Author Interviews, Diabetes, Microbiome, Nutrition, Science / 13.03.2018

MedicalResearch.com Interview with: Liping Zhao PhD, Professor Department of Biochemistry and Microbiology School of Environmental and Biological Sciences Rutgers University-New Brunswick NJ MedicalResearch.com: What is the background for this study? Response: Microbes in the human gut (collectively known as the gut microbiota) provide many functions that are important for human health. A notable example is that some gut bacteria are able to ferment non-digestible carbohydrates in our diet, e.g. dietary fibers, to produce short-chain fatty acids (SCFAs). These SCFAs nourish our gut epithelial cells, reduce inflammation, and play a role in appetite control. Deficiency of SCFAs has been associated with many diseases including type 2 diabetes. Many gut bacteria have the genes (and therefore the capacity) to produce SCFAs from carbohydrate fermentation. However, we know little about how these bacteria, as individual strains and as a group, actually respond to an increased supply of carbohydrates. This is key to improve clinical efficacy of dietary fiber interventions to improve human health. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 12.03.2018

MedicalResearch.com Interview with: Muthiah Vaduganathan, MD MPH Heart and Vascular Center Brigham and Women's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of heart failure with preserved ejection fraction (HFpEF) is rising globally, yet no medical therapies are currently available to alter its natural history and its progression remains incompletely understood. Sudden death may represent a target for therapy in this disease entity. In 1,767 patients with HFpEF enrolled in the Americas region of the TOPCAT trial, we found that sudden death accounts for ~20% of all deaths. Male sex and insulin-treated diabetes mellitus identify patients at higher risk for sudden death. Sudden death was numerically lower but not statistically reduced in those randomized to spironolactone. (more…)
Author Interviews, Diabetes, Heart Disease, JACC, Surgical Research / 21.02.2018

MedicalResearch.com Interview with: Dr. Jayan Nagendran MD, PhD, FRCSC Director of Research, Division of Cardiac Surgery Associate Professor, Department of Surgery Division of Cardiac Surgery University of Alberta MedicalResearch.com: What is the background for this study? Response: The primary modalities of treatment of symptomatic coronary artery disease (coronary heart disease) are either percutaneous coronary intervention (coronary stunting) or coronary artery bypass grafting surgery. There are well designed clinical trials that guide clinical practice for the treatment of patients with diabetes requiring coronary revascularization and there are trials that examine the best modality of coronary revascularization in patients with left ventricular dysfunction. However, there is a lack of evidence for patients with both diabetes and left ventricular dysfunction. As such, we performed a propensity matched study of patients with diabetes and left ventricular dysfunction undergoing either percutaneous coronary intervention compared to coronary artery bypass grafting surgery. We used our provincial database that captures >100,000 patients undergoing coronary angiography to attain our two cohorts for comparison. (more…)
Author Interviews, Diabetes, Occupational Health / 13.02.2018

MedicalResearch.com Interview with: “Night Shift - Hard@Work (5of8)” by cell105 is licensed under CC BY 2.0Dr. Céline Vetter Assistant Professor Department of Integrative Physiology University of Colorado at Boulder Boulder, CO MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Shift work, particularly night shifts, can change our social rhythms, as well as the internal biological rhythms including our sleep, and these effects could explain why shift work is linked to conditions such as obesity and type 2 diabetes. However, we don’t know which type of shift pattern is most strongly linked to type 2 diabetes. In addition, we know that some lifestyle factors can modify the link between a genetic predisposition to a disease and the disease itself, but we don’t know if this applies to shift work and type 2 diabetes. (more…)
Author Interviews, Diabetes, OBGYNE / 12.02.2018

