Author Interviews, Biomarkers, Diabetes, Diabetes Care, Johns Hopkins / 26.03.2020

MedicalResearch.com Interview with: Olive Tang, MD/PhD Student Johns Hopkins School of Medicine   Elizabeth Selvin, PhD, MPH Professor of Epidemiology & Medicine Director, Cardiovascular and Clinical Epidemiology Department of Epidemiology Welch Center for Prevention, Epidemiology and Clinical Research and the Johns Hopkins Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: The best approach to diabetes management in older adults is unclear. A new blood test called high-sensitivity troponin can detect damage to the heart, even in people without any signs or symptoms of heart disease. (more…)
Author Interviews, Diabetes, Stem Cells / 12.02.2020

MedicalResearch.com Interview with: Andrew F. Stewart MD Director, Diabetes Obesity and Metabolism Institute Irene and Dr. Arthur M. Fishberg Professor of Medicine Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? Response: Both common forms of diabetes result from reductions in the numbers of healthy insulin-producing beta cells in the pancreas. Having said that, people with both T1D and T2D almost always have residual beta cells. One way to approach this problem is by pancreas or islet transplant, or stem cell transplant approaches. These cannot easily or economically be scaled to the 30 million people in the US and the 420 million in the world with diabetes. Therefore, our approach is to develop drugs that can make the remaining beta cells regenerate and re-fill the beta cell tank. (more…)
Author Interviews, Diabetes, Sugar / 01.02.2020

MedicalResearch.com Interview with: Marta Yanina Pepino, PhD Assistant Professor Department of Food Science and Human Nutrition Division of Nutritional Sciences College of Agricultural, Consumer and Environmental Sciences Administration University of Illinois at Urbana-Champaign Urbana, IL 61801 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a general belief that substituting sugars with low calorie sweeteners contributes to diet healthfulness. However, accumulating data suggest that consuming a diet high in low calorie sweeteners , mainly in diet sodas, is associated with the same health issues than consuming a diet high in added sugars, including an increased risk of developing type 2 diabetes.  The potential mechanism underlying such association are varied and still unclear. Our findings contribute to the growing evidence  that despite having very little or no calories, sweeteners can affect our metabolism (i.e.  the way we handle blood sugar) and that their effects may be different in people with obesity from those of normal weight. (more…)
Author Interviews, Diabetes, Global Health / 20.01.2020

MedicalResearch.com Interview with: Prof. Andrea On Yan LUK (陸安欣) Associate Professor, Department of Medicine & Therapeutics Faculty of Medicine, The Chinese University of Hong Kong Specialist in Endocrinology, Diabetes and Metabolism Honorary Associate Consultant, Hospital Authority MedicalResearch.com: What is the background for this study? Response: The overall mortality in people with diabetes has declined in many developed countries but little is known about the mortality trend in Asia. In this study, we examined the trend in mortality rates using a territory-wide database of 770,000 people with diabetes in Hong Kong. (more…)
Author Interviews, Diabetes, Supplements / 08.01.2020

MedicalResearch.com Interview with: Jonathan P. Little PhD Associate Professor Canadian Institutes of Health Research New Investigator Michael Smith Foundation for Health Research Scholar Faculty of Health and Social Development School of Health and Exercise Sciences The University of British Columbia Syilx Okanagan Nation Territory Kelowna, BC  Canada MedicalResearch.com: What is the background for this study? Response: Ketones are energy-yielding molecules that are bodies naturally produce during periods of starvation or when we restrict carbohydrate intake. Recently, scientists from Oxford and the NIH have created exogenous ketone supplements, which now enable us to be able to drink ketones. This puts our body into a unique state – we can consume a drink that raises blood levels of ketones without having to starve or restrict carbohydrate intake. Some are even touting ketone supplements as a “fourth macronutrient”. Ketone supplements are primarily marketed for athletes to provide an alternative fuel for improving endurance exercise performance. We were actually studying how ketone supplements impacted exercise performance when we noticed that they consistently lowered blood glucose after participants consumed them. We went to the literature and found some classic papers where it was shown that infusing ketones did in fact lower glucose and the mechanism seemed to involve reducing liver glucose output. This was very exciting to us because we also study type 2 diabetes, a condition where blood sugars are too high and elevated liver glucose output is one of the major reasons. So we came up with the hypothesis that ketone supplements might be a unique strategy to help with blood glucose control. In the recent study, we tested this out in a randomized crossover experiment in 15 participants with overweight/obesity who were at risk for type 2 diabetes. Participants drank the ketone monoester supplement or a placebo and 30 minutes later they consumed an oral glucose tolerance test drink containing 75 grams of sugar. Blood samples were collected for 2 hours after the glucose test drink. (more…)
Author Interviews, Diabetes, JAMA, Nutrition / 18.12.2019

