Diabetes, Genetic Research / 16.05.2024

How At-Home Genetic Testing Can Detect Your Diabetes Risk 

Disclaimer: This blog content is for informational purposes only and should not be taken as medical advice. In recent years, the popularity of at-home genetic testing has surged, offering individuals ease and convenience at their doorstep. These tests provide a glimpse into their genetic blueprint and the potential health risks they might face. The promise of insights into various genetic predispositions, including the risk for diseases like diabetes is one you can’t miss.  While these tests can provide valuable information about one's genetic susceptibility to diabetes, it is crucial to approach the results with caution. They are not a substitute for traditional methods of diabetes screening and risk assessment but can complement them by providing additional layers of insight. (more…)
Author Interviews, Diabetes, Orthopedics, Weight Research / 14.02.2024

MedicalResearch.com Interview with: Matthew Magruder, MD PGY3 Orthopaedic Residency Program Department of Orthopaedic Surgery and Rehabilitation Maimonides Medical Center MedicalResearch.com: What is the background for this study? Response: The prevalence of obesity and diabetes mellitus has reached epidemic proportions. Approximately 37.3 million people in the United States, accounting for 11.3% of the total population, have diabetes, and 100.1 million, or 41.9%, of all US citizens are obese. Furthermore, these numbers are only projected to increase in the coming decades. This is an issue for orthopaedic surgeons because diabetes and obesity have consistently been demonstrated to be risk factors for complications following total joint replacements, especially total hip replacements. Therefore, we are in desperate need of new and more effective tools in mitigating the risk of poor outcomes in our joint replacement patients. Semaglutide, and other GLP-1 agonists, are potentially a new tool that can be used to help decrease the risks following joint replacement surgery. Initially a medication to treat diabetes, semaglutide has recently been approved by the FDA to treat obesity as well, as randomized controlled trials have consistently demonstrated significant weight loss with minimal side effects. The purpose of our study was to see what effect the use of semaglutide had on total hip arthroplasty patient outcomes. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, Weight Research / 28.08.2023

MedicalResearch.com Interview with: Dr. Alexis Elias Malavazos Endocrinology Unit Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy   MedicalResearch.com: What is the background for this study? Response: Psoriasis is a systemic inflammatory disease often associated with obesity and type-2 diabetes (T2D). The inflammatory process of psoriasis can target adipose tissue depots, particularly those surrounding the heart and the coronary arteries, exposing them to an increased risk of cardiovascular disease. (more…)
Author Interviews, Biomarkers, Brigham & Women's - Harvard, Diabetes, Endocrinology / 26.06.2023

MedicalResearch.com Interview with: Dr. Bita Zahedi MD MA Endocrinologist Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: The purpose of this study was to develop and validate a measure of dietary advanced glycation end-products (AGEs) to investigate the role of dietary AGEs in diabetic disease processes.  AGEs are a group of highly reactive compounds involved in the pathophysiology of diabetic complications, such as microvascular disease, cardiomyopathy, and possibly bone health. AGEs form through a nonenzymatic reaction between reducing sugars and free amino groups of proteins, lipids, and nucleic acids, also known as a Maillard or browning reaction. Endogenous AGE formation and accumulation is a normal part of metabolism and aging, however the process of glycation can be enhanced by hyperglycemia, hyperlipidemia, and increased oxidative stress. Additionally, AGEs can be absorbed from exogenous sources via consumption of various food items. Prior studies demonstrate that skin AGEs are predictive of Dietary AGEs (dAGEs) which are naturally present in certain uncooked foods, mainly animal-derived products, furthermore the method of food preparation can result in significant AGE formation. Considering the ubiquitous intake of dAGEs, it is possible that the consumption of exogenous AGEs contribute to AGE-induced oxidative stress, inflammation, and its subsequent detrimental sequalae. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Ophthalmology / 16.06.2023

