Author Interviews, Diabetes, Nutrition, PLoS, University of Michigan / 06.11.2016 Interview with> Katarina Borer, Ph.D. Professor Po-Ju Lin,PhD School of Kinesiology The University of Michigan Ann Arbor, MI What is the background for this study? Response: This study was part of the doctoral dissertation of Po-Ju Lin, who is now a post-doctoral fellow at the University of Rochester. With this study, we wanted to answer three questions: (1) Is daily carbohydrate load responsible for evening glucose intolerance and post-meal insulin resistance. (Evening glucose intolerance represents well-documented higher glucose and insulin responses in the evening than in the morning when the same quantity of glucose is eaten or infused intravenously) To answer this question we offered two daily meals containing about 800 Kcal and either 30% or 60% of carbohydrates. (2) Will exercise before the meals improve glucose tolerance (glucose clearance from the blood and insulin response) after eating? (Exercise is a well-known means of increasing glucose uptake by the muscle and of increasing muscle sensitivity to insulin action for a number of hours after exercise). To answer this question we had the subjects exercise for two hours walking on a treadmill at 45% of their maximal aerobic effort one hour before each meal. (3) Is the upper-intestinal hormone GIP involved in any effects associated with variation in dietary carbohydrate? (GIP or glucose-dependent insulinotropic peptide, stimulates insulin secretion in advance of absorbed glucose). (more…)
Author Interviews, Diabetes, Weight Research / 04.11.2016 Interview with: Patrick M. O'Neil, Ph.D. Director, Weight Management Center Professor, Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston, SC 29425 What is already known about the subject? • Even modest weight loss (2-5%) from clinical interventions improves glycemic control in type 2 diabetes. • Commercial weight loss programs, comparatively more affordable and accessible than clinic-based modalities, can produce weight losses in this range, although they typically do not offer diabetes-specific counseling. • Data are sparse on such programs’ effects on glycemic control for adults with T2DM. (more…)
Author Interviews, Diabetes, Electronic Records / 04.11.2016 Interview with: Lee Kallenbach, PhD, MPH Principal Investigator Practice Fusion What is the background for this study? Response: Clinical inertia, or the tendency for patients and providers to continue using the same course of treatment even when clinical markers may suggest that treatment intensification is necessary, is an ongoing factor that can contribute to inadequate diabetes care. This is especially true when the treatment intensification may involve a switch from an oral medication to an injectable medication. It is less challenging for a patient to take a pill than it is to give themselves a shot. Even with all the new diabetes treatments available, clinical inertia is still common among patients with uncontrolled type 2 diabetes (T2D). To further understand the extent of clinical inertia among patients with T2D, the study assessed treatment intensification patterns and associated demographic and clinical characteristics for patients with uncontrolled T2D who were already taking two or more oral anti-diabetes medications. The study consisted of a retrospective observational analysis leveraging data from Practice Fusion’s de-identified clinical database, which includes more than 38 million records, representing 6.7 percent of all practices across the United States.1 Using a cohort of 25,365 de-identified records, we studied the care given by providers in independent practices to patients in need of intensifying their antidiabetic therapy for managing T2D. To our knowledge, this is one of the largest real world evidence (RWE) studies of T2D that has leveraged a de-identified clinical database from an electronic health record (EHR) platform. (more…)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Nutrition / 18.10.2016 Interview with: Andrew Reynolds Department of Human NutritionUniversity Otago Dunedin New Zealand What is the background for this study? What are the main findings? Response: Current guidelines for people with type 2 diabetes are to undertake activities such as walking for at least 150 minutes a week, or 30 minutes a day. When to walk in the day is not specified. We thought it reasonable that walking after meals would improve blood sugars more so than a walk where the timing was unspecified. Our randomised controlled trial considered exactly this, a prescription to walk as per the guideline of 30 minutes a day and a prescription to walk for 10 minutes after each meal. Our participants were free-living, but wore accelerometers to record their movement, and continuous glucose monitoring systems to observe their blood glucose levels. We found that post-meal blood sugar levels dropped 12 per cent on average when the participants followed the walking after meals advice compared to walking at any time of the day. Most of this effect came from the highly significant 22 per cent reduction in blood sugar when walking after evening meals, which were the most carbohydrate heavy, and were followed by the most sedentary time. (more…)