MedicalResearch.com Interview with: Dr Mathilde Touvier, MPH, PhD Head of the Nutritional Epidemiology Research Team Dr Bernard Srour, PharmD, PhD Inserm, Inrae, University of Paris MedicalResearch.com: What is the background for this study? Response: We found that for an increase of 10 in the percentage of ultra-processed food quantity in the diet, we had a significant 15% increase in Type 2 diabetes risk. We have already shown, in the NutriNet-Santé cohort, associations between the consumption of ultra-processed foods and overall cancer, breast cancer, cardiovascular, coronary heart diseases risk, mortality and depressive symptoms. However, no prior study had studies the associations between ultra-processed food and Type 2 diabetes risk. We suspected that we would find these associations since some components of ultra-processed foods light have metabolic interactions with human health (some food additives for instance). (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, OBGYNE / 18.10.2019

MedicalResearch.com Interview with: Haitham M. Ahmed, MD, MPH Chair of Cardiology, Advantage Care Physicians Brooklyn, New York MedicalResearch.com: What is the background for this study? Response: This was a meta-analysis of more than a quarter m illion mothers looking at the long-term cardiovascular risk reduction of mothers who breastfed their babies.  (more…)
Author Interviews, Diabetes, Heart Disease, Infections / 13.10.2019

MedicalResearch.com Interview with: Hean Teik Humphrey Ko PhD candidate School of Pharmacy and Biomedical Sciences Faculty of Health Sciences, Curtin University Perth, Western Australia, Australia MedicalResearch.com: What is the background for this study? Response: Bacterial skin infections consume precious healthcare resources because such infections are common and may sometimes be severe. Statins are relatively affordable and extensively prescribed worldwide to prevent cardiovascular diseases. Additionally, the safety/adverse effects of statins have been well documented. Staphylococcus aureus is a major cause of bacterial skin infections, and statins have been separately reported to exert antibacterial effects against S. aureus, as well as reduce the risk of S. aureus related blood infections. As such, it seemed plausible that statins may prove beneficial in S. aureus related skin infections. However, statins may also induce new-onset diabetes mellitus, a condition which in turn, is a risk factor for skin infections. Therefore, in order to determine if statins could potentially serve as a novel therapeutic agent for skin infections to reduce healthcare costs, this study was conducted to examine the interrelationships between statins, diabetes, and skin infections.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Diabetes, JAMA / 02.10.2019

MedicalResearch.com Interview with: Andrew Sumarsono, MD UT Southwestern Medical Center MedicalResearch.com: What is the background for this study?   Response: There are currently 12 types of medications used to treat type 2 diabetes. With approximately 30 million adults living with diabetes in the United States, the rising cost of insulin has raised concerns about the affordability of diabetes care. We evaluated trends in total spending and number of prescriptions of all diabetes therapies among Medicare Part D beneficiaries between 2012 and 2017. (more…)
Author Interviews, BMC, Cost of Health Care, Diabetes, Yale / 28.09.2019

