Author Interviews, Diabetes, JAMA, Pediatrics / 20.09.2022

MedicalResearch.com Interview with: Michael Cabana, M.D., M.A., M.P.H Professor of Pediatrics Albert Einstein College of Medicine Physician-in-chief at the Children's Hospital at Montefiore Chair of the Department of Pediatrics at the Albert Einstein College of Medicine. Dr. Cabana joined the U.S. Preventive Services Task Force in January 2019 MedicalResearch.com: What is the background for this study? Response: Prediabetes and type 2 diabetes have historically been far more common in adults, but the number of children and teens who have these conditions is rising. However, there is still very limited research on whether screening, early detection, and early treatment of diabetes will improve a child’s long-term health. Due to this lack of evidence, the Task Force was unable to assess the benefits and harms of screening, particularly in Black, Hispanic, American Indian, and Pacific Islander populations, who are at a significantly higher risk of developing type 2 diabetes. We are calling for more research on this important topic. (more…)
Author Interviews, Diabetes, NEJM, OBGYNE / 19.08.2022

MedicalResearch.com Interview with: Professor Caroline Crowther MB ChB, DCH, FRANZCOG, MD, DDU, FRCOG, CMFM Maternal Fetal Medicine Subspecialist Professor of Maternal & Perinatal Health Liggins Institue Waipapa Taumata Rau | University of Auckland MwdicalResearch.com: What is the background for this study? Response: Gestational diabetes is a growing and significant health problem worldwide for women affected and their babies. Treatment of gestational diabetes improves maternal and infant health but it remains unclear what degree of maternal hyperglycaemia should be used to make the diagnosis. Because of this uncertainty, recommended diagnostic criteria vary around the world. The GEMS randomised trial assessed whether use of lower glycaemic diagnostic criteria, recommended by the International Association of Diabetes and Pregnancy Study Groups would improve perinatal health, without increasing maternal risks, compared to use of higher criteria, and to assess the effects on use of the health services. (more…)
Author Interviews, Diabetes, Kidney Disease / 08.06.2022

MedicalResearch.com Interview with: prof. dr. H.J. (Hiddo) Lambers Heerspink Clinical Pharmacologist Department Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen  MedicalResearch.com:  What is the background for this study?    Response: Tirzepatide is a novel GIP-GLP1 receptor agonist recently FDA approved for the treatment of type 2 diabetes. The SURPASS_4 trial demonstrated that in patients with type 2 diabetes at high cardiovascular risk tirzepatide compared to insulin glargine markedly reduces Hba1c and body weight. About 1 out of 3 patients with type 2 diabetes and CV disease has kidney disease and these patients are at high risk of kidney failure. The aim of this study was to assess whether tirzepatide could slow CKD progression in high risk individuals with type 2 diabetes participating in the SURPASS 4 trial.  (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 07.06.2022

MedicalResearch.com Interview with: HoJin Shin, BPharm, PhD Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The public health burden of cardiovascular disease has been increasing in people with diabetes along with the burden of diabetes itself.
  •  Cardiovascular disease affects approximately one-third of the population with type 2 diabetes and accounts for     50%–80% of their mortality
  • 1 in 10 people in the US has diabetes
Since 2008, the US FDA has recommended post-approval cardiovascular outcome trials to ensure the safety of new glucose-lowering drugs responding to this growing burden of cardiovascular disease in type 2 diabetes and the potential increase in cardiovascular risk with certain existing glucose-lowering drugs (e.g., rosiglitazone). Notably, SGLT-2i have demonstrated superiority to placebo in reducing the risk of cardiovascular events, including hospitalization for heart failure. Consequently, beginning in 2018, clinical guidelines in the US have recommended SGLT-2i as a preferred second-line treatment for patients with type 2 diabetes and cardiovascular disease. As the paradigm of second-line pharmacological treatment for type 2 diabetes has shifted to include the management of cardiovascular risk in addition to glycemic control, this further raised the question of whether SGLT-2i should be advanced to first-line treatment. Since 2019, SGLT-2i have been recommended as a first-line agent for patients with type 2 diabetes and cardiovascular disease by the European guidelines (the European Society of Cardiology and the European Association for the Study of Diabetes). In the absence of head-to-head RCTs, non-randomized studies using real-world data could provide information on whether SGLT-2i may have greater cardiovascular benefits over metformin more timely than randomized clinical trials among both patients with and without existing CVD. Therefore, we evaluated the risk for cardiovascular events among adults with T2D who initiated treatment with first-line SGLT-2i versus metformin in clinical practice. (more…)
Author Interviews, Diabetes, Genetic Research, Herpes Viruses / 12.05.2022