MedicalResearch.com Interview with: Rachel McGrath BSc (Hons), PhD Senior Research Fellow - Department of Endocrinology, RNSH Clinical Senior Lecturer - Northern Clinical School University of Sydney  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women with type 1 diabetes are significantly more likely to experience complications during pregnancy and to have infants with high birth weights. This can result in adverse outcomes at the time of delivery for both mother and baby, and can also predispose infants to obesity and chronic disease in later life. The relationship between maternal blood glucose levels and foetal growth in type 1 diabetes in pregnancy has not been completely elucidated. Thus, we examined the association between maternal glycaemic control and foetal growth by examining serial ultrasound measurements and also by determining the relationship between HbA1c (a measure of circulating glucose exposure over a three month time period) and infant birth weight. We found that maternal glucose levels were directly related to foetal abdominal circumference in the late second and third trimesters and also to birth weight. We also confirmed the results of previous studies to show that the optimal HbA1c during pregnancy to reduce the likelihood of large-for-gestational-age neonates is < 6%.  (more…)
Author Interviews, Diabetes, Diabetologia, Technology / 18.01.2018

MedicalResearch.com Interview with: Silvia Conde, PhD CEDOC, NOVA Medical School Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisboa MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2013, Silvia Vilares Conde and her research group described that the carotid body, a paired organ that is located in the bifurcation of the common carotid artery and that is classically defined as an oxygen sensor, regulates peripheral insulin sensitivity and that its dysfunction is involved in the development of metabolic diseases. This first study (Ribeiro et al. 2013, Diabetes, 62:2905-16) and others afterwards performed by her group in diabetic rats (Sacramento et al. 2017, Diabetologia 60(1):158-168) showed that the bilateral resection of the carotid sinus nerve, and therefore the abolishment of the connection between the carotid body and the brain, restore insulin sensitivity and glucose tolerance. Although efficient this surgical irreversible approach has disadvantages, since the carotid body possesses other physiological functions as the response to the lack of oxygen (hypoxia) or the adaptation to exercise. Silvia Conde’s team also described that the carotid body is over-activated in animal models of type 2 diabetes, suggesting that decreasing the activity of the organ could be a good therapeutic strategy. In this new work (Sacramento et al. 2018, doi: 10.1007/s00125-017-4533-7), her group in collaboration with Galvani Bioelectronics (former Glaxo Smith Kline Bioelectronics) demonstrated that is possible to electrically modulate the carotid sinus nerve to maintain glucose homeostasis in diabetic animals without significant adverse effects.  (more…)
Author Interviews, Diabetes, JAMA, OBGYNE, Surgical Research / 16.01.2018

MedicalResearch.com Interview with: Charles Billington MD Chief, Section of Endocrinology and Metabolism Minneapolis VA Health Care System Professor of Medicine, University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We wanted to know if adding gastric bypass to intense lifestyle and medical therapy would improve overall diabetes treatment as represented by the triple endpoint of blood sugar, blood pressure and cholesterol control. We found that adding gastric bypass did provide significant benefit at five years after surgery, but that the size of the benefit declined substantially from the first to the fifth year. We also found that gastric bypass did provide significantly better blood sugar control throughout the five years, but the rate of diabetes remission at five years was low. There were many more adverse events in the gastric bypass group.  (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Genetic Research, University of Pittsburgh / 07.01.2018

MedicalResearch.com Interview with: Xiangwei Xiao, M.D., Ph.D. Assistant Professor of Department of Surgery, Children’s Hospital of Pittsburgh University of Pittsburgh School of Medicine, Pittsburgh, PA MedicalResearch.com: What is the background for this study? Response: Diabetes is a prevalent chronic disease characterized by persistently high blood glucose. Diabetes has two main subtypes, type 1 diabetes and type 2 diabetes. In type 1 diabetes, the immune system attacks and destroys insulin-producing beta cells in the pancreas, resulting in high blood levels of glucose. In type 2 diabetes, the beta cells do not produce enough insulin or the body is not able to use insulin effectively. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, Weight Research / 02.01.2018

