Author Interviews, Diabetes, Diabetes Care / 08.07.2014

MedicalResearch.com: Interview with: Interview with Professor Donald W Bowden and Dr. Amanda J Cox Center for Diabetes Research, Center for Genomics and Personalized Medicine Research Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC Medical Research: What are the main findings of the study? Answer: The study examined modifiable cardiovascular disease (CVD) risk factors and risk for mortality in a subset of individuals from the Diabetes Heart Study who were at high risk based for cardiovascular disease based on burden of subclinical CVD assessed by coronary artery calcified plaque scores greater than 1000. Even among this high risk group, known CVD risk factors were still useful in assessing ongoing risk for mortality.  Use of cholesterol-lowering medication was one factor identified to be protective against mortality.
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness / 07.07.2014

Lukas Schwingshackl, MSc Department of Nutritional Sciences University of Vienna Vienna, AUSTRIAMedicalResearch.com: Interview with: Lukas Schwingshackl, MSc Department of Nutritional Sciences University of Vienna Vienna, AUSTRIA Medical Research: What are the main findings of the study? Lukas Schwingshackl: The results of the present meta-analyses showed that, in patients with established diabetes, aerobic training might be more effective in reducing glycosylated haemoglobin and fasting glucose when compared with resistance training. Combined aerobic and resistance training was more powerful in reducing glycosylated haemoglobin compared with aerobic training, and more effective in reducing glycosylated haemoglobin, fasting glucose and tricylglycerols when compared with resistance training. However, these results could not be confirmed when only low risk of bias studies were included.
Author Interviews, Diabetes, Lancet / 03.07.2014

MedicalResearch.com Interview with: Professor Yves Reznik Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center Caen, France MedicalResearch: What are the main findings of the study? Prof. Reznik: OPT2MISE definitively demonstrate that pump therapy is a valuable option for treating those type 2 diabetes patients with uncontrolled hyperglycemia despite a high dose insulin regimen including at least 3 injections per day of rapid-acting and slow-acting insulin analogues, the gold standard for intensified insulin therapy. Such benefit on glucose control is obtained with lower daily insulin doses and without weight gain in comparison with multiple injection therapy. Pump therapy is effective in a population of patients un-preselected for their ability to deal with a medical device.
Diabetes, Transplantation, Weight Research / 03.07.2014

Yalcin Basaran, MD Gulhane Military Medical Academy School of Medicine Ankara, Turkey.MedicalResearch.com Interview with: Yalcin Basaran, MD Gulhane Military Medical Academy School of Medicine Ankara, Turkey. MedicalResearch: What are the main findings of the study? Dr. Basaran: We designed a cross-sectional study to identify the relation between the gut microbiota composition and obesity and diabetes. 27 severely obese individuals (20 men and 7 women with mean BMI: 39.98±5.56 kg/m2), 26 patients with newly diagnosed type 2 diabetes (18 men and 8 women with mean BMI: 28.63±5.08 kg/m2) and 28 healthy control subjects (22 men and 6 women with mean BMI: 23.02±1.70 kg/m2), between 18-65 years of age, were included in the present study. None of the participants was undergoing chronic treatment and no antibiotics, probiotics or prebiotics were taken within 3 months before collecting fecal material. Fecal samples were self-collected in sterile boxes, stored at -80o until analysis, and analyzed by quantitative real-time PCR for the presence of the most common types of intestinal bacteria. Although tended to increase, we observed no significant difference between the three groups in regards to fecal concentrations of Bacteroidetes. There was also no considerable difference in the fecal Bifidobacteria, Firmicutes and Clostridium Leptum levels among the obesity and diabetes groups. However, Bifidobacteria, Firmicutes and Clostridium Leptum counts were all significantly lower in obese and diabetic patients compared with healthy control individuals. Additionally, logistic regression analysis showed that parameters of adiposity (weight, BMI and waist circumference) and those of glucose control (FBG and HbA1c) were related to the altered gut microbiota composition. This suggests that alterations in the gut microbiota composition may influence metabolic profile in humans.
Author Interviews, Diabetes, JAMA / 01.07.2014

