Author Interviews, Diabetes, Gender Differences / 12.11.2013

MedicalResearch.com Interview with: Guy Fagherazzi, PhD Epidemiologist Scientific manager – E4N cohort study (www.e4n.fr) Inserm U1018 Team 9 Nutrition,hormones and women’s healthGuy Fagherazzi, PhD Epidemiologist Scientific manager – E4N cohort study (www.e4n.fr) Inserm U1018 Team 9 Nutrition,hormones and women’s health MedicalResearch.com: What are the main findings of the study?
 Dr. Fagherazzi: Our study of more than 60 000 French women from the E3N cohort study has shown that higher overall acidity of the diet, regardless of the individual foods making up that diet, was associated with a higher risk of type 2 diabetes. (more…)
Author Interviews, Diabetes, NYU, Weight Research / 06.11.2013

Manish Parikh MD Associate Professor of Surgery, NYU School of Medicine Director of Bariatric Surgery, Bellevue Hospital Center 550 First Ave NBV 15 South 7 New York, NY 10010MedicalResearch.com Interview with: Manish Parikh MD Associate Professor of Surgery, NYU School of Medicine Director of Bariatric Surgery, Bellevue Hospital Center 550 First Ave NBV 15 South 7 New York, NY 10010 MedicalResearch.com: What are the main findings of the study? Dr. Parikh: The main findings of this study is that surgery is safe and effective in patients with type 2 diabetes and BMI under 35.  The overall estimated rate of diabetes remission was 55% at 12 months, ranging from 33% for the adjustable gastric banding, 49% for the “mini” gastric bypass, 54% for the sleeve gastrectomy, 64% for the gastric bypass, 71% for the biliopancreatic diversion, and 81% for ileal transposition. (more…)
Antioxidants, Author Interviews, Diabetes, Nutrition / 01.11.2013

Kumar Sharma, M.D. Professor of Medicine Director, Institute of Metabolomic Medicine Director, Center for Renal Translational Medicine University of California, San Diego La Jolla, CA 92093-0711MedicalResearch.com Interview with: Kumar Sharma, M.D. Professor of Medicine Director, Institute of Metabolomic Medicine Director, Center for Renal Translational Medicine University of California, San Diego La Jolla, CA 92093-0711 MedicalResearch.com: What are the main findings of the study? Dr. Sharma: Main findings are that diabetes is associated with reduced superoxide production in the kidney and heart and that stimulation of superoxide production with AMPK led to improvement in organ function. (more…)
Author Interviews, Diabetes, Nutrition / 01.11.2013

Diewertje Sluik, DrPH Postdoctoral fellow | Division of Human Nutrition | Section Epidemiology & Pubic Health | Wageningen University Postal address: PO Box 8129 | NL-6700 EV Wageningen| The Netherlands Visiting address: Agrotechnion, Building 309, Room 1019 | Bomenweg 4 | 6703 HD WageningenMedicalResearch.com Interview with: Diewertje Sluik, DrPH Postdoctoral fellow | Division of Human Nutrition | Section Epidemiology & Pubic Health | Wageningen University Postal address: PO Box 8129 | NL-6700 EV Wageningen| The Netherlands Visiting address: Agrotechnion, Building 309, Room 1019 | Bomenweg 4 | 6703 HD Wageningen MedicalResearch.com: What are the main findings of the study? Response: The main finding of the study is that lifestyle advice with respect to mortality for patients with diabetes should not differ from recommendations for the general population. Diabetes status did not substantially influence the associations between lifestyle and mortality risk. People with diabetes may benefit more from a healthy diet, but the directions of association were similar. These results highlight that the difficulties in recognizing and diagnosing diabetes and its different stages are of minor importance with respect to healthy diet and lifestyle recommendations, because no difference in recommendations depending on the stage of the disease seems necessary. (more…)
Diabetes, Diabetes Care, Heart Disease / 28.10.2013

