Author Interviews, Diabetes, Pharmacology / 15.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25212" align="alignleft" width="191"]Professor Philip Home D.M., D.Phil Professor of Diabetes Medicine Newcastle University Prof. Philip Home[/caption] Professor Philip Home D.M., D.Phil Professor of Diabetes Medicine Newcastle University MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Home: MK1293 is a biosimilar insulin designed with the same amino acid sequence, manufacturing process and formulation as originator insulin glargine (Lantus). This is the clinical proving study in type 1 diabetes, being a 24-week randomized study in 508 participants between MK1293 and Lantus. The primary efficacy endpoint of non-inferiority of HbA1c was met, as was a secondary of equivalence (difference in change from baseline 0.04 (95% CI -0.11, 0.19) %-units), with other measures including hypoglycaemia, insulin antibodies and adverse events also consistent with similarity.
Author Interviews, Brigham & Women's - Harvard, Diabetes, Nutrition, PLoS / 15.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25189" align="alignleft" width="200"]Ambika Satija Departments of Nutrition & Epidemiology Harvard T. H. Chan School of Public Health Boston, MA Ambika Satija[/caption] Ambika Satija Departments of Nutrition & Epidemiology Harvard T. H. Chan School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: In this study, we followed more than 200,000 male and female health professionals across the U.S. for more than 20 years who had regularly filled out questionnaires on their diet, lifestyle, medical history, and new disease diagnoses as part of three large long-term studies.
Author Interviews, Diabetes, Kidney Disease, Pharmacology / 13.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25158" align="alignleft" width="133"]Doctor Hiddo Lambers Heerspink Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen the Netherlands Dr. Heerspink[/caption] Doctor Hiddo Lambers Heerspink Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: SGLT2 inhibitors, including canagliflozin, have beneficial effects on multiple cardiovascular and renal risk parameters. This suggests that SGLT2 inhibitors may confer cardiovascular and renal protection. A recent large clinical trial with the SGLT2 inhibitor empagliflozin demonstrated marked reductions in cardiovascular morbidity and mortality and suggested possible renoprotective effects. Whether SGLT2 inhibition slows the progression of kidney function decline independent of its glucose-lowering effect, however, is unknown. We therefore assessed whether canagliflozin slows the progression of kidney function decline by comparing the effects of canagliflozin versus glimepiride on eGFR and albuminuria.
Author Interviews, Diabetes, Frailty, JAMA, Mayo Clinic / 07.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25035" align="alignleft" width="133"]Rozalina McCoy, M.D Assistant Professor of Medicine Division of Primary Care Internal Medicine Department of Medicine Mayo Clinic Rochester Dr. Rozalina McCoy[/caption] Rozalina McCoy, M.D Assistant Professor of Medicine Division of Primary Care Internal Medicine Department of Medicine Mayo Clinic Rochester MedicalResearch.com: What is the background for this study? Dr. McCoy: Hypoglycemia is a serious potential complication of diabetes treatment; it worsens quality of life and has been associated with cardiovascular events, dementia, and even death. Most professional societies recommend targeting HbA1C levels less than 6.5% or 7%, with individualized treatment targets based on patient age, other medical conditions, and risk of hypoglycemia with therapy. Treating patients to very low HbA1c levels is not likely to improve their health, especially not in the short-term, but can cause serious harms such as hypoglycemia. The goal of our study was to assess how frequently patients with type 2 diabetes are treated intensively, focusing specifically on patients who are elderly or have serious chronic conditions such as dementia, kidney disease including dialysis need, heart disease, stroke, lung disease, and cancer. Moreover, while prior studies have suggested that intensive treatment may be common, there was no strong evidence that intensive treatment does in fact increase risk of hypoglycemia. Our study was designed specifically to assess this risk. We examined medical claims, pharmacy fill data, and laboratory results of 31,542 adults with stable and controlled type 2 diabetes who were included in the OptumLabs™ Data Warehouse between 2001 and 2013. None of the patients were treated with insulin or had prior episodes of severe hypoglycemia, both known risk factors for future hypoglycemic events. None of the patients had obvious indications for very tight glycemic control, such as pregnancy. “Intensive treatment” was defined as being treated with more glucose-lowering medications than clinical guidelines consider to be necessary given their HbA1C level. Patients whose HbA1C was less than 5.6 percent (diabetes is defined by HbA1C 6.5 percent or higher) were considered intensively treated if they were taking any medications. Patients with HbA1C in the “pre-diabetes” range, 5.7-6.4 percent, were considered to be intensively treated if using two or more medications at the time of the test, or if started on additional medications after the test, because current guidelines consider patients with HbA1C less than 6.5 percent to already be optimally controlled. For patients with HbA1C of 6.5-6.9 percent the sole criteria for intensive treatment was treatment intensification with two or more drugs or insulin. The patients were separated by whether they were considered clinically complex (based on the definition by the American Geriatrics Society)—75 years of age or older; or having end-stage kidney disease, dementia; or with three or more serious chronic conditions. This distinction has been made to help identify patients for whom adding glucose-lowering medications is more likely to lead to treatment-related adverse events, including hypoglycemia, while not providing substantial long-term benefit.