MedicalResearch.com Interview with: Ali Hafezi-Moghadam, Ph.D., M.D Director, Molecular Biomarkers Nano-Imaging Laboratory (MBNI) Associate Professor of Radiology, Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: “It is very easy to answer many fundamental biological questions” said Richard Feynman in his 1959 address, where he also offered his simple and ingenious solution: “you just look at the thing!”[1]. As a biologist, I am familiar with the challenges surrounding looking at things in the context of life. There is no single device or technology that lets me simply see the answers to my questions. How does diabetes harm the tissues in the body? When exactly does the pathology start and which molecules and cells are involved? Trying to answer these questions, I have spent the past two decades innovating new ways of quantifying expression of molecules in the living organism [2]. At the same time to study diabetes, we needed a realistic rodent model that mirrors the human disease. In collaboration with KC Hayes[3], we first introduced the Nile grass rat (NGR, Arvicanthis niloticus), a gerbil that recapitulates the main features of the human type 2 diabetes [4]. For visualization of early changes, the eye offers a unique site. Much of my lab’s work focused on the first effects of diabetes in the retina, the site of the neurons that perceive light in the back of the eye [5], [6], [7]. In recent studies, we focused on how diabetes affects the lens in the eye of our animals [8], [9]. Diabetes is a major risk factor for cataract formation, a condition during which the lens loses its original transparency to visible light. How diabetic cataracts are formed is not well understood. A popular and prevailing theory, termed “sugar cataracts”, has been around for over half a century. According to the sugar hypothesis of cataracts, the excess levels of the sugar molecule, glucose, in the lens are transformed through the polyol pathway into the sugar-alcohol sorbitol. The resulting osmotic dysbalance leads to swelling of the fiber cells and opacity of the lens. Even though the sugar hypothesis has never been proven, it was generally accepted and remained unchallenged for a very long time. That is where our latest experimental results became relevant. (more…)
Anemia, Author Interviews, Diabetes, Kidney Disease, NEJM / 30.05.2023

MedicalResearch.com Interview with: Prof. Heerspink Prof. Hiddo Lambers Heerspink, PhD PHARMD Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen

MedicalResearch.com: What is the background for this study? What is dapagliflozin primarily indicated for?   Response: Dapagliflozin is a sodium glucose cotransporter 2 (SGLT2) inhibitor. The multinational, double-blinded, randomized, placebo-controlled, DAPA-CKD trial demonstrated the kidney and cardiovascular benefits of dapagliflozin in 4304 patients with chronic kidney disease (CKD) with and without type 2 diabetes (T2D). Based on the results of this and other trials, current guidelines recommend use of SGLT2 inhibitors in patients with CKD, T2D, or heart failure. Anemia is common among patients with CKD and is associated with worse clinical outcomes. Previous studies showed that SGLT2 inhibitors increase hemoglobin and hematocrit levels, but data are lacking in patients with CKD with and without T2D. In this post-hoc analysis of DAPA-CKD, we assessed the effect of dapagliflozin versus placebo on the correction and prevention of anemia in this population. (more…)
Author Interviews, Diabetes, Gastrointestinal Disease / 04.05.2023

MedicalResearch.com Interview with: Celine B. E. Busch, Research Associate Gastroenterology and Hepatology Standard PhD Candidate Dr. Jacques Bergman Professor, Gastroenterology and Hepatology Amsterdam UMC MedicalResearch.com: What is the background for this study? Would you describe the ReCET procedure? Response: Currently more than 400 million people worldwide have type 2 diabetes (T2D) and these numbers are rapidly increasing. At the moment there is no treatment option available that effectively treats the root cause of T2D, i.e. insulin resistance, the increasing loss of response to our body’s own insulin. T2D is generally treated with drug therapy, yet drug therapy can be expensive, requires the patient to take their drugs every day, and at best “controls” the disease without actually resolving it. Despite the availability of many T2D drugs, less than 50% of all T2D have adequately controlled blood glucose levels. The duodenum (the first part of the small bowel, immediately distal to the stomach) has proven to play a crucial role in glucose homeostasis in T2D. We know from bariatric surgery, that bypassing the duodenum by an Roux-en-Y Gastric Bypass has an immediate and profound effect on T2D by improving the sensitivity to the body’s own insulin resistance. However, performing invasive bariatric surgery for many T2D is not feasible. But we can reach the duodenum easily via upper GI endoscopy. ReCET is a single endoscopic procedure, performed under deep sedation. The ReCET catheter is advanced next to the scope, and once it is placed in the duodenum the flex circuit is unfolded until it touches the full circumference of the duodenum. The flex circuit contains the electrodes that create a pulsed electric field which “electroporates” the cells. Electroporation irreversibly makes small, that cause the cell to die of natural cell death, or apoptosis. This process can be precisely titrated for its depth of damage and does not generate heat thus avoiding damage to deeper wall layers, a major hurdle for standard endoscopic ablation techniques. The ReCET procedure lasts about 60 minutes to treat a 10-15 cm segment of the duodenum. The procedure does not cause significant side-effects and patients are discharged the same day. (more…)
Author Interviews, Diabetes, Karolinski Institute, Pediatrics, Weight Research / 28.02.2023