MedicalResearch.com Interview with: Phoebe Tran Doctoral Student Department of Chronic Disease Epidemiology Yale School of MedicinePhoebe Tran Doctoral Student Department of Chronic Disease Epidemiology Yale School of Medicine  MedicalResearch.com: What is the background for this study? Response: As the prevalence of diabetes risk factors such as obesity, high blood pressure, high cholesterol, and physical inactivity are considerably higher in US individuals residing in rural areas compared to their urban counterparts, rural residents face increased risk of developing diabetes. Diabetes screening is a useful tool that can be used to identify people with newly developed type 2 diabetes and offer them early treatment. In this study, we examined whether there are differences in diabetes screening levels between rural and urban areas across the US using nationally representative survey data from 2011, 2013, 2015, and 2017.   (more…)
Author Interviews, Cost of Health Care, Diabetes, Diabetes Care, JAMA / 23.09.2019

MedicalResearch.com Interview with: Rebecca Myerson, PhD Assistant Professor, Population Health Sciences School of Medicine and Public Health University of Wisconsin, Madison MedicalResearch.com: What is the background for this study? Response: Many people with diabetes are undiagnosed, and those who are diagnosed often are untreated and uncontrolled. Increasing access to health insurance for patients with health care needs was a goal of the Affordable Care Act. We analyzed information from 11 years of the National Health and Nutrition Examination Survey, which gathers data that are nationally representative of the civilian population. The biennial survey includes biomarkers, including HbA1c, a measure of blood-sugar control. Using the NHANES data allowed the researchers to identify those with undiagnosed diabetes. (more…)
Author Interviews, Diabetes, Endocrinology, Menopause / 18.09.2019

MedicalResearch.com Interview with: Dr Sopio Tatulashvili Avicenne Hospital Bobigny, FranceDr Sopio Tatulashvili Avicenne Hospital Bobigny, France MedicalResearch.com: What is the background for this study? Response: Diabetes and pre-diabetes are associated with increased cardiovascular morbidity and mortality. Early screening and the treatment of glucose metabolism disorders could lower the risk of further complications. Furthermore, type 2 diabetes can be prevented. For this purpose, it is of major importance to better identify the risk factors of type 2 diabetes. Hormonal factors are increasingly suspected to play a role in the etiology of type 2 diabetes. The aim of this study was to determine the associations between various hormonal factors and the risk of incident type 2 diabetes in the large prospective female E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de L’Education Nationale) cohort study. Based on a very detailed set of information available in 83,799 women from the large prospective E3N cohort study followed for 22 years, we have been able to clarify the relationships between various hormonal factors and type 2 diabetes risk.   (more…)
AstraZeneca, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 10.09.2019

MedicalResearch.com Interview with: Dr. David Berg MD Senior Fellow in Cardiovascular Medicine and Critical Care Medicine Brigham and Women’s Hospital Postdoctoral Research Fellow with the TIMI Study Group. MedicalResearch.com: What is the background for this study? Response: Heart failure is a frequent and important complication of type 2 diabetes mellitus (T2DM), but there are limited tools for identifying which patients with T2DM are at the highest risk of developing heart failure. In this study, we developed and validated the TIMI Risk Score for Heart Failure in Diabetes [TRS-HF(DM)], a novel clinical risk score that identifies patients with T2DM who are at heightened risk for hospitalization due to heart failure. Fortunately, the risk score also identifies patients who have the greatest absolute reduction in the risk of hospitalization for heart failure with a new class of glucose-lowering therapies called sodium-glucose cotransporter-2 (SGLT2) inhibitors.  (more…)
Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Diabetes, Heart Disease, Lancet / 08.09.2019

