April 2009 eUpdate
Research News
GLUCOSE KILLS BRAIN CELLS AFTER SEVERE HYPOGLYCEMIA? The Diabetes Center at UCSF is proud of its partnership with diabetes researchers and clinicians across all UCSF campuses, hospitals and research centers. These complementary “neighborhoods” are helping to drive research in numerous directions – all focused on improving the lives of those living with diabetes. One physician researcher located at the Veterans Affairs Medical Center (VAMC) in San Francisco has long been interested in the challenging problem of diabetic hypoglycemia, or severe low blood sugar. Ray Swanson, MD, Chief of Neurology and Rehabilitation at the VAMC, and his colleagues have learned through animal studies that brain damage -- thought to be caused by severe hypoglycemia -- actually occurs when glucose is administered to treat the low blood sugar. Furthermore, it appears as though high levels of glucose given right after hypoglycemia is more damaging than a slower return to normal glucose levels. Even though these studies were in animal models and haven’t been investigated in humans yet, the findings were surprising and may have clinical relevance for the treatment of hypoglycemia in an emergency room situation. Dr. Swanson’s full study can be found in the Journal of Clinical Investigation. [ journal article ] [ Dr. Swanson ]
STUDY EXPLORES THE PREVALENCE OF PSYCHOLOGICAL ISSUES IN TYPE 2 DIABETES Dr. Larry Fisher is on a quest to learn who and why some type 2 patients experience affective and anxiety disorders, depressive affect and diabetes-related distress over time – and some do not. In previous research, Larry Fisher, PhD, Professor in the UCSF Department of Family & Community Medicine, has learned that most people with high depressive affect are not necessarily clinically depressed, but are instead suffering from high levels of diabetes-related distress. In a recent longitudinal study that appeared in Diabetic Medicine, Dr. Fisher and his colleagues have learned that younger adults, those of the female gender, and individuals experiencing complications were at greater risk of experiencing depressive affect and diabetes-related distress over time. In addition, individuals experiencing these disorders over time exhibited behaviors that impacted their hemoglobin A1c levels, a powerful indicator of the effectiveness of blood glucose control. The bottom line message – Dr. Fisher and his team strongly encourage clinicians to conduct frequent mental health and diabetes-related distress screening with their patients, especially for younger adults, women and those experiencing diabetes complications. [ journal article ] [ Dr. Fisher ]
Clinical News
FIRST WILSEY CLINICAL FELLOW SHARES EXPERIENCE Thanks to the generosity of Bobbie and Mike Wilsey who helped to create a clinical fellowship at UCSF, Dr. Bonnie Kimmel is nearing completion of an extraordinary year serving as the first UCSF Wilsey Fellow. Dr. Kimmel’s fellowship allowed her to gain valuable experience in the Adult Diabetes Clinic and the Diabetes Teaching Center, and related sub-specialty clinics such as ophthalmology, nephrology, neurology, podiatry, PCOS, and high risk obstetrics. In addition to this clinical training, she has been involved in clinical research involving diabetes. For example, Dr. Kimmel has been studying how to effectively transition long-acting insulin management from an in-patient setting to a patient’s home environment. Dr. Kimmel, who received her undergraduate education at Stanford, her medical degree at Brown, and her residency and chief residency at Yale before heading to UCSF, says she is eternally grateful to the Wilsey Family for creating this clinically focused training opportunity. For more information on fellowship opportunities in need of funding at the Diabetes Center, contact Suzanne Ritchie, sritchie@support.ucsf.edu
IT’S NOT TOO LATE TO REGISTER FOR SATURDAY’S ANNUAL PATIENT SYMPOSIUM! The UCSF Diabetes Teaching Center is holding its annual Adult Diabetes Patient Symposium THIS SATURDAY, April 4 from 7:45 a.m. – 12:30 p.m. at the UCSF Laurel Heights Campus (3333 California Street, San Francisco). Topics include: “Counting Carbohydrates vs. Glycemic Index/Load”, “Why We Remain Hopeful About Stem Cells”, “Islet and Pancreas Transplantation: An Update”, “Continuous Glucose Monitoring – Panel Discussion”, “From Discouraged to Encouraged: Yes You Can Manage Your Diabetes”. A continental breakfast and a comprehensive symposium syllabus are included in the fee ($25 per person; $35 per family of two). For more information: 415-353-2266; marina.demetsky@ucsfmedctr.org [flyer] [website]
Clinical Trials
The Diabetes Center at UCSF is among the premier institutions for clinical trials of emerging therapies in diabetes. Numerous clinical trials in type 1 and 2 diabetes are now underway.
Interested in participating? A sample of our trials currently enrolling patients:
Type 1 Diabetes: TrialNet Natural History Study [Antibody Screening] Seeking relatives of people with type 1 diabetes to find out if these family members are at risk for developing diabetes [ more ]
Type 1 Diabetes: Oral Insulin Preventative Study Seeking relatives of people with type 1 diabetes from age 3 to age 45 [ more ]
Type 1 Diabetes: Islet Transplantation with Belatacept Seeking volunteers 18 and older, with type 1 diabetes and weighing less than 175 lbs [ more ]
Type 1 Diabetes: Teplizumab (HOKT3y1 (Ala-Ala)) [Protégé Study] Seeking volunteers, 16 to 35 years of age, within 12 weeks of diagnosis [ more ]
Type 2 Diabetes: Paleolithic-Type Diets and Metabolic Control Seeking volunteers 18 years of age and older with type 2 diabetes [ more ]
Non-Diabetics: Alpha Lipoic Acid and Insulin Resistance Seeking volunteers 20 to 60 years of age [ more ]
Non-Diabetics: Chromium and Insulin Resistance Seeking volunteers 20 to 50 years of age, not exercising regularly, and of normal body weight [ more ]
For more opportunities, visit the Clinical Trials section of our website , or contact Kathleen Fraser, our Clinical Trials Recruitment Coordinator at kfraser@diabetes.ucsf.edu.
If you wish to financially support the UCSF Diabetes Center, please visit our donation website and designate your gift to "The Diabetes Center", or contact Suzanne Ritchie at 415-476-6334; sritchie@support.ucsf.edu
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