MedicalResearch.com Interview with:Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan MedicalResearch: What are the main findings of the study? Dr. Vijan: The main finding was that the burdens and side effects of intensive glycemic treatment significantly detract from the overall benefit of lower risks of diabetes complications, often to the point where the treatments cause more loss than gain in quality of life. It takes many (often 15-20) years to gain benefit from treatment, but the burdens begin right away and continue throughout treatment. By the time you might experience treatment benefit in terms of reduced complication risk, you've had a lot of years to have the downsides of treatment - which commonly include significant weight gain, low blood sugars, gastrointestinal symptoms, not to mention having to take multiple pills or injections on a daily basis.
Author Interviews, Diabetes, Genetic Research, Nature / 30.06.2014

Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032MedicalResearch.com: Interview with Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032 MedicalResearch: What are the main findings of the study? Dr. Accili: By switching off a single gene (foxo1), scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin.
Diabetes, Weight Research / 27.06.2014

Su Ann Ding, MBBS Research Fellow Joslin Diabetes Center Boston, MassachusettsMedicalResearch.com Interview with: Su Ann Ding, MBBS Research Fellow Joslin Diabetes Center Boston, Massachusetts MedicalResearch: What are the main findings of the study? Answer: We conducted a randomized controlled trial comparing the effectiveness of Roux-en- Y gastric bypass with an intensive diabetes and weight management program. We recruited 38 obese individuals (BMI 30-42 kg/m2) with type 2 diabetes. Participants had suboptimal glucose control and mean diabetes duration of 10 years. Both surgical and non-surgical interventions led to patients losing a clinically significant amount of weight and keeping it off for 2 years, with average loss of approximately 57 pounds (25% of initial body weight) for the surgery group and 13 pounds (6% of initial weight) for the lifestyle and medication modification group. Other important health goals also improved more in the surgical group, including improvements in blood sugar control, blood pressure and lipid levels which together may contribute to reducing risk of developing coronary heart disease.
Diabetes, Endocrinology, OBGYNE / 26.06.2014

MedicalResearch.com Interview with: Dr Anju Joham PhD student, SPHPM Endocrinologist, Monash Health MedicalResearch: What is the background for your study? Dr. Joham: This research led by Professor Helena Teede and Dr Anju Joham, from the School of Public Health and Preventive Medicine at Monash University analysed a large-scale epidemiological study, called the Australian Longitudinal Study of Women’s Health (ALSWH). Polycystic Ovary Syndrome (PCOS) is a condition affecting nearly 20% of Australian women. Women with PCOS may experience irregular menstrual cycles, reduced fertility, increased risk of diabetes, high cholesterol and psychological features such as depression and reduced quality of life. MedicalResearch: What are the main findings of the study? Dr. Joham:   Approximately 6000 women aged between 25-30 years were monitored for nine years, including nearly 500 women with diagnosed PCOS. Our research found that there is a clear link between PCOS and type 2 diabetes. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. In analysing the key contributing factors to the increased diabetes risk, we found that having PCOS was in itself a key contributing factor.
Diabetes, Scripps / 20.06.2014