Author Interviews, Diabetes, Pediatrics / 14.10.2016 Interview with: Tuure Kinnunen, MD, PhD Academy Research Fellow School of Medicine, University of Eastern Finland Kuopio, Finland What is the background for this study? Response: Type 1 diabetes is an autoimmune disease where the immune system destroys the insulin-producing beta cells in the pancreas. It typically manifests in childhood and early adolescence. Diabetes-associated autoantibodies are highly predictive of type 1 diabetes risk and they can be typically detected in the blood of patients even years before the onset of the disease. Follicular helper T cells are a recently described type of immune cells that have a central role in activating B cells, which in turn are responsible for producing antibodies. Since the emergence of autoantibodies is a common feature of type 1 diabetes development, it is plausible that follicular T helper cells have a role in the disease process. This notion is also supported by evidence recently generated in the murine models of type 1 diabetes. (more…)
Author Interviews, Diabetes, JAMA / 03.10.2016 Interview with: Dr. Saeid Shahraz Assistant Professor of Medicine Tufts Medical Center What is the background for this study? Response: American Diabetes Association (ADA) has set up a lower cut point for diagnosing prediabetes ( those with Impaired Fasting  Glucose   100 mg/dL) compared to the World Health Organization's cut point, which is 110 mg/dL. This arbitrariness in cut point definition triples the number of cases labeled as prediabetes. Along with lowering the diagnostic threshold by the ADA, the Centers for Disease Control and Prevention (CDC), the American Medical Association (AMA), and the ADA endorsed and advertised a web-based risk model to define high-risk population for prediabetes. The risk engine asks a few questions ( age, sex, family history of diabetes, history of gestational diabetes and high blood pressure, physical activity and weight) and outputs a score that defines if the person is at risk for prediabetes. We suspected that the risk engine might overestimate the risk. (more…)
Author Interviews, Diabetes, Diabetologia, NIH, OBGYNE / 21.09.2016 Interview with: Cuilin Zhang MD, PhD Senior Investigator NICHD, National Institutes of Health What is the background for this study? What are the main findings? Response: Pregnant women are at high risk of developing depressive symptoms; at least 10% US women suffering from depression during pregnancy. Gestational diabetes is a common pregnancy complication, affecting 4-7% of pregnancies in the U.S..  Gestational diabetes has  adverse health implications on both women and their children.   Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes and depression during pregnancy and the postpartum period is less understood. (more…)
Author Interviews, Diabetes, JAMA, Mayo Clinic, Outcomes & Safety / 21.09.2016 Interview with: Victor M. Montori, MD MSc Knowledge and Evaluation Research Unit in Endocrinology Mayo Clinic, Rochester, Minnesota What is the background for this study? Response: Hypoglycemia can acutely disrupt patients’ lives through symptoms ranging from bothersome to life-threatening; worsen quality of life; and hinder medication adherence and glycemic control. Hypoglycemia is now known to increase risk of mortality, cognitive impairment, and cardiovascular events. In order to improve the quality of diabetes care, healthcare organizations use publicly reported performance measures for quality measurement and improvement, and pay-for-performance initiatives. The degree to which existing performance measures are aligned with guidelines, particularly in regard to hypoglycemia avoidance, is uncertain. (more…)
Author Interviews, Diabetes, Endocrinology, Hormone Therapy / 19.09.2016 Interview with: Jon Rasmussen, MD, PhD fellow Department of Internal Medicine Herlev Hospital, Denmark What is the background for this study? Response: Abuse of anabolic androgenic steroids has become highly prevalent among young men involved in recreational strength training. A recent meta-analysis estimated that approximately 18% of young men involved recreational strength training abuse anabolic steroids. Well-known adverse effects following abuse of anabolic steroids include hypogonadism (For those who have interest, we have recently published a paper concerning this issue, it can be read and downloaded at: Yet, we have a poor understanding on the adverse effects these compounds might have on the metabolism and insulin sensitivity. (more…)