MedicalResearch.com Interview with: Marcin Sadowski Świętokrzyskie Cardiology Center, Kielce, Poland MedicalResearch.com: What are the main findings of the study? Dr. Sadowski: In multivariable analysis, diabetes was an independent risk factor of in-hospital and 1-year mortality in women treated for STEMI. In women with STEMI and diabetes one-year mortality was significantly lower in those treated with primary percutaneous coronary intervention than in those on optimal medical therapy. Early and long-term prognoses after STEMI were the worst in diabetic women, compared with non-diabetic women and diabetic men. (more…)
Author Interviews, Diabetes, Mediterranean Diet, Memory / 24.10.2013

MedicalResearch.com Interview with: Lucia Kerti MA From the Departments of Neurology Charité–University Medicine, Berlin MedicalResearch.com: What are the main findings of the study? Answer: The results of our study on 141 healthy older people suggest that chronically higher blood glucose levels may have a negative influence on memory performance even in the absence of type 2 diabetes or even pre-diabetes. Moreover, our findings indicate that elevated blood glucose levels  impair the functioning of brain areas like the hippocampus, a structure particularly relevant for memory. An important novel aspect in our study was the additional analysis of diffusion tensor imaging-based mean diffusivity within the hippocampal, which allowed us to  obtain information on microstructure.  We here provided first-time data of an association between higher blood glucose levels and lower hippocampal microstructure. Decreased hippocampal microstructure as measured by mean diffusivity may reflect a disruption of neuronal membranes and increased extracellular water content, leading to decreased signaling within and between hippocampal cells. Thus, information transfer between cells, indispensable for memory encoding, storage and retrieval, would be compromised. In sum, our data suggest that chronically higher blood glucose levels even within the "normal range" may decrease memory functions, possibly in part mediated by microstructural changes within the hippocampus. (more…)
Author Interviews, Diabetes, Diabetes Care, Stroke / 23.10.2013

MedicalResearch.com Interview with: Stefanie Hägg, MB Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland MedicalResearch.com: What are the main findings of the study? Answer: We studied the incidence of stroke in a large cohort of patients with type 1 diabetes in Finland. During 36,680 person-years of follow-up, we found that the incidence of total stroke, and the subtypes cerebral infarction and cerebral hemorrhage was 406, 286, and 120 per 100,000 person-years, respectively, which is higher than in the Finnish general population, for whom the incidence of stroke varies between 135 and 236 per 100,000 person years. Furthermore, we studied the impact of two diabetic microvascular complications, diabetic nephropathy and severe diabetic retinopathy, on the risk of stroke, as well as for the subtypes of stroke. The incidence of stroke, cerebral infarction, and cerebral hemorrhage increased with both the presence of severe diabetic retinopathy and with advancing diabetic nephropathy. Furthermore, we found that both diabetic nephropathy and severe diabetic retinopathy increased the risk for all subtypes of stroke, independently of traditional risk factors. A novel finding was that already incipient diabetic nephropathy (microalbuminuria) increased the risk of stroke, cerebral infarction, and cerebral hemorrhage more than 3-fold, compared with patients free of renal disease. The highest risk of stroke was seen in patients with end-stage renal disease. (more…)
Author Interviews, Diabetes, Heart Disease, Nutrition, Omega-3 Fatty Acids / 22.10.2013

MedicalResearch.com Interview wit: Elin Strand

Researcher, Department of Clinical Science University of Bergen, Norway MedicalResearch.com: What are the main findings of this study? Answer: The main findings in this prospective observational cohort study among patients with established coronary artery disease were that a very high intake of omega-3 fatty acids was associated with a reduced risk of acute myocardial infarction in patients with diabetes, but with an increased risk of fatal acute myocardial infarction and with lower glycosylated hemoglobin in those without impaired glucose metabolism. (more…)
Author Interviews, Diabetes, Diabetologia / 17.10.2013

Richard A. Oram, BMBCh, BA(hons), MRCP NIHR Exeter Clinical Research Facility University of Exeter Medical School, Barrack Road, Exeter, UKMedicalResearch.com Interview with: Richard A. Oram, BMBCh, BA(hons), MRCP NIHR Exeter Clinical Research Facility University of Exeter Medical School, Barrack Road, Exeter, UK MedicalResearch.com: What are the main findings of the study? Answer: Historically people with Type 1 diabetes were thought to progress to make absolutely none of their own insulin. Modern assays allow us to measure very low levels of insulin, and using these we can find very tiny amounts of insulin production in most people with Type 1 diabetes even if they have had the disease for many years. (more…)
Author Interviews, Diabetes, Surgical Research, Weight Research / 14.10.2013