MedicalResearch.com Interview with: Yuxia Wei PhD Student Unit of Epidemiology Institute of Environmental Medicine Karolinska Institutet Stockholm | Sweden   MedicalResearch.com: What is the background for this study? Response: Diabetes is traditionally known for having two types (type 1 diabetes and type 2 diabetes). However, it is becoming increasingly clear that diabetes is much more complex than this traditional classification. Several attempts have been made to address this heterogeneity and in 2018, a  Swedish ground-breaking study proposed that there are five distinct subtypes of diabetes in adults. They have been replicated in different populations and it has been shown that there are differences between the subtypes in terms of genetics and risks of complications. Another way of elucidating the relevance of these subtypes is to investigate whether the influence of known risk factors for diabetes is different on different subtypes. Our study is one of the first attempts to address this. We used a study design known as Mendelian randomization, to investigate the influence of childhood obesity on these diabetes subtypes that typically occur after age 35. This work was a collaboration between Karolinska institutet in Stockholm, University of Bristol in the UK and Sun Yat-Sen University in China. (more…)
Author Interviews, Diabetes, NEJM / 09.02.2023

MedicalResearch.com Interview with: Brian S Kim, MD, MTR Sol and Clara Kest Professor Vice Chair of Research | Site Chair, Mount Sinai West and Morningside Director, Mark Lebwohl Center for Neuroinflammation and Sensation The Kimberly and Eric J. Waldman Department of Dermatology Precision Immunology Institute | Friedman Brain Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: We generated preliminary data in mice that difelikefalin suppresses itch robustly with very little to no effect on inflammation in a model of atopic dermatitis. This led us to hypothesize that the primary mode of action of difelikefalin must be by direct modulation of sensory neurons to suppress itch and thus would be best suited for a neuropathic itch condition. These are conditions in which itch occurs relatively independently of skin inflammation as in atopic dermatitis due to hyperactive nerves. (more…)
Author Interviews, Diabetes, JCEM, Pharmacology / 28.01.2023

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle, MedicalResearch.com Interview with: Tingting Geng PhD Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and Safety Ministry of Education Key Lab of Environment and Health State Key Laboratory of Environment Health (Incubating) School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan, China MedicalResearch.com: What is the background for this study? Response: Previous studies have suggested that proton pump inhibitors (PPIs) may lead to an increase in cardiovascular events due to the drug-drug interactions between PPIs and clopidogrel and gut microbiota dysbiosis. Patients with Type 2 Diabetes (T2D) are at more than three times higher prevalence of using PPIs, and two- to fourfold higher risk of developing cardiovascular complications and premature death than general populations. However, evidence regarding the influence of PPI use on subsequent risks of cardiovascular disease and mortality among patients with T2D is scarce. We conducted a prospective study using the UK Biobank study to examine the association of PPI use with risks of coronary artery disease, myocardial infarction, heart failure, stroke and mortality among patients with T2D. Using multivariable-adjusted Cox regression models and a propensity score-matched cohort, researchers found robust results that PPIs use was associated with a higher risk of coronary artery disease (adjusted HR=1.27), myocardial infarction (adjusted HR=1.34), heart failure (adjusted HR=1.35), and mortality (adjusted HR=1.30). (more…)
Author Interviews, Circadian Rhythm, Diabetes, Exercise - Fitness, Hepatitis - Liver Disease / 01.11.2022