Author Interviews, Diabetes, OBGYNE / 19.09.2016 Interview with: Anastasia Katsarou PhD LUND University What is the background for this study? What are the main findings? Response: The study is using data from the Mamma study which screened pregnant women during 2003-2005. During this period, we gathered results from the oral glucose tolerance tests that the women underwent at the 28th week of pregnancy. We used data on the 2hour blood glucose levels from these tests and the frequency of women who were diagnosed with gestational diabetes and grouped them into months and seasons. We gathered also data on the mean monthly temperatures from the Swedish Meteorological and Hydrological Institute. We observed that the 2hour glucose levels and the frequency of women diagnosed with gestational diabetes were statistically significantly higher during the summer months. (more…)
Author Interviews, Biomarkers, Diabetes, Pancreatic / 19.09.2016 Interview with: Dr. Pavel Škrha Charles University, Prague Czech Republic What is the background for this study? What are the main findings? Response: Incidence of pancreatic cancer (PAC) is still increasing. The main problem is in the late diagnosis of the cancer. It was found, that diabetes mellitus was much more frequent in the pancreatic cancer patients than in the general population. DM can be already the first symptom of the disease (secondry T3cDM). In our study nearly 80 % of all the pancreatic cancer patients had DM/prediabetes and it was of new-onset (less than 2 years before the cancer diagnosis) in 73 % out of them. We have measured the current marker of PAC (CA 19-9) together with serum microRNA-196 and -200 (that we have chosen in the previous pilot study). All the markers were significantly elevated in the pancreatic cancer patients, without any difference between the subgroups according to DM presence/absence. While the sensitivity of CA 19-9 alone (to detect the cancer) was 85 % (specificity 73 %), combining all the three markers improved it to 95 % (specificity 77 %). In the pancreatic cancer group, there were only six patients with T1 or T2 stage (others had an advanced stage of the disease - T3, T4). While CA 19-9 alone identified only 2 patients of them, the combined test identified all the six patients (data not shown in the poster). (more…)
Author Interviews, Diabetes, Social Issues, Weight Research / 16.09.2016 Interview with: Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK What is the background for this study? What are the main findings? Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact. We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching. (more…)
Author Interviews, Diabetes, Vitamin D / 16.09.2016 Interview with: Dr. Elisa Benetti PhD Department of Drug Science and Technology University of Turin Turin, Italy What is the background for this study? Response: The idea for this study comes from the debate on the role of vitamin D supplementation in the prevention or progression of type 2 diabetes (T2DM). Epidemiological data point at a strong association between vitamin D deficiency and T2DM prevalence, however a causal relationship is still lacking. Here we wanted to explore the effect of vitamin D administration on insulin-sensitivity, particularly focusing on skeletal muscle, which is a crucial tissue in the maintenance of glucose homeostasis and which was suggested to be a tissue target of vitamin D. Using a murine model of insulin-resistance induced by a High Fat-High Sugar Diet (HFHS), we demonstrated that a vitamin D supplementation (7 μg•kg-1, i.p. three times/week) was able to revert the deleterious effects evoked by the diet, including the increase in body weight and in the HOMA-IR (a parameter of insulin resistance) and the glucose tolerance impairment. Consistently, at the muscle level, vitamin D increased the insulin sensitivity by reducing tissue inflammation and fat accumulation (myosteatosis). These effects are due, at least in part, to the inhibition exerted by vitamin D on carboxymethyl-lysine (CML) production, one of the main Advanced Glucose End-products (AGEs), and on its receptor RAGE. Collectively, our data indicate the ability of vitamin D to reduce the development of muscle insulin resistance, the primary defect in T2DM patients. (more…)