Dr. Mitchell S. Roslin, MD Lenox Hill Hospital Manhattan Minimally Invasive & Bariatric Surgery 186 E 76th Street, 1st Floor New York, NY 10021.MedicalResearch.com Interview with:

Dr. Mitchell S. Roslin, MD Lenox Hill Hospital Manhattan Minimally Invasive & Bariatric Surgery 186 E 76th Street, 1st Floor New York, NY 10021. MedicalResearch.com: What are the main findings of the study? Dr. Roslin: The cornerstone of medical management for weight loss and to prevent weight gain is to regulate glucose and insulin and prevent wide fluctuation.  Yet, Gastric bypass, widely considered the gold standard operation, accentuates these fluctuations.  The purpose of our study was to compare glucose tolerance of gastric bypass, sleeve gastrectomy and a modified version of duodenal switch that  preserves adequate intestine. We found that all operations improve insulin resistance, but that duodenal switch normalizes the curve, whereas gastric bypass causes wide spikes in insulin and glucose. (more…)
Author Interviews, CMAJ, Diabetes / 18.09.2013

Dr. Yunsheng Ma MD, PHD, MPH Division of Preventive and Behavioral Medicine Department of Medicine University of Massachusetts Medical School 55 Lake Avenue North, Worcester, MA 01655MedicalResearch.com Interview with: Dr. Yunsheng Ma MD, PHD, MPH Division of Preventive and Behavioral Medicine Department of Medicine University of Massachusetts Medical School 55 Lake Avenue North, Worcester, MA 01655 MedicalResearch.com: What are the main findings of the study? Dr. Ma: Regardless of race/ethnicity, diabetes increases the risk of mortality the same compared to non-diabetes among different race/ethnicity. However, since there are higher prevalence of  diabetes in Black and Hispanic, death rate due to diabetes is much higher in Black and Hispanic, this is because the diabetes prevalence rates are much higher in these population. Therefore, diabetes prevention is key to reduce diabetes related mortality disparities among racial/ethnic groups. (more…)
Author Interviews, Diabetes, MRI, Nature, Stroke / 13.09.2013

Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, GermanyMedicalResearch.com Interview with: Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, Germany  MedicalResearch.com: What are the main findings of the study?  Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden. (more…)
Author Interviews, Cognitive Issues, Diabetes, Genetic Research / 11.09.2013

MedicalResearch.com Interview with: Ramit Ravona-Springer M.D., Psychiatrist Director of Memory Clinic, Sheba Medical Center, Tel Hashomer, Israel MedicalResearch.com: What are the main findings of the study? Answer: In a cohort of elderly, cognitively normal type 2 diabetes (T2D) subjects, those with Haptoglobin (Hp) 1-1 genotype present lower cognitive performance compared to Hp 2 carriers (Hp 1-2 and Hp 2-2). The contribution of cardiovascular risk factors to cognition was significantly higher in subjects with Hp1-1 genotype compared to Hp 2 carriers. (more…)
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively. (more…)
BMJ, Brigham & Women's - Harvard, General Medicine, Medical Research Centers / 30.08.2013

Qi Sun, MD ScD Assistant Professor of Medicine Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Assistant Professor Department of Nutrition, Harvard School of Public Health 665 Huntington Avenue, Boston, MA 02115MEDICALRESEARCH.COM: INTERVIEW WITH: Qi Sun, MD ScD Assistant Professor of Medicine Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School, Assistant Professor Department of Nutrition, Harvard School of Public Health 665 Huntington Avenue, Boston, MA 02115 MEDICALRESEARCH.COM: What are the main findings of the study? Response: We have three major findings.
  • First, we found that total fruit consumption was consistently associated with lower risk of developing type 2 diabetes in these large scale studies among U.S. men and women.
  • Second, we found that different individual fruits were differentially associated with diabetes risk. For example, higher intakes of blueberries, grapes or raisins, apples or pears are particularly associated with a lower diabetes risk.
  • Last, we found that fruit juice was associated with a higher diabetes risk, and replacing fruit juices with whole fruits will likely lead to reduced diabetes risk. (more…)
Diabetes, Surgical Research / 30.08.2013