MedicalResearch.com Interview with: Jeroen van der Velde, PhD Leiden University Medical Center Dept. Clinical Epidemiology, C7-102 Leiden, The Netherlands MedicalResearch.com: What is the background for this study? Response: We hypothesized that, in addition to the amount of physical activity, the pattern in which physical activity is accumulated over the day is relevant for metabolic health. Several studies previously showed beneficial effects of interrupting sedentary periods with short periods of activity (breaks in sedentary time) on glucose control. In addition, very recently it has been argued that the timing of physical activity during the day may be relevant for metabolic health. This was mainly shown in animal studies and intervention studies with supervised high intensity exercise training in men with impaired glucose control or type 2 diabetes. If timing of physical activity matters in a ‘free-living’ setting in the general population is largely unknown. Therefore, our aim was to investigate associations of timing of physical activity and breaks in sedentary time with liver fat content and insulin resistance in a middle-aged population. (more…)
Author Interviews, Diabetes, Sleep Disorders, Weight Research / 26.09.2022

MedicalResearch.com Interview with: Steven K. Malin, PhD, FACSM (he/him) Associate Professor Department of Kinesiology and Health | School of Arts and Sciences Division of Endocrinology, Metabolism and Nutrition | Robert Wood Johnson Medical School Institute of Translational Medicine and Science New Brunswick, NJ 08901 MedicalResearch.com: What is the background for this study? Response: Type 2 diabetes is a condition where blood glucose (sugar) is elevated in the  blood. This can be problematic as it leads to blood vessel damage and the promotion of cardiovascular disease. Nearly 30 million people  in the U.S. have type 2 diabetes, making it a major public health issue. The cause is not entirely clear, but many, including our team view insulin resistance as a central culprit. Insulin resistance is when the body does not respond well to the hormone insulin. Insulin is vital because it promotes glucose uptake into tissues, like skeletal muscle. Two reasons that are often used to explain the development of insulin resistance include: poor diet (e.g. high sugar and/or high fat coupled with excess calories) and a lack of physical activity. However, more recently, a lack of sleep has been raised as another critical behavioral factor contributing to insulin resistance. Thus, targeting a healthy diet, activity and sleep pattern is thought to prevent the transition from health to insulin resistance and type 2 diabetes. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 20.09.2022

MedicalResearch.com Interview with: Michael Cabana, M.D., M.A., M.P.H Professor of Pediatrics Albert Einstein College of Medicine Physician-in-chief at the Children's Hospital at Montefiore Chair of the Department of Pediatrics at the Albert Einstein College of Medicine. Dr. Cabana joined the U.S. Preventive Services Task Force in January 2019 MedicalResearch.com: What is the background for this study? Response: Prediabetes and type 2 diabetes have historically been far more common in adults, but the number of children and teens who have these conditions is rising. However, there is still very limited research on whether screening, early detection, and early treatment of diabetes will improve a child’s long-term health. Due to this lack of evidence, the Task Force was unable to assess the benefits and harms of screening, particularly in Black, Hispanic, American Indian, and Pacific Islander populations, who are at a significantly higher risk of developing type 2 diabetes. We are calling for more research on this important topic. (more…)
Author Interviews, Diabetes, NEJM, OBGYNE / 19.08.2022

MedicalResearch.com Interview with: Professor Caroline Crowther MB ChB, DCH, FRANZCOG, MD, DDU, FRCOG, CMFM Maternal Fetal Medicine Subspecialist Professor of Maternal & Perinatal Health Liggins Institue Waipapa Taumata Rau | University of Auckland MwdicalResearch.com: What is the background for this study? Response: Gestational diabetes is a growing and significant health problem worldwide for women affected and their babies. Treatment of gestational diabetes improves maternal and infant health but it remains unclear what degree of maternal hyperglycaemia should be used to make the diagnosis. Because of this uncertainty, recommended diagnostic criteria vary around the world. The GEMS randomised trial assessed whether use of lower glycaemic diagnostic criteria, recommended by the International Association of Diabetes and Pregnancy Study Groups would improve perinatal health, without increasing maternal risks, compared to use of higher criteria, and to assess the effects on use of the health services. (more…)
Author Interviews, BMJ, Diabetes, Osteoporosis / 05.08.2022

MedicalResearch.com Interview with: Stig Larsen
 PhD Professor Emeritus Controlled Clinical Research Methodology and Statistics Norwegian University of Life Sciences Oslo, Norway

MedicalResearch.com:? What are the main findings?

