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…)
Author Interviews, Diabetes, PLoS, Primary Care, Telemedicine / 26.07.2016 Interview with: Brian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre EdinburghBrian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre Edinburgh What is the background for this study?  Response: The prevalence of diabetes is rising as the population ages and becomes more obese. Clinical services are increasingly stretched, so much so that it will be difficult for doctors and nurses to continue to look after patients using the same service delivery they have used in the past. Increasingly patients are being asked to self-manage long-term illnesses, but particularly with type 2 diabetes they find this stressful. One solution is to encourage self-management but with monitoring at a distance through telehealth. We performed a randomised controlled trial in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) ( a measure of control over the previous three months) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycaemic or blood pressure control in the context of incentives in family practice based on a sliding scale of financial rewards for achieving glycaemic and blood pressure control targets. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed. (more…)
Author Interviews, Diabetes, Pharmacology / 25.07.2016 Interview with: Stig Ejdrup Andersen MD, PhD Clinical Pharmacology Unit Zealand University Hospital Roskilde Denmark What is the background for this study? Response: For decades, we have used sulphonylurea derivates in the medical treatment of type 2 diabetes. Although several newer drugs have become available, adding an SU is still a recommended and acceptable strategy when metformin monotherapy fails. The SUs are among the cheapest glucose lowering drugs on the marked but the risk of hypoglycaemia make clinicians prefer a newer oral drug such as a DPP-IV inhibitor or a SGLT-2 inhibitor to ansulphonylurea because even mild hypoglycaemia may affect the patients’ quality of life negatively. Several meta-analyses have examined the effectiveness and safety of noninsulin antidiabetic drug, all of which have considered the SUs a homogenous drug class. Pharmacologically, however, the SU agents are quite different. In 2004, a randomized controlled trial by Shernthaner et al. indicated that in comparison with glimepiride, gliclazide MR is equally effective and is associated with fewer hypoglycaemic episodes. Still, head-to-head comparisons of the SU-agents as add-on to metformin are few. In the absence of robust designed comparative trials, we decided to compare the relative risk of hypoglycaemia among the newer SU-agents in a network meta-analysis. (more…)
Author Interviews, Biomarkers, Diabetes, Diabetologia, OBGYNE / 25.07.2016 Interview with: Dr. Sandra Hummel and Dr. Daniela Much Institute of Diabetes Research Helmholtz Center Munich German Research Center for Environmental Health Munich What is the background for this study? What are the main findings? Response: Gestational diabetes mellitus is associated with a seven-fold increased risk of developing type 2 diabetes postpartum. In 2012, we published that type 2 diabetes risk was markedly reduced up to 15 years after delivery in women with gestational diabetes if they breastfed for more than 3 months. However the underlying biological mechanisms are still unclear to date. Aim of this biomarker study was to identify the mechanism underlying the protective effect of prolonged lactation. At our study site in Munich, we enrolled 197 women with previous gestational diabetes participating in a postpartum assessment of glucose tolerance at a median time of 3.6 years after delivery. By using a targeted metabolomics approach (including a broad spectrum of lipids and amino acids), we identified lactation-associated biochemical changes in maternal plasma samples. Most interestingly, these metabolite signatures have been described with decreased risk for type 2 diabetes previously. Our results indicate that lactation-associated alterations persisted up to 11 years post-lactation. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA / 21.07.2016 Interview with: Dr Fiona Bragg Clinical Research Fellow Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford What is the background for this study? Response: Diabetes is known to be a risk factor for cardiovascular disease. It is less clear, however, whether higher blood glucose levels in individuals without diabetes are also associated with higher risk for cardiovascular diseases. It is important to examine this association because it may help us to understand the mechanisms underlying these diseases as well as appropriate approaches to preventing them. We therefore looked at this association in the China Kadoorie Biobank study of 0.5 million Chinese adults, examining the relationship between blood glucose levels and the subsequent risk for cardiovascular diseases among participants with no history of diabetes at the time of recruitment to the study. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 20.07.2016 Interview with: Andy Menke PhD Social & Scientific Systems, Inc. Silver Spring, MD, 20910 What is the background for this study? What are the main findings? Response: Limited information was available on the prevalence of diabetes among adolescents in the US, particularly the percentage that are undiagnosed and unaware of the condition. We found that 0.8% of adolescents 12-19 years of age had diabetes and 18% had prediabetes. Of those with diabetes, 29% overall were unaware of it and this increased to 40% among Hispanic adolescents and 50% among non-Hispanic black adolescents. (more…)
Author Interviews, Diabetes, Lipids, PLoS / 20.07.2016 Interview with: Dr. Fumiaki Imamura Ph.D. MRC Epidemiology Unit University of Cambridge What is the background for this study? What are the main findings? Response: There was insufficient evidence for effects of polyunsaturated fatty acids (PUFA) intake or blood biomarkers on the development of type 2 diabetes. For instance, previous studies using PUFA biomarkers had a maximum of only 673 type 2 diabetes cases. In the EPIC-InterAct Study - a large European collaborative, prospective study where 12,132 diabetes cases were ascertained during its follow-up - we found diverse associations of blood levels of different types of PUFAs with incidence of type 2 diabetes. Despite this diversity, clinically relevant results were observed for major polyunsaturated fatty acids. Higher blood levels of total omega-6 PUFAs and the major omega-6 PUFA (linolenic acid) were associated with a lower risk of developing type 2 diabetes. Likewise, levels of alpha linolenic acid, known as a plant-origin omega-3 PUFA, were associated with lower type 2 diabetes risk. Marine-origin omega-3 PUFAs, including docosahexaenoic acid (DHA), showed inconsistent associations with type 2 diabetes risk. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Pharmacology / 19.07.2016 Interview with: Principal investigator A/Prof Suetonia Palmer PhD University of Otago, New Zealand Senior investigator Prof. Giovanni Strippoli MD, PhD, MPH, MM University of Sydney, Australia and Diaverum, Sweden What is the background for this study? Response: Network meta-analysis is a new technique that allows us to evaluate ALL medical therapies for a specific clinical problem. We wondered whether any of the usual drugs used to treat glucose levels in people with diabetes were safest or most effective. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Nutrition, PLoS, Weight Research / 15.07.2016 Interview with: Dr. Qi Sun Sc.D, M.D., M.M.S. Dr. Geng Zong, Ph.D., a research fellow Assistant Professor in the Department of Nutrition Harvard T.H. Chan School of Public Heath Boston What is the background for this study? What are the main findings? Response: There is growing trend of eating meal prepared out of home in many countries. For example, energy intake from out-of-home meals has increased from less than 10% in mid 60s to over 30% in 2005-2008 among Americans, and average time spent on cooking has decreased by one third. In the meantime, the prevalence of diabetes and obesity of this country keep on growing. In the current study, we followed nearly 100 thousands middle-aged men and women for 26 years. In 1986, we asked people how often their lunch and dinner were prepared at home per week, which will be 14 meals in maximum, and updated this information during follow-up. We found men and women with 11-14 meals prepared at home per week had 14% lower risk of diabetes compared to those had 6 or less meals prepared at home. If we look at lunch and dinner separately, people with 5 or more lunch prepared at home per week had 9% lower risk of diabetes, and those with 5 or more dinner prepared at home had 15% lower risk of diabetes compared to the group who had 2 or less than lunch or dinner at home per week. We further investigated whether people with more meals prepared at home had lower risk of obesity or weight gain in our study. In the first eight years of follow-up, participants with 11-14 meals prepared at home had 14% lower risk of developing obesity compared to people had 0-6 meals prepared at home. For men, these people had 1.2kg less weight gain, and for women they had 0.3 kg less weight gain. Furthermore, we found potential impact of having meals at home and risk of diabetes became weaker. This suggest that weight gain could be one gearwheel that links eating meals prepared at home and diabetes risk. (more…)