MedicalResearch.com Interview with: Michael P. Bancks, PhD Northwestern University Chicago, Illinois  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the disparity in diabetes between black and white youth and young adults is growing, but the reasons why are unclear. We also know that traditional risk factors for diabetes, such as obesity and low socioeconomic status, are more common among blacks as compared with whites. Our study describes how the unequal rates of these traditional diabetes risk factors explain or account for the higher rates of diabetes among blacks. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Pediatrics / 02.01.2018

MedicalResearch.com Interview with: “Baby Bottle” by brokinhrt2 is licensed under CC BY 2.0Mikael Knip, MD, PhD Professor of Pediatrics TRIGR PI  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Experimental studies have indicated that the avoidance of early exposure to cow's milk proteins reduces the cumulative incidence of autoimmune diabetes in animal models of human type 1 diabetes, e.g. BB rats and NOD mice. Epidemiological studies in humans have suggested that there may be a link between type 1 diabetes and short breastfeeding or early introduction of infant formulas. All regular infant formulas contain intact cow's milk proteins. The main finding was that weaning to an extensively hydrolyzed formula did not reduce the cumulative incidence of Type 1 diabetes in at-risk children by the mean age of 11 years. The extensively hydrolyzed formula did not contain any intact cow's milk proteins but only small peptides (maximal size 2000 daltons). (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, End of Life Care, JAMA / 01.01.2018

MedicalResearch.com Interview with: Dr. Laura A. Petrillo MD Instructor in Medicine Harvard Medical School, and Palliative Care Physician Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hospice is end-of-life care focused on maximizing quality of life. Hospice often involves reducing or stopping treatments that are unlikely to have short-term benefit in order to avoid uncomfortable side effects. About a quarter of Americans die in nursing homes, and some of them receive hospice care in their final days. We looked at whether adults with type 2 diabetes experience low blood sugar while on hospice in veterans’ nursing homes, since low blood sugar signals inappropriately aggressive diabetes treatment in patients close to death and contributes to unnecessary discomfort. We found that one in nine people experienced low blood sugar at least once while receiving hospice care. Among people who were on insulin, the number was one in three. (more…)
Author Interviews, Diabetes, JAMA, Ophthalmology, Technology / 13.12.2017

MedicalResearch.com Interview with: Dr. Tien Yin Wong MD PhD Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore Singapore MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, annual screening for diabetic retinopathy (DR) is a universally accepted practice and recommended by American Diabetes Association and the International Council of Ophthalmology (ICO) to prevent vision loss. However, implementation of diabetic retinopathy screening programs across the world require human assessors (ophthalmologists, optometrists or professional technicians trained to read retinal photographs). Such screening programs are thus challenged by issues related to a need for significant human resources and long-term financial sustainability. To address these challenges, we developed an AI-based software using a deep learning, a new machine learning technology. This deep learning system (DLS) utilizes representation-learning methods to process large data and extract meaningful patterns. In our study, we developed and validated this using about 500,000 retinal images in a “real world screening program” and 10 external datasets from global populations. The results suggest excellent accuracy of the deep learning system with sensitivity of 90.5% and specificity of 91.6%, for detecting referable levels of DR and 100% sensitivity and 91.1% specificity for vision-threatening levels of DR (which require urgent referral and should not be missed). In addition, the performance of the deep learning system was also high for detecting referable glaucoma suspects and referable age-related macular degeneration (which also require referral if detected). The deep learning system was tested in 10 external datasets comprising different ethnic groups: Caucasian whites, African-Americans, Hispanics, Chinese, Indians and Malaysians (more…)
Author Interviews, Cancer Research, Chemotherapy, Diabetes, PLoS / 08.12.2017

