Author Interviews, Diabetes, Sugar / 30.01.2015

MedicalResearch.com Interview with: James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart InstituteJames J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute Medical Research: What is the background for this study? What are the main findings? Dr. DiNicolantonio: We performed a comprehensive literature review comparing the isocaloric exchange of added sugars (sucrose, also known as table sugar, or high fructose corn syrup) versus other types of carbohydrates (such as lactose found in milk, glucose, starch, or dextrose).  Our main findings were that "a calorie isn't a calorie," i.e., that added sugars are more harmful than other carbohydrates even when matched for calories for promoting pre-diabetes and diabetes and the related morbidity and mortality associated with these diseases
Author Interviews, Diabetes, Nature, University of Michigan / 23.01.2015

MedicalResearch.com Interview with: Martin G. Myers, Jr., M.D., M.P.H. Director, Michigan Diabetes Research & Training Center Associate Professor of Internal Medicine - MEND Division Professor of Molecular & Integrative Physiology Marilyn H. Vincent Professor of Diabetes Research and Department of Pharmacology, University of Cambridge, Cambridge, UK.MedicalResearch.com Interview with: Martin G. Myers, Jr., M.D., M.P.H. Director, Michigan Diabetes Research & Training Center Associate Professor of Internal Medicine - MEND Division Professor of Molecular & Integrative Physiology Marilyn H. Vincent Professor of Diabetes Research and Department of Pharmacology, University of Cambridge, Cambridge Medical Research: What is the background for this study? What are the main findings? Dr. Myers: Diabetic people who take insulin to treat their diabetes are at risk of low blood sugar, which can cause serious consequences (including death).  This risk increases as blood sugar control improves, and so this risk limits the ability to control blood sugar.  The body has a system (the counter-regulatory response) that acts to prevent blood sugar from going too low, but this is often impaired in diabetic patients. We identified a brain circuit that senses and responds to falling blood sugar, and which acts to increase blood sugar.  Furthermore, we showed that the hormone leptin modulates the sensitivity of this circuit, and identified the neurotransmitter (CCK) that acts in this circuit to increase blood sugar.  Thus, we have identified several potential drug targets that could be used to prevent or treat low blood sugar in insulin-treated diabetics.  If we are able to pharmacologically modulate the activity of this brain circuit, it could improve the treatment of these patients.
Author Interviews, Diabetes, PLoS / 23.01.2015

Dr. Holger Rehmann Department of Molecular Cancer Research UMC Utrecht The NetherlandsMedicalResearch.com Interview with: Dr. Holger Rehmann Department of Molecular Cancer Research UMC Utrecht The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Rehmann: We have developed a chemical modified version of the second messenger cAMP, Sp-8-BnT-cAMPS that allows selective activation of Epac2, a protein that augments glucose induced insulin secretion. The second messenger cAMP activates a couple of receptor proteins, which controls such divergent physiological effects as gene transcription, pacemaker activity, olfaction, and cell adhesion. Almost any cell responses in one or the other way to cAMP and thus selective action on only one cAMP receptor would be a requirement for a drug to induce specific effects. The study confirms that it is possible to pharmacologically discriminate between structurally highly related cAMP receptors. And indeed, Sp-8-BnT-cAMPS augments glucose induced insulin secretion in primary human islets. Epac2 is thus a putative target for the development of an antidiabetic drug.
Author Interviews, Brigham & Women's - Harvard, Diabetes, Diabetes Care, Nutrition / 19.01.2015