MedicalResearch.com Interview with: Ta-Liang Chen, MD, PhD Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan MedicalResearch.com: What are the main findings of the study? Reply: Diabetes increases postoperative 30-day mortality, complications, and medical expenditures in patients undergoing in-hospital noncardiac surgeries. (more…)
Author Interviews, Diabetes, Genetic Research, Heart Disease, JAMA / 28.08.2013

Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public HealthMedicalResearch.com Interview with: Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public Health

MedicalResearch.com: What are the main findings of the study? Answer: The main findings include, we for the first time identified a genetic variant predisposing to high risk of coronary heart disease in patients with type 2 diabetes, using genome-wide association (GWA) approach. More interesting, we demonstrated that the variant may affect expression of a gene involved in metabolism of amino acid glutamic acid, which has been related to insulin secretion and heart health in previous studies. (more…)
Author Interviews, JCEM, Weight Research / 28.08.2013

MedialResearch.com Interview with: Dr Catherine M. Phillips Health Research Board Centre for Diet and Health Research Room 4.033, Department of Epidemiology and Public Health Western Gateway Building, University College Cork, Cork, Ireland MedialResearch.com: What are the main findings of the study? Answer: Obesity is associated with increased risk of diabetes and heart disease leading to reduced life expectancy. However in recent years it has been recognized that not all obese individuals are at increased risk – these individuals have been described as being metabolically healthy obese (MHO) in that despite carrying excess weight they do not have the typical abnormal metabolic features associated with obesity such as hypertension, insulin resistance and alterations to their lipid profile. It is not clear what factors determine whether an obese person becomes metabolically healthy or unhealthy. In this study conducted at the Dept. of Epidemiology and Public Health at University College Cork, Ireland, we examined levels of a range of inflammatory markers in 2047 middle-aged Irish adults to investigate to what extent differences between metabolically healthy and unhealthy obese and non-obese male and female adults are explained by inflammatory status. Participants, who were between the ages of 50 and 69, completed lifestyle questionnaires, physical and clinical assessments, and underwent blood testing so their body mass index (BMI), metabolic profiles and inflammatory markers could be determined. We found that, regardless of a person’s BMI, having a favorable inflammatory profile was associated with being metabolically healthy. Specifically metabolically healthy individuals presented with lower levels of complement component 3, C reactive protein, tumour necrosis factor alpha, interleukin 6, plasminogen activator inhibitor-1, reduced white blood cell count and higher adiponectin levels compared to their metabolically unhealthy counterparts. (more…)
Author Interviews, Diabetes, Exercise - Fitness, JCEM / 24.08.2013

Thomas P. J. Solomon, Ph.D. Associate Professor of Biomedical Sciences Department of Biomedical Sciences | Cellular & Metabolic Research Section Panum Institute 4.5 | University of Copenhagen | Blegdamsvej 3B | 2200 Copenhagen N | DenmarkMedicalResearch.com Interview with: Thomas P. J. Solomon, Ph.D. Associate Professor of Biomedical Sciences Department of Biomedical Sciences | Cellular & Metabolic Research Section Panum Institute 4.5 | University of Copenhagen | Blegdamsvej 3B | 2200 Copenhagen N | Denmark MedicalResearch.com: What are the main findings of the study? Dr. Solomon: The main findings were that when impaired glucose tolerant and type 2 diabetic subjects underwent 3-4 months of regular aerobic exercise training, although the majority of subjects (86-90%) increased increased VO2max, lost weight, and increased insulin sensitivity, only around two-thirds of subjects improved glycemic control (HbA1c, fasting glucose, and 2-hour OGTT glucose). The novel finding was that the changes in glycemic control were congruent with changes in oral glucose-stimulated insulin secretion (GSIS). We also found that exercise training-induced changes in glycemic control were related to changes in GSIS (P0.05), but not insulin sensitivity. Furthermore, we found that training-induced improvements in glycemic control were largest in subjects with greater pre-training GSIS, i.e. in subjects with greatest beta-cell function. And, we noted that high pre-training hyperglycemia blunted exercise-induced improvements in beta-cell compensation for insulin resistance. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Diabetes / 23.08.2013