MedicalResearch.com Interview with: Prof. Annette Peters PhD Chair of Epidemiology Institute of Medical Information Sciences, Biometry and Epidemiology, Ludwig-Maximilians University Munich, Germany Institute of Epidemiology, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany German Center for Diabetes Research (DZD), München-Neuherberg, Germany MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: A large number of genetic, behavioural and environmental risk factors have been identified as contributing to the risk of type 2 diabetes. However, little is known about a potential link between virus infections and type 2 diabetes developments. We had the unique opportunity to use a multiplex assay to measure antibodies for herpes viruses by the Waterboer laboratory at the German Cancer Center in Heidelberg and set out to investigate the potential associations in the prospective KORA cohort. First of all, we detected that herpes virus antibodies were highly prevalent in the study population at baseline and increased with age. We found an association between Herpes simplex virus 2 and cytomegalovirus and type 2 diabetes during a seven year follow-up. These associations were robust against controlling for other known risk factors. (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes / 17.03.2022

MedicalResearch.com Interview with: Prof. Wolfgang Rathmann MSPH Prof. of Epidemiology Deputy Director, Institute for Biometrics and Epidemiology, German Diabetes Center, Heinrich Heine University Düsseldorf, Germany MedicalResearch.com:  What is the background for this study?  Response: Diabetes is associated with a poor prognosis of COVID-19. There have been raised concerns about a bidirectional relationship between diabetes and COVID-19. Recent studies raised the possibility that SARS-CoV-2 can cause diabetes. However, there is a lack of studies investigating the incidence of diabetes after recovery from COVID-19 in mild cases. To provide more evidence, we analyzed electronic health records from 1,171 general and internal medicine practices across Germany between March 2020 and January 2021. This included 35,865 patients who were diagnosed with COVID-19. The incidence of diabetes after COVID-19 was compared with patients, who were diagnosed with an acute upper respiratory tract infection (AURI), matched for sex, age, and comorbidities including obesity, high blood pressure, high cholesterol, heart attack, and stroke.  (more…)
Author Interviews, Diabetes, NEJM, Pediatrics, Technology / 20.01.2022

MedicalResearch.com Interview with: Dr Julia Ware (née Fuchs) Clinical Research Associate Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge Addenbrooke’s Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Management of type 1 diabetes is challenging in very young children, due to their high variability of insulin requirements and unpredictable eating and activity patterns. As a result, many young children do not meet the recommended glycemic targets, or only maintain recommended glycemic control with extensive caregiver input. This in turn leads to high management burden and reduced quality of life for the whole family. While the increasing use of continuous glucose-monitoring devices and insulin-pump therapy has led to reductions in the incidence of severe hypoglycaemia and diabetic ketoacidosis, and has been accompanied by modest improvements in glycemic control, the burden of management has remained high. Hybrid closed-loop systems (also called an artificial pancreas), in which an algorithm automatically adjusts insulin delivery on the basis of real-time sensor glucose levels, may address ongoing challenges in this age group. However, to date hybrid closed-loop studies involving very young children have been small and of short duration and the efficacy and safety of longer term use of a closed-loop system, as compared with standard therapy, was unclear.   To address this knowledge gap, we compared 16-week use of the Cambridge closed-loop algorithm with sensor-augmented pump therapy in children aged 1 to 7 years with type 1 diabetes in a multi-national randomised crossover study. (more…)
Author Interviews, Diabetes, Global Health, Lancet / 12.01.2022

MedicalResearch.com Interview with: Prof Dianna J Magliano PhD Baker Heart and Diabetes Institute Melbourne Australia  MedicalResearch.com: What is the background for this study? Response: Mortality among people with diabetes, and how it changes over time, is an important indicator of quality of and access to health care. However, population level trends in mortality among people with diabetes are inadequately described. The establishment of national diabetes registers, health insurance data and administrative data has allowed the examination of mortality among those with diabetes at a granular level which has been previously not possible. This has allowed us to examine whether global efforts in regards to diabetes care over the last couple of decades have been effective. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Author Interviews, Coffee, Heart Disease, JAMA, OBGYNE / 09.11.2021