MedicalResearch.com Interview with: Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC Professor of Medicine, Harvard Medical School Executive Director of Interventional Cardiovascular Programs, Brigham and Women’s Hospital Heart & Vascular Center MedicalResearch.com: What is the background for this study? Response: Dual antiplatelet therapy (DAPT) is known to improve outcomes in patients with acute coronary syndromes (ACS), prior myocardial infarction (MI), or recent coronary stenting. What was unknown is whether patients with diabetes and stable coronary artery disease – a group generally believed to be at high ischemic risk – would benefit from initiation of long-term DAPT with low-dose aspirin plus ticagrelor versus low-dose aspirin (plus placebo). This is what THEMIS was designed to test, with THEMIS-PCI designed prospectively to examine those patients specifically who had a history of previous percutaneous coronary intervention (PCI). (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Jose Carlos Nicolau, MD PhD Heart Institute University of Sao Paulo Medical School, Sao Paulo, Brazil  MedicalResearch.com: What is the background for this study? Response: There are few evidence about the late phase (1-3 years) of patients with diabetes and myocardial infarction, especially regarding quality of life (qol) and health resource utilization. Our study showed that the population with diabetes (dm), compared with the population without diabetes, have worse quality of life, more hospitalizations, and when hospitalized showed a longer hospital stay. Additionally, as expected, dm population have worse outcomes, including the composite of cv death, myocardial infarction or stroke, and all-cause death. (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Prof. John McMurray Professor of Cardiology Institute of Cardiovascular & Medical Sciences University of Glasgow MedicalResearch.com: What is the background for this study? Response: SGLT2 inhibitors prevent the development of heart failure (HF) in patients with type 2 diabetes (T2D) – can they be used to treat patients with established heart failure? Also, although introduced as a glucose-lowering treatment for T2D, experimental evidence suggests these drugs may have non-glucose mediated benefits. So, might they be a treatment for HF even in patients without diabetes?  (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Nicolas Danchin MD, FESC Professor of Medicine, Consultant Cardiologist Intensive Cardiac Care Unit Hôpital Européen Georges Pompidou Paris, France MedicalResearch.com: What is the background for this study? Response: FAST-MI is a programme of nationwide French surveys, carried out every 5 years in France since 2005 in patients hospitalised with STEMI or NSTEMI. Patients are included consecutively for one month and 10-year follow-up is organized. We can thus analyse patients' outcomes in relation with their profile. Knowing that diabetic patients represent a large proportion of patients with AMI, we thought it would be worthwhile determining whether they suffered specific complications, and in particular, heart failure, both at the acute stage and in the subsequent months. (more…)
Author Interviews, Diabetes, Microbiome / 06.09.2019

MedicalResearch.com Interview with: Prof. Dr. Christoph Kaleta Institute for Experimental Medicine Institute for Experimental Medicine, Kiel University Kiel, GermanyProf. Dr. Christoph Kaleta Institute for Experimental Medicine Institute for Experimental Medicine, Kiel University Kiel, Germany  MedicalResearch.com: What is the background for this study? Response: Even though Metformin is the first-line treatment option in type-2 diabetic patients, its specific mechanism of action has remained elusive so far. Moreover, metformin is of particular interest as an anti-aging drug since it's usage has been shown to be associated with a lower incidence of several aging diseases in type-2 diabetic patients taking metformin when compared to matched healthy controls. While previous work was able to show pronounced changes in the microbiota of patients taking metformin and a health-promoting effect of metformin-adapted microbiota, how this beneficial effect could be mediated has remained unclear. (more…)
Author Interviews, BMJ, Diabetes, Lipids, Omega-3 Fatty Acids / 23.08.2019

MedicalResearch.com Interview with: Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School University of East Anglia England, UK MedicalResearch.com: What is the background for this study? Response: The World Health Organization asked us to carry out a set of studies (systematic reviews of randomised controlled trials) assessing health effects of omega-3 and omega-6, which are polyunsaturated fats. This is because the WHO are planning to update their dietary guidance on fats in the near future. Worries about effects of long chain omega-3 on control of diabetes have long existed, and some experimental studies have suggested that omega-3 supplementation and diets high in PUFA and omega-3 raise fasting glucose. Pollutants such as methylmercury and polychlorinated biphenyl levels exceeding recommended thresholds are rarer now, but have been reported in seafoods and fish oil supplements; elevated mercury levels interrupt insulin signalling, raising fasting glucose, in mouse models. Body concentrations of organic pollutants are correlated with prevalence of diabetes in the US, but other cross sectional studies have suggested either no association with or benefits of eating fish on glycaemic control. Systematic reviews of observational studies have suggested both positive and negative associations with glucose metabolism, but strong evidence shows that omega-3 supplements reduce raised triglycerides and have little or no effect on body weight. Theories suggest that omega-3 and omega-6 fats compete in some metabolic pathways so that the omega-3/omega-6 ratio is more important than absolute intakes of either.  (more…)
Author Interviews, Diabetes, JAMA, PTSD / 21.08.2019