Author Interviews, Depression, Diabetes / 16.09.2016 Interview with: Dr Cathy E. Lloyd Professor of Health Studies School of Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies The Open University Milton Keynes UK What is the background for this study? What are the main findings? Response: We know from earlier epidemiological research that people with diabetes have an increased risk of developing depression and other mental health problems compared to those without diabetes. However the impact of this and what treatment and care should be provided is still unclear, in particular in countries other than the US or the UK. Our study aims to redress that imbalance, collecting data on diabetes and depression in 16 countries across the globe. Ours is the first study to measure depressive symptoms but also use a standardised clinical interview to diagnose depression according to ICD criteria. Overall 10.6% received a diagnosis of Major Depressive Disorder (MDD), however prevalence rates differed widely between countries with 1% diagnosed with MDD in Uganda and nearly 30% in Bangladesh. Twenty-five percent reported subthreshold levels (PHQ-9 score 5 -9) of depression. Those with MDD were significantly more likely to be female and living in an urban rather than rural location (p<0.001). Age and duration of diabetes did not significantly differ between those with and without MDD. Multi-variable analyses demonstrated that while controlling for country, a diagnosis of MDD was significantly associated with female sex, lower education, taking insulin, less exercise, higher levels of diabetes-related distress and a previous diagnosis of MDD. A negligible proportion of those with either MDD or subthreshold levels of depression had a diagnosis or any treatment for their depression recorded in their medical records. (more…)
Author Interviews, Diabetes / 16.09.2016 Interview with: Dr. Samiul Mostafa Honorary Clinical Lecturer Diabetes Trials Unit University of Oxford What is the background for this study? Response: In managing people with Type 2 diabetes mellitus (T2DM), international guidelines recommend individualisation of HbA1c (glucose) targets for long term maintenance; however, few data are available on the potential benefits that different blood sugar control targets might achieve. Therefore, there is a need to learn more about the incremental benefits of progressively lowering blood sugar levels. In this computer modelling study, we used the UKPDS Outcomes Model version 2.0 to estimate 10-year event rates for myocardial infarction (MI, heart attack), stroke, blindness and amputation by entering baseline risk factor variables (for example, weight, height, LDL-cholesterol, systolic blood pressure) taken from a for a current population of 5766 people with T2DM. Complication rates were estimated with HbA1c levels held constant at 10%, 9%, 8%, 7% and 6% for each individual whilst maintaining their risk factors at their baseline values. Standard statistical methods were used to calculate relative risk reductions of complications at each HbA1c level. (more…)
Author Interviews, Dental Research, Diabetes / 09.09.2016 Interview with: In-Seok Song, DDS, PhD Clinical Assistant Professor Oral and Maxillofacial Surgeon Department of Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea What is the background for this study? What are the main findings? Response: Periodontitis is a well-known cause of various systemic diseases including cardiovascular disease, type 2 diabetes. As for type 2 diabetes, insulin resistance is responsible for the low-grade systemic inflammation, which can deteriorate body function throughout pancreatic β-cell dysfunction and impaired fasting glucose. There are emerging evidences that insulin resistance is a cause of periodontal disease progression among Korean adults as well as other citizens including American, French, Finnish, and the British. In this study, we hypothesized that insulin resistance aggravates the severity of periodontitis. We investigated the associations between type 2 diabetes, insulin resistance, and severe periodontitis. The associations between severe periodontitis and insulin resistance in non-obese adults with normal body mass index (BMI) or waist circumference (WC) were also evaluated. We found that non-abdominal obese adults with insulin resistance were more likely to have severe periodontitis compared to metabolically healthy adults with normal waist circumference. Insulin resistance without abdominal obesity can be considered an independent risk factor of severe periodontitis. (more…)
Author Interviews, Diabetes, Diabetologia / 02.09.2016 Interview with: Oluf Pedersen, MD Specialist in Internal Medicine and Endocrinology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Peter Gæde and Jens Oellgaard Department of Cardiology and Endocrinology Slagelse Hospital Copenhagen What is the background for this study? What are the main findings? Response: The Steno-2 study was the attempt to investigate the effect of an intensified, multifactorial intervention in type 2 diabetes simultaneously targeting risk factors such as hyperglycaemia, hypertension, dyslipidaemia, blood platelet aggregation, and elevated urinary albumin excretion rate as well as life style factors such as smoking, diet and a sedentary lifestyle. On top of that patients were by a dedicated team of care givers offered continued education and motivation. A total of 160 Danish type 2 diabetes