MedicalResearch.com Interview with: Terra G Arnason, MD PhD, Associate Professor, Division of Endocrinology, Department of Medicine University of Saskatchewan Saskatoon, SK, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Response: Metformin has been used worldwide for decades to treat Type diabetes. Metformin is a cheap non-toxic compound that was originally plant derived. In the past decade a number of meta-analyses have demonstrated that Type 2 individuals taking metformin have a reduced risk of developing many different cancers and do better longterm. The molecular events facilitating metformin’s activity remain obscure and it is unknown whether metformin can help cancer patients avoid the development of drug resistant cancers years after successful treatment. In our study we asked whether metformin can not only restore sensitivity of multiple drug resistant tumors to chemotherapy once again, but whether metformin can prevent the development of multiple drug resistance in the "rst place. We demonstrate that metformin can sensitize drug resistant cells to chemotherapy once again, which supports recent studies, but we also show for the "first time that Metformin can prevent the progression of cancer cells towards drug resistance using cell culture experiments. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Personalized Medicine / 21.11.2017

MedicalResearch.com Interview with: Dr. MalikDr. Shaista Malik MD PhD MPH Director of Samueli Center For Integrative Medicine Assistant Professor, School of Medicine University of California, Irvine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Having diabetes has been considered to be a risk equivalent to already had a myocardial infarction for predicting future cardiovascular events.  We were interested in testing whether further risk stratification in those with diabetes and metabolic syndrome, using coronary artery calcium (CAC), would result in improved prediction of cardiovascular events. We found that CAC score was associated with incident coronary heart disease and cardiovascular disease more than a decade after the scoring was performed.  We also found that even after we controlled for the duration of diabetes (of 10 years or more), insulin use, or hemoglobin A1c level, coronary artery calcium remained a predictor of cardiovascular events. (more…)
Author Interviews, Compliance, Diabetes / 16.11.2017

MedicalResearch.com Interview with: Saeid Shahraz, MD, PhD Heller School of Social Policy and Management Brandeis University Waltham, Massachusetts  MedicalResearch.com: What is the background for this study? Response: Previous researchers had shown a significant improvement in diabetes control in the US between the years 1998 and 2010. We wanted to show if the betterment in diabetes control continued after then. As previously, we measured hemoglobin A1C that shows the extent to which blood glucose level is under control. Our main finding was that this upward improving trend plateaued for years after 2007 up to 2014, the last year for which we had data. We examined both genders, white and non-white populations as well as three age groups; young, middle age, and elderly population and results were the same: no change. Overall, in 2007, 14% of patients with diabetes showed a poor diabetes control (Hemoglobin A1C more than 9%) ; in 2014, 15% of patients with diabetes fell within the category of poor diabetes control. 55% of the patients had a Good control of diabetes (Hemoglobin A1C less than 7%) in 2007; this measure was 54% in 2014. (more…)
Author Interviews, Diabetes, Heart Disease / 15.11.2017

MedicalResearch.com Interview with: “Diabetes Test” by Victor is licensed under CC BY 2.0Jesper Svane Medical student The Heart Center, University Hospital Rigshospitalet Copenhagen  MedicalResearch.com: What is the background for this study? Response: At the beginning of this research project, we were aware that persons with diabetes have an increased risk of death, which is partly explained by an increased risk of sudden cardiac death. However, previous studies on causes of death and mortality among young persons with diabetes, particularly type 2 diabetes, are sparse. Furthermore the incidence of sudden cardiac death among young persons with diabetes in a nationwide setting is unknown. The main purpose of the study was to illuminate the risk of death and especially the risk of cardiac death among children/young adults with diabetes. On a personal note, a friend of mine, who was healthy and fit, died suddenly a few years ago at the age of 19. This tragic death raised a lot of feelings as well as questions in me. When I got the chance to work with Dr. Lynge and Dr. Tfelt, I saw this as an opportunity to expand my knowledge of sudden cardiac death among the young. Furthermore, the opportunity of contributing to research in order to prevent these devastating events in the future was personally appealing to me. I initiated the project together with Thomas Hadberg Lynge, MD, last year, with Jacob Tfelt-Hansen, MD, DMSc as supervisor. Both are experienced researchers within the field of sudden cardiac death. Dr. Tfelt-Hansen leads a very productive research group at Rigshospitalet, Copenhagen, whose main focus is arrhythmias and sudden cardiac death. (more…)
Author Interviews, Diabetes, JAMA, Lifestyle & Health / 09.11.2017

