WEBVTT

NOTE duration: "00:18:23.402"


NOTE Confidence: 0.9785649

00:00:00.240 --> 00:00:01.839
Hi. My name is Claire

NOTE Confidence: 0.9785649

00:00:01.839 --> 00:00:02.340
Flannery.

NOTE Confidence: 0.986545

00:00:02.879 --> 00:00:03.780
I'm an endocrinologist

NOTE Confidence: 0.9917634

00:00:04.559 --> 00:00:06.480
and a researcher in women's

NOTE Confidence: 0.9917634

00:00:06.480 --> 00:00:06.980
health,

NOTE Confidence: 0.9535579

00:00:08.080 --> 00:00:10.000
diabetes and body weight here

NOTE Confidence: 0.9535579

00:00:10.000 --> 00:00:10.880
at the Yale School of

NOTE Confidence: 0.9535579

00:00:10.880 --> 00:00:11.380
Medicine.

NOTE Confidence: 0.9402863

00:00:11.920 --> 00:00:14.225
And, today, I'm very excited,

NOTE Confidence: 0.9562701

00:00:14.625 --> 00:00:15.985
to have a conversation with

NOTE Confidence: 0.9562701

00:00:15.985 --> 00:00:17.285
Doctor. Sonia Caprio,

NOTE Confidence: 0.99481094

00:00:17.744 --> 00:00:19.125
who is also an endocrinologist

NOTE Confidence: 0.9128833

00:00:19.665 --> 00:00:21.345
here at Yale and who

NOTE Confidence: 0.9128833

00:00:21.345 --> 00:00:21.845
studies,

NOTE Confidence: 0.973103

00:00:22.465 --> 00:00:24.485
how body weight and diabetes

NOTE Confidence: 0.973103

00:00:24.704 --> 00:00:25.685
evolves in,

NOTE Confidence: 0.99935037

00:00:26.224 --> 00:00:27.685
children and teenagers.

NOTE Confidence: 0.98014975

00:00:28.500 --> 00:00:30.100
I've long admired her work,

NOTE Confidence: 0.98014975

00:00:30.100 --> 00:00:30.900
and so this is a

NOTE Confidence: 0.98014975

00:00:30.900 --> 00:00:32.020
privilege to get to speak

NOTE Confidence: 0.98014975

00:00:32.020 --> 00:00:34.100
with her. I also we

NOTE Confidence: 0.98014975

00:00:34.100 --> 00:00:35.800
have recently joined forces,

NOTE Confidence: 0.94992524

00:00:36.979 --> 00:00:38.979
so to understand how these,

NOTE Confidence: 0.99354213

00:00:39.380 --> 00:00:40.900
children and teenagers have now

NOTE Confidence: 0.99354213

00:00:40.900 --> 00:00:42.180
grown up as adults and

NOTE Confidence: 0.99354213

00:00:42.180 --> 00:00:43.159
how they're doing.

NOTE Confidence: 0.9689721

00:00:44.795 --> 00:00:46.155
Thank you very much for

NOTE Confidence: 0.9689721

00:00:46.155 --> 00:00:47.454
inviting me. And,

NOTE Confidence: 0.8686367

00:00:48.155 --> 00:00:48.655
yes,

NOTE Confidence: 0.9817357

00:00:49.354 --> 00:00:51.195
the interest is is there

NOTE Confidence: 0.9817357

00:00:51.195 --> 00:00:51.695
for,

NOTE Confidence: 0.94607395

00:00:52.715 --> 00:00:54.555
particularly to start as as

NOTE Confidence: 0.94607395

00:00:54.555 --> 00:00:55.915
the focus was in in

NOTE Confidence: 0.94607395

00:00:55.915 --> 00:00:59.020
diabetes. And slowly, we, understood

NOTE Confidence: 0.94607395

00:00:59.020 --> 00:01:00.780
that there was a link

NOTE Confidence: 0.94607395

00:01:00.780 --> 00:01:02.620
between type two diabetes and

NOTE Confidence: 0.94607395

00:01:02.620 --> 00:01:03.920
and, and obesity.