patients with microalbumuria (a biomarker of generalized vascular damage) were originally randomized either to intensified multifactorial treatment at Steno Diabetes Center, Copenhagen or to conventional multifactorial treatment at their general practitioners. The trial ended after 8 years, and patients in both of the original treatment arms were for the following 13 years given intensified multifactorial treatment as the one originally given to the intensified intervention group only. Three previous milestone reports from the Steno-2 trial published in Lancet and New England Journal of Medicine have provided unprecedented evidence that this targeted and multifaceted approach reduces the risk of diabetic late complications such as kidney, eye or nerve disease as well as cardiovascular disease and total mortality with around fifty percent. (more…)
Author Interviews, Baylor College of Medicine Houston, Diabetes, Health Care Systems, Heart Disease / 02.09.2016 Interview with: Salim S. Virani, MD, PhD and Julia Akeroyd MPH Health Services Research and Development Michael E. DeBakey Veterans Affairs Medical Center Houston What is the background for this study? Response: Given the increase in the number of Americans seeking primary health care due to the Affordable Care Act, combined with current and anticipated physician shortages in the US, there is a growing need to identify other models of primary care delivery to address chronic diseases. (more…)
Author Interviews, Diabetes, Heart Disease, Stem Cells / 30.08.2016 Interview with: Jolanta U Weaver, FRCP MRCS PhD CTLHE Senior Lecturer in Diabetes Medicine Honorary Consultant Diabetologist Newcastle What is the background for this study? What are the main findings? Response: Vascular stem cells, which are associated with an improvement of heart disease, are improved in type 1 diabetes by repurposing metformin, known to reduce heart disease in type 2 diabetes. We treated patients with type 1 diabetes with metformin for 8 weeks. The metformin dose varied between 500 mg a day to 2000 mg a day, depending on what patients were happy to take. Subjects were requested to keep diabetic control unchanged to study the direct effect of metformin on heart disease. Circulating endothelial progenitor cells (vascular stem cells) count, Hill’s colonies and pro angiogenic cells function (in test tube) improved in comparison to patients, who did not take metformin but remained on standard therapy. Endothelial cells associated with vascular damage, on the other hand, were reduced following metformin therapy confirming improved vascular health. The glycaemic control remained unchanged (as planned at the onset of the study) to allow us to examine the effect of metformin ALONE on vascular health. Patients did not suffer any serious side effects. (more…)
Author Interviews, Autism, Diabetes, Mental Health Research / 25.08.2016 Interview with: Evdokia Anagnostou MD Canada Research Chair (Tier II) in Translational Therapeutics in Autism Senior Clinician Scientist and co-lead of the Autism Research Centre Holland Bloorview Kids Rehabilitation Hospital What is the background for this study? What are the main findings? Response: Researchers from Holland Bloorview Kids Rehabilitation Hospital / University of Toronto (Canada), Ohio State University, University of Pittsburgh, Columbia University, and Vanderbilt University, led a double-blind, placebo-controlled randomized clinical trial to examine whether metformin, a common type-2 diabetes drug, may be effective in counteracting weight gain commonly seen with the use of atypical antipsychotic medications, indicated by the FDA for the treatment of irritability in children and youth with autism spectrum disorder (ASD). Results showed that metformin was effective in helping overweight children and adolescents with autism spectrum disorder (ASD) who take antipsychotic medications lower their body mass index (BMI). Both FDA-approved antipsychotic medications for treating irritability and agitation symptoms in children and adolescents with ASD can cause a significant increase in weight gain, which in addition to increasing BMI, enhances long-term risk of diabetes. This complicates an already challenging issue as adolescents with autism spectrum disorder are ~ two times more likely to be obese than adolescents without developmental disabilities. Findings of this research are important, especially for families of children with ASD, as managing long-term physical health while also treating irritability/agitation symptoms, can help ensure that their child can participate fully in life (school, etc.). (more…)