MedicalResearch.com Interview with: Xiaohui Zhuo PhD Health economist Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? First, someone diagnosed with type 2 diabetes may pay an average of about $85,500 treating the disease over his or her lifetime. Lifetime cost is higher for women, and for patients who developed the disease earlier in life. Second, treating diabetic complications account for more than half of lifetime costs, and a majority of which is attributed by damage to large blood vessels, which can lead to coronary heart disease and stroke. (more…)
Author Interviews, Diabetes, JCEM, OBGYNE, Obstructive Sleep Apnea, Sleep Disorders / 22.08.2013

Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612MedicalResearch.com: Interview with Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612   MedicalResearch.com: What are the main findings of the study? Answer: We found a strong association between obstructive sleep apnea and gestational diabetes mellitus. In pregnant women diagnosed with gestational diabetes, the risk of obstructive sleep apnea is increased nearly 7-fold compared to those without gestational diabetes.  In addition, we found that in non-diabetic women, pregnancy is associated with more disrupted sleep. (more…)
Author Interviews, Diabetes / 20.08.2013

Leonardo Trasande, MD, MPP Departments of Pediatrics, Environmental Medicine, Population Health, and Medicine, School of Medicine, and Wagner School of Public Service, and Steinhardt School of Culture, Education, and Human Development, Department of Nutrition MedicalResearch.com: Interview with Leonardo Trasande, MD, MPP Departments of Pediatrics, Environmental Medicine,  Population Health, and  Medicine, School of Medicine, and  Wagner School of Public Service, and  Steinhardt School of Culture, Education, and Human Development, Department of Nutrition MedicalResearch.com: What are the main findings of the study? Answer: We detect associations of urinary phthalate metabolites in a cross-sectional study of US adolescents.  The association is highly robust to multiple sensitivity analyses, and specific to phthalates commonly found in food.  Further, longitudinal study of dietary phthalate exposures is needed. (more…)
Author Interviews, Diabetes, Heart Disease, Nature / 13.08.2013

MedicalResearch.com Interview with: Tina Costacou, Ph.D. Assistant Professor of Epidemiology University of Pittsburgh MedicalResearch.com: What are the main findings of the study? Answer: The generation of reactive oxygen species is a natural and essential feature of human physiology, although excess production of free radicals has been related to the development and progression of diabetes complications. Simply put, a “balance” is required between the pro- and the anti-oxidant forces to maintain good health. Our aim in this study of people with type 1 diabetes was to evaluate whether an individual’s antioxidant vitamin levels in blood can modify the heart disease risk conferred by increased oxidative stress. Indeed, we observed that higher concentrations of α-tocopherol (a form of vitamin E) in blood overtime were related to lower risk of developing coronary heart disease, whereas greater oxidative stress (as measured by urinary 15-isoprostane F2t) was related to greater risk of disease. Interestingly, the ratio of α-tocopherol to urinary 15-isoprostane F2t, which we used as a measure of an individual’s ability to respond to / counteract oxidative stress, also was a strong predictor of subsequent coronary heart disease development. Our findings thus point to a different way of assessing a person’s risk for developing disease. Currently in clinical practice, physicians assess an individual’s risk factors (e.g. oxidative stress) for a pathologic condition (e.g. heart disease) to make inferences about the person’s risk to develop this condition and take preventive measures if needed (e.g. assign a treatment regimen). Our findings, however, suggest that an individual’s risk for disease may be better evaluated by simultaneously assessing factors representing the risk and those representing protection from or resistance to the risk. Thus, though two individuals may have similarly high levels of oxidative stress, there may be differences in the concentration of antioxidant vitamins between the two (and vice versa), which may put them at different risk categories, with one person potentially requiring vitamin supplementation while the second not needing to use supplements. (more…)
Diabetes, Neurological Disorders / 12.08.2013