NOTE Confidence: 0.9581414

00:01:04.780 --> 00:01:06.780
My, interest was mainly in

NOTE Confidence: 0.9581414

00:01:06.780 --> 00:01:07.280
children

NOTE Confidence: 0.98638505

00:01:07.900 --> 00:01:09.180
to see if I could,

NOTE Confidence: 0.95674294

00:01:09.900 --> 00:01:12.000
bring whatever I the experience

NOTE Confidence: 0.95674294

00:01:12.140 --> 00:01:13.120
that we have,

NOTE Confidence: 0.9748511

00:01:14.015 --> 00:01:14.834
and had,

NOTE Confidence: 0.99813676

00:01:15.454 --> 00:01:16.814
in in the field of

NOTE Confidence: 0.99813676

00:01:16.814 --> 00:01:17.314
diabetes

NOTE Confidence: 0.7344066

00:01:17.694 --> 00:01:18.194
to,

NOTE Confidence: 0.9808695

00:01:19.134 --> 00:01:20.034
at that time,

NOTE Confidence: 0.97246563

00:01:20.655 --> 00:01:21.854
I I must say this

NOTE Confidence: 0.97246563

00:01:21.854 --> 00:01:23.295
was the beginning of nineteen

NOTE Confidence: 0.97246563

00:01:23.295 --> 00:01:25.134
nineties, things like that, and

NOTE Confidence: 0.97246563

00:01:25.134 --> 00:01:26.435
there was very little,

NOTE Confidence: 0.52715415

00:01:27.375 --> 00:01:27.875
diabetes,

NOTE Confidence: 0.99634206

00:01:28.790 --> 00:01:29.450
if ever

NOTE Confidence: 0.9282446

00:01:30.069 --> 00:01:31.050
type two diabetes

NOTE Confidence: 0.9688139

00:01:31.350 --> 00:01:32.170
in youth.

NOTE Confidence: 0.9526402

00:01:33.590 --> 00:01:35.270
So little by little, we

NOTE Confidence: 0.9526402

00:01:35.270 --> 00:01:37.110
focus more on on the

NOTE Confidence: 0.9526402

00:01:37.110 --> 00:01:39.030
metabolic syndrome to see if

NOTE Confidence: 0.9526402

00:01:39.030 --> 00:01:39.930
kids with

NOTE Confidence: 0.49805802

00:01:40.710 --> 00:01:41.210
obesity

NOTE Confidence: 0.92444503

00:01:42.245 --> 00:01:43.145
were also,

NOTE Confidence: 0.6250535

00:01:44.005 --> 00:01:44.505
having

NOTE Confidence: 0.9270751

00:01:45.125 --> 00:01:47.045
other problems in the in

NOTE Confidence: 0.9270751

00:01:47.045 --> 00:01:47.705
the lipid

NOTE Confidence: 0.88355047

00:01:48.325 --> 00:01:50.985
system, for example, lipid assessment

NOTE Confidence: 0.9701322

00:01:51.285 --> 00:01:51.785
and

NOTE Confidence: 0.926045

00:01:52.325 --> 00:01:53.625
and and, hypertension.

NOTE Confidence: 0.9250337

00:01:54.570 --> 00:01:56.490
And, and, at that time,

NOTE Confidence: 0.9250337

00:01:56.490 --> 00:01:58.090
there was no fatty liver

NOTE Confidence: 0.9250337

00:01:58.090 --> 00:02:00.250
yet, in, in in the

NOTE Confidence: 0.9250337

00:02:00.250 --> 00:02:01.130
in the air in in

NOTE Confidence: 0.9250337

00:02:01.130 --> 00:02:02.350
the pro as a problem,

NOTE Confidence: 0.9250337

00:02:02.570 --> 00:02:03.710
at least in kids.

