Dr Neville McClenaghan, from the University of Ulster, conducted a large review of scientific studies investigating the effect of high and low carbohydrate diets on blood glucose control in people with and without diabetes.

The author of this review concludes that there is no evidence to suggest that carbohydrate-rich diets are a cause of insulin resistance or type 2 diabetes in humans. In fact, he suggests that diets rich in carbohydrates, which tend to be naturally low in fat may help improve insulin control. Furthermore it is well established that high fat diets, particularly those rich in saturates, not only interfere the normal action of insulin but also encourage weight gain, which itself increases risk of insulin resistance.

Many people with type 2 diabetes wrongly restrict the amount of carbohydrate in their diet. This paper adds weight to current dietary advice which recommends that meals should be based around carbohydrate rich foods, such as bread, pasta or rice, that there is no need to restrict sugars specifically, and that the amount of saturated fat in the diet is restricted.

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"Perhaps as we age, hedgehog signals become blocked or decreased. This study implies that if we block hedgehog signals, humans would have less bone and more fat. Conversely, if we can activate the pathway, we might be able to prevent or reverse osteoporosis and simultaneously prevent or reduce fat accumulation," he said.

Dr. Graff said that other researchers have spent a great deal of effort developing agents to regulate the hedgehog pathway. These agents, currently in the early development phase for anti-cancer treatments, hold promise for human use.

"The drugs already in clinical development might be useful for this purpose as well," Dr. Graff said. "If medicine could stimulate the hedgehog pathway in adults, those adults could potentially not only get leaner and become more fit, but could also add bone mass as well. That could affect obesity, diabetes, lipodystrophy and osteoporosis, all of which are major human diseases."

Dr. Graff cautioned that because the hedgehog pathway is so involved in many biological processes, side effects are possible. However, agents could be developed to target hedgehog therapies to specific human tissues, such as fat or bone, he said.

"There are still tremendous hurdles to overcome before a treatment or a drug is developed," Dr. Graff said. "We have to do the basic research before we even know what those hurdles are."

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