MedicalResearch.com Interview with: Dr. Orit Twito Department of Endocrinology, Hillel Yaffe Medical Center, Hadera, Israel MedicalResearch.com: What are the main findings of the study? Answer: An HbA1c level above 7.5% (58mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patient with new onset diabetes mellitus. HbA1c above 8.5 %( 69nmol/mol) was associated with even higher mortality rate, although this difference did not reach statistical significance. (more…)
Author Interviews, Disability Research, Lancet / 07.08.2013

MedicalResearch.com Interview with: Evelyn Wong MBBS (Hons) MPH PhD Candidate Baker IDI Heart and Diabetes Institute Level 4, 99  Commercial Rd, Melbourne. VIC 3004 MedicalResearch.com: What are the main findings of the study? Answer: Researchers at Baker IDI Heart and Diabetes Institute reviewed previously published literature on the association between diabetes and the risk of developing physical and functional disability. In this study, disability was defined by a person’s difficulty walking; carrying out daily activities such as using a telephone or transport, managing finances, shopping; or attending to basic self-care needs such as eating, dressing and bathing. Although there have been many previous studies on diabetes and disability, the findings have varied and to date, no one has pooled all studies together for a combined measure of risk. From 26 relevant studies, we measured the pooled effect of the association between diabetes and disability. We found that diabetes increased the risk of disability by 50-80% compared to those without diabetes and this result was consistent across all types of disability. (more…)
Author Interviews, Diabetes / 30.07.2013

MedicalResearch.com Interview with: Dr. Henna Cederberg MD PhD, Postdoctoral Fellow University of Eastern Finland and Kuopio University Hospital Department of Medicine 70210 Kuopio, Finland MedicalResearch.com:  What are the main findings of the study? Dr. Cederberg: The association of risk variants previously identified for type 2 diabetes and hyperglycemia with gestational diabetes were evaluated in 533 Finnish women with gestational diabetes and 407 controls. The main finding of the study was that gestational diabetes and type 2 diabetes share a similar genetic background. Two risk variants of MTNR1B were significantly associated with gestional diabetes. Our study suggests that risk variants of MTNR1B are associated with gestational diabetes by increasing fasting glucose and decreasing insulin secretion.  In addition, another six single nucleotide polymorphisms associated with type 2 diabetes and hyperglycemia were nominally associated with gestational diabetes. (more…)
Author Interviews, Diabetes, Johns Hopkins, Weight Research / 19.07.2013

MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS Assistant Professor of Medicine & Epidemiology The Johns Hopkins University Early Response to Preventive Strategies in the Diabetes Prevention Program MedicalResearch.com: What are the main findings of the study? Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road.  Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose.  These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk. (more…)
Author Interviews, Diabetes, Infections, JAMA, Respiratory / 15.07.2013

Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, GermanyMedicalResearch.com Interview with: Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany MedicalResearch.com What are the main findings of the study? Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Pediatrics / 11.07.2013

MedicalResearch.com Interview with Jill M. Norris, MPH, PhD Colorado School of Public Health, University of Colorado, Aurora MedicalResearch.com: What were the most significant findings? How do they relate to what was already known about this subject? Dr. Norris: One of the most intriguing findings is that if mothers are still breast-feeding when they introduce gluten-containing foods to their baby, they may reduce the risk for T1D.  This is similar to a finding from a Swedish study that found that breast-feeding while introducing gluten-containing foods may reduce the risk for celiac disease, an autoimmune condition that has several similarities with T1D. In children at increased genetic risk for T1D, our data suggest that parents should wait to introduce any solid foods until after the 4 month birthday.  And when the baby is ready, solid foods should be introduced by the 6 months birthday or soon thereafter, preferably while the mother is still breast-feeding the baby, which may reduce the risk of T1D. (more…)
Author Interviews, Diabetes, Frailty, Lancet / 09.07.2013

MedicalResearch.com Interview with: Dr David Strain, MRCP MD Clinical senior lecturer and honorary consultant University of Exeter Medical School Institute of Biomedical and Clinical Science Department of Diabetes and Vascular Research Royal Devon & Exeter Hospital Exeter EX2 5AX MedicalResearch.com: What is the Background of the study? In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study. It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results.  For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients. (more…)