NOTE Confidence: 0.9959294

00:02:04.410 --> 00:02:05.870
So little by little,

NOTE Confidence: 0.9322826

00:02:07.130 --> 00:02:09.070
we moved and and understood

NOTE Confidence: 0.9499715

00:02:09.805 --> 00:02:11.325
that the problem many of

NOTE Confidence: 0.9499715

00:02:11.325 --> 00:02:12.445
the problem that we have

NOTE Confidence: 0.9499715

00:02:12.445 --> 00:02:13.105
in overweight

NOTE Confidence: 0.9780239

00:02:13.885 --> 00:02:15.345
and obesity in adults

NOTE Confidence: 0.88606095

00:02:15.805 --> 00:02:17.565
were also seen in the

NOTE Confidence: 0.88606095

00:02:17.565 --> 00:02:19.005
adolescents that I was seeing

NOTE Confidence: 0.88606095

00:02:19.005 --> 00:02:19.725
in a in,

NOTE Confidence: 0.99880964

00:02:20.365 --> 00:02:21.264
in the clinic.

NOTE Confidence: 0.9797195

00:02:21.805 --> 00:02:23.105
Yeah. So your career

NOTE Confidence: 0.99919534

00:02:23.960 --> 00:02:25.960
in service of children and

NOTE Confidence: 0.99919534

00:02:25.960 --> 00:02:26.460
teenagers

NOTE Confidence: 0.97319156

00:02:26.840 --> 00:02:28.680
has now spanned over thirty

NOTE Confidence: 0.97319156

00:02:28.680 --> 00:02:30.760
years with funding from the

NOTE Confidence: 0.97319156

00:02:30.760 --> 00:02:32.380
National Institutes of Health,

NOTE Confidence: 0.96207666

00:02:33.160 --> 00:02:34.380
which is quite prestigious.

NOTE Confidence: 0.987339

00:02:35.080 --> 00:02:36.120
And I know that you've

NOTE Confidence: 0.987339

00:02:36.120 --> 00:02:37.560
written over a hundred and

NOTE Confidence: 0.987339

00:02:37.560 --> 00:02:38.060
fifty

NOTE Confidence: 0.8751548

00:02:38.715 --> 00:02:39.695
peer reviewed publications.

NOTE Confidence: 0.99542874

00:02:40.715 --> 00:02:42.335
You know, many of the,

NOTE Confidence: 0.9977825

00:02:43.035 --> 00:02:44.555
children and teenagers who saw

NOTE Confidence: 0.9977825

00:02:44.555 --> 00:02:46.155
you in clinic participated in

NOTE Confidence: 0.9977825

00:02:46.155 --> 00:02:46.975
these studies.

NOTE Confidence: 0.99433726

00:02:47.355 --> 00:02:48.815
Yeah. In fact, it started,

NOTE Confidence: 0.9509499

00:02:49.595 --> 00:02:51.055
very fast because

NOTE Confidence: 0.97210133

00:02:51.510 --> 00:02:53.430
we started doing these very

NOTE Confidence: 0.97210133

00:02:53.430 --> 00:02:54.970
simple tests that were

NOTE Confidence: 0.66044325

00:02:55.270 --> 00:02:56.410
raising reasonably

NOTE Confidence: 0.9996221

00:02:56.870 --> 00:02:57.370
accepted

NOTE Confidence: 0.8918828

00:02:57.750 --> 00:02:59.350
by a young person, a

NOTE Confidence: 0.8918828

00:02:59.350 --> 00:03:00.570
a a child, basically,

NOTE Confidence: 0.95682424

00:03:01.270 --> 00:03:02.389
because it was from set

NOTE Confidence: 0.95682424

00:03:02.470 --> 00:03:03.669
the age of seven and

NOTE Confidence: 0.95682424

00:03:03.669 --> 00:03:03.975
up.