Jinnie J. Rhee Department of Epidemiology, Harvard School of Public Health, Boston, MAMedicalResearch.com Interview with: Jinnie J. Rhee MSc, ScD Department of Medicine, Stanford University School of Medicine Palo Alto, CA Medical Research: What is the background for this study? What are the main findings? Response: The goal of this study was to see if the dietary determinants of type 2 diabetes observed in predominantly white populations were similar to those in other racial and ethnic groups.  We created a dietary diabetes risk reduction score using eight different dietary factors found to be associated with risk of type 2 diabetes, where a higher score indicates a healthier overall diet (A higher score included low intakes trans fat, sugar-sweetened beverages, and red and processed meats; lower glycemic index; and higher intakes of cereal fiber, nuts, and coffee; and higher polyunsaturated to saturated fat ratio).  We found a protective association of similar magnitude between a healthy overall diet and type 2 diabetes risk in all racial and ethnic groups.  However, in terms of the actual number of preventable cases, a healthier diet conferred even greater benefit for minority women because they were initially at higher risk than white women. This study is significant because diabetes is a rapidly growing epidemic in most parts of the world, but most previous studies of diet and diabetes have been conducted in populations of European origin.  This analysis was very powerful because it combined two large populations with a total of 156,030 women who were followed for up to 28 years with many repeated assessments of diet.  This allowed us to conduct detailed analyses within specific racial and ethnic groups.
Author Interviews, Diabetes, Geriatrics, JAMA / 12.01.2015

Kasia Joanna Lipska MD, MHS Assistant Professor of Medicine (Endocrinology) Yale School of Medicine New Haven, CT 06520-8020MedicalResearch.com Interview with: Kasia Joanna Lipska MD, MHS Assistant Professor of Medicine (Endocrinology) Yale School of Medicine New Haven, CT 06520-8020 Medical Research: What is the background for this study? What are the main findings? Dr. Lipska: Diabetes is common and affects about 1 in 4 older adults (65 years or more). For younger adults with diabetes, most guidelines suggest lowering blood sugar levels to a hemoglobin A1c below 7%. However, in older patients, especially those with complex medical problems, the benefits of this strategy are unclear. What’s more, this strategy can cause harm. Aiming for a hemoglobin A1c below seven increases the risk for hypoglycemia. And older adults are especially susceptible to this risk. As a result, many guidelines suggest that treatment should be more cautious for these vulnerable elders and that aiming for “tight” blood sugar control may not be worth the risk. Medical Research: What are the main findings? Dr. Lipska: We looked at diabetes treatment of older adults using nationally representative data from 2001 to 2010. We found that 62% of older adults with diabetes had a hemoglobin A1c below 7%. But what’s really striking is that this proportion was similar for patients who were relatively healthy, for those with intermediate health, and for those with poor health. What’s more, the use of insulin or sulfonylureas (drugs that increase the risk for hypoglycemia) was common and similar across these groups.
Author Interviews, Diabetes, Ophthalmology, Telemedicine / 08.01.2015

MedicalResearch.com Interview with: Shi Lili Department of Medical informatics and Nantong University Library Nantong University, Nantong, China Medical Research: What is the background for this study? What are the main findings? Response: Diabetic retinopathy (DR) is the most frequently occurring complication of diabetes and one of the major causes of acquired blindness in the working-age population around the world. DR can be detected using various methods. Telemedicine based on digital photographs of the fundus is being used with increasing frequency to detect DR, and especially for Diabetic retinopathy screening. The purpose of our study was to assess the diagnostic accuracy of telemedicine in the full range of DR and DME severity compared with the current gold standard. We found that the diagnostic accuracy of telemedicine using digital imaging in DR was overall high. It can be used widely for Diabetic retinopathy screening.
Author Interviews, Diabetes, Lancet / 07.01.2015

Ahmad Haidar PhD Institut de Recherches Cliniques de Montreal Montreal, QC, CanadaMedicalResearch.com Interview with: Ahmad Haidar PhD Institut de Recherches Cliniques de Montreal Montreal, QC, Canada Medical Research: What is the background for this study? What are the main findings? Response: We published a study in 2013 (Canadian Medical Association Journal 185.4 (2013): 297-305) where we did the first randomized trial comparing dual-hormone artificial pancreas against conventional pump therapy. We showed spectacular reduction in hypoglycemia (8-fold) with the artificial pancreas, but the first question people asked: Out of the improvement you showed, how much is due to simply closing the loop between the glucose sensor and the insulin pump, and how much is due to adding glucagon? In other words: if you just close the loop with insulin alone and use an advanced dosing algorithm, you may get a very high reduction of hypoglycemia that glucagon may not be needed (glucagon is associated with increased cost and device complexity). We were not able to answer this question with our study design. Since then, there have been other studies by other groups either comparing single-hormone artificial pancreas vs conventional pump therapy, or comparing dual-hormone artificial pancreas vs conventional pump therapy, and most of these studies showed improvement of both artificial pancreas systems compared to conventional pump therapy. However, there has been no study comparing the three interventions to allow us to quantify the relative benefits of simply closing the loop between glucose sensor and insulin pump versus adding glucagon to the system. Quantifying the relative benefits of glucagon is important given the increased cost and device complexity of the dual-hormone artificial pancreas. So our study compared the three interventions, and is the first study to do so.
Author Interviews, Brigham & Women's - Harvard, Diabetes, JAMA / 02.01.2015

Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Massachusetts General Hospital, BostonMedicalResearch.com Interview with: Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Massachusetts General Hospital, Boston Medical Research: What is the background for this study? What are the main findings? Dr. Berkowitz: Prior studies had looked the association between single unmet basic material needs and diabetes control, but hadn't necessarily looked at multiple things people may not be able to afford, which more closely mirrors real-life. Also, prior studies had been done in a 'pre-Affordable Care Act' setting, while, by being in Massachusetts, our study was conducted in a setting of near-universal healthcare coverage that is similar to what the rest of the US is moving towards. We found that difficulties meeting basic material needs, such as difficulties affording food, known as food insecurity, and having financial barriers to taking medications, called cost-related medication underuse, are associated with worse diabetes control and increased use of costly health services in diabetes patients, despite near-universal health insurance coverage
Author Interviews, Diabetes / 30.12.2014

Aramesh Saremi MD Phoenix VA Health Care System Health Research Scientist Phoenix, AZ 85012-1892MedicalResearch.com Interview with: Aramesh Saremi MD   Phoenix VA Health Care System Health Research Scientist Phoenix, AZ 85012-1892   Medical Research: What is the background for this study? What are the main findings? Dr. Saremi: Our study was a post-hoc analysis of the data that was available from VA cooperative study,  the Veterans Affair Diabetes Trial  (VADT).  The VADT was one of the  recent landmark studies examining the effect of intensive glycemic control on cardiovascular events  in older adults with type 2 diabetes. The main finding in the VADT and other two other landmark studies (ACCORD and ADVANCE ) was that intensive glycemic control does not reduce cardiovascular  disease events in people with type 2 diabetes of moderate to long duration.  However, our subsequent post-hoc analysis suggests that intensive glycemic control was associated with reduced risk of cardiovascular events in Hispanics, but not in non-Hispanic Whites or Blacks.
Author Interviews, Diabetes, Diabetologia / 20.12.2014

MedicalResearch.com Interview with: Dr Guy Fagherazzi Center for Research in Epidemiology and Population Health INSERM, Villejuif, France, and colleagues. Medical Research: What is the background for this study? What are the main findings? Dr. Fagherazzi: Our work has been based on previous findings regarding the associations between blood type and the risk of stroke or coronary heart disease, where people with the O blood group seamed to have lower risk of developping the disease. The suggested mechanisms could be also be involved with type 2 diabetes. And our results were in agreement with our first hypothesis. We have followed more than 80 000 women from the E3N cohort study, during 18 years and we have found that individuals with the O blood type had lower risk of type 2 diabetes than the others (people with groups A, B and AB).
Author Interviews, Diabetes, Nature, Weight Research / 12.12.2014