MedicalResearch.com Interview with: Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research  MedicalResearch.com: What is the background for this study? Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease.  Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease. The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators' findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure.  Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors. (more…)
Author Interviews, Diabetes, JAMA / 12.08.2019

MedicalResearch.com Interview with: Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk. (more…)
Author Interviews, Diabetes, Pediatrics / 09.07.2019

MedicalResearch.com Interview with: Nelly Mauras, MD Chief, Division of Pediatric Endocrinology, Nemours Children’s Health System Professor of Pediatrics Mayo College of Medicine MedicalResearch.com: What is the background for this study?   Response: Keeping blood sugars close to normal in young children with diabetes is often limited by parental fears of the risks of low blood sugars and impaired cognitive development. Dr. Nelly Mauras, at the Nemours Children’s Health System in Jacksonville FL, along with Dr. Allan Reiss at Stanford University are co-principal investigators of the Diabetes Research in Children Network, a 5-center consortium performing studies in children with diabetes, also including the University of Iowa, Washington University St Louis and Yale University. The investigators recruited 144 children with type 1 diabetes who were 4-7 years old and performed brain imaging (MRIs), did special cognitive tests, and monitored blood sugars using continuous glucose monitors. These studies were repeated after 18 months, approximately 54 months and 74 months, to examine changes in the brain and compare the results with those of 70 children the same age who do not have diabetes. (more…)
Author Interviews, CDC, Cost of Health Care, Diabetes / 09.07.2019

MedicalResearch.com Interview with: Xiaohui Zhuo, PhD Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, GA  MedicalResearch.com: What is the background for this study? Response: Prescription drug spending (spending from families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.) and employees across the United States) has increased at a much higher rater than other components of the total medical expenditure associated with diabetes.  The share of spending on prescription drugs in per capita annual excess expenditure due to diabetes increased from 27% to 41% between 1987 and 2011, according to a previous study using national data from the Agency for Healthcare Research and Quality Medical Expenditures Panel Surveys. In this most recent study, CDC researchers estimated the increase in the national spending on antidiabetic drugs from 2005 to 2016 in total and by drug class and broke down the increase in total national spending by examining what factors have contributed to the increase estimating the magnitude of each factor’s contribution. (more…)
AstraZeneca, Author Interviews, Diabetes, Kidney Disease / 24.06.2019

MedicalResearch.com Interview with: Naeem Khan MD Vice President at AstraZeneca  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A pre-specified exploratory analysis of renal data from the DECLARE-TIMI 58 trial, the largest SGLT-2 inhibitor (SGLT-2i) cardiovascular outcomes trial (CVOT) conducted to date, showed that FARXIGA (dapagliflozin) reduced the composite of kidney function decline, end-stage renal disease (ESRD) or renal death by 47% in patients with type 2 diabetes (T2D). Additionally, FARXIGA reduced the relative risk of a cardio-renal composite of kidney function decline, ESRD, or renal or cardiovascular (CV) death by 24% compared to placebo. The analysis evaluated 17,160 patients with type 2 diabetes and predominantly preserved renal function, irrespective of underlying atherosclerotic CV disease (ASCVD). (more…)
Author Interviews, Diabetes, NIH, Pediatrics / 18.06.2019