MedicalResearch.com Interview with: Dr. Karla Galaviz PhD Hubert Department of Global Health Rollins School of Public Health Emory University Sonya Haw, MD| Assistant Professor Division of Endocrinology, Metabolism & Lipids Emory University, School of Medicine Grady Memorial Hospital Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings?
  • Diabetes affects 1 in 11 adults worldwide and though there is evidence that lifestyle modification (eating healthier diets and exercising about 150 mins a week) and certain medications can prevent or delay diabetes onset, it is not clear which of these strategies offers long-term benefits.
  • To answer this question, we compiled all available randomized controlled trials of lifestyle programs and medications to prevent diabetes and analyzed the data to see if the diabetes prevention effects persisted in the long-term. We specifically compared studies where the lifestyle or drug interventions were discontinued to see if the effect was long lasting or diminished when the intervention was stopped.
(more…)
Author Interviews, CDC, Diabetes, Kidney Disease / 08.11.2017

MedicalResearch.com Interview with: Nilka Ríos Burrows, MPH, MT (ASCP) Lead, Chronic Kidney Disease Initiative CDC Division of Diabetes Translation.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Kidney failure treated with dialysis or a kidney transplant is called end-stage renal disease (ESRD).  ESRD is a costly and disabling condition often resulting in premature death. During 2000–2014, kidney failure from diabetes among U.S. adults with diabetes decreased by 33%, and it declined significantly in most states, the District of Columbia, and Puerto Rico. No state experienced an increase in kidney failure from diabetes. Continued awareness and interventions to reduce risk factors for kidney failure, improve diabetes care, and prevent type 2 diabetes might sustain these positive trends. (more…)
Author Interviews, Diabetes, Lipids, NEJM / 01.11.2017

MedicalResearch.com Interview with: M. Loredana Marcovecchio, M.D. Clinical Scientist and Professor David Dunger M.D. Director of Research Professor of Paediatrics University of Cambridge MedicalResearch.com: What is the background for this study? What are the main findings? Response: The efficacy and safety of ACE Inhibitors and statins in adolescents have been shown in the context of hypertension and familial hypercholesterolemia, respectively. However, there is a lack of data on the long-term use of these drugs in those with type 1 diabetes and, in particular, there is no clear indication for their use in patients with increased albumin excretion. The Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT) was a multi-centre, international study, set up by investigators in the UK, Australia and Canada to explore if drugs already used to lower blood pressure (ACE inhibitors) and cholesterol levels (Statins) in adults with diabetes could reduce the risk of kidney, eye and cardiovascular disease in adolescents with Type 1 diabetes. Neither ACE inhibitors nor statins significantly reduced the albumin-creatinine ratio during the 2-4 year trial period. However, some of the secondary outcomes suggest that the drugs may have important benefits. Treatment with the ACE inhibitor resulted in a 43% reduction in the rates of progression to microalbuminuria, which was not statistically significant, but it could have important clinical implications. Preventing even intermittent cases of microalbuminuria is known to reduce the future risk of kidney and cardiovascular complications. Statin therapy led to reduced levels of lipid levels, which could reduce long-term risk for cardiovascular complications. These findings could translate into long-term benefits, but follow-up of this unique cohort will be essential. The essential biological samples and data provided by the participants will continue to inform our future understanding and our options for effective therapies for this vulnerable group of young people with type 1 diabetes. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 18.10.2017