Response: Osteoporosis is a major problem among elderly and malnourished people. Calcium, Vitamin D and Vitamin K are beneficial for bone health. Vitamin D stimulates calcium absorption and studies have shown that poor Vitamin K status intake is linked to low bone mass. Osteocalcin (OC) is a protein hormone found in the blood in activated and inactivated form. The activated form of Osteocalcin (cOC) binds calcium to bone tissue and plays an important role in regulating the metabolism. In addition, low levels of cOC are associated with insulin resistance, diabetes, and metabolic syndrome. It is desirable to have largest possible uOC, and vitamin K2 central in this process. The most important vitamin K2 variants in Jarlsberg® are the long-chain MK-7, -8, -9 and -9(4H), where lactic acid bacteria produce the first three, while MK-9(4H) is produced by Propionibacterium freudenreichii. The latter bacterium also produces the substance "1,4-dihydroxy-2- naphthoic acid" (DHNA), which has previously been shown to increase bone density in experimental mice. Two previous studies related to Jarlsberg® intake have been published:

  • The first study showed that cOC in the blood increased with increasing Jarlsberg® dose up to a daily intake of 57 grams of Jarlsberg®. Even more startling was that the total OC (tOC) level increased significantly, and that triglycerides and cholesterol were significantly reduced.1
  • The second study reproduced the findings from the first study and demonstrated additionally that the Jarlsberg dose of 57g/day could be reduced to 45 grams after 6 weeks without reducing the achieved level of tOC and vitamin K2.2

The BMJ-study3: The central variables measured in this study were the serum bone turnover markers (BTM); tOC and cOC, procollagen type 1 N-terminal propeptide (PINP) and serum cross-linked C- telopeptide type I collagen (CTX). Additionally, Vitamin K2 and Vitamin K status, serum calcium and serum magnesium were recorded together with the development in glycated hemoglobin (HbA1c), lipids and protein turnover. The participants in the study were randomly divided into two groups. One group of 41 healthy volunteer women of childbearing age ate 57 grams of Jarlsberg® per day and the other group of 25 women ate 50 grams of Camembert for 6 weeks. The Camembert was manufactured with a starting culture not producing Vitamin K2. The fat, protein, and energy content of the daily consumption of Jarlsberg® and Camembert is approximately the same. After 6 weeks, Camembert was replaced with 57 grams of Jarlsberg® per day for another 6 weeks. (more…)

Author Interviews, Diabetes, Kidney Disease / 08.06.2022

MedicalResearch.com Interview with: prof. dr. H.J. (Hiddo) Lambers Heerspink Clinical Pharmacologist Department Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen  MedicalResearch.com:  What is the background for this study?    Response: Tirzepatide is a novel GIP-GLP1 receptor agonist recently FDA approved for the treatment of type 2 diabetes. The SURPASS_4 trial demonstrated that in patients with type 2 diabetes at high cardiovascular risk tirzepatide compared to insulin glargine markedly reduces Hba1c and body weight. About 1 out of 3 patients with type 2 diabetes and CV disease has kidney disease and these patients are at high risk of kidney failure. The aim of this study was to assess whether tirzepatide could slow CKD progression in high risk individuals with type 2 diabetes participating in the SURPASS 4 trial.  (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 07.06.2022