Author Interviews, Cancer Research, Diabetes / 13.07.2016 Interview with: Iliana Lega, MD, FRCPC Assistant Professor Department of Medicine and a Clinician Scientist University of Toronto What is the background for this study? What are the main findings? Response: Diabetes and cancer share a variety of risk factors that predispose individuals to both conditions. However the exact mechanism of this relationship is unclear. Our study examined differences in cancer diagnosis at different time points around a diagnosis of diabetes. We found two interesting trends. First, people with diabetes have the highest risk for cancer in the first 3 months following a diagnosis of diabetes. Second, we found that people with diabetes are also more likely to have had cancer even prior to being diagnosed with diabetes. (more…)
Author Interviews, Diabetes, PLoS, Race/Ethnic Diversity / 12.07.2016 Interview with: Matthew James O'Brien MD Northwestern University Feinberg School of Medicine What is the background for this study? Response: In October 2015, the United States Preventive Services Task Force (USPSTF) released new diabetes screening guidelines. This government-supported expert group recommended screening asymptomatic adults who are 40-70 years old and overweight or obese for diabetes. Recent population trends show that racial/ethnic minorities develop diabetes at younger ages and lower weights than whites. Therefore, we sought to determine whether these screening criteria may fail to identify racial/ethnic minorities or other high-risk population subgroups. Our study population was 50,515 patients from federally-funded community health centers, which serve large numbers of minorities and socioeconomically disadvantaged individuals. (more…)
Author Interviews, Diabetes, Diabetologia / 12.07.2016 Interview with: Dr Fraser W Gibb MBChB PhD FRCP Edin Consultant Physician / Honorary Clinical Senior Lecturer Edinburgh Centre for Endocrinology & DiabetesDr Fraser W Gibb MBChB PhD FRCP Edin Consultant Physician / Honorary Clinical Senior Lecturer Edinburgh Centre for Endocrinology & Diabetes What is the background for this study? What are the main findings? Response: We know that diabetic ketoacidosis is associated with a low risk of death in those admitted to hospital but we did not know what the risk of death was in the months and years following discharge from hospital. We have found that recurrent DKA admissions (more than 5 in a lifetime) are associated with a greater than 1 in 5 risk of death in the following three years compared to a 1 in 20 risk for those with only a single DKA. Recurrent DKA is more common in younger, more socially disadvantaged people. (more…)
Author Interviews, Cancer Research, Diabetes, NYU, Sleep Disorders / 09.07.2016 Interview with: Mr. Lloyd Gyamfi and Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine What is the background for this study? What are the main findings? Response: An association exists between unhealthy sleep duration (short:≤6 hrs. or long sleep: ≥ 9hrs.) and cancer. The specific link between cancer and diabetes is unknown. Evidence suggests that cancer and diabetes may share common risk factors such as age, gender, race, being overweight an alcohol use. Based on the data extracted from the National Health Interview Survey (NHIS) dataset (2004-2013) with a sample size of 283,086, it was identified that individuals who had a history of cancer and who reported long sleep duration did not have increased risk of diabetes diagnosis. (more…)
Author Interviews, CDC, Diabetes, Heart Disease, JAMA / 09.07.2016 Interview with: Edward Gregg, PhD Chief of the Epidemiology and Statistics Branch Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention What is the background for this study? What are the main findings? Response: The research was led by the lead author, Karen R. Siegel, PhD, as part of her PhD graduate studies at Emory for her dissertation. Although subsidized foods are intended to ensure adequate availability of storable, staple foods, studies at the population level have linked these subsidies to risk of cardiovascular disease and type 2 diabetes. This study is the first of its kind to examine these relationships at the individual level – specifically, the relationship between diets made up of more subsidized foods, and an individual’s personal risks for developing cardiovascular disease and type 2 diabetes. The study design that was used here does not allow us to say that these subsidized foods specifically cause type 2 diabetes and cardiovascular disease. Rather, people whose diets contain more corn, soybean, wheat, rice, sorghum, dairy, and livestock products are at greater risk for type 2 diabetes and cardiovascular disease. According to this research, people whose diets contained more subsidized foods were on average younger, less physically active and more likely to be smokers. They also had much less income, education and food security - or the ability to get enough safe and healthy food to meet their dietary needs. (more…)