MedicalResearch.com Interview with: Prof. Dr. med. Reinhard Holl Division of Endocrinology and Diabetes, Medical Faculty Aachen University, Aachen, Institute of Epidemiology and Medical Biometry University of Ulm, Ulm Germany  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today there are two accepted strategies to treat type-1 diabetes: pump or multiple daily injections. In a large group of patients we compared both strategies, and our results indicate advantages for pump therapy with fewer severe hypos, fewer events of diabetic ketoacidosis, and better metabolic control. (more…)
AstraZeneca, Author Interviews, Boehringer Ingelheim, Diabetes, Eli Lilly, J&J-Janssen, Merck, Pharmacology / 18.10.2017

MedicalResearch.com Interview with: Melanie J Davies CBE MB ChB MD FRCP FRCGP Professor of Diabetes Medicine NIHR Senior Investigator Emeritus Diabetes Research Centre Leicester Diabetes Centre – Bloom University of Leicester MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This was the first study to test the effectiveness of an oral GLP-1 in patients with type 2 diabetes. The main findings were that compared to both placebo and a GLP-1, Semaglutide, delivered by sub-cutaneous injection weekly, the oral therapy delivered once a day produced better results than placebo and similar results to injectable GLP-1 with regard to reductions in HbA1c and weight loss. (more…)
Author Interviews, Depression, Diabetes, JAMA, Pediatrics, Pharmacology / 17.10.2017

MedicalResearch.com Interview with: Mehmet Burcu, PhD, MS Department of Pharmaceutical Health Services Research University of Maryland, Baltimore  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antidepressants are one of the most commonly used psychotropic medication classes in U.S. youth, with serotonin reuptake inhibitors representing a large majority of total antidepressant use in youth. The most interesting finding was that the current use of serotonin reuptake inhibitors in youth was associated with an increased risk of type 2 diabetes mellitus, and this increased risk intensified further with the increasing duration of use and with the increasing dose. A secondary analysis also revealed that the risk of incident type 2 diabetes was most apparent in youth who used serotonin reuptake inhibitors for longer durations AND in greater daily doses. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, OBGYNE / 17.10.2017

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health. Bethesda, MD 20817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes (GDM) is a common pregnancy complication. The American Heart Association identifies gestational diabetes as a risk factor for cardiovascular disease (CVD) in women, based on consistent evidence for the relationships between gestational diabetes and subsequent hypertension, dyslipidemia, type 2 diabetes, vascular dysfunction and atherosclerosis. Also, previous studies identify GDM as a risk factor for intermediate markers of CVD risk; however, few are prospective, evaluate hard cardiovascular disease end points, or account for shared risk factors including body weight and lifestyle. (more…)
Author Interviews, Diabetes, Nature / 04.10.2017

MedicalResearch.com Interview with: Andrew F. Stewart MD Irene and Dr. Arthur M. Fishberg Professor of Medicine Director, Diabetes, Obesity and Metabolism Institute Institute at the Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? Response: Diabetes results ultimately from an inadequate number of insulin-producing “beta” cell in the pancreas.  Ideally, these would regenerate when they are lost or damaged, but unfortunately inducing them to regenerate or proliferate has proven impossible until recently. In 2015 and others we identified the first class of drugs – the harmine analogues - that are able to induce human beta cells to proliferate.  In this study, we wanted to identify additional pathways that can lead to human beta cell proliferation at higher rates than we had been able to induce with harmine.   For this we turned to a rare type of benign (i.e., not malignant, not cancer) tumor of the beta cells in the pancreas called “insulinomas”. These tiny tumors overproduce insulin and cause hypoglycemia (low blood glucose) which in turn causes seizures, loss of consciousness and confusion.  Once they are discovered, then can easily be removed via laparoscopic surgery, and the person is cured.  Since they are so rare, and since they are benign and easily cured, insulinomas have not been included in large genome sequencing studies of patients wit cancer.  However, we reasoned that they must hold the genomic recipe or wiring diagram for inducing human beta cells to replicate, so we perfumed next-generation DNA and RNA sequencing on a large series (38) of insulinomas. (more…)
Author Interviews, Diabetes, Gastrointestinal Disease, Lancet, Mayo Clinic, Weight Research / 29.09.2017