Author Interviews, Diabetes, Infections, Surgical Research / 04.06.2016

MedicalResearch.com Interview with: [caption id="attachment_24751" align="alignleft" width="100"]Mary Forhan OT Reg (Alberta), PhD, Assistant Professor Dr. Mary Forhan[/caption] Dr. Mary Forhan OT Reg (Alberta), PhD, Assistant Professor ad [caption id="attachment_24752" align="alignleft" width="100"]Dr. Tasuku Terada, post-doctoral research fellow Dr-Tasuku-Terada[/caption] Dr. Tasuku Terada, post-doctoral research fellow Faculty of Rehabilitation Medicine University of Alberta MedicalResearch.com: What is the background for this study? Response: The prevalence of obesity has increased. Notably, a proportion of severe obesity (body mass index: body weight [kg] divided by height squared [m2]: >40kg/m2) has shown the most significant increase. Greater body mass increases the risk of cardiovascular disease and referrals for coronary artery graft surgery (CABG) have increased in patients with severe obesity. Interestingly, while obesity is often considered to increase the risk of complications and associated health care costs, many studies have reported better prognosis in patients with obesity compared to patients with normal weight, a phenomenon referred to as the obesity paradox. Therefore, it was not clear if patients with severe obesity were at higher risk of complications and contributed to greater resource use. A better understanding of the relationship between obesity and post-surgical adverse outcomes was needed to provide quality and efficient care.
Author Interviews, Diabetes, FASEB / 03.06.2016

MedicalResearch.com Interview with: Dr. Soo Jung Park, Ph.D. Senior Scientist Division of Bioconvergence Korea Basic Science Institute in Seoul, South Korea MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetes is a leading cause of morbidity and mortality worldwide. The elevated level of blood glucose (hyperglycemia) can induce the cell death of the pancreatic beta cells which are responsible for the production of insulin. Loss of β-cell number and function underlies much of the pathology of diabetes. However, the mechanism is not fully understood, and we found the novel regulator for hyperglycemia induced beta cell death. MedicalResearch.com: What should readers take away from your report? Response: TSPAN2 protein levels dramatically increased in response to high glucose. High TSPAN2 levels upregulated phosphorylated-JNK (p-JNK) and induced apoptosis. p-JNK enhanced the phosphorylation of β-catenin (p-β-catenin) and Dickkopf-1 (Dkk1). Dkk1 knockdown by siRNA upregulated nuclear β-catenin, suggesting that it is a JNK/β-catenin-dependent pathway. siRNA-mediated TSPAN2 depletion in RNAKT-15 cells increased nuclear β-catenin. This decreased Bax activation, leading to marked protection against high glucose-induced apoptosis. Bax subfamily proteins induced apoptosis through caspase-3. Thus, TSPAN2 might have induced Bax translocation and caspase-3 activation in pancreatic β cells, thereby promoting the apoptosis of RNAKT 15 cells by regulating the JNK/β-catenin pathway in response to high glucose concentrations.
Author Interviews, Diabetes, Diabetologia, Heart Disease, Pediatrics / 01.06.2016

MedicalResearch.com Interview with: [caption id="attachment_24813" align="alignleft" width="180"]Dr. Nina Berentzen PhD National Institute for Public Health and the Environment Bilthoven, the Netherlands Dr. Nina Berentzen[/caption] Dr. Nina Berentzen PhD National Institute for Public Health and the Environment Bilthoven, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Berentzen: Cardiovascular disease and type 2 diabetes often occur together and share risk factors including an unhealthy diet, a lack of physical activity, and being overweight or obese. This study is the first to investigate the occurrence of both diabetes and CVD across two generations of parents and grandparents, and relate it to measurable risk factors in children. We found that one third of the 12-year-olds studied had a strong family history of one or both of cardiovascular disease (myocardial infarction and stroke) and type 2 diabetes. Children had a ‘strong family history’ if they had one affected parent, or at least one grandparent with early disease onset, or 3–4 grandparents with late disease onset. These children had higher levels of total cholesterol, and a higher ratio of total/HDL cholesterol than children with no family history of disease.