Author Interviews, Diabetes, UT Southwestern / 05.07.2016 Interview with: Dr. Eunhee Choi Research scientist in the Yu laboratory and lead author of the study UT SouthWestern Dr. Hongtao Yu, Professor of Pharmacology at UT Southwestern and Investigator with the Howard Hughes Medical Institute (HHMI). What is the background for this study? What are the main findings? Response: Diabetes is a metabolic disease. High blood sugar is a common symptom of diabetes, and over time it can lead to serious damage to multiple organs. Insulin, a hormone made by the pancreas, regulates blood sugar. Diabetes can occur either when the pancreas does not produce enough insulin (type 1 diabetes) or when the cells in our body cannot efficiently respond to insulin (type 2 diabetes). Diabetes is now a major global epidemic. The World Health Organization (WHO) estimates that more than 400 million people worldwide have diabetes. Insulin binds the insulin receptor (IR) at the cell surface. The insulin-bound IR can send signals inside the cell and instruct the cell to take up sugar from the blood, thus maintaining healthy blood sugar levels. After insulin has done its job, insulin-bound IR is packaged into small vesicles with a protein coat and dragged into the cell, thus terminating the signals. An adequate level of IR on the cell surface is crucial for insulin signaling and blood sugar metabolism. We have found a new mechanism that keeps IR at the cell surface. Without such a mechanism, IR is prematurely dragged inside the cell before it encounters insulin. Our discovery is quite unexpected. A main interest of our lab is to study the molecular control of cell division. During each cell division, the duplicated sister chromosomes are evenly separated into two daughter cells. A cellular surveillance system called the spindle checkpoint ensures the accuracy of sister-chromosome separation. Three checkpoint proteins, p31comet, MAD2 and BUBR1, are critical for accurate chromosome segregation. In the process of studying this checkpoint, we have unexpectedly discovered that mice lacking p31comet in the liver develop diabetes. Liver cells lacking p31comet do not have IR on the cell surface, and thus cannot respond to insulin. We have further shown that MAD2 directly binds to IR, and along with BUBR1, helps to drag IR inside the cell. p31comet prevents BUBR1 from interacting with IR-bound MAD2, thus keeping IR at the cell surface. In cells lacking p31comet, MAD2 and BUBR1 gain the upper hand and remove IR from the cell surface. Thus, the dynamic tug-of-war between p31comet and MAD2-BUBR1 determines the status of IR at the cell surface. (more…)
Author Interviews, Diabetes, Diabetologia, Technology / 05.07.2016 Interview with: Dr Hood Thabit and Co-author: Dr Roman Hovorka University of Cambridge Metabolic Research Laboratories Wellcome Trust-MRC Institute of Metabolic Science Cambridge UK What is the background for this study? What are the main findings? Response: Type 1 diabetes is an insulin-deficient condition, therefore people with type 1 diabetes need to be on life-long insulin therapy to maintain normal blood glucose levels. Currently insulin is delivered either by injections (with an insulin pen) or by infusion (with an insulin pump). In addition, they have to monitor their blood glucose regularly by performing fingerprick measurements several times a day, to avoid over- or under-dosing with insulin. Hypoglycaemia, or low blood glucose, can occur as a result of giving too much insulin; if severe or prolonged can lead to the patient being unconscious and in some cases sudden death. Hyperglycaemia, or high blood glucose, can occur as a result of giving too little insulin, and chronic hyperglycaemia can lead to diabetes related complications such as blindness, kidney failure and heart disease. Maintaining blood glucose within a normal range poses a daily challenge and struggle for many people with type 1 diabetes, who have to juggle with the variability and unpredictability of their glucose levels and insulin requirements due to meals, physical activity and stress. People with type 1 diabetes have on average 3 episodes of severe hypoglycaemia per year which requires third party assistance and sometimes hospitalisation. In the UK, the average HbA1c for people with type 1 diabetes is around 8.5% (69mmol/mol), which puts them at risk of diabetes complications and developing significant disability affecting their lives. There is therefore an unmet need of a novel therapeutic approach to be able to automatically modulate and change the amount of insulin delivered, based on real-time glucose levels. The artificial pancreas, or closed-loop insulin delivery, is an emerging technology which couples real-time sensor glucose levels with insulin delivery under the direction of a control algorithm, and automatically steps-up insulin delivery when glucose levels are going up, and reduces or suspends insulin delivery when glucose levels are going down. The longest home study to date was recently performed by researchers at the University of Cambridge and showed that compared to best available therapy, the artificial pancreas significantly improved long-term glucose control (HbA1c) and reduces the risk of hypoglycaemia. (more…)