Author Interviews, Diabetes, Diabetologia, Nutrition, Weight Research / 25.08.2016 Interview with: Jaime Uribarri, MD Professor, Nephrology Icahn School of Medicine Mt. Sinai Medical Center What is the background for this study? Response: We have been doing research in the area of dietary advanced glycation end-products (AGEs) for many years. AGEs are chemical compounds that form normally in the body in small amounts and also in food when cooking under high heat and dry conditions; a percent of AGEs in food is absorbed and part of it is retained in the body leading to increased smoldering inflammation and oxidative stress that eventually produce most of modern chronic diseases such as diabetes, cardiovascular disease, dementia, etc. We have previously demonstrated that a diet low in AGEs, which essentially means changing the cooking methods to include less application of heat, plenty of water,etc, decreases inflammation of oxidative stress in people with diabetes, chronic kidney disease and in healthy subjects. In the current study we applied the same low dietary AGE intervention to a group of obese patients with the so-called Metabolic syndrome, a risk factor for Diabetes Mellitus. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH / 24.08.2016 Interview with: Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIH What is the background for this study? What are the main findings? Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown. (more…)
Author Interviews, Diabetes, Diabetologia, OBGYNE, Pediatrics, Weight Research / 19.08.2016 Interview with: Dr. Gang Hu, Associate Professor LSU’s Pennington Biomedical Research Center & Director Chronic Disease Epidemiology Lab What is the background for this study? What are the main findings? Response: Some studies have found that maternal gestational diabetes mellitus (GDM) places offspring at increased risk of long-term adverse outcomes, including obesity. However, most of studies are from high income countries, with limited data from low to middle income countries. The present study, conducted at urban and suburban sites in 12 countries, found that the increased risk for children of GDM mothers compared with non-gestational diabetes mellitus mothers was 53% for obesity, 73% for central obesity, and 42% for high body fat. (more…)
Author Interviews, Diabetes, NEJM, OBGYNE, Technology / 19.08.2016 Interview with: Professor Helen Murphy and Dr Zoe Stewart Institute of Metabolic Science University of Cambridge What is the background for this study? Response: Controlling blood glucose levels is a daily challenge for people with Type 1 diabetes and is particularly crucial during pregnancy. Previous research shows that women with type 1 diabetes spend only 12 hours per day within the recommended glucose target levels, leading to increased rates of complications including preterm delivery and large for gestational age infants. National surveys show that one in two babies suffer complications related to type 1 diabetes in the mother. The hormonal changes that occur in pregnancy make it difficult for women to predict the best insulin doses for every meal and overnight. Too much insulin causes low glucose levels harmful for the mother and too little causes problems for the developing baby. The artificial pancreas automates the insulin delivery giving better glucose control than we can achieve with currently available treatments. Previous studies show that the closed-loop system also known as artificial pancreas can be used safely in children and adults and our study aimed to investigate whether or not it was helpful for women with type1 diabetes during pregnancy. (more…)
Author Interviews, Clots - Coagulation, Diabetes, Heart Disease, JACC / 12.08.2016 Interview with: Raffaele Piccolo, MD Department of Cardiology Bern University Hospital University of Bern Bern, Switzerland What is the background for this study? Response: Over the past two decades, the prevalence of diabetes mellitus has doubled in Western countries and future projections are even worse by showing a 55% increase by 2035 when approximately 592 million of people are expected to live with diabetes all over the world. Acute myocardial infarction still represents the most common diabetes-related complication and its occurrence is associated with a higher risk of mortality. Timely recanalization of the occluded coronary vessel with primary percutaneous coronary intervention (PCI) represents the therapy of choice for acute ST-segment elevation myocardial infarction (STEMI). Our study investigated whether the direct application of an intracoronary bolus of abciximab, which is an antiplatelet drug blocking the glycoprotein IIb/III a receptor, at the time of primary PCI improves the outcomes at 1-year follow-up compared with the standard intravenous route. The study was in individual patient-level pooled analysis of 3 randomized trials including 2,470 patients, of whom 473 (19%) had diabetes. (more…)