MedicalResearch.com Interview with: Prof. Dr. Patrice D. Cani PhD, Research Associate FRS-FNRS Louvain Drug Research Instiute, Metabolism and Nutrition WELBIO, Walloon Excellence in Life sciences and BIOtechnology NeuroMicrobiota lab, European Associated Laboratory (INSERM/UCL) and Dr Amandine Everard Université Catholique de Louvain, Louvain Drug Research Institute, WELBIO (Walloon Excellence in Life sciences and BIOtechnology), Metabolism and Nutrition Research Group, Brussels, Belgium Medical Research: What is the background for this study? What are the main findings? Response: Our intestine harbors more than 100 trillions of bacteria. This huge number of bacteria permanently interacts with our own human cells. Among the systems involved in this crosstalk, the immune system plays a key role in these interactions. We previously showed that specific gut bacteria are able to control energy metabolism, harmful inflammation associated with obesity, body weight gain and type-2 diabetes. However mechanisms involved these effects of gut bacteria on the host during obesity and type-2 diabetes were poorly understood. We identify the essential role of the intestinal immune system in the onset of obesity and type-2 diabetes both induced by a high dose of fat in the diet. This discovery highlights an unexpected mechanism for the control of energy metabolism during obesity and type-2 diabetes. We demonstrate for the first time that the inactivation of a part of the intestine immune system (more specifically the protein MyD88), which is overstimulated by a diet rich in fat, allows to induce weight-loss and to reduce type-2 diabetes associated with obesity. When we tune the immune system by disabling the protein MyD88 specifically in cells covering the intestine, we are able to limit the adipose tissue development induced by the diet rich in fat, to slow down diabetes, to reduce harmful inflammation associated with obesity, to reinforce gut barrier function assumed by our intestine to avoid the inappropriate translocations of bacteria compounds from our intestine in our body. We reveal various mechanisms explaining the partial protection against obesity induced by the inactivation of this protein of the immune system. Among them, we point out that mice that do not have this protein of the immune system (i.e. MyD88) in their intestine are partially protected against obesity because they spend more energy than other obese mice. Moreover, our study shows that this protein of the immune system is able to shape the composition of the gut microbiota residing in our intestine under a high-fat diet. These changes observed in mice deleted for this protein also explain their protection against obesity because when we transfer intestinal bacteria of these mice into other mice that are axenic (without flora), these latest mice are also partially protected against obesity. In conclusions, our studies published in the scientific journal Nature Communications, demonstrated that during consumption of fat food, the intestinal immune system plays an important role in fat storage regulation in the body and is capable to modify the composition of intestinal bacteria (including some which are still unidentified), confirm the implication of intestinal bacteria in the onset of obesity.
Author Interviews, Diabetes, Heart Disease / 07.12.2014

Simin Liu, MD, ScD, Professor of Epidemiology School of Public Health, Professor of Medicine The Warren Alpert School of Medicine Director, Molecular Epidemiology and Nutrition Brown UniversityMedicalResearch.com Interview with: Simin Liu, MD, ScD, Professor of Epidemiology School of Public Health, Professor of Medicine The Warren Alpert School of Medicine Director, Molecular Epidemiology and Nutrition Brown University MedicalResearch: What is the background for this study? What are the main findings? Dr. Liu: Cardiovascular Disease (CVD) and type 2 diabetes (T2D) are highly heritable and share many risk factors and show ethnic-specific prevalence. Nevertheless, a comprehensive molecular-level understanding of these observations is lacking. We conducted a comprehensive assessment of whole genome assessment using network-based analysis in >15,000 women and identified eight molecular pathways share in both diseases as well as several “key driver” genes that appear to form the gene networks in which these pathways connect and interact.
Author Interviews, Diabetes, General Medicine / 28.11.2014