Author Interviews, Diabetes, Endocrinology, Environmental Risks, Lipids / 27.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24723" align="alignleft" width="150"]Maayan Yitshak Sade MPH Chief Scientific Officer, Clinical Research Center, Soroka University Medical Center, Israel Maayan Yitshak Sade[/caption] Maayan Yitshak Sade MPH Chief Scientific Officer Clinical Research Center, Soroka University Medical Center, Israel and   [caption id="attachment_24725" align="alignleft" width="125"]Dr-Victor-Novack Dr. Victor Novack[/caption] Victor Novack, MD, PhD Soroka University Medical Center and Ben-Gurion University in Beer Sheva, Israel   MedicalResearch.com: What is the background for this study? Response: Numerous studies found association between exposure the air pollution and increased risk of cardiovascular and respiratory diseases. In recent years links were found between air pollution and diabetes as well. The scientific evidence supports a causal association between air pollution and oxidative stress, possibly involving impaired metabolism of glucose and lipids. In a recent study performed by our group, we observed a significantly increased risk for ischemic stroke among young adults, associated with air pollution exposure. Following these findings, and as a part of the possible theory linking the association air pollution exposure and cardiovascular diseases, we sought to investigate if this association might be mediated through the well-established cardiovascular risk factors such as abnormal lipid and glucose metabolism.
Artificial Sweeteners, Author Interviews, Diabetes, Weight Research / 26.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24680" align="alignleft" width="150"]Jennifer L. Kuk, PhD Associate Professor York University School of Kinesiology and Health Science Toronto, Ontario Dr. Jennifer Kuk[/caption] Jennifer L. Kuk, PhD Associate Professor York University School of Kinesiology and Health Science Toronto, Ontario MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kuk: Artificial sweeteners are used to help individuals manage their weight, however, individuals who consume aspartame (a type of artificial sweeteners) have worse glucose metabolism than individuals with the same body weight but do not consume aspartame. This observation was only true for adults with obesity. Further, saccharin and natural sugars were not associated with differences in health after considering differences in obesity.
Author Interviews, Diabetes, Genetic Research, Hepatitis - Liver Disease, Weight Research / 24.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24667" align="alignleft" width="131"]Prof-Dr. Annette Schürmann Department of Experimental Diabetology German Institute of Human Nutrition Potsdam-Rehbruecke Nuthetal, Germany Dr. Annette Schürmann[/caption] Prof-Dr. Annette Schürmann Department of Experimental Diabetology German Institute of Human Nutrition Potsdam-Rehbruecke Nuthetal, Germany MedicalResearch.com: What is the background for this study? Dr. Schürmann: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern of liver at two time points, at the age of 6 weeks, (the earliest time point to distinguish between those that respond to the diet (responder mice) and those that did not (non-responders)), and at the age of 20 weeks. One transcript that was significantly reduced in the liver of responder mice at both time points was Igfbp2. The reason for the reduced expression was an elevated DNA-methylation at a position that is conserved in the mouse and human sequence. The elevated DNA-methylation of this specific site in human was recently described to associate with elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old mice did not show differences in liver fat content between responder and non-responder mice we conclude that the alteration of Igfbp2 expression and DNA methylation occurs before the development of fatty liver. Our data furthermore showed that the epigenetic inhibition of Igfbp2 expression was associated with elevated blood glucose and insulin resistance but not with fatty liver.
Author Interviews, Diabetes, Environmental Risks / 19.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24501" align="alignleft" width="128"]Kathryn Reid PhD Research associate Professor of Neurology Northwestern University Feinberg School of Medicine. Dr. Kathryn Reid[/caption] Kathryn Reid PhD Research associate Professor of Neurology Northwestern University Feinberg School of Medicine.  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reid: There is increasing evidence that light and dark exposure patterns over time impact health outcomes such as body weight and food intake. This study found that bright light exposure increased insulin resistance compared to dim light exposure in both the morning and the evening. In the evening, bright light also caused higher peak glucose (blood sugar) levels.
