your child jump, spin, and crawl through the various sections to promote coordination and sensory integration.

Tilt a Ball: Cut a hole at the bottom of a cardboard box to make a basic ball maze. Have your child tilt the box to direct the ball through the maze to develop hand-eye coordination.

Fine Motor Games

Free the Animals: Secure plastic toy animals with painter’s tape and have your child peel them off to strengthen fine motor skills.

Clay Sculpting: Use therapy putty or clay to model different shapes or animals, enhancing dexterity and creativity.

Interactive and Group Play Activities

Scavenger Hunt: Create a themed scavenger hunt to encourage problem-solving and exploration.

Ribbon Wand Dancing: Place ribbons on wooden spoons and invite dancing to music, enhancing gross motor skills and sensory awareness.

Row, Row, Row Your Boat: A cooperative game wherein children rock back and forth as they sing, enhancing cooperative play and rhythmic movement.

Role of Parents in Play Therapy

Parent participation is essential to the success of play therapy. By attending therapy sessions and applying learned skills in everyday life, parents can support gains and create further opportunities for development. Parents are frequently taught by therapists to use play-based strategies to facilitate communication, emotional control, and social interaction within the home environment.

Choosing the Right Play Therapy for Your Child

When selecting a play therapist, keep the following in mind:

Credentials: Seek professionals who hold a psychology, social work, or counseling degree, and play therapy certifications (e.g., Registered Play Therapist, RPT).

Experience: Opt for a therapist experienced in treating autistic children, as they will have in-depth knowledge of ASD-specific issues.

Approach: Talk to various therapy approaches to select the one that will best suit your child's needs and personality.

How Can Parents Support Play Therapy at Home?

To ensure maximum returns from play therapy, parents can:

• Encourage play learning: Integrate therapy skills into daily life.
• Design a supportive play environment: Create a quiet, stimulating area with sensory-friendly materials.
• Learn from sessions: Use therapist-recommended techniques to build on progress in the home environment.

Play therapy is an effective intervention for autistic children, providing a natural and fun means of establishing communication, social, and emotional skills. With the help of trained therapists and the integration of play-based strategies at home, parents can facilitate their children in acquiring key life skills in a fun and nurturing environment. Consulting professional services and remaining actively engaged in the therapy process ensures that autistic children get the assistance they require to flourish.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder affecting social interaction, behavior, and communication. The etiology of autism is yet to be deciphered, although there is burgeoning evidence that an intimate relationship between the gut microbiome and the brain exists. In recent times, researchers have been investigating the possibility of using probiotics—the so-called "good bacteria"—as therapeutic interventions in children with autism. These supplements not only enhance digestive health but also reduce some of the behavioral symptoms, bringing hope to millions of families around the globe.

ASD is highly variable in its signs and symptoms. Some children have speech and communication problems, whereas others have sensory sensitivity or repetitive behaviors. Most have a problem with emotional regulation and social communication. Less openly spoken is that kids with autism very often have gastrointestinal (GI) problems like bloating, constipation, diarrhea, and irritable bowel syndrome (IBS).

Research has shown that people with autism tend to have an imbalance of their gut microbiota, with less healthy bacteria and more pathogenic bacteria like Clostridia. This has prompted scientists to study if normalization of the gut through probiotics would help improve symptoms of ASD.

Role of Probiotics in Gut Health

Probiotics are live bacteria and yeasts that are beneficial to the digestive system. They are present in fermented foods such as yogurt, kefir, kimchi, and miso, and also in dietary supplements. Probiotics assist in keeping the good and bad bacteria in the gut in balance. These good microbes enhance digestion, boost the immune system, and can lower inflammation—factors that may contribute to autism symptoms.

