National Research Battling Diabetes On Multiple Fronts

Federally funding basic and clinical research isn’t enough to stem the tide of Type 2 diabetes, says Griffin Rodgers, director of the National Institute of Diabetes and Digestive and Kidney Diseases. The federal government also must – and does – support efforts to get the results into public hands.

Speaking at the 2012 Global Diabetes Summit hosted by the Ohio State’s Diabetes Research Center at Wexner Medical Center, Rodgers outlined the research efforts of the federal agency responsible for diabetes as well as numerous related conditions, including kidney disease and obesity.

Because of those multiple areas of research, Rodgers said the agency’s approach is integrated, recognizing that in the United States, Type 2 diabetes is the leading cause of kidney disease, which can have an amplifying effect on cardiovascular complications.

“These diseases are common, costly and consequential,” he said.

Prevention of diabetes is a significant national effort. While about 26 million Americans have diabetes, 79 million have prediabetes – meaning their blood sugar is higher than normal but not high enough to trigger the diabetes diagnosis. They are considered at highest risk for developing diabetes.

The decade-old Diabetes Prevention trial showed that a lifestyle intervention emphasizing dietary changes and 150 minutes of physical activity per week was highly effective at delaying or preventing the onset of diabetes in high-risk individuals compared to a drug, metformin, or no intervention at all. The lifestyle intervention showed a 58 percent reduction in diabetes onset, compared to a 31 percent reduction for those on metformin. A follow-up showed that the results can be sustained in the long term. Among participants who were 65 or older, the reduction was 71 percent.

Women who develop gestational diabetes during pregnancy are also considered a high-risk group under study for the most effective interventions. Research suggests that children born to these women are at higher risk, as well, for developing Type 2 diabetes.

In addition, children are being watched closely as experts grow increasingly concerned about weight issues in youths. Researchers are seeing an increase in the prevalence of Type 2 diabetes in the pediatric population, Rodgers noted, which indicates that the need for prevention interventions must start earlier in life. A middle-school-based program helped children lower weight, but not any more than could be attributed to chance.

“Not only does one have to intervene in schools, but also in other settings,” Rodgers said.

Perhaps the biggest challenge is engaging potential intervention participants – which is why sharing information about research results is so vital.

“Fundamentally, if one is funding studies that develop the acquisition of knowledge and subsequently transformation of that data into knowledge that can affect patients, if one doesn’t also invest in dissemination, one is in a sense leaving at the table discoveries as well as efficiencies,” he said. “Not only is it important to fund clinical research, but also the dissemination of information to individuals so that we might make a substantial public health impact.”

-Emily Caldwell

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