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness / 17.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24436" align="alignleft" width="143"]Dr Lisa Chow MD MS University of Minnesota, Minnesota, MI Dr. Lisa Chow[/caption] Dr Lisa Chow MD MS University of Minnesota, Minnesota, MI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chow: A number of previous studies have shown people who maintain or increase their cardiac fitness (CRF) through adulthood have a lower risk of developing diabetes, abnormal metabolic measures, cardiovascular disease and cardiovascular mortality than those whose CRF declines. However, these previous studies are limited for several reasons, including use of a largely male population, measurement of fitness over a limited duration (5–7 years) or measurement of fitness at varying intervals prospectively. In this new research, the authors used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to objectively and rigorously analyse the link between cardiac fitness and development of either prediabetes or diabetes over a 20-year period. The main finding is that higher cardiac fitness  is associated with lower risk for developing prediabetes and diabetes, even when adjusting for prospective changes in body mass index.
Author Interviews, BMJ, Diabetes, Genetic Research / 08.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24154" align="alignleft" width="150"]Wenpeng You, PhD student Biological Anthropology and Comparative Anatomy Research Unit University of Adelaide | School of Medicine Adelaide, Australia Wenpeng You[/caption] Wenpeng You, PhD student Biological Anthropology and Comparative Anatomy Research Unit University of Adelaide | School of Medicine Adelaide, Australia  [caption id="attachment_24262" align="alignleft" width="180"]Maciej Henneberg, PhD, DSc, FAIBiol Wood Jones Professor of Anthropological and Comparative Anatomy University of Adelaide | School of Medicine Adelaide, Australia  Institute for Evolutionary Medicine, University of Zurich  Editor in Chief, Journal of Comparative Human Biology HOMO Dr. Maciej Henneberg[/caption] Maciej Henneberg, PhD, DSc, FAIBiol Wood Jones Professor of Anthropological and Comparative Anatomy University of Adelaide School of Medicine; Institute for Evolutionary Medicine, University of Zurich Editor in Chief, Journal of Comparative Human Biology HOMO MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 1 diabetes disease has very strong genetic background. Prevalence of type 1 diabetes has been increasing globally. Previous studies focusing on regional genetics and environmental factors cannot fully explain this phenomenon. Due to insufficient medical knowledge up until early 20th century, people with type 1 diabetes disease would most commonly die during their teens or early 20s. Therefore, they did not have the opportunity to pass on their genes providing background for the development of type 1 diabetes to their next generations. Since discovery and introduction of insulin to modern medicine in early 1920s, more and more type 1 diabetes patients have been able to survive their reproduction cycle (up until and past 50 years of age). This has made more and more genes related to type 1 diabetes to accumulate in human populations. We applied the Biological State Index which measures a probability to pass genes on to the next generation at population level.  We found that the rapid increase in type 1 diabetes over the last few decades was correlated with increases of the Biological State Index and its proxy, human life expectancy, especially in more developed world in which natural selection has been relaxed most. This correlation was found after statistically excluding differences in countries income, levels of urbanization, sugar consumption and obesity prevalence.
Author Interviews, Diabetes, Pharmacology / 21.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23655" align="alignleft" width="148"]Pedro L. Herrera, PhD Professor Dept. Genetic Medicine & Development, room #F09.2770 Faculty of Medicine, University of Geneva Geneva, Switzerland Dr. Pedro Herrera[/caption] Pedro L. Herrera, PhD Professor Dept. Genetic Medicine & Development, room #F09.2770 Faculty of Medicine, University of Geneva Geneva, Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Herrera: After meals, the digestion of food leads to an accumulation of sugar (glucose) in the blood (hyperglycemia). This triggers the release of the hormone insulin from the pancreas (beta-cells), which allows the tissues (liver, muscle and fat) to use and store it. Another pancreatic hormone, glucagon, is released by alpha-cells during fasting or exercising, and opposes the action of insulin: it tells the liver to release glucose, which increases blood sugar levels. The balance between insulin and glucagon keeps blood sugar levels steady. Persistent hyperglycemia due to insulin deficiency is diabetes. Glucagon production is exacerbated in diabetes, which aggravates hyperglycemia.
Author Interviews, Diabetes, Metabolic Syndrome, OBGYNE, Pediatrics, University Texas, Weight Research / 21.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23639" align="alignleft" width="150"]Antonio Saad, MD Fellow in Maternal Fetal Medicine University of Texas Medical Branch at Galveston. Dr. Antonio Saad[/caption] Antonio Saad, MD Fellow in Maternal Fetal Medicine & Critical Care Medicine University of Texas Medical Branch at Galveston MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Saad: Recently the WHO announced an alarming news, the prevalence of diabetes has increased four fold in the past quarter-century. The major factors attributed for this increase included excessive weight, and obesity. In the US alone, two thirds of people are either overweight or obese. There are shocking numbers that should alert physicians, patients and government officials for awareness and interventions that we can alter the path away from this drastic epidemic. In light of recent events, our group strongly believes that poor diet during pregnancy predisposes offspring in adult life to develop obesity and diabetes through fetal programming. High fructose introduction into our food chain has coincided with the obesity and diabetes epidemics. Hence, we designed an animal study where we fed pregnant mice with either regular diet or high fructose diet until delivery. Then we looked at the offspring, at 12 months of age. We looked at  their blood pressure, glucose tolerance tests, insulin resistance,  and weights. We also tested for serum marker of metabolic dysfunction and used computed tomography imaging to assess for liver fat infiltration and percent visceral adipose tissue. To our surprise, these offspring (mothers were fed high fructose diet) developed several features of metabolic syndrome.  Female offspring’s cardiovascular and metabolic function at one year of age (adulthood) had increased weight, blood pressure, visceral adiposity, liver fat infiltrates and  insulin resistance with impaired glucose tolerance).  The  male counterparts were limited to high blood pressure  and glucose intolerance. Keeping in mind that the amount of fructose given to these animals were equivalent to daily soda cans consumption in humans.
Author Interviews, Diabetes, JAMA, Surgical Research, Weight Research / 20.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23623" align="alignleft" width="133"]Annemarie G. Hirsch, PhD, MPH Center for Health Research Geisinger Health System Danville, Pennsylvania Dr. Annemarie Hirsch[/caption] Annemarie G. Hirsch, PhD, MPH Center for Health Research Geisinger Health System Danville, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bariatric surgery is currently the most effective treatment in reversing insulin resistance in patients with type 2 diabetes. However, the likelihood of remission or cure after surgery varies tremendously based on certain patient characteristics. The DiaRem score provides patients with a personalized prediction of whether or not they can expect long-term remission of their disease if they choose to have surgery.
Author Interviews, Diabetes, Diabetes Care, Exercise - Fitness, Lifestyle & Health / 20.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23604" align="alignleft" width="113"]Paddy Dempsey MPhEd, PhD in Medicine (expected June 2016) Physical Physical Activity and Behavioural Epidemiology Laboratory Baker IDI Heart and Diabetes Institute Melbourne VIC Paddy Dempsey[/caption] Paddy Dempsey MPhEd, PhD in Medicine (expected June 2016) Physical Physical Activity and Behavioural Epidemiology Laboratory Baker IDI Heart and Diabetes Institute Melbourne VIC MedicalResearch.com: What is the background for this study? What are the main findings? Response: In addition to too little physical activity (PA), sedentary behavior – defined as any waking sitting or reclining behavior with low energy expenditure – has emerged as a ubiquitous and significant population-wide influence on cardiometabolic health outcomes, with potentially distinct and modifiable environmental and social determinants. There is now a consistent base of epidemiologic evidence reporting deleterious associations of excessive sedentary behaviors (e.g. TV viewing, car use, and desk work) with mortality and cardiometabolic morbidity, independent of moderate-vigorous PA. To date, efforts to influence participation in moderate-to-vigorous exercise (i.e. 30 min a day of ‘exercise’ on most days a week for health) at the population level, such as through large-scale campaigns to promote walking, and other initiatives to encourage people to exercise during their leisure time have achieved only modest success. There may, however, be untapped preventive-health and clinical management potential through shifting the high volume of time spent sedentary to light-intensity physical activity interspersed throughout the day. As such, sedentary behavior represents a potentially feasible and therapeutic target, particularly in the promotion of metabolic health. We posited that people with type 2 diabetes (T2D) were likely to derive the greatest benefits from interrupting their sitting time. However, until now the contributions of prolonged sitting and/or interrupting prolonged sitting with very-brief bouts of light-intensity PA had never been experimentally tested in patients with T2D. Moreover, this study for the first time moved beyond interrupting sitting with standing or ambulatory bouts (although walking bouts were also examined), which may have differing levels of metabolic stimulus (i.e. not physiologically taxing the body enough), practicality, or health efficacy, to examine a potential addition/alternative: simple resistance activities (SRA). A key premise behind these SRA bouts (half-squats, calf raises, gluteal contractions, and knee raises) were that they required no specialized equipment, only small amounts of space, and could be easily performed in a fixed position behind a work desk or at home with minimal disruption to work tasks or leisure pursuits. In addition, they also markedly increase muscle activity, and may also have other longer-term benefits (for example physical function, muscle strength, bone density), however we can only speculate on these aspects at present. In this study in men and women with type 2 diabetes, plasma glucose, insulin and C-peptide (marker of insulin secretion and pancreatic beta cell function) levels following standardized breakfast and lunch meals were all markedly attenuated when prolonged sitting was regularly interrupted with light walking or resistance activities (3 min every 30 min) over an 8 hour day. Plasma triglyceride levels were also reduced for both types of activity bout; however, the reduction was only significant for the SRAs. Interestingly, the magnitude of glucose reduction for the walking bouts was greater in women for glucose levels.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Diabetes, NIH, Nutrition, OBGYNE / 20.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23530" align="alignleft" width="158"]Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 Dr. Cuilin Zhang[/caption] Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch.com: What is the background for this study? Dr. Zhang: Hypertension is one of the most prevalent and preventable risk factors for cardiovascular and kidney diseases, and is one of the leading causes of death in the United States. We have previously reported that the cumulative incidence of hypertension for women with a history of gestational diabetes mellitus (GDM) was 26% higher than those who did not have GDM even 16 years after the index pregnancy. Thus, women with a history of GDM represent a high-risk population for hypertension that could benefit from early prevention. While there is extensive literature on how lifestyle factors may influence blood pressure in the general population, no information is currently available on the role of diet and lifestyle in the development of hypertension specifically in this susceptible population. To address these gaps, we prospectively examined the associations between long-term adherence to three healthy diets with subsequent risk of hypertension among women with a history of gestational diabetes mellitus, specifically the DASH diet, the alternative Mediterranean diet (aMED), and the Alternative Healthy Eating Index (AHEI).