MedicalResearch.com Interview with: Stefanie N. Hinkle, PhD Assistant Professor Department of Biostatistics Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: Over 80% of U.S. women of reproductive age consume caffeine daily.While most women decrease consumption after becoming pregnant, many continue to consume caffeine throughout pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women limit their caffeine consumption to <200 mg/d out of an abundance of caution due to potential associations with pregnancy loss and fetal growth restriction at higher intakes. There remains limited data on associations with maternal cardiometabolic outcomes in pregnancy.   (more…)
Author Interviews, Diabetes, Statins / 04.10.2021

MedicalResearch.com Interview with: Ishak Mansi, MD Staff Internist, VA North Texas Health System. Professor in Department of Medicine & Department of Data & Population Science, University of Texas Southwestern, Dallas, TX MedicalResearch.com: What is the background for this study? Response: Several scientific societies guidelines recommend Statins prescription to patients with diabetes aged 40 to 75 with LDL-cholesterol ≥70 mg/dL to prevent cardiovascular diseases from occurring. Statins have been shown to lower the risk of cardiovascular diseases. However, prior research has shown statins to be associated with increased insulin resistance. But doctors do not routinely measure “insulin resistance” for their patients, rather, it is done on research and academic circles only but not in everyday life. Increased insulin resistance may result in less controlled diabetes and/or escalation of anti-diabetes medications. (more…)
Author Interviews, Diabetes, JAMA / 01.09.2021

MedicalResearch.com Interview with: Dr. Chien-Wen Tseng M.D., M.P.H., M.S.E.E. Professor,  Associate Research Director Department of Family Medicine and Community Health University of Hawaii John A. Burns School of Medicine Hawaii Medical Service Association Endowed Chair MedicalResearch.com: What is the background for this study? What are the main recommendations? Response: Diabetes is the seventh leading cause of death in the United States and raises a person’s risk for heart disease, stroke, kidney failure, and even blindness and limb amputation. The Task Force recommends screening for prediabetes and type 2 diabetes in adults who are 35 to 70 years old and have overweight or obesity, which is one of the leading risk factors for diabetes. By screening, we can detect prediabetes and type 2 diabetes early and prevent these conditions from getting worse and leading to serious health problems. (more…)
Author Interviews, CDC, Diabetes, Social Issues / 30.06.2021

MedicalResearch.com Interview with: Yu Chen, Ph.D. Prevention Effectiveness Fellow Division of Diabetes Translation CDC MedicalResearch.com: What is the background for this study? Response: Overall prevalence of diabetes has increased over the past two decades in the US, disproportionately affecting populations with low-income. The age-adjusted prevalence of diagnosed diabetes among adults aged 18 years or older increased from 6.4% in 1999−2002 to 9.4% in 2013−2016. Between 2011 and 2014, compared with persons with high income, the relative percentage increase in diabetes prevalence was 40.0%, 74.1%, and 100.4% for those classified as middle income, near poor and poor, respectively. However, recent changes in income-related inequalities in diabetes prevalence are unknown. (more…)
Author Interviews, Diabetes / 29.06.2021

MedicalResearch.com Interview with: Dr. Ziyad Al-Aly, MD, FASN Clinical Epidemiology Center Research and Development Service Veterans Affairs St. Louis Health Care System St. Louis, MO MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There are several randomized controlled trials of  Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) but none (not a single study) provided a head-to-head comparison with sulfonylureas -- the most commonly prescribed antihyperglycemics after metformin. We resolved to leverage advanced methodologies to undertake a head-to-head investigation of the comparative effectiveness of SGLT2I vs sulfonylureas on the risk of all-cause mortality. (more…)
Author Interviews, Diabetes, Gastrointestinal Disease, Weight Research / 16.05.2021

MedicalResearch.com Interview with: Anna Carolina Hoff, MD Lead researcher on the study Founder and Clinical Director Angioskope Brazil São José dos Campos  MedicalResearch.com: What is the background for this study? Response: Obesity is a chronic disease that has become a global pandemic, and its prevalence continues to increase. Overweight (Body Mass Index (BMI) ≥ 27 kg/m2) and obesity (BMI ≥ 30kg/m2) lead to numerous clinical comorbidities, including metabolic, cardiovascular, oncologic, and mental health disorders. It is challenging to achieve significant and sustained weight loss with diet and lifestyle modification alone. Additionally, a reversal of obesity-related co-morbidities and improvement in quality of life entails a percent total body weight loss (%TBWL) of between 5-10%, which is rarely achieved with medications alone. The Endoscopic Sleeve Gastroplasty (ESG) results in a %TBWL between 14.6%-19.7% at 18-24 months,  and improvements in systolic blood pressure (SBP), HbA1c, and dyslipidemia at 12 months. (more…)