Type 2 diabetes is by far the most common form of diabetes, accounting for 90 to 95 percent of the 21 million diagnosed diabetes cases in the U.S. (Another 8.1 million are undiagnosed.) But preventive action can be powerful.
Diabetes not only increases the risk of death, it can lead to a host of complications such as blindness, heart disease and stroke.
Even modest lifestyle changes can greatly decrease the risk of type 2 diabetes.
Making one or two small changes per week will, over time, add up to a considerably healthier lifestyle. Doing so may also prevent type 2 diabetes.
Listen in as Dr. Fouad Kandeel discusses diabetes, it's treatments and what you can do to keep it in check.
Selected Podcast
City of Hope on Cutting Edge of Diabetes Research
Featured Speaker:
Director, Division of Development & Translational Diabetes and Endocrine Research.
Chair and Professor, Department of Clinical Diabetes, Endocrinology and Metabolism.
Fouad Kandeel, MD
Dr. Fouad Kandeel is a Professor at the Department of Diabetes and Metabolic Diseases Research.Director, Division of Development & Translational Diabetes and Endocrine Research.
Chair and Professor, Department of Clinical Diabetes, Endocrinology and Metabolism.
Transcription:
City of Hope on Cutting Edge of Diabetes Research
Melanie Cole (Host): City of Hope’s Diabetes and Metabolism Research Institute offers a comprehensive diabetes and endocrinology program combining groundbreaking research and unique treatments with patient education to help people living with diabetes and other endocrine diseases get the medical care and information they need to achieve an optimal quality of life. My guest today is Dr. Fouad Kandeel. He is the chairman of the Department of Clinical Diabetes, Endocrinology, and Metabolism at City of Hope. Welcome to the show, Dr. Kandeel. Tell us a little bit what’s going on in diabetes, exciting research and treatment today.
Dr. Fouad Kandeel (Guest): Diabetes is a major disease, threatening world-wide in the 21st century with incidents that is rising very significantly, and unless actually medical institutes and research centers are able to bring about new strategies for diagnosing and treating those Type 1 and Type 2 diabetes, nobody is going to afford the cost of the disease. City of Hope has done a significant contribution to the care of diabetics over the years, starting from the time of Rachmiel Levine, who is one of the fathers of modern diabetes sciences, and who actually clarified the role of insulin in mediating glucose entry into the cell to be used as a source of fuel in the 1940s, to the discovery of hemoglobin A1c by Samuel Rahbar, one of City of Hope scientists, and to the development of human insulin for the first time in the lab by Dr. Arthur Riggs and Dr. Itakura here at City of Hope to actually the development of cell therapy approach for Type 1 diabetes, which started at City of Hope in 2004.
Melanie: With this growing epidemic of diabetes Type 2, mainly, but Type 1 certainly is prevalent, but the growing epidemic with the obesity problem we’ve got going, so we’re seeing so much more Type 2 diabetes, even in children and obese children. Doctor, what do you want the listeners to know about diabetes Type 2 and what’s going on in the country?
Dr. Kandeel: Certainly, Type 2 diabetes is exploding and because of the change in lifestyle of individuals and the adoption of fast food eating, so the lack of physical activity and overeating in general, or open caloric intake in general, has led to the explosion of diabetes Type 2. Also diabetes Type [1] is increasing at a significant rate as well. However, in fact, the CDC has announced approximately three years ago that the level of obesity is leveling off, yet the level of diabetes or the incidents of diabetes development is rising significantly. In fact, by 2015, it’s expected that one out of every three Americans will be diabetic. Today, one out of every three Americans is pre-diabetic. What that really means is no increase in obesity, but there is going to be a significant increase in diabetes. It really suggests to me that we imprinted our genes through the epigenetic mechanisms of regulating gene expression, so that the influence of this is going to be the manifestation of diabetes over the next few decades, well above what is expected from an increase in body weight. We need really to reverse that trend by adopting good dietary and physical activity programs and keep that going effectively for several generations to resolve the effect of the bad food intake habits and the lack of physical activity that we actually incurred over the last two or three decades.
Melanie: Speak about living with diabetes and treatment. If people have already been diagnosed, whether it’s Type 2, insulin-resistant, or Type 1, what is your best recommendation for keeping track of those blood sugars and activity and sedentary lifestyle and nutrition and what role do all of these play in the lifestyle management of diabetes?