Author Interviews, Diabetes, JAMA, Kidney Disease / 10.08.2016 Interview with: Ian de Boer, MD, MS Associate Professor of Medicine Adjunct Associate Professor of Epidemiology Division of Nephrology and Kidney Research Institute University of Washington, Seattle, WA What is the background for this study? What are the main findings? Response: From the perspective of patients with diabetes, kidney disease can be a devastating complication, leading to end stage renal disease requiring dialysis or kidney transplantation and markedly increasing the risks heart disease, stroke, peripheral vascular disease, and amputation. From a public health perspective, diabetes is the most common cause of end stage renal disease in the US, so understanding, preventing, and treating diabetic kidney disease is critical to reduce the numbers of people needing dialysis and kidney transplants. There have been major changes in the treatment of patients with diabetes over the last 30 years, so we were interested in evaluating how diabetic kidney disease was changing in this context. We observed that the clinical manifestations of kidney disease have indeed changed among US adults with diabetes over the last 30 years. Albuminuria, or elevated levels of albumin in the urine, has traditionally been thought of as the first evidence of kidney damage for people with diabetes. Reduced GFR, or a reduced ability of the kidneys to filter out waster products, has typically been thought of as a late stage of diabetic kidney disease. But from 1988 to 2014, we saw a significant decrease in the prevalence of albuminuria accompanied by a significant increase in reduced GFR. (more…)
Author Interviews, Diabetes, Education, OBGYNE / 09.08.2016 Interview with: Dr Valerie Holmes Senior Lecturer Centre for Public Health School of Medicine, Dentistry and Biomedical Science Queen's University Belfast Belfast What is the background for this study? Response: Women with diabetes, type 1 diabetes and type 2 diabetes, are advised to plan for pregnancy as there are higher risks of complications for both the mother and baby when compared to the general maternity population. Careful planning in partnership with diabetes care teams, especially in relation to achieving optimum blood glucose control and taking folic acid can significantly reduce the risks. However, while most women know that they should plan for pregnancy, they are unaware as to why this is important or how to engage with the process, and thus the majority of women (up to two thirds of women) enter pregnancy unprepared. This study describes the implementation of a regional preconception counsellng resource, in the format of a DVD, into routine care in Northern Ireland to raise awareness of pregnancy planning. The authors assessed if the introduction of this resource improved pregnancy planning among women with diabetes in the region. (more…)
Author Interviews, Diabetes, Orthopedics / 08.08.2016 Interview with: Patrick Griffin, PhD Professor Department of Molecular Therapeutics The Scripps Research Institute Florida Campus What is the background for this study? Response: Over the past decade, our laboratory and that of TSRI Associate Professor Theodore Kamenecka, have focused on molecules that increase sensitivity to insulin. Using newly discovered information, we have made significant advances in developing a family of drug candidates that target a receptor known as peroxisome proliferator-activated receptors gamma (PPARγ), a key regulator of stem cells controlling bone formation and bone resorption and a master regulator of fat. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Weight Research / 04.08.2016 Interview with: Prof. Peter Nordström PhD Department of Community Medicine and Rehabilitation Geriatrics, Umeå University Umeå, Sweden What is the background for this study? What are the main findings? Response: Numerous studies has shown an association between BMI, CVD and death. However, it is not known to what extent genetic factors influence this relationship. We used over 4000 monozygous twin pairs that had different BMI. This mean that the difference in BMI must be due to environmental factors since the genetic setup is similar in monozygous twins. Since the fatter twin did not have a higher risk of myocardial infarction (MI) or death, environmental factors that increase BMI is very unlikely to increase the risk of myocardial infarction or death. By inference the strong association between BMI, MI and death must be explained by the fact that the same genes control both obesity, MI and death. By contrast, the fatter twin had a higher risk of diabetes. (more…)
Aging, Author Interviews, Diabetes, Diabetologia / 29.07.2016 Interview with: Dr. Stephanie Read, PhD University of Edinburgh, UK What is the background for this study? What are the main findings? Response: The number of people living with type 2 diabetes in Scotland is increasing. We wanted to identify to what extent this trend was due to people living longer with type 2 diabetes or due to increasing numbers of new cases each year. (more…)