NOTE Confidence: 0.95422727

00:03:04.615 --> 00:03:05.755
Once we started,

NOTE Confidence: 0.942425

00:03:06.695 --> 00:03:08.455
to the the idea that

NOTE Confidence: 0.942425

00:03:08.455 --> 00:03:10.375
we should basically focus whether

NOTE Confidence: 0.942425

00:03:10.375 --> 00:03:11.435
there was prediabetes

NOTE Confidence: 0.980402

00:03:11.975 --> 00:03:13.675
in youth with obesity,

NOTE Confidence: 0.87378985

00:03:15.255 --> 00:03:16.775
we started by doing these

NOTE Confidence: 0.87378985

00:03:16.775 --> 00:03:17.275
tests

NOTE Confidence: 0.9973731

00:03:17.790 --> 00:03:18.530
that were

NOTE Confidence: 0.8435866

00:03:19.709 --> 00:03:21.010
fairly well accepted.

NOTE Confidence: 0.88984317

00:03:22.349 --> 00:03:23.630
Not all not all every

NOTE Confidence: 0.88984317

00:03:23.630 --> 00:03:25.330
child will drink that sugary,

NOTE Confidence: 0.6848244

00:03:26.349 --> 00:03:27.410
test, basically.

NOTE Confidence: 0.92529863

00:03:27.950 --> 00:03:29.810
But that was the main

NOTE Confidence: 0.92529863

00:03:29.870 --> 00:03:31.455
point to do it, a

NOTE Confidence: 0.92529863

00:03:31.455 --> 00:03:33.135
test, a simple test, not

NOTE Confidence: 0.92529863

00:03:33.135 --> 00:03:33.875
very invasive,

NOTE Confidence: 0.9418656

00:03:34.655 --> 00:03:35.935
that would allow us to

NOTE Confidence: 0.9418656

00:03:35.935 --> 00:03:38.035
know where, the glucose,

NOTE Confidence: 0.67320323

00:03:40.175 --> 00:03:40.835
the tolerance

NOTE Confidence: 0.89240855

00:03:41.135 --> 00:03:43.795
is basically, if it's altered

NOTE Confidence: 0.89240855

00:03:43.855 --> 00:03:44.515
or not.

NOTE Confidence: 0.9074057

00:03:45.150 --> 00:03:45.650
And,

NOTE Confidence: 0.9926029

00:03:46.350 --> 00:03:47.870
and to repeat that in

NOTE Confidence: 0.9926029

00:03:47.870 --> 00:03:49.490
two years as a follow-up.

NOTE Confidence: 0.9926029

00:03:49.710 --> 00:03:51.250
That's what we started doing.

NOTE Confidence: 0.9862819

00:03:51.630 --> 00:03:52.530
In the meantime,

NOTE Confidence: 0.80376995

00:03:53.470 --> 00:03:55.710
because year was very and

NOTE Confidence: 0.80376995

00:03:55.710 --> 00:03:57.010
is still very,

NOTE Confidence: 0.9669528

00:03:57.710 --> 00:03:59.625
famous for doing imaging

NOTE Confidence: 0.9841456

00:04:00.004 --> 00:04:00.825
of the body.

NOTE Confidence: 0.9669587

00:04:01.525 --> 00:04:02.724
So we were the first

NOTE Confidence: 0.9669587

00:04:02.724 --> 00:04:04.004
one to do really the

NOTE Confidence: 0.9669587

00:04:04.004 --> 00:04:06.325
imaging of adipose tissue in

NOTE Confidence: 0.9669587

00:04:06.325 --> 00:04:08.025
children that were overweight

NOTE Confidence: 0.976125

00:04:08.325 --> 00:04:08.985
or not.

NOTE Confidence: 0.9308943

00:04:09.444 --> 00:04:10.965
And so we combined the

NOTE Confidence: 0.9308943

00:04:10.965 --> 00:04:13.280
two things and and, we

NOTE Confidence: 0.9308943

00:04:13.280 --> 00:04:15.220
we started doing these tests.

NOTE Confidence: 0.96998566

00:04:15.840 --> 00:04:17.440
And I would say that

NOTE Confidence: 0.96998566

00:04:17.440 --> 00:04:18.720
by the end the beginning

NOTE Confidence: 0.96998566

00:04:18.720 --> 00:04:20.080
of two thousand, we had

NOTE Confidence: 0.96998566

00:04:20.080 --> 00:04:21.060
about two hundred,

NOTE Confidence: 0.97789603

00:04:21.440 --> 00:04:22.900
kids that underwent,

NOTE Confidence: 0.7656896

00:04:24.080 --> 00:04:26.180
the the OGGTT and,

NOTE Confidence: 0.9687414

00:04:27.505 --> 00:04:28.325
the the imaging.