Increased numbers of studies now indicate that probiotics may provide an effective complimentary treatment for individuals with ASD. In a more recent study revealed by the BMJ Journal, it was identified that children consuming probiotic supplements noticed a reduction of 47.77% in behavioral signs. The trial further indicated an attenuation of social withdrawal by 40% as well as the rate of repetition reduced by 37.77%. Further, enhancements in gastrointestinal well-being were observed, such as a rise of 18.18% in formed stools and a decrease of 6.66% in watery stools.

The Autism-Gut-Brain Connection

The brain and the gut are closely linked by the gut-brain axis, a two-way communication network between the nervous system and the digestive system. The US Department of Health and National Institutes of Health (NIH) place significant importance on gut microbiota in postnatal brain development. Scientists feel that alterations in gut bacteria can be responsible for neurological and behavioral abnormalities in children with autism.

Ohio State University Study links kids with ASD were noted to have lower amounts of Faecalibacterium prausnitzii, a gut bacterium linked to good gut health.

Another research stated that how chemicals made by gut bacteria affect autism behaviors.

A 2016 International Meeting for Autism Research (IMFAR) detected Haemophilus parainfluenzae in the stools of autistic children, tying it to gastrointestinal distress and behavioral difficulties.

Based on this evidence, numerous scientists now think that enhancing gut health with probiotics may help ease symptoms of autism.

Probiotics and Digestive Health in Autism

Individuals with autism have a higher tendency to experience GI disorders like IBS and leaky gut syndrome, which results when toxic bacteria and toxins escape into the blood through a weakened intestinal lining. Leaky gut symptoms can be:

• Constipation
• Bloating
• Excess gas
• Nutrient deficiencies
• Food allergies

By restoring the balance of gut flora, probiotics can potentially treat these gastrointestinal disturbances. Probiotic strains including Lactobacillus acidophilus, L. rhamnosus GG, L. reuteri, and Bifidobacterium have been effective in maintaining intestinal health and relieving symptoms of children with inflammatory bowel disease (IBD), a condition typically observed in children with ASD. Saccharomyces boulardii, a probiotic yeast, has also been reported to be responsible for the relief of obsessive-compulsive behaviors, which are characteristically observed in children with autism.

How to Choose the Right Probiotic for Autism?

When choosing a probiotic supplement for an autistic child, parents need to take the following into account:

Strain Diversity: A variety of bacterial strains is best for maintaining gut health.

Scientific Support: Opt for probiotics that have scientific evidence, like Lactobacillus and Bifidobacterium species.

Live Cultures: Make sure the product has active, live bacteria that can withstand stomach acid and travel to the intestines.

Consultation with a Physician: Always consult with a physician prior to the initiation of probiotics, particularly for children with weakened immune systems.

Although probiotics are regarded as safe, side effects can be in the form of slight gas, bloating, constipation, or allergic reactions. Nevertheless, these are generally tolerated as the body acclimatizes to the new bacterial load.

Are Probiotics a Safe and Effective Treatment for Autism?

The US Food and Drug Administration (FDA) oversees probiotics as foods, not as drugs, so their efficacy and safety are not under the same level of intense testing as pharmaceuticals. However, experts in the health field are unanimous in saying that probiotics are safe for children as well as adults when used properly.

Although probiotics cannot be considered a sole treatment for autism, they can be used to augment current therapies like behavioral therapy, speech therapy, and special education programs. Stool analysis can also be used to identify the most appropriate probiotic strains for a child's individual needs so that a customized approach to gut health can be adopted.

Autism can be difficult to handle by families, but research on the gut-brain relationship provides new promise. While researchers keep finding the connection between gut health and neurological function, probiotics can become the hoped-for component in the overall treatment of autism.

Improvements in microbiome science, as well as greater knowledge of probiotics, are a giant leap toward enhancing the quality of life in ASD-affected children. Although larger clinical trials are necessary to delineate the role of probiotics in autism treatment comprehensively, the early results are promising. Parents willing to use probiotics for the child should visit a healthcare practitioner to decide on the most suitable method for their child's specific requirements.