Longjian Liu, MD, PhD, MSc(LSHTM), FAHA Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics Senior Investigator, Center for Health Equality Drexel University School of Public Health, and Adjunct Associate Professor of Medicine, Drexel U. College of Medicine MedicalResearch.com Interview with: Longjian Liu, MD, PhD, MSc(LSHTM), FAHA Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics, Senior Investigator, Center for Health Equality Drexel University School of Public Health, and Adjunct Associate Professor of Medicine, Drexel U. College of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Liu: The prevalence of diabetes is increasing rapidly in the United States and worldwide. In 2010, 25.8 million Americans, or 8.3% of the population had diabetes in the United States. In 2012, these figures were 29.1 million, or 9.3% in the nation. Philadelphia, the largest city in PA, ranks as the 5th largest city in the nation. However, the city also had the highest prevalence of diabetes according to the national surveys in 2009. We face a great challenge to stop the epidemic of diabetes locally and nationally. It is well-known personal risk factors at individual level, including lifestyles, play a role in the prevention and control of diabetes. However very limited studies addressed the importance that physical and socioeconomic environmental factors at community level may also play a pivotal role in the prevention and control of the disease. This study aimed to quantitatively examine (1) the trend of diabetes from 2002 to 2010 in the city of Philadelphia, and (2) the impact of physical and socioeconomic environmental factors at community level (assessed using zip-codes based neighborhoods) on the risk of the prevalence of diabetes. The main findings support our hypotheses that
  • (1) the prevalence of diabetes significantly increased from 2002 to 2012.
  • (2) residents who lived in neighborhoods with physical and socioeconomic disadvantage had an increased risk of the prevalence of diabetes.
Author Interviews, BMC, Brigham & Women's - Harvard, Diabetes, Nutrition / 27.11.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalresearch.com with: Frank B. Hu, MD, PhD Professor of Nutrition and Epidemiology Harvard School of Public Health Professor of Medicine Harvard Medical School Boston, MA 02115 Medical Research: What is the background for this study? Dr. Hu: Type 2 diabetes (T2D) affects approximately 26 million people in the United States and 366 million people worldwide, and thus primary prevention of T2D has become a public health imperative. The relation between consumption of different types of dairy and risk of type 2 diabetes remains uncertain. 
Author Interviews, Diabetes, Exercise - Fitness / 25.11.2014

Lauren Marie Sparks, PhD Faculty Scientist at the Translational Research Institute for Metabolism and Diabetes Florida Hospital and the Sanford-Burnham Medical Research Institute Orlando, FLMedicalResearch.com Interview with: Lauren Marie Sparks, PhD Faculty Scientist at the Translational Research Institute for Metabolism and Diabetes Florida Hospital and the Sanford-Burnham Medical Research Institute Orlando, FL Medical Research: What is the background for this study? What are the main findings? Dr. Sparks: As a clinical scientist focused on exercise effects on muscle metabolism in diabetes, I have seen first-hand a significant minority of individuals with diabetes not improve their glucose control (HbA1c) after 9 months of supervised exercise. They poured their hearts out on those treadmills 3-4 days a week for 9 months and still ended up no better than when they started. I have also seen similar data from some of my colleagues’ studies. So I really want diabetes research to invest the intellect and dollars into discovering what these roadblocks are—I happen to believe it is in the DNA (genetics) and the way that DNA is “read” or expressed (epigenetics). So it’s a bit of a ‘call to action’ for researchers to start looking into some of their data to find these people and better understand this phenomenon and for hopefully the funding sources to recognize this as a viable area of research.
Author Interviews, Brigham & Women's - Harvard, Diabetes, Nutrition / 23.11.2014

MedicalResearch.com Interview with: Wenjie Ma MS Doctoral Student Harvard School of Public Health Medical Research: What is the background for this study? What are the main findings? Response: De novo lipogenesis (DNL) is the process whereby excess carbohydrate and protein are converted into saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs). Emerging animal and in vitro evidence suggests that DNL might play an important role in metabolic regulation and influence the pathogenesis of type 2 diabetes. We used circulating biomarkers SFAs and MUFAs to investigate the prospective associations with incident diabetes in the Cardiovascular Health Study, a community-based cohort of older US adults. We found that circulating palmitic acid and stearic acid were associated with higher risk of incident diabetes, whereas vaccenic acid was associated with lower risk. In contrast, dietary intakes of saturated fatty acids and monounsaturated fatty acids were not associated with diabetes risk.
Author Interviews, Diabetes, Nutrition / 18.11.2014