MedicalResearch.com Interview with: Dr. Ellen Leschek MD Program Director: Division of Diabetes, Endocrinology, and Metabolic Diseases The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Type 2 diabetes (T2D) is thought to be characterized by a progressive loss of pancreatic beta cell (insulin producing/releasing cell) function. For this reason, T2D medications eventually stop working and individuals with T2D require treatment with insulin. The Restoring Insulin Secretion (RISE) Consortium was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to evaluate the effects of treatment and treatment withdrawal on the loss of pancreatic beta cell function. In the RISE Study, progression of disease was assessed by the measurement of pancreatic beta cell function in youth and adults who had either impaired glucose tolerance (IGT; prediabetes) or recently diagnosed Type 2 diabetes before, during and after treatment with study medications. Importantly, the RISE Pediatric Medication Study and the RISE Adult Medication Study were designed in tandem to allow direct comparison of the effects of two pharmacologic treatment regimens (the only two FDA-approved medications for Type 2 diabetes in youth) on disease progression in youth and adults. For more information about the RISE Study, please visit https://rise.bsc.gwu.edu/web/rise. (more…)
Author Interviews, Diabetes, Transplantation / 12.06.2019

MedicalResearch.com Interview with: Dr. Rodolfo Alejandro, MD Professor of Medicine University of Miami Miller School of Medicine Co-Director of the Cell Transplant Center Director/Attending Physician of the Clinical Cell Transplant Program Diabetes Research Institute www.DiabetesResearch.org  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In type 1 diabetes, the insulin-producing islets cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed some patients to live without the need for insulin injections after receiving a transplant of donor cells. Some patients who have received islet transplants have been insulin independent for more than a decade, as DRI researchers have published. Currently, islet transplantation remains an experimental procedure limited to a select group of adult patients with type 1 diabetes.Although not all subjects remain insulin independent, like the subjects described in this presentation, after an islet transplant a significant number of them continue with excellent graft function for over 10 years that allows them to have near-normal glucose metabolism in the absence of severe hypoglycemia on small doses of insulin. In 2016, the National Institutes of Health-sponsored Clinical Islet Transplantation Consortium reported results from its Food and Drug Administration (FDA)-authorized Phase 3 multi-center trial, of which the DRI was a part, indicating that islet transplantation was effective in preventing severe hypoglycemia (low blood sugar levels), a particularly feared complication in type 1 diabetes that can lead to seizures, loss of consciousness and even death. The study was a significant step toward making islet transplantation an approved treatment for people with type 1 diabetes and reimbursable through health insurance, as it is in several other countries around the world.   (more…)
Author Interviews, Diabetes, Weight Research / 11.06.2019

MedicalResearch.com Interview with: Kalypso Karastergiou, MD, PhD Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease Diabetes, Obesity and Metabolism Institute Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study?   Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women. The overarching questions in the field are:
  • What factors determine body shape?
  • Why are subjects with lower-body shape protected?
  • Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases? 
(more…)
Author Interviews, Diabetes, Vitamin D / 09.06.2019

MedicalResearch.com Interview with: Anastassios G. Pittas, M.D MS Professor Co-Director, Diabetes and Lipid Center; Tufts Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Observational studies have consistently reported an association between low blood vitamin D level and development of type 2 diabetes. However, whether vitamin D supplementation lowers risk of developing diabetes is not known. We designed and conducted the Vitamin D and diabetes (D2d) study to answer this question.  We randomized 2,423 people with prediabetes to 4,000 IU/day of vitamin D3 or placebo and followed them for new-onset diabetes with blood tests every 6 months for an average of 2.5 years. About 80% of participants had sufficient vitamin D level at baseline (25-hydroxyvitamin D level >= 20 ng/mL). The trial was designed to show a reduction of 25% or more in diabetes risk with vitamin D. The study was unable to show a reduction of 25% or more. At the end of the study, there was a 12% reduction in risk of developing diabetes with vitamin D, which missed statistical significance (hazard ration 0.88; 95% confidence interval 0.75 to 1.04). In a small subgroup of participants with vitamin D deficiency at baseline (25-hydroxyvitamin D level < 12 ng/mL) there was 62% reduction in risk of diabetes with vitamin D (hazard ration 0.38; 95% confidence interval 0.18 to 0.80). (more…)