Dr. Kandeel: Well, actually, the lifestyle management of diabetes is very, very important. That was panned out in a study that was done in 1990, supported by the federal government, known as Type 2 Prevention Trial. In that trial, diet and exercise management reduced the incidents of development of new diabetes in high-risk group by about 60 percent, whereas actual use of drugs alone was successful in preventing diabetes only in about 28 percent. So, diet and exercise is twice as effective in reducing the development of diabetes as compared to medications. That is very important for everybody to know that actually diet and exercise is a very important aspect of the care of diabetes. It is important for Type 2 and now we are also recognizing how important it is for Type 1 because also some Type 1 patients do have insulin resistance that could actually be helped with diet and exercise.
Melanie: Wow, that’s quite a good statement to make, Dr. Kandeel, that if you’re noticing insulin resistance in Type 1, they can benefit from this type of exercise effect. Exercise has that insulin-like effect.
Dr. Kandeel: Right.
Melanie: That’s a pretty huge way to look at it. Now, what do you want people to know about making those changes in their lives to help prevent this? And tell us about what research you’re doing there at City of Hope.
Dr. Kandeel: Certainly. Well, with regard to what people should do is really physical activity and it’s not required to be a vigorous physical activity. Fast-paced walking for half an hour a day can actually influence insulin sensitivity significantly and lower blood glucose by improving insulin action. As with regard to diet, really adopting some changes in the dietary intake by reducing carbohydrate intake, eating more of vegetables type of food, and limiting the saturated fat content in the food would actually significantly improve the metabolic makeup of an individual. I think diet and exercise should be very important aspect of treating effectively of living in every individual whether they have diabetes or not, but most definitely they are very important in the management of a diabetic individual. What City of Hope is doing for Type 2 is actually developing research to understand the mechanisms of the gene regulation that leads to development of diabetes complications. That’s called metabolic memory. We want to understand how the diet and exercise we do actually imprint our genes or alter the gene expression potentially for a generation or two that leads to a higher increase of complications of diabetes. We have a major program in diabetes epigenetics to understand the mechanisms of diabetes complications and to develop therapeutic targets where we could actually develop new drugs and interventions to circumvent the development of diabetes complications. We also actually are developing electronic systems to analyze patient food intake and physical activity and help them to optimize the physical activity and food intake based on what they prefer and what the limitations that they may have in their lifestyles and physical abilities and then to optimize the drug therapy based on mathematical modeling of the metabolism of that individual. We are not there yet. We are still working on that program. It probably will go into a clinical trial in about a year or so, and we hope actually, if that’s successful, can actually be widely disseminated. Remember, saving of 10 percent of the care of diabetic individual in the US will translate to a national savings of approximately $36 billion a year.
Melanie: Well, that is fascinating. Thank you so much for being with us, Dr. Kandeel. You’re listening to City of Hope Radio. For more information, you can go to cityofhope.org/diabetes. That’s cityofhope.org/diabetes for information on the Diabetes, Endocrinology, and Metabolism Institute at City of Hope. This is Melanie Cole. Thanks so much for listening.
City of Hope on Cutting Edge of Diabetes Research
Melanie Cole (Host): City of Hope’s Diabetes and Metabolism Research Institute offers a comprehensive diabetes and endocrinology program combining groundbreaking research and unique treatments with patient education to help people living with diabetes and other endocrine diseases get the medical care and information they need to achieve an optimal quality of life. My guest today is Dr. Fouad Kandeel. He is the chairman of the Department of Clinical Diabetes, Endocrinology, and Metabolism at City of Hope. Welcome to the show, Dr. Kandeel. Tell us a little bit what’s going on in diabetes, exciting research and treatment today.
Dr. Fouad Kandeel (Guest): Diabetes is a major disease, threatening world-wide in the 21st century with incidents that is rising very significantly, and unless actually medical institutes and research centers are able to bring about new strategies for diagnosing and treating those Type 1 and Type 2 diabetes, nobody is going to afford the cost of the disease. City of Hope has done a significant contribution to the care of diabetics over the years, starting from the time of Rachmiel Levine, who is one of the fathers of modern diabetes sciences, and who actually clarified the role of insulin in mediating glucose entry into the cell to be used as a source of fuel in the 1940s, to the discovery of hemoglobin A1c by Samuel Rahbar, one of City of Hope scientists, and to the development of human insulin for the first time in the lab by Dr. Arthur Riggs and Dr. Itakura here at City of Hope to actually the development of cell therapy approach for Type 1 diabetes, which started at City of Hope in 2004.
Melanie: With this growing epidemic of diabetes Type 2, mainly, but Type 1 certainly is prevalent, but the growing epidemic with the obesity problem we’ve got going, so we’re seeing so much more Type 2 diabetes, even in children and obese children. Doctor, what do you want the listeners to know about diabetes Type 2 and what’s going on in the country?