Dr. Patrice Carter Diabetes, Nutrition & Lifestyle Research Associate Diabetes Research Centre (Broadleaf) University of Leicester Leicester General Hospital Leicester UKMedicalResearch.com Interview with: Dr. Patrice Carter Diabetes, Nutrition & Lifestyle Research Associate Diabetes Research Centre (Broadleaf) University of Leicester Leicester General Hospital Leicester UK Medical Research: What is the background for this study? What are the main findings? Dr. Carter: Type 2 diabetes is a growing concern, worldwide prevalence is expected to increase to 552million by 2030.  Prevalence is closely linked to increasing obesity rates which are associated to environmental changes that have led to more sedentary lifestyles and poor-quality dietary intake.  Consumption of fast food has previously been linked to the obesity epidemic and consumption is associated with low adherence to dietary recommendations. We analysed data of over 10,000 individuals to investigate the association between screen detected type 2 diabetes and the number of fast food outlets in their neighbourhood. In summary we found the mean number of fast food outlets in areas with high social deprivation as compared to low social deprivation; mean number  of outlets was 3.53 (SD 4.83) and 0.91 (1.89) respectively. The number of fast food outlets was positively associated with screen-detected type 2 diabetes (OR=1.05; 95% CI 1.04, 1.07; p<0.001).  In addition, we used these data to calculate that for every additional two outlets we would expect to see one more diabetes case, assuming a 7% prevalence of undiagnosed type 2 diabetes in neighbourhoods with no outlets and approximately 200 residents in a 500m radius, and assuming a causal relationship.
AHA Journals, Author Interviews, Diabetes, Heart Disease, Metabolic Syndrome, Weight Research / 12.11.2014

Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director, Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health, LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, LouisianaMedicalResearch.com Interview with: Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, Louisiana Medical Research: What is the background for this study? What are the main findings? Dr. Hu: Many previous studies had small samples, and thus lacked adequate statistical power when the analysis was focused on those who are extremely obese (BMI ≥40 kg/m2). In addition, most epidemiological studies only use a single measurement of BMI at baseline to predict risk of all-cause mortality, which may produce potential bias. The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2.
Author Interviews, CMAJ, Diabetes, Electronic Records / 04.11.2014

Dr. Tim A. Holt PhD MRCP FRCGP NIHR Academic Clinical Lecturer University of Oxford Department of Primary Care Health Sciences Radcliffe Observatory Quarter Woodstock Road OxfordMedicalResearch.com Interview with: Dr. Tim A. Holt PhD MRCP FRCGP NIHR Academic Clinical Lecturer University of Oxford Department of Primary Care Health Sciences Radcliffe Observatory Quarter Woodstock Road Oxford Medical Research: What is the background for this study? Dr. Holt: Undiagnosed diabetes is a serious and very costly problem. Early diagnosis is important to reduce risk of long term complications. A structured approach to management at the practice level involves electronic diabetes registers, enabling audit of care, automated recall, and screen reminders. Such registers depend on the presence of an electronic code for diabetes in the record. 
Author Interviews, Diabetes, General Medicine, Heart Disease / 03.11.2014

MedicalResearch.com Interview with: Dr. Arnold Ng, MBBS, PhD Department of Cardiology Princess Alexandra Hospital University of Queensland, Australia Medical Research: What is the background for this study? What are the main findings? Dr. Arnold: The WHO and American Diabetes Association currently recommends the use of HbA1c >=6.5% as a diagnostic criterion for diabetes. HbA1c is advantageous over fasting plasma glucose and glucose tolerance testing by avoiding the need for patient fasting and inconvenient patient preparation. In addition, patients who are acutely unwell (e.g. STEMI) may develop stress hyperglycemia, complicating the diagnosis of diabetes. It is currently unclear if HbA1c (indicative of overall glycemic control) or fasting plasma glucose predicts worse left ventricular function after acute STEMI. The present study demonstrated that HbA1c identified approximately another 20% of previously undiagnosed patients as diabetic. Furthermore, the present study was first to demonstrate that HbA1c, not fasting plasma glucose, was independently associated with more impaired LV diastolic function and elevated filling pressures after STEMI.
Author Interviews, CDC, Diabetes, OBGYNE / 30.10.2014