MedicalResearch.com Interview with: Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment. (more…)
Author Interviews, Diabetes, NEJM, Surgical Research, Weight Research / 20.09.2017

MedicalResearch.com Interview with: Ted Adams PhD Adjunct Professor, Internal Medicine Adjunct Associate Professor, Nutrition & Integrative Physiology The University of Utah  MedicalResearch.com: Why did you decide to conduct this study? Response: The primary aim of the study was to determine the clinical outcomes in patients who underwent gastric bypass surgery. As NIDDK/NIH continued to fund the study, the aim was extended to determining the durability) long-term outcomes) of gastric bypass surgery when compared to non-surgical, severely obese patients. (more…)
Author Interviews, Diabetes, Geriatrics, Primary Care / 19.09.2017

MedicalResearch.com Interview with: Matthew L. Maciejewski, PhD Professor in Medicine Division of General Internal Medicine, Department of Medicine Center for Health Services Research Primary Care Durham VA Medical Center Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Treating diabetes requires balancing the risks of long-term harm from under-treatment with the short-term and long-term harm from potential over-treatment. Randomized trials have shown that the benefits of aggressive glycemic control only begin after at least 8 years of treatment. Yet, the harms of aggressive glycemic control –  hypoglycemia, cardiovascular events, cognitive impairment, fractures, and death – can happen at any time. In some older people, “deintensification” of diabetes treatment may be the safer route, because of the risks that come with too-low blood sugar. The American Geriatrics Society (AGS) specifically states that medications other than metformin should be avoided when an older patient’s hemoglobin A1c is less than 7.5%, because the risks of hypoglycemia are larger and the potential benefits of treatment are smaller for older adults with diabetes.  Most attention in prior work has focused on undertreatment of diabetes and there has been only limited investigation of patient characteristics associated with overtreatment of diabetes or severe hypoglycemia. Since the elderly are therefore at greatest risk of overtreatment and Medicare is the primary source of care of the elderly, we examined rates of overtreatment and deintensification of therapy for Medicare beneficiaries, and whether there were any disparities in these rates.  We found that almost 11 percent of Medicare participants with diabetes had very low blood sugar levels that suggested they were being over-treated. But only 14 percent of these patients had a reduction in blood sugar medication refills in the next six months. (more…)
Author Interviews, Diabetes, Flu - Influenza, Genetic Research / 19.09.2017

MedicalResearch.com Interview with: Paz Lopez-Doriga Ruiz MD, PhD candidate Norwegian Institute of Public Health Department of Non Communicable Diseases OsloPaz Lopez-Doriga Ruiz MD, PhD candidate Norwegian Institute of Public Health Department of Non Communicable Diseases Oslo  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Some case reports have linked pandemic influenza to the development of type 1 diabetes. Other studies have suggested that also respiratory infections may contribute to type 1 diabetes risk.  Our findings supports a suggested role of respiratory infections in the etiology of type 1 diabetes and influenza virus could be a contributing factor to the development of clinical diabetes, due to stress and inflammation in predisposed individuals. (more…)
Author Interviews, Compliance, Diabetes / 15.09.2017

MedicalResearch.com Interview with: Alexander Turchin, MD, MS Director of Quality in Diabetes in the Division of Endocrinology, Diabetes and Hypertension Brigham and Women's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anecdotally, many clinicians report that their patients with diabetes frequently decline recommendations to start treatment with insulin. However, until now, there was no systematic information available on this phenomenon. Our study has found that 30% of patients initially decline their healthcare providers’ recommendation to start insulin therapy. Patients who do ultimately start treatment with insulin, do it on average more than two years after initially declining it. (more…)