Author Interviews, Diabetes, Gender Differences, JCEM, Sleep Disorders / 04.07.2016 Interview with: Dr. Femke Rutters Department of Epidemiology and Biostatistics Vrije Universiteit Medical Centre Amsterdam, The Netherlands; EMGO+ Institute for Care Research What is the background for this study? What are the main findings? Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Diabetes / 27.06.2016 Interview with: Dr. Judith Schwartzbaum PhD Associate professor of epidemiology Ohio State's Comprehensive Cancer Center What is the background for this study? Response: Meningioma is a slow-growing brain tumor that is associated with obesity. To further understand this risk we examined records of blood sugar levels within approximately 15 years before tumor diagnosis comparing blood sugar levels of people who developed meningioma to those in people who did not. are the main findings? Response: To our surprise we found that risk of this tumor was lower in people with high levels of blood sugar and diabetes. (more…)
Author Interviews, Diabetes, Diabetologia, OBGYNE, Pediatrics / 27.06.2016 Interview with: Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 What is the background for this study? What are the main findings? Response: Prenatal malnutrition and other stresses may cause small newborn babies, who are more likely develop type 2 diabetes and other chronic diseases during adulthood. However, whether such relation is causal remains to be determined. Genetic associations provide a new approach to provide evidence for such causality. (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Hepatitis - Liver Disease, Pharmacology / 22.06.2016 Interview with: Kenneth Cusi, M.D., F.A.C.P., F.A.C.E. Professor of Medicine VAMC staff Chief, Division of Endocrinology, Diabetes and Metabolism The University of Florida Gainesville, FL 32610-0226 What is the background for this study? Dr. Cusi: Many patients with prediabetes or Type 2 Diabetes Mellitus (T2DM) are not diagnosed with Nonalcoholic steatohepatitis (NASH), a disease that is the second cause of liver transplantation in the United States. It is also associated with worse cardiovascular disease and harder to control T2DM. We had done in this population a proof-of-concept study published in Nov 2006 in the NEJM. But we lacked a larger, long-term study for definitive proof. This is the largest SINGLE center study, and the longest ever (3 years). NASH is an overlooked problem for perhaps as many as one-third of patients with Type 2 Diabetes Mellitus. There is now a safe and effective treatment option for patients with T2DM and NASH – pioglitazone will become for NASH what metformin is to the treatment of T2DM: a safe, effective, the “backbone therapy" to which other treatments will be added. (more…)
Author Interviews, Diabetes, Exercise - Fitness, University of Pittsburgh / 21.06.2016 Interview with: Dr-Andrea-M-KriskaDr. Andrea M. Kriska PhD MS Professor, Department of Epidemiology Graduate School of Public Health Pittsburgh, PA 15261 What is the background for this study? Dr. Kriska:  The Diabetes Prevention Program (DPP) was a well administered national research study primarily supported by the National Institutes of Health (NIDDK) that demonstrated that lifestyle intervention with weight loss and physical activity goals can prevent type 2 diabetes in diverse, high risk US adults. The importance of physical activity in preventing diabetes development in the DPP until now was thought to be due to its role in achieving weight loss and weight maintenance but activity was not considered a strong key factor alone. The lifestyle group had a significantly greater increase in physical activity and decrease in weight than the other two groups. They also had a 58% decrease in diabetes incidence compared to the control group. The successful decrease in T2D held across all age, sex, baseline BMI and ethnicity/race subgroups. Despite the fact that the lifestyle intervention was then offered to all participants, in the follow-up years, the lifestyle participants still maintained a lower cumulative diabetes incidence that could not be explained by differences in weight loss. (more…)