Dr. Cora Peterson PhD Health Economist at Centers for Disease ControlMedicalResearch.com: Interview with: Dr. Cora Peterson PhD Health Economist at Centers for Disease Control Medical Research: What is the background for this study? What are the main findings? Dr. Peterson: Women with pregestational diabetes mellitus (PGDM) have increased risk for adverse birth outcomes. Preconception care for women with  pregestational diabetes mellitus reduces the frequency of such outcomes, most likely by improving glycemic control before and during the critical first weeks of pregnancy. Preconception care for women with  pregestational diabetes mellitus includes the following activities:
  • medical or dietary blood sugar control, blood sugar monitoring, screening and treatment of complications due to diabetes,
  • counseling and education about the risks of diabetes in pregnancy, and
  • using effective birth control or contraceptives until appropriate levels of blood sugar are achieved.
In this study, CDC researchers estimated the number of preterm births, birth defects, and perinatal deaths (death between the time a baby is at least 20 weeks old in the mother’s womb to one week after the baby is born) that could be prevented and the money that could potentially be saved if preconception care was available to and used by all women with  pregestational diabetes mellitus before pregnancy. Researchers estimated about 2.2% of births (88,081 births each year) in the United States are to women with pregestational diabetes mellitus, including women who know they have diabetes before they become pregnant and those who are unaware they have diabetes. Preconception care before pregnancy among women with known pregestational diabetes mellitus could potentially generate benefits of up to $4.3 billion by preventing preterm births, birth defects, and perinatal deaths. Up to an additional $1.2 billion in benefits could be produced if women who do not know they have diabetes were diagnosed and received preconception care.
Author Interviews, Diabetes, Infections, OBGYNE / 27.10.2014

Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head of the WHO Collaborating Center for the Study of Diabetes in YouthMedicalResearch.com Interview with: Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head WHO Collaborating Center for the Study of Diabetes in Youth Medical Research: What are the main findings of the study? What was most surprising about results? Prof. Laron: The main findings were the finding of specific antibodies to the pancreatic insulin secreting beta cells together with antibodies against rota-virus in both the mother at delivery and in the newborn's cord blood. We were not surprised, but pleased to find proof to our hypothesis that part, if not the majority of childhood onset Type 1 (autoimmune diabetes) starts "in utero".
Author Interviews, Diabetes, Infections / 20.10.2014

MedicalResearch.com Interview with: Dr Tsai Chung-Li Graduate Institute of Biostatistics, College of Management, China Medical University,Taichung, Taiwan and Dr. Hsiao-Chuan Lin Department of Public Health, College of Public Health, and Department of Pediatrics, China Medical University, Taichung, Taiwan Medical Research: What are the main findings of the study? Response: We conducted a nationwide population-based cohort study that included two groups. Children with enterovirus infection (aged < 18 years) during 2000-2007 were identified and followed up until December 31, 2008 or until first occurrence of type 1 diabetes. The group without enterovirus infection comprised half of all insured children of the same age and without a diagnosis of enterovirus infection. By use of frequency-matching with sex and birth year, children in the group with enterovirus were selected from those eligible. This nationwide retrospective cohort study found:
  • type 1 diabetes is positively correlated with enterovirus infection in patients younger than 18 years.
  • the incidence rate of type 1 diabetes was lower in the non-enterovirus than the enterovirus group (4 vs 6 per 100,000 person-years; incidence rate ratio 1.48 [95% CI 1.19, 1.83]).
  • children that have been infected with enterovirus are 48% more likely to have developed type 1 diabetes.
  • the risk of developing type 1 diabetes is 2.18 times greater among children aged 10 years and older than among those aged younger than 1 year.
Author Interviews, Diabetes, Imperial College, Nature / 15.10.2014

Dr. David Hodson PhD Faculty of Medicine, Department of Medicine Imperial College LondonMedicalResearch.com: Interview with: Dr. David Hodson PhD Faculty of Medicine, Department of Medicine Imperial College London Medical Research: What is the background for this research? Dr. Hodson: Type 2 diabetes represents a huge socioeconomic challenge. As well as causing significant morbidity due to chronically elevated glucose levels, this disease is also a drain on healthcare budgets (~$20billion in the UK per year). While current treatments are effective, they are sometimes associated with side effects, usually due to off-target actions on organs such as the heart and brain. In addition, the ability to regulate blood glucose levels more tightly may decrease complications stemming from type diabetes (e.g. nerve, kidney and retina damage). As a proof-of-principle that the spatiotemporal precision of light can be harnessed to finely guide and control drug activity, we therefore decided to produce a light-activated anti-diabetic.
Author Interviews, CMAJ, Diabetes, Thyroid Disease / 07.10.2014