Athena Philis-Tsimikas, M.D. Corporate Vice President Scripps Whittier Diabetes Institute, a subsidiary of Scripps HealthMedicalResearch.com Interview with: Athena Philis-Tsimikas, M.D. Corporate Vice President Scripps Whittier Diabetes Institute, a subsidiary of Scripps Health MedicalResearch: What are the main findings of the study? Dr. Philis-Tsimikas: Findings from the Dulce Digital study suggest that a text message-based self-management intervention improves glycemic control in high risk Latinos with type 2 diabetes. Researchers recruited 126 Latinos with type 2 diabetes and HbA1c greater than 7.5% from federally-qualified health centers (FQHCs) that serve disadvantaged populations to investigate the impact of a diabetes self-management intervention delivered via mobile text messaging. Cell phones were provided to patients who did not have them, along with text messaging instructions. Patients were randomized after completing clinical and self-reported measurements at baseline and these assessments were then repeated at 3 and 6 months. Both Dulce Digital and control groups received usual care.   The Dulce Digital group received three types of text messages — educational and motivational; medication reminders; and blood glucose monitoring prompts — two to three messages each day initially, with frequency tapering over 6 months. Project Dulce staff then monitored blood glucose responses, assessed reasons for hyperglycemia or hypoglycemia and encouraged follow up with providers as needed. Still ongoing, the current analyses included 106 completed participants (mean age= 49.25±9.49 years, 74% female), 52 of which were Dulce Digital participants. Findings showed significantly greater decreases in HbA1c with text messages compared with usual care only (9.4% to 8.4%, vs. 9.5% to 9.3%, P<.05) at 6 month follow-up. No significant group differences, however, have been observed for lipids, weight or blood pressure.
Author Interviews, Diabetes, Weight Research / 19.06.2014

Benjamin D. Horne, PhD, MPH, FAHA, FACC Director, Cardiovascular and Genetic Epidemiology, Intermountain Heart Institute Adjunct Assistant Professor, Genetic Epidemiology Division, Department of Medicine, University of UtahMedicalResearch.com Interview with: Benjamin D. Horne, PhD, MPH, FAHA, FACC Director, Cardiovascular and Genetic Epidemiology, Intermountain Heart Institute Adjunct Assistant Professor, Genetic Epidemiology Division, Department of Medicine, University of Utah MedicalResearch: What is the background for this study? Dr. Horne: The Fasting II trial was a single-arm interventional trial of 24-hour water-only fasting among pre-diabetics with metabolic syndrome. The participants were adults with fasting blood glucose >100 mg/dL and at least two other components of the metabolic syndrome, including high triglycerides, low HDL cholesterol (the “good” cholesterol), high blood pressure, or high waist circumference. The participants were asked to fast once per week for 6 weeks, with multiple goals in this pilot study. This is the first interventional trial of fasting in people with pre-diabetes or diabetes.
Author Interviews, Diabetes, Diabetes Care, Mediterranean Diet, Nutrition / 17.06.2014

David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaMedicalResearch.com Interview with: David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada   MedicalResearch: What are the main findings of the study? Prof. Jenkins: The main findings were that inclusion of just over an once (31g) of canola oil in low glycemic index diets of type 2 diabetes study participants, to further reduce the glycemic load (GL), reduced HbAIC more than a high cereal fiber diet, as predicted. However the Canola oil low GL diet also reduced serum TG and LDL-C and thus Framingham risk score for cardiovascular disease. The effect was seen most clearly in those at highest CHD risk and those with features of the metabolic syndrome.
Author Interviews, Diabetes, JCEM / 16.06.2014

L. Keoki Williams, MD, MPH Center for Health Policy and Health Services Research Department of Internal Medicine Henry Ford Health System Detroit, Michigan 48104MedicalResearch.com Interview with L. Keoki Williams, MD, MPH Center for Health Policy and Health Services Research Department of Internal Medicine Henry Ford Health System Detroit, Michigan 48104 MedicalResearch: What are the main findings of the study? Dr. Williams: Metformin is recommended as first line treatment for type 2 diabetes, and these recommendations are based on the results of clinical trials performed almost exclusively in white individuals.  This is the first study to specifically assess whether metformin is effective at reducing blood glucose levels in African American individuals.  In our large study of over 19,000 individuals, we showed that metformin was consistently more effective at reducing glycated hemoglobin (HbA1c) levels (a measure of long-term blood glucose control) in African Americans when compared with white individuals.
Diabetes, Pharmacology / 16.06.2014

MedicalResearch.com Interview with: Peter Stein, M.D. Vice president, Clinical Research for Diabetes and Dndocrinology Merck Research Laboratories. MedicalResearch: What are the main findings of the study? Dr. Stein: This late-breaking observational study assessed the differences in time to initiation of insulin use and the proportion of the population initiating insulin among patients with type 2 diabetes taking the combination of JANUVIA® (sitagliptin) and metformin, and patients taking the combination of a sulfonylurea and metformin.  In this study, patients treated with a combination of JANUVIA and metformin initiated insulin therapy at a slower rate during the period of observation than patients treated with a combination of sulfonylurea and metformin. In this study, the percentages of patients initiating insulin by years one through six were 3.6, 8.4, 12.9, 17.7, 22.4, 26.6 for patients taking JANUVIA; and 4.1, 9.4, 14.6, 21.0, 27.1, 34.1 for patients taking a sulfonylurea. An analysis of the data overall (Kaplan-Meier method) showed that patients taking JANUVIA progressed more slowly to insulin use than patients taking a sulfonylurea (p=0.0034). The Cox proportional hazard regression analysis indicated that by year six, patients in the JANUVIA group were 24 percent less likely to initiate insulin during the period of observation compared to patients taking a sulfonylurea (HR = 0.76; p = 0.0011). Similar results were observed in the sub-group of patients with a baseline A1C of less than 9 percent (HR = 0.77; p = 0.0128]; however there was no statistically significant difference in time to insulin initiation in the sub-group with a baseline A1C of greater than or equal to 9 percent (HR = 0.75; p = 0.1818).
Author Interviews, Diabetes, Diabetologia, Pediatrics / 13.06.2014

MedicalResearch.com Interview with: Dr. Marcus de Goffau and Dr. Hermie Harmsen Department of Medical Microbiology University Medical Center Groningen MedicalResearch: What are the main findings of the study? Dr. Marcus de Goffau: In this study we aimed at analysing the gut microbiota composition of children aged 1–5 years with new-onset type 1 diabetes with the microbiota of age-matched healthy controls with a 16S rRNA based method (HITChip). The reason for this selection is that the increase in the incidence of type 1 diabetes worldwide is particularly sharp under the age of 5 years; recent studies indicate that adverse changes in gut microbiota are associated with the development of type 1 diabetes, but little is known about the microbiota in children who have diabetes at an early age. In this study we found that the differences between healthy controls and diabetics change over time, highlighting the importance of a normal gut microbial development. Diabetic children younger than 3 years old often had lower numbers of the Clostridium clusters XIVa and IV, which contain many of the beneficial butyrate producers, than their healthy age-matched controls. The diabetic children older than 3 years have normal numbers of Clostridium clusters XIVa and IV yet not the right species composition; the ones which produce butyrate were underrepresented. The development of the microbiota of diabetic children appears to be one step behind that of healthy controls and/or appears to be going into an aberrant direction. The abundances of other bacteria such as Bacteroides and streptococci were also found to be aberrant in diabetic children.
Author Interviews, Diabetes, JAMA, Obstructive Sleep Apnea / 11.06.2014

Tetyana Kendzerska MD, PhD Postdoctoral Fellow Institute for Clinical Evaluative Science, Sunnybrook Health Sciences Center, Toronto, ONMedicalResearch.com Interview with: Tetyana Kendzerska MD, PhD Postdoctoral Fellow Institute for Clinical Evaluative Science, Sunnybrook Health Sciences Center, Toronto, ON MedicalResearch: What are the main findings of the study? Dr.  Kendzerska: Based on a large sample of more than 8,500 participants with suspected sleep apnea, our study shows that among people with obstructive sleep apnea (OSA), and controlling for risk factors for diabetes development, initial OSA severity predicted risk for incident diabetes. Measures of the physiologic consequences of OSA (e.g., low level of oxygen, sleep deprivation) were also risk factors for diabetes in this population.
Author Interviews, Diabetes, Heart Disease, JAMA, Vanderbilt / 10.06.2014

MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212 MedicalResearch: What are the main findings of the study? Dr. Roumie: This retrospective cohort study compared time to acute myocardial infarction (AMI), stroke, or death among Veterans with diabetes that were initially treated with metformin, and subsequently added either insulin or sulfonylurea. Among 178,341 Veterans on metformin monotherapy, 2,948 and 39,990 added insulin or sulfonylurea, respectively. Patients were about 60 years old, about 35% had history of heart disease or stroke, had been on metformin for an average of 14 months and their hemoglobin A1c was 8.1% at the time of addition of the second medication. Compared to those who added a sulfonylurea, those who added insulin to metformin had a 30% higher risk of the combined outcome of heart attack, stroke, and all-cause mortality. Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin.
Author Interviews, Diabetes, JAMA, Surgical Research, Weight Research / 10.06.2014

Lars Sjöström, MD, PhD Professor Department of Body Composition and Metabolism Sahlgrenska University Hospital Göteborg, SwedenMedicalResearch Interview with: Lars Sjöström, MD, PhD Professor Department of Body Composition and Metabolism Sahlgrenska University Hospital Göteborg, Sweden   MedicalResearch: What are the main findings of the study? Prof. Sjöström: In obese diabetic subjects, the 2-year diabetes remission was 72% in bariatric surgery patients but only 16% in obese controls obtaining conventional obesity and diabetes treatment. After 15 years, 30% were in remission in the surgery group and 6.5% in the control group. In addition, the 20-year incidence of diabetes complication was 30 -55% lower in surgery than control patients.
Author Interviews, BMJ, Diabetes / 10.06.2014

Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610MedicalResearch.com Interview with: Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610 MedicalResearch: What are the main findings of the study? Professor Arch Mainous: This study focused on prediabetes, which is a high risk state for developing diabetes and associated complications. We investigated the national prevalence of prediabetes in England between 2003 and 2011. We found that the prevalence of prediabetes rose substantially in that time period from 11.6% to 35.3%. Further, by 2011 more than half of the population who were 40 years of age and older and were overweight had prediabetes. Minority ethnic groups are particularly affected.
Author Interviews, Diabetes, PNAS / 07.06.2014

Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven BelgiumMedicalResearch.com Interview with: Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven Belgium MedicalResearch: What are the main findings of the study? Answer: We discovered that the lifespan-extending effect of metformin is dependent on the increased production of reactive oxygen species in the roundworm Caenorhabditis elegans. Antioxidants, compounds that remove these reactive oxygen species, abolished the lifespan-extending effect of metformin, adding to the growing body of evidence that anti-oxidants are not as beneficial for health as generally assumed. We also identified the protein, belonging to the group of peroxiredoxins, that seems responsible for translating this increase in reactive oxygen species production into longevity.
Diabetes, Weight Research / 30.05.2014

John Wilding DM FRCP Professor of Medicine & Honorary Consultant Physician Head of Department of Obesity and Endocrinology Institute of Ageing & Chronic Disease Clinical Sciences Centre University Hospital Aintree Liverpool United KingdomMedicalResearch.com Interview with: John Wilding DM FRCP Professor of Medicine & Honorary Consultant Physician Head of Department of Obesity and Endocrinology Institute of Ageing & Chronic Disease Clinical Sciences Centre University Hospital Aintree Liverpool United Kingdom MedicalResearch: What are the main findings of the study? Dr. Wilding: This trial studied over 3700 obese people who were trying to lose weight. The main findings were that liraglutide (an injectable medication already approved for diabetes treatment at lower dose of 1.8mg) can help reduce body weight in people with obesity when used at a higher dose than is usually used in diabetes (3mg). Trial participants experienced a weight loss of 8 % from baseline compared to 2.6 % with placebo (diet and exercise alone). Some risk factors for diabetes and heart disease such as blood sugar, blood pressure and cholesterol also improved with liraglutide treatment to a greater extent than with placebo. The main side effects seen were nausea which in most cases resolved after a few weeks treatment; there were also more cases of gallstones (which could be due to weight loss) and a few more cases of acute pancreatitis in people treated with liraglutide.
Author Interviews, Diabetes, Diabetes Care, Pharmacology / 29.05.2014

MedicalResearch Interview with: Dr. Valeria Pechtner Medical Advisor, Lilly Diabetes MedicalResearch: What are the main findings of the study? Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint. Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications.
Diabetes / 23.05.2014

Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New YorkMedicalResearch.com Interview with: Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New York MedicalResearch: What are the main findings of the study? Dr. Kuhadiya: This is the first randomized clinical trial to show that the addition of liraglutide 1.2 and 1.8mg to insulin significantly reduces HbA1c, mean blood glucose, total insulin doses, body weight, carbohydrate intake, C-Reactive protein (a marker of cardiovascular risk), significantly improves quality of life and reduces systolic blood pressure(top number in a blood pressure reading) in 1.8mg group in patients with type 1 diabetes over a period of 12 weeks. In 1.2mg, HbA1c fell by 0.78% from 7.84 to 7.06% and in 1.8mg group fell by 0.42% from 7.41 to 6.99% which means that more number of patients will be able to achieve HbA1c levels close to 7% and lower which is recommended by most diabetes organizations. Also the total daily dose of insulin fell by about 10-12 units in both groups.  The total daily carbohydrate intake in both the groups fell by an average of 40 grams.   There was a 5 kg weight loss in both 1.2 mg and 1.8 mg groups and both these groups on an average lowered their Body Mass Index from 29 to 28 kg/m2 .    In 1.8 mg group  there was fall in systolic blood pressure by 9 mm from  120 to 111 mm Hg. The improvements seen are important because 40 to 50 percent of people with Type 1 diabetes have the metabolic syndrome(Cluster of risk factors, including high blood pressure, large waistline, high blood sugar, low HDL ("good") cholesterol and high triglycerides (fats in the blood) which increases the chances of later developing Type 2 diabetes and heart disease. Our findings have significant implications for the future treatment of patients with Type 1 Diabetes.
Author Interviews, Diabetes, JAMA, OBGYNE / 22.05.2014

Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852MedicalResearch.com Interview with: Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch: What are the main findings of the study? Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are: (1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI). (2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI. (3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
Author Interviews, Diabetes, Diabetologia, Heart Disease / 22.05.2014

MedicalResearch.com Interview with: Malene Nøhr Demant Department of Cardiology Copenhagen University Hospital Gentofte Hellerup, Denmark MedicalResearch: What are the main findings of the study? Dr. Demant: Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk. Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes.
Cancer Research, Diabetes / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study we identified all diabetic patients with localized clear cell renal cell carcinomas who were surgically treated between 1990 and 2008 in our institution and matched them with nondiabetic patients. Our main findings were that, after controlling for major confounders such as age, sex, type of surgery, renal function, smoking status, performance status, and tumor grade and stage, diabetic patients had inferior overall survival than nondiabetic patients. Furthermore, among patients with clear cell carcinoma, diabetic patients also had shorter cancer-specific survival, suggesting that diabetes is a poor prognostic factor for patients with surgically treated renal cell carcinoma.
Author Interviews, Diabetes, Diabetologia, Weight Research / 17.05.2014

Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech RepublicMedicalResearch.com Interview with: Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech Republic MedicalResearch: What was the aim of your study? Dr. Kahleova: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function. MedicalResearch: What are the main findings of the study? Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity.
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Sugar / 14.05.2014

MedicalResearch Interview with: Monique Francois Teaching Fellow & Research Assistant at the University of Otago School of Physical Education, Sport and Exercise Sciences University of Otago Dunedin, New Zealand MedicalResearch: What are the main findings of the study? Answer: We found that small 'snacks' of interval exercise before the three main meals lowered postprandial blood glucose and contributed to a lower blood glucose across the day. Whereas 30 minutes of continuous moderate exercise before dinner did not lower postprandial blood glucose nor mean glucose levels the exercise day or the following day, compared to exercise snacking. Six one minute intervals as walking or a combination of walking and resistance 3x per day (before the three main meals) improved glycaemic control in individuals with insulin resistance.
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet / 14.05.2014

MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years.
Author Interviews, Diabetes, JAMA, Pediatrics / 06.05.2014

Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045MedicalResearch.com Interview with:  Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups.  While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages.
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