Author Interviews, Diabetes, Diabetologia, Heart Disease, Race/Ethnic Diversity / 09.07.2013

MedicalResearch.com Interview with: Dr Nazim Ghouri MBChB, MRCP UK Specialty Registrar (Diabetes/Endocrinology/GIM) and Honorary Clinical Lecturer Institute of Cardiovascular and Medical Sciences BHF Glasgow Cardiovascular Research Centre University of Glasgow Glasgow G12 8TA Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we aimed to determine the extent to which increased insulin resistance and blood sugar levels in South Asian men, compared to white European men, living in the UK, was due to lower fitness and physical activity levels. We studied 100 South Asian and 100 European men aged 40-70 years living in Scotland without diagnosed diabetes and measured their blood sugar levels, insulin resistance and other risk factors. The men also undertook a treadmill exercise test to determine how much oxygen their bodies were able to use during intense exercise – a key measure of physical fitness, wore accelerometers for a week to assess their physical activity levels, and had a detailed assessment of their body size and composition. Statistical modeling was then used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in insulin resistance and blood sugar between South Asians and Europeans. The results suggested that lower fitness, together with greater body fat in South Asians, explained over 80 per cent of their increased insulin resistance compared to white men with Low fitness being the single most important factor associated with the increased insulin resistance and blood sugar levels in middle-aged South Asian compared to European men living in the UK. (more…)
Author Interviews, Diabetes, Frailty, Lancet / 09.07.2013

MedicalResearch.com Interview with: Dr David Strain, MRCP MD Clinical senior lecturer and honorary consultant University of Exeter Medical School Institute of Biomedical and Clinical Science Department of Diabetes and Vascular Research Royal Devon & Exeter Hospital Exeter EX2 5AX MedicalResearch.com: What is the Background of the study? In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study. It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results.  For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients. (more…)
Diabetes, Kidney Disease / 04.07.2013

MedicalResearch.com Interview with: C Raina Elley C Raina Elley Associate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New ZealandAssociate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Answer: Type 2 Diabetes is the leading cause of end-stage renal failure and dialysis in many countries. Early identification of those who are at risk within primary care could prompt more intensive intervention to control glycaemia and blood pressure and use of ACE inhibitors or angiotensin receptor blockers to slow progression. Traditionally estimated glomerular filtration rate and/or urine albumin creatinine ratio have been used to alert clinicians of deteriorating renal function in people with diabetes. However, a far more accurate renal risk score has been developed that combines serum creatinine, demographic characteristics, albuminuria, glycaemia, blood pressure, cardiovascular co-morbidity and duration of diabetes. The 5-year renal risk score was developed by following more than 25,000 people with type 2 diabetes in New Zealand for a median of 7.3 years (equivalent to 180,497 person-years). The study identified those who commenced dialysis for end-stage renal disease, received a renal transplant or died from renal failure to derive the risk score. (more…)
Author Interviews, Diabetes, General Medicine / 28.06.2013

MedicalResearch.com:  Interview with Christina Ellervik Associate Professor Faculty of Health and Medical Sciences University of Copenhagen , Denmark MedicalResearch.com: What are the main findings of the study? Answer: Early measurement of transferrin saturation leading to early intervention in patients with late-onset type 1 diabetes improves life expectancy. Excess death is mainly due to cancer-specific death. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Red Meat / 28.06.2013

MedicalResearch.com: An Pan, PhD

Research Associate, Dept Nutrition 655 Huntington Avenue Building 2, Room 351 Boston, Massachusetts 02115

Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes Mellitus: Three Cohorts of US Men and Women MedicalResearch.com: What are the main findings of the study? Answer: -- Compared with people who did not change their intake of red meat, those who increased it by as little as half a serving a day (about 1.5 ounces) over a four-year period had a 48% increased risk of developing type 2 diabetes in the subsequent 4 years. -- People who decreased their intake by half a serving a day over four years did not have an acute reduced risk in the next four years compared to people who did not change their intake, but had a reduced risk of developing the disease by 14% in the entire follow-up period, suggesting a prolonged effect. -- The findings included both processed meat such as lunch meat and hot dogs and unprocessed meats such as hamburger, steak and pork. And the association was generally stronger for processed red meat compared to unprocessed red meat. -- Adjusting for weight modestly reduced the association between red meat consumption and diabetes suggesting that weight gain played a role in the development of the disease. (more…)
Diabetes, JAMA, Pediatrics / 20.06.2013