MedicalResearch.com Interview with: Jean-Pascal Fournier, MD, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and Laurent Azoulay, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Department of Oncology, McGill University, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36).
Author Interviews, Diabetes, Lancet / 03.10.2014

Dr Nita Forouhi Lead Scientist and Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical MedicineMedicalResearch.com Interview with: Dr Nita Forouhi, MRCP, PhD, FFPHM Lead Scientist and Programme Leader MRC Programme Leader and Consultant Public Health Physician MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge Biomedical Campus Cambridge, UK Medical Research: What are the main findings of the study? Dr. Forouhi: This large study found that low blood concentrations of 25-hydroxyvitamin D [25(OH)D], a clinical indicator of vitamin D status, were associated with an increased risk of type 2 diabetes, but this did not appear to be a cause-effect relationship. To investigate these associations, we did two things. We first did a systematic review and meta-analysis across 22 published studies and confirmed that there was a strong inverse relation between vitamin D levels and the risk of future new-onset type 2 diabetes among people who did not initially have diabetes. We then used a genetic approach, called Mendelian randomisation, which allows us to test a cause-effect relationship, and found that genetically lower vitamin D levels were not related to risk of type 2 diabetes. This means that we were able to distinguish between association and causation, and concluded that the vitamin D levels did not have a causal link with type 2 diabetes.
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Genetic Research / 01.10.2014

Dr. Yann C Klimentidis, PhD Assistant professor of Epidemiology and Biostatistics Mel and Enid Zuckerman College of Public Health University of Arizona Medical CenterMedicalResearch.com Interview Invitation with: Dr. Yann C Klimentidis, PhD Assistant professor of Epidemiology and Biostatistics Mel and Enid Zuckerman College of Public Health University of Arizona Medical Center   Medical Research: What are the main findings of the study? Dr. Klimentidis: The main finding is that the association of physical activity with type-2 diabetes risk is weakest among those who are at high genetic risk for type-2 diabetes. Furthermore, we find that this trend is stronger among women as compared to men, and that it appears to be driven mainly by genetic risk to insulin resistance, as opposed to genetic risk for reduced beta-cell function.
Author Interviews, Diabetes, Heart Disease / 29.09.2014

MedicalResearch.com Interview with: Jorge F. Saucedo MD Allstate Foundation, Judson B. Branch Chair of Cardiology Head, Division of Cardiology Co-Director Cardiovascular Institute NorthShore University HealthSystem Clinical Professor of Medicine University of Chicago Pritzker School of Medicine Talla A. Rousan, MD Oklahoma City, OK. First author of study. Medical Research: What are the main findings of the study? Answer: It was found that patients with diabetes mellitus (DM) presenting with acute myocardial infarction (AMI) have a higher in-hospital mortality rate compared to patients without DM. Patients with insulin-requiring diabetes mellitus presenting with non-ST-segment elevation myocardial infarction had higher in-hospital mortality rate than patients with non-insulin requiring diabetes mellitus.
Author Interviews, Diabetes, Lipids, Statins / 22.09.2014

\MedicalResearch.com Interview with: Prof. Moses Elisaf Professor of Internal Medicine University of Ioannina, Greece Medical Research: What are the main findings of the study? Dr. Elisaf: We evaluated the effects of rosuvastatin in two groups of hyperlipidemic patients: one group had impaired fasting glucose (IFG) while the second group had normal fasting glucose. After study end, both groups had similar changes in their lipidemic profile. However, patients with IFG had a significant greater decrease in the cholesterol concentration of the more atherogenic small dense low-density lipoprotein (sdLDL) particles (-65.7%) compared with controls (-38.5%). Moreover, a greater increase in the mean LDL particle size was observed in the impaired fasting glucose group (+1.5% vs +0.4%). In addition, redistribution from the more atherogenic sdLDL to large buoyant LDL (lbLDL) subfractions was observed in the IFG group.
Author Interviews, Diabetes / 22.09.2014

MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu Department of Cardiology, the First People's Hospital of Shunde, Shunde District, Foshan, PR China. Medical Research: What are the main findings of the study? Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines. In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses.