Causes of type 2 diabetes (once called adult-onset) include genetic determinants investigated and reported on by NIH director Dr. Francis Collins, said Rodgers, while our environment may turn possibility and susceptibility into reality.
“African Americans are 13 percent of the U.S. population,” he continued, “yet they account for 33 percent of patients in dialysis centers around the U.S.—almost a three-fold amplification. You can’t give an example in which there’s a more stark disparity in terms of human health.”
Rodgers described progress and resources to improve health:
• A 3-arm trial of 3,200 overweight pre-diabetics. 79 million Americans have pre-diabetes, where the amount of glucose in the blood is higher than normal but not high enough to be called diabetes. Pre-diabetes often leads to type 2 diabetes. The Diabetes Prevention Program (DPP) illustrated the enormous power of lifestyle change for people with pre-diabetes. In this landmark study, modest weight loss through dietary changes and increased physical activity reduced the risk of developing type 2 diabetes by 58 percent in a diverse group of individuals at risk for the disease. “The effect was impressive,” Rodgers said, “and quite durable.”
• NIDDK partners with YMCA. The one-on-one counseling tested in the DPP is expensive, Rodgers explained, “so we partnered with the YMCA, an accessible and affordable resource for communities, to test a DPP-based intervention in a group setting. Outcomes for people in group sessions were equivalent to those managed in the DPP, while yearly costs per participant dropped tenfold.
“We’ve blazed a trail forward,” Rodgers said, “and we ask all of you to be ambassadors for NIH, to educate your friends, your family and the general public about [NIH] resources. You will be making science a very powerful tool for justice.”
Photos: Bill Branson
“We’re looking at how these projects can be scalable and brought to individuals at greatest risk,” Rodgers said.
• Intramural study on Pima Indians. The Pima have the highest prevalence of diabetes in the world. NIH researchers are studying the intersection of genetics and environment and using the information to help determine how to prevent and treat diabetes.
• LIFE-Moms. If an obese woman develops gestational diabetes or has diabetes during pregnancy, her infant has a much higher risk of developing diabetes than a sibling born when the mother did not have diabetes. Co-funded by NIDDK, ORWH and others, LIFE-Moms is a multi-center consortium across the U.S. that is testing a variety of lifestyle interventions to reduce weight gain in expectant mothers and avoid gestational diabetes.
• The National Diabetes Education Program. This joint program of NIH and the CDC offers a wide variety of materials to help with diabetes prevention and control.
• Sisters Together: Move More, Eat Better. Given the high rates of obesity in African-American women, NIDDK created Sisters Together: Move More, Eat Better to offer tips to help black women improve their eating and physical activity habits.
Rodgers said he hopes people will use NIH as a source of health information.
“We’ve blazed a trail forward,” he said, “and we ask all of you to be ambassadors for NIH, to educate your friends, your family and the general public about [NIH] resources. You will be making science a very powerful tool for justice.”
From the Q&A session:
Food deserts. “The First Lady has taken this on very ably,” said Rodgers, resulting “in a number of food wagons going into these local communities [where fresh food is scarce] to provide fruits and vegetables.” NIH’s role and responsibility is to support research to identify factors involved in obesity; results guide other groups to make societal changes, he said.
Type 1 diabetes. Type 1, once called juvenile-onset, diabetes accounts for about 5 percent of all diabetes cases, Rodgers said. A combination of genetic and unknown environmental triggers leads to autoimmunity, where the immune system destroys insulin-producing cells in the pancreas. NIDDK’s TEDDY study follows 8,000 children from birth to 15 to identify triggers. TEDDY “will ultimately serve as the standard for most genetic-environmental interaction studies,” Rodgers said, “because we already know so much about the genetic risk factors for type 1 diabetes.”
The videocast is available at http://videocast.nih.gov/summary.asp?Live=12539.