MedicalResearch.com Interview with:  Dr. Ezio Bonifacio, Ph.D. Professor, Preclinical Stem Cells/Diabetes Center for Regenerative Therapies Dresden Technische Universität Dresden MedicalResearch.com:  What are the main findings of the study? Dr. Bonifacio: Children who develop multiple islet autoantibodies are destined to develop diabetes. Only a minority will be diabetes-free 15 years after developing islet autoantibodies. This is regardless of whether they have a family history of type 1 diabetes. Progression to diabetes after seroconversion varied from weeks to decades, and 20% of children had diabetes within 2 years from seroconverting. Progression was fastest in children who developed their islet autoantibodies before age 3 years. MedicalResearch.com:  Were any of the findings unexpected? Dr. Bonifacio: Unexpected is probably not the right word. The Eisenbarth model of chronic disease proposes that diabetes will happen some time after autoimmunity and the findings show the reality of it. Perhaps the unexpected finding is that it is not always chronic and that for a number of children, intervention would need to be applied quickly. (more…)
Author Interviews, Diabetes / 03.06.2013

Dr. Fumiaki Imamura, Ph.D. Research Fellow Harvard School of Public Heath Department of Epidemiology 677 Huntington Ave, Kresge-913C Boston, MA

MedicalResearch.com: What are the main findings of the study? Dr. Imamura: Among older adults, risk factors for type 2 diabetes mellitus (DM) were differentially associated with DM preceded predominantly by IR or β-cell dysfunction. MedicalResearch.com:Were any of the findings unexpected? Dr. Imamura: For subsets of incident DM, some conventional DM risk factors, including body-mass index and HDL-cholesterol, could not predict incident DM. (more…)
Author Interviews, Diabetes, Exercise - Fitness, Weight Research / 31.05.2013

Martin Sénéchal, Ph.D. Postdoctoral Researcher The Manitoba Institute of Child Health University of Manitoba 511E- 715 McDermot Ave Winnipeg, ManitobaMedicalResearch.com eInterview with Martin Sénéchal, Ph.D. Postdoctoral Researcher The Manitoba Institute of Child Health University of Manitoba 511E- 715 McDermot Ave Winnipeg, Manitoba MedicalResearch.com: What are the main findings of the study? Answer: The main finding of this study is that reducing central adiposity and increasing fitness in men and women with Type 2 diabetes are key components for successfully improving glycemic control. A secondary finding of the study is that improvement in both central adiposity (reduction) and fitness (increasing) simultaneously; increase the likelihood of reducing HbA1c, one of the most widely used indicators of glucose control, and/or Type 2 diabetes medications. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Kidney Disease, Medical Research Centers, Mediterranean Diet, Nutrition / 29.05.2013

MedicalResearch.com eInterview with Iris Shai, RD, PhD PI of the DIRECT trial Ben Gurion University of the Negev, Israel MedicalResearch.com: What are the main findings of the study? Dr. Shai: Low-carbohydrate is as effective as Mediterranean or low-fat diets in improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine<176µmol/L (not sever renal stage).  The effect is likely to be mediated by weight-loss induced improvements in insulin sensitivity and blood pressure. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Kidney Disease, Pediatrics / 28.05.2013

MedicalResearch.com eInterview with: Dr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San AntonioDr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San Antonio MedicalResearch.com: What are the main findings of the study? Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes. MedicalResearch.com: Were any of the findings unexpected? Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control. (more…)
Author Interviews, Diabetes, Race/Ethnic Diversity, Stroke / 08.05.2013

MedicalResearch.com eInterview with Jane C Khoury, PhD

Associate Professor Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital Medical Center MLC 5041, 3333 Burnet Avenue Cincinnati, Ohio 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Khoury: Over all age groups, those with diagnosed diabetes have at least 3-fold increased risk of incident ischemic stroke compared to those without diabetes. This is even more pronounced in those less than 65 years of age, with 5-fold and 12-fold increase for those of black and white race respectively.  All rates are adjusted to the 2000 population. (more…)
Author Interviews, Diabetes / 02.05.2013

MedicalResearch.com: Dr. Kyoung-bok Min Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea MedicalResearch.com: What are the main findings of the study? Answer: The aim of this study was to investigate the prospective association of serum C-peptide with all-cause, cardiovascular disease, and coronary heart disease mortality in a non-diabetic population. We also estimated the observed mortality as C-peptide increased across the strata of glycated hemoglobin and fasting blood glucose. We found a linear association between serum C-peptide levels and death from all-cause and cause-specific mortality among adults without non-diabetes mellitus at baseline. Our finding suggests that elevated C-peptide levels may be a marker of subsequent mortality in non-diabetic subjects. (more…)
Author Interviews, Diabetes, Nutrition / 30.04.2013

This interview content is written by Dr Dae-Kyu Song, the corresponding and responsible author of the manuscript shown at “Park, Jae-Hyung et al. (2013). Green tea extract with polyethylene glycol-3350 reduces body weight and improves glucose tolerance in db/db and high-fat diet mice. Naunyn-Schmiedeberg’s Archives of Pharmacology. DOI 10.1007/s00210-013-0869-9“. Dr Jae-Hyung Park is the first author of the manuscript and a graduate student of Dr. Dae-Kyu Song MedicalResearch.com: What are the main findings of the study? Answer: At doses which could be achieved by drinking green tea on a daily basis, it has been known that green tea extract (GTE) inhibits intestinal glucose and lipid absorption when it is present in the intestinal tract. It is a reason why green tea consumption has been known to be beneficial for controlling obesity and type 2 diabetes. However, we have found that, after the intestinal absorption of GTE itself, the circulating GTE can elevate blood glucose levels by blocking cellular glucose uptake in most tissues, thereby limiting glucose utilization of the tissues. Therefore, we have tried to prolong the residence time of GTE in the intestine and block the intestinal absorption of GTE, by adding non-toxic polymer polyethylene glycol (PEG) to GTE. As a result, in 4 week treatment, the GTE+PEG regimen dramatically helps obesity-induced diabetic mice lose body weight and ameliorate glucose intolerance. Interestingly, GTE alone is without any effect. (more…)
Author Interviews, BMJ, Diabetes, Exercise - Fitness, Nutrition, Weight Research / 10.04.2013

MedicalResearch.com eInterview with

Manuel Franco MD, PhD Associate Professor Department of Health Sciences, Public Health Unit Universidad de Alcalá mfranco@uah.es http://www.uah.es/pdi/manuel_franco Adjunct Associate Professor Department of Epidemiology Johns Hopkins Bloomberg School of Public Health mfranco@jhsph.eduManuel Franco MD, PhD Associate Professor Department of Health Sciences, Public Health Unit Universidad de Alcalá Johns Hopkins Bloomberg School of Public Health Adjunct Associate Professor Dept. of Epidemiology mfranco@jhsph.edu

MedicalResearch.com: What are the main findings of the study? Dr. Franco: Population wide weight loss of about 5 kg was related with large decreases in diabetes and cardiovascular mortality. On the contrary, Body weight regain was related with an increase in diabetes prevalence, incidence, and mortality, as well as a deceleration in the previously declining rates of cardiovascular death. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, JAMA, Medical Research Centers, Melatonin, Sleep Disorders / 04.04.2013

Dr. Ciaran McMullan MD from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston MassMedicalResearch.com Interview with Dr. Ciaran McMullan MD from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston Mass MedicalResearch.com: What are the main findings of the study? Dr. McMullan: In this observational study performed in non-diabetic women we found that lower nocturnal melatonin secretion predicted future risk of developing type 2 diabetes. When we categorized the individuals by category of nocturnal melatonin secretion we found that those in the lowest category had twice the risk as those in the highest category of nocturnal melatonin secretion. This association remained even after adjusting for other well established risk factors for development of diabetes including body mass index, physical activity, dietary factors, family history of diabetes, smoking and hypertension. This increased risk translates into the lower melatonin secretion group having an additional 5 cases of incident diabetes per 1000 person years than the high melatonin secretion group. (more…)
Author Interviews, Diabetes, UT Southwestern, Weight Research / 03.04.2013

MedicalResearch.com Author Interview: Ildiko Lingvay, MD, MPH, MSCS Departments of Internal Medicine–Endocrinology and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas MedicalResearch.com: What are the main findings of the study? Dr. Lingvay: We found that the restrictive diet imposed after a bariatric procedure like RYGB is the key element to the rapid improvement in the diabetes seen immediately after surgery. (more…)