Author Interviews, Diabetes, Kidney Disease / 17.04.2016

MedicalResearch.com Interview with: Axel C. Carlsson, PhD Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University Uppsala Sweden MedicalResearch.com: What is the background for this study? Dr. Carlsson: Circulating endostatin levels has been shown to be associated with duration of hypertension and cardiovascular events. Moreover, endostatin levels were recently shown to parallel kidney function decline, and has been associated with increased mortality risk in different settings. However, less is known of circulating endostatin in patients with type 2 diabetes. 
Author Interviews, Diabetes, Exercise - Fitness, UCSD / 12.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23387" align="alignleft" width="180"]Britta Larsen, Ph.D. Assistant Professor Family Medicine & Public Health University of California, San Diego Medical Teaching Facility La Jolla, CA 92093-0628 Dr. Britta Larsen[/caption] Britta Larsen, Ph.D. Assistant Professor Family Medicine & Public Health University of California, San Diego Medical Teaching Facility La Jolla, CA 92093-0628  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Larsen: We know that muscle is important for metabolic processes, but there has been very little research on the role muscle may play in the development of metabolic diseases like type 2 diabetes. While excess fat can increase the risk of metabolic disease, there are people who are normal weight who still develop diabetes, and it’s possible that this could be due to low muscle mass. Our main findings were that, in normal weight women, women with more abdominal, thigh, and overall muscle were less likely to develop diabetes over a 13-year period. 
Author Interviews, Diabetes, Pharmacology / 12.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23375" align="alignleft" width="117"]Christopher Sorli, MD SUSTAIN 1 investigator and  Chair of the Department of Diabetes, Endocrinology and Metabolism Billings Clinic, Billings, Montana Dr. Christopher Sorli[/caption] Christopher Sorli, MD SUSTAIN 1 investigator and Chair of the Department of Diabetes, Endocrinology and Metabolism Billings Clinic, Billings, Montana MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sorli: GLP-1 receptor agonists (GLP-1 RAs) have been found to be useful in the treatment of Type 2 diabetes with potent effects on blood glucose lowering while minimizing the risk of hypoglycemia and weight gain often seen with other classes of hypoglycemic agents. Semaglutide is a novel GLP-1RA that is currently in clinical development. The molecule shares 94% amino acid homology with native GLP-1 and has a half-life of approximately one week allowing for once weekly dosing. SUSTAIN 1 was designed to demonstrate superiority of semaglutide 0.5 mg and 1.0 mg once weekly over placebo in lowering HbA1c after 30 weeks of treatment. Additional secondary endpoints included weight loss versus placebo, percent of patients achieving HbA1c goals, percent of patients achieving 5% and 10% weight loss, and safety and tolerability.
Author Interviews, Diabetes, Diabetologia / 06.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23245" align="alignleft" width="183"]Dr. Dennis James Petrie Melbourne School of Population and Global Health Dr. Dennis Petrie[/caption] Dr. Dennis James Petrie Melbourne School of Population and Global Health MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Petrie: Life expectancy estimates for those with type 1 diabetes allow gaps with the general population to be identified and improvements to be quantified. This research examined mortality for those with type 1 diabetes in Sweden from 2002 till 2011. The aim was to explore whether life expectancy of those with type 1 diabetes has improved in Sweden over the last decade and how any improvement compared with improvements seen in the general population. It found that for men with type 1 diabetes, the remaining life expectancy at age 20 increased significantly by about 2 years (from 47.7 in 2002–06 to 49.7 years in 2007–11) but for women with type 1 diabetes there was no significant change, with a life expectancy at age 20 of 51.7 years in 2002–06 and 51.9 years in 2007–11. There have been recent gains for both men and women from reductions in cardiovascular mortality however these gains were also seen in the general population which meant that the life expectancy gaps have stayed at about 11 years for men and 12 years for women over the last decade in Sweden.
Author Interviews, Diabetes, Diabetologia / 04.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23116" align="alignleft" width="133"]Associate Professor Dianna Magliano BAppSci(Hon) MPH PhD Head, Diabetes and Population Health Baker IDI Heart and Diabetes Institute Melbourne. VIC Dr. Dianna Magliano[/caption] Associate Professor Dianna Magliano BAppSci(Hon) MPH PhD Head, Diabetes and Population Health Baker IDI Heart and Diabetes Institute Melbourne. VIC MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Magliano: This work shows  that Australians with type 1 diabetes had an estimated life loss of 11.6 years for men and 12.5 years for women compared with the general population. We saw no evidence of improvement in this over recent years. For those who are older with type 1, cardiovascular disease contributed substantially to the years of life lost in type 1 diabetes. Death before 60 years and mortality from endocrine and metabolic disease were also important contributors to the years of life lost in type 1 diabetes.
Author Interviews, Diabetes, Endocrinology, Surgical Research, Weight Research / 04.04.2016

MedicalResearch.com Interview with: Ana Priscila Soggia Sirio Libanes Hospital, São Paulo, Brazil MedicalResearch.com: What is the background for this study? What are the main findings? Response: For many years, bariatric surgery is performed to treat class II and III obesity with diabetes remission in 80-90% of cases, related to weight loss and change in the secretion of intestinal factors that control blood glucose, like GLP-1 and GIP. In 2010, the International Diabetes Federation (IDF), proposed that diabetic patients with BMI between 30-35kg/m2 could be eligible, for bariatric surgery, in the case of no glycemic control with drug treatment. In this context, once glycemic control after bariatric surgery, was not related only to weight loss and also due to intestinal factors with physiological actions, the protocol was proposed. The objectives were to compare the clinical and surgical treatment in diabetics patients with class I obesity; and to compare the efficacy and security between two different surgical techniques. This study was developed and conducted by a research team from Sirio-Libanês Hospital in partnership with Ministry of Health through its philanthropic program PROADI. It is a clinical trial, with 42 class I obese diabetic type 2 patients with inadequate glycemic control that were randomized to tree arms: clinical treatment, gastric bypass surgery or sleeve with ileal transposition (sleeve-IT) surgery. The results showed that the sleeve-IT procedure is more effective for the treatment of diabetes in these patients compared with treatment with medication and with bypass surgery, currently considered the first choice of treatment. Among patients who underwent sleeve-IT, 100% achieved glycemic control after 1 year (HbA1c<6,5%) compared to 46% for bypass and 8% in the case of medication therapy. In addition, diabetes remission, that was defined as adequate glycemic control without any anti-diabetic medication, occured in 75% of sleeve-IT patients had versus 30% in bypass group.
Alcohol, Author Interviews, Diabetes, Endocrinology / 03.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23098" align="alignleft" width="200"]Ken C. Chiu, MD, FACE, FACP Professor Endocrinology Fellowship Training Program Department of Clinical Diabetes, Endocrinology, and Metabolism Diabetes and Metabolism Research Institute City of Hope National Medical Center Duarte, CA 91010-3000 Dr. Ken C. Chiu[/caption] Ken C. Chiu, MD, FACE, FACP Professor Endocrinology Fellowship Training Program Department of Clinical Diabetes, Endocrinology, and Metabolism Diabetes and Metabolism Research Institute City of Hope National Medical Center Duarte, CA 91010-3000  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chiu: The benefit of moderate alcohol consumption is well established in cardiovascular disease. However, the role of alcohol consumption in type 2 diabetes is less clear. We examined the role of alcohol consumption in type 2 diabetes using the data from the National Health and Nutrition Examination Survey 2005-1012, which is a representative US population. In the rare alcohol consumption group (< 12 drinks per year), 24.04% were diabetic while only 14.67% were diabetic in the moderate alcohol consumption (1-4 drinks per day) group (P><0.000001). In contrast, 21.05% were diabetic in the heavy alcohol consumption (≥ 5 drinks/day) group (P=0.003) when compared to the rare alcohol consumption group. Thus, in compared to the rare alcohol consumption, moderate alcohol consumption was associated with a lower risk of diabetes (OR: 0.72; 95%CI: 0.65-0.79) after adjustment for co-variates, while there was no benefit from heavy alcohol consumption (OR: 0.97; 95%CI: 0.90-1.05). Our study demonstrates that moderate alcohol consumption reduces the risk of diabetes by 28%.