Dr. Kandeel: Certainly, Type 2 diabetes is exploding and because of the change in lifestyle of individuals and the adoption of fast food eating, so the lack of physical activity and overeating in general, or open caloric intake in general, has led to the explosion of diabetes Type 2. Also diabetes Type [1] is increasing at a significant rate as well. However, in fact, the CDC has announced approximately three years ago that the level of obesity is leveling off, yet the level of diabetes or the incidents of diabetes development is rising significantly. In fact, by 2015, it’s expected that one out of every three Americans will be diabetic. Today, one out of every three Americans is pre-diabetic. What that really means is no increase in obesity, but there is going to be a significant increase in diabetes. It really suggests to me that we imprinted our genes through the epigenetic mechanisms of regulating gene expression, so that the influence of this is going to be the manifestation of diabetes over the next few decades, well above what is expected from an increase in body weight. We need really to reverse that trend by adopting good dietary and physical activity programs and keep that going effectively for several generations to resolve the effect of the bad food intake habits and the lack of physical activity that we actually incurred over the last two or three decades.
Melanie: Speak about living with diabetes and treatment. If people have already been diagnosed, whether it’s Type 2, insulin-resistant, or Type 1, what is your best recommendation for keeping track of those blood sugars and activity and sedentary lifestyle and nutrition and what role do all of these play in the lifestyle management of diabetes?
Dr. Kandeel: Well, actually, the lifestyle management of diabetes is very, very important. That was panned out in a study that was done in 1990, supported by the federal government, known as Type 2 Prevention Trial. In that trial, diet and exercise management reduced the incidents of development of new diabetes in high-risk group by about 60 percent, whereas actual use of drugs alone was successful in preventing diabetes only in about 28 percent. So, diet and exercise is twice as effective in reducing the development of diabetes as compared to medications. That is very important for everybody to know that actually diet and exercise is a very important aspect of the care of diabetes. It is important for Type 2 and now we are also recognizing how important it is for Type 1 because also some Type 1 patients do have insulin resistance that could actually be helped with diet and exercise.
Melanie: Wow, that’s quite a good statement to make, Dr. Kandeel, that if you’re noticing insulin resistance in Type 1, they can benefit from this type of exercise effect. Exercise has that insulin-like effect.
Dr. Kandeel: Right.
Melanie: That’s a pretty huge way to look at it. Now, what do you want people to know about making those changes in their lives to help prevent this? And tell us about what research you’re doing there at City of Hope.
Dr. Kandeel: Certainly. Well, with regard to what people should do is really physical activity and it’s not required to be a vigorous physical activity. Fast-paced walking for half an hour a day can actually influence insulin sensitivity significantly and lower blood glucose by improving insulin action. As with regard to diet, really adopting some changes in the dietary intake by reducing carbohydrate intake, eating more of vegetables type of food, and limiting the saturated fat content in the food would actually significantly improve the metabolic makeup of an individual. I think diet and exercise should be very important aspect of treating effectively of living in every individual whether they have diabetes or not, but most definitely they are very important in the management of a diabetic individual. What City of Hope is doing for Type 2 is actually developing research to understand the mechanisms of the gene regulation that leads to development of diabetes complications. That’s called metabolic memory. We want to understand how the diet and exercise we do actually imprint our genes or alter the gene expression potentially for a generation or two that leads to a higher increase of complications of diabetes. We have a major program in diabetes epigenetics to understand the mechanisms of diabetes complications and to develop therapeutic targets where we could actually develop new drugs and interventions to circumvent the development of diabetes complications. We also actually are developing electronic systems to analyze patient food intake and physical activity and help them to optimize the physical activity and food intake based on what they prefer and what the limitations that they may have in their lifestyles and physical abilities and then to optimize the drug therapy based on mathematical modeling of the metabolism of that individual. We are not there yet. We are still working on that program. It probably will go into a clinical trial in about a year or so, and we hope actually, if that’s successful, can actually be widely disseminated. Remember, saving of 10 percent of the care of diabetic individual in the US will translate to a national savings of approximately $36 billion a year.
Melanie: Well, that is fascinating. Thank you so much for being with us, Dr. Kandeel. You’re listening to City of Hope Radio. For more information, you can go to cityofhope.org/diabetes. That’s cityofhope.org/diabetes for information on the Diabetes, Endocrinology, and Metabolism Institute at City of Hope. This is Melanie Cole. Thanks so much for listening.