MedicalResearch.com Interview with: HoJin Shin, BPharm, PhD Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The public health burden of cardiovascular disease has been increasing in people with diabetes along with the burden of diabetes itself.
  •  Cardiovascular disease affects approximately one-third of the population with type 2 diabetes and accounts for     50%–80% of their mortality
  • 1 in 10 people in the US has diabetes
Since 2008, the US FDA has recommended post-approval cardiovascular outcome trials to ensure the safety of new glucose-lowering drugs responding to this growing burden of cardiovascular disease in type 2 diabetes and the potential increase in cardiovascular risk with certain existing glucose-lowering drugs (e.g., rosiglitazone). Notably, SGLT-2i have demonstrated superiority to placebo in reducing the risk of cardiovascular events, including hospitalization for heart failure. Consequently, beginning in 2018, clinical guidelines in the US have recommended SGLT-2i as a preferred second-line treatment for patients with type 2 diabetes and cardiovascular disease. As the paradigm of second-line pharmacological treatment for type 2 diabetes has shifted to include the management of cardiovascular risk in addition to glycemic control, this further raised the question of whether SGLT-2i should be advanced to first-line treatment. Since 2019, SGLT-2i have been recommended as a first-line agent for patients with type 2 diabetes and cardiovascular disease by the European guidelines (the European Society of Cardiology and the European Association for the Study of Diabetes). In the absence of head-to-head RCTs, non-randomized studies using real-world data could provide information on whether SGLT-2i may have greater cardiovascular benefits over metformin more timely than randomized clinical trials among both patients with and without existing CVD. Therefore, we evaluated the risk for cardiovascular events among adults with T2D who initiated treatment with first-line SGLT-2i versus metformin in clinical practice. (more…)
Author Interviews, Diabetes, Genetic Research, Herpes Viruses / 12.05.2022

MedicalResearch.com Interview with: Prof. Annette Peters PhD Chair of Epidemiology Institute of Medical Information Sciences, Biometry and Epidemiology, Ludwig-Maximilians University Munich, Germany Institute of Epidemiology, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany German Center for Diabetes Research (DZD), München-Neuherberg, Germany MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: A large number of genetic, behavioural and environmental risk factors have been identified as contributing to the risk of type 2 diabetes. However, little is known about a potential link between virus infections and type 2 diabetes developments. We had the unique opportunity to use a multiplex assay to measure antibodies for herpes viruses by the Waterboer laboratory at the German Cancer Center in Heidelberg and set out to investigate the potential associations in the prospective KORA cohort. First of all, we detected that herpes virus antibodies were highly prevalent in the study population at baseline and increased with age. We found an association between Herpes simplex virus 2 and cytomegalovirus and type 2 diabetes during a seven year follow-up. These associations were robust against controlling for other known risk factors. (more…)
Author Interviews, Cleveland Clinic, Diabetes, JACC, Surgical Research, Weight Research / 14.04.2022

MedicalResearch.com Interview with: Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195  MedicalResearch.com:  What is the background for this study?    Response:  There is evidence that bariatric or weight loss surgery can decrease the risk of heart attack, stroke, and death in young and middle age patients with obesity and diabetes. However, the evidence is less clear for older patients and patients without diabetes. There is also no long-term data on outcomes of bariatric surgery in the Medicare beneficiaries. So, in our study, we aimed to report long-term outcomes of bariatric surgery from a contemporary nationwide cohort from the US, while also looking into outcomes in patients older than 65 years, and patients without type 2 diabetes specifically. (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes / 17.03.2022

MedicalResearch.com Interview with: Prof. Wolfgang Rathmann MSPH Prof. of Epidemiology Deputy Director, Institute for Biometrics and Epidemiology, German Diabetes Center, Heinrich Heine University Düsseldorf, Germany MedicalResearch.com:  What is the background for this study?  Response: Diabetes is associated with a poor prognosis of COVID-19. There have been raised concerns about a bidirectional relationship between diabetes and COVID-19. Recent studies raised the possibility that SARS-CoV-2 can cause diabetes. However, there is a lack of studies investigating the incidence of diabetes after recovery from COVID-19 in mild cases. To provide more evidence, we analyzed electronic health records from 1,171 general and internal medicine practices across Germany between March 2020 and January 2021. This included 35,865 patients who were diagnosed with COVID-19. The incidence of diabetes after COVID-19 was compared with patients, who were diagnosed with an acute upper respiratory tract infection (AURI), matched for sex, age, and comorbidities including obesity, high blood pressure, high cholesterol, heart attack, and stroke.  (more…)
Author Interviews, Dermatology, Diabetes / 22.02.2022