Author Interviews, Diabetes, Endocrinology, Weight Research / 03.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23094" align="alignleft" width="172"]Olivia Farr, Ph.D. Instructor in Medicine Division of Endocrinology, Beth Israel Deaconess Medical Center 330 Brookline Ave, Stoneman 820B Boston, MA 02215 Dr. Olivia Far[/caption] Olivia Farr, Ph.D. Instructor in Medicine Division of Endocrinology, Beth Israel Deaconess Medical Center 330 Brookline Ave, Stoneman 820B Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Farr: There are two main studies. In the first, we used immunohistochemistry to analyze 22 human brain tissue samples for the presence of GLP-1 receptors, which are protein molecules that respond to the GLP hormone’s signal. We found—for the first time—that GLP-1 receptors are expressed in the human brain, including the cortex, the part of the brain responsible for higher thought. Our second study was performed in 18 adults with type 2 diabetes. Participants received 17 days of either liraglutide, up to 1.8 milligrams, or a placebo (dummy drug) in a random order. Then after a three-week “washout” of no medication, the same participants received 17 days of the opposite treatment. Participants and investigators were unaware which treatment they received. On day 17 of each treatment, participants underwent brain scanning with functional magnetic resonance imaging (fMRI). During fMRI, participants viewed images of different foods. In response to highly desirable foods such as cake, pastries and fried foods, liraglutide decreased reward- and salience-related brain activations in the cortex compared with images of less desirable foods, such as fruits, vegetables and other low-calorie, low-fat foods.​
Author Interviews, Diabetes, Mental Health Research, OBGYNE / 30.03.2016

MedicalResearch.com Interview with: [caption id="attachment_22988" align="alignleft" width="159"]Eyal Sheiner, MD,PhD Department of Obstetrics and Gynecology Soroka University Medical Center Beer-Sheva Israel Prof. Eyal Sheiner[/caption] Eyal Sheiner, MD,PhD Department of Obstetrics and Gynecology Soroka University Medical Center Beer-Sheva Israel   MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sheiner: The reported rates of gestational diabetes mellitus (GDM) are constantly escalating and little is known about the long term complications in the offspring. Evidence from the field of epigenetics strongly advocated the need for research on the neuropsychiatric impact of being exposed prenatally to GDM. In our study, in utero exposure to  gestational diabetes mellitus was found to be an independent risk factor for long term neuropsychiatric morbidity of the offspring.
Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, Weight Research / 18.03.2016

MedicalResearch.com Interview with: Debbie Lawlor PhD School of Social and Community Medicine University of Bristol, Oakfield House, Oakfield Grove Medical Research Council Integrative Epidemiology Unit University of Bristol, UK and Rachel Freathy PhD, University of Exeter, Institute of Biomedical and Clinical Science, Royal Devon and Exeter Hospital,  Exeter  UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: A healthy birth weight is important for babies’ health and wellbeing in the first year of their life. It reflects how well the baby has grown and developed in the womb. The experience of fetuses in the womb and how well they grow and develop might also determine their future health, even into adulthood. Both being too light or too heavy at birth is not good for the baby. Lots of studies have shown that mothers who are fatter at the start of their pregnancy have babies who are more likely to be heavier. But is it not clear whether the mother being fatter causes their baby to be bigger at birth. If mothers’ fatness does cause their baby to be heavier at birth, why this happens is not clear. We used genes to find out whether being fatter in pregnancy causes babies to be born heavier. We also tested whether risk factors in the mother that are affected by her fatness, such as her blood pressure, and the level of glucose (sugar) and lipids (fats) in her blood stream affect how heavy her baby is. Our results showed that being fatter during pregnancy did cause a mothers’ baby to be born heavier. We also showed that having higher blood levels of glucose in pregnancy also caused a mothers’ baby to be heavier. But we did not find any effect of mothers’ blood levels of lipids in pregnancy on their baby’s weight. Whilst mothers who are heavier in pregnancy will tend to have higher blood pressure in pregnancy we found that higher blood pressure caused the women’s babies to be lighter.