MedicalResearch.com Interview with: Chih-Shan Jason Chen, MD, PhD Director, Dermatologic and Mohs Micrographic Surgery Unit Memorial Sloan Kettering Skin Cancer Center at Hauppauge Attending Mohs Surgeon, Dermatology Service Memorial Sloan Kettering Cancer Center Chief, Dermatologic Surgery Northport VA Medical Center Associate Professor of Clinical Dermatology Renaissance School of Medicine at Stony Brook University MedicalResearch.com:  What is the background for this study?    Response: Managing a surgical wound on the lower leg can be a challenge. Often, higher wound tension, atrophic skin, edema, and compromised circulation result in higher risks of wound dehiscence and infection, and significantly limit the capacity of wound closure post-surgically. Therefore, healing by secondary intention is a practical option for many lower leg Mohs defects. However, a secondary intention wound on the lower leg is expected to take a longer time to heal. Certain factors such as older age and health conditions of the host may adversely affect healing time. Timolol is a nonselective beta-adrenergic receptor antagonist that has FDA approval for the treatment of glaucoma. In addition to this FDA-approved indication, topical timolol has several off-label uses in dermatology, such as for the treatment of infantile hemangiomas, venous stasis ulcers, and refractory wounds. Although timolol solution has been used in chronic wounds, knowledges of the efficacy and utility of timolol in an acute post-surgical wound setting is lacking. (more…)
Author Interviews, Diabetes, NEJM, Pediatrics, Technology / 20.01.2022

MedicalResearch.com Interview with: Dr Julia Ware (née Fuchs) Clinical Research Associate Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge Addenbrooke’s Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Management of type 1 diabetes is challenging in very young children, due to their high variability of insulin requirements and unpredictable eating and activity patterns. As a result, many young children do not meet the recommended glycemic targets, or only maintain recommended glycemic control with extensive caregiver input. This in turn leads to high management burden and reduced quality of life for the whole family. While the increasing use of continuous glucose-monitoring devices and insulin-pump therapy has led to reductions in the incidence of severe hypoglycaemia and diabetic ketoacidosis, and has been accompanied by modest improvements in glycemic control, the burden of management has remained high. Hybrid closed-loop systems (also called an artificial pancreas), in which an algorithm automatically adjusts insulin delivery on the basis of real-time sensor glucose levels, may address ongoing challenges in this age group. However, to date hybrid closed-loop studies involving very young children have been small and of short duration and the efficacy and safety of longer term use of a closed-loop system, as compared with standard therapy, was unclear.   To address this knowledge gap, we compared 16-week use of the Cambridge closed-loop algorithm with sensor-augmented pump therapy in children aged 1 to 7 years with type 1 diabetes in a multi-national randomised crossover study. (more…)
Author Interviews, Diabetes, Global Health, Lancet / 12.01.2022

MedicalResearch.com Interview with: Prof Dianna J Magliano PhD Baker Heart and Diabetes Institute Melbourne Australia  MedicalResearch.com: What is the background for this study? Response: Mortality among people with diabetes, and how it changes over time, is an important indicator of quality of and access to health care. However, population level trends in mortality among people with diabetes are inadequately described. The establishment of national diabetes registers, health insurance data and administrative data has allowed the examination of mortality among those with diabetes at a granular level which has been previously not possible. This has allowed us to examine whether global efforts in regards to diabetes care over the last couple of decades have been effective. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Author Interviews, Diabetes, Statins / 04.10.2021

MedicalResearch.com Interview with: Ishak Mansi, MD Staff Internist, VA North Texas Health System. Professor in Department of Medicine & Department of Data & Population Science, University of Texas Southwestern, Dallas, TX MedicalResearch.com: What is the background for this study? Response: Several scientific societies guidelines recommend Statins prescription to patients with diabetes aged 40 to 75 with LDL-cholesterol ≥70 mg/dL to prevent cardiovascular diseases from occurring. Statins have been shown to lower the risk of cardiovascular diseases. However, prior research has shown statins to be associated with increased insulin resistance. But doctors do not routinely measure “insulin resistance” for their patients, rather, it is done on research and academic circles only but not in everyday life. Increased insulin resistance may result in less controlled diabetes and/or escalation of anti-diabetes medications. (more…)