NOTE Confidence: 0.97419286

00:04:28.785 --> 00:04:30.945
And that paper was very

NOTE Confidence: 0.97419286

00:04:30.945 --> 00:04:31.445
important,

NOTE Confidence: 0.9464617

00:04:32.305 --> 00:04:33.925
at least was accepted

NOTE Confidence: 0.9202925

00:04:34.545 --> 00:04:35.125
in the

NOTE Confidence: 0.8877901

00:04:36.225 --> 00:04:37.685
New England Journal of Medicine.

NOTE Confidence: 0.8858688

00:04:39.040 --> 00:04:40.660
And that opened the door

NOTE Confidence: 0.8858688

00:04:40.720 --> 00:04:42.480
to see, to to let

NOTE Confidence: 0.8858688

00:04:42.480 --> 00:04:44.400
people understand, you know, that

NOTE Confidence: 0.8858688

00:04:44.400 --> 00:04:46.240
the the start of obesity

NOTE Confidence: 0.8858688

00:04:46.240 --> 00:04:46.900
of diabetes

NOTE Confidence: 0.9779996

00:04:47.600 --> 00:04:49.360
started very early, type two

NOTE Confidence: 0.9779996

00:04:49.360 --> 00:04:50.960
diabetes, very early in these

NOTE Confidence: 0.9779996

00:04:50.960 --> 00:04:51.460
kids.

NOTE Confidence: 0.96651

00:04:52.035 --> 00:04:53.395
So that's what,

NOTE Confidence: 0.90021795

00:04:54.035 --> 00:04:55.634
was the first step and

NOTE Confidence: 0.90021795

00:04:55.634 --> 00:04:57.875
was very well important because

NOTE Confidence: 0.90021795

00:04:57.875 --> 00:04:59.495
then the n I NIH

NOTE Confidence: 0.9971489

00:04:59.875 --> 00:05:01.495
decided to do trials

NOTE Confidence: 0.95067364

00:05:02.195 --> 00:05:04.529
in kids with obesity and

NOTE Confidence: 0.95067364

00:05:04.529 --> 00:05:06.370
type two diabetes and see

NOTE Confidence: 0.95067364

00:05:06.370 --> 00:05:07.410
what would be the best

NOTE Confidence: 0.95067364

00:05:07.410 --> 00:05:08.610
way to treat this many

NOTE Confidence: 0.95067364

00:05:08.770 --> 00:05:10.390
these, problem in kids.

NOTE Confidence: 0.99746454

00:05:11.410 --> 00:05:12.870
And why is it important

NOTE Confidence: 0.9992582

00:05:13.650 --> 00:05:15.510
to diagnose children and teenagers?

NOTE Confidence: 0.9390506

00:05:15.845 --> 00:05:17.445
It's very important because the

NOTE Confidence: 0.9390506

00:05:17.445 --> 00:05:19.365
earlier you start it, the

NOTE Confidence: 0.9390506

00:05:19.365 --> 00:05:20.725
the problem I mean, you

NOTE Confidence: 0.9390506

00:05:20.725 --> 00:05:21.845
you know that they have

NOTE Confidence: 0.9390506

00:05:21.845 --> 00:05:23.605
it because it's not like

NOTE Confidence: 0.9390506

00:05:23.605 --> 00:05:25.285
type one diabetes that it

NOTE Confidence: 0.9390506

00:05:25.285 --> 00:05:27.285
it it comes out and

NOTE Confidence: 0.9390506

00:05:27.285 --> 00:05:28.085
you don't,

NOTE Confidence: 0.9357904

00:05:29.045 --> 00:05:30.330
you cannot miss it.

NOTE Confidence: 0.99868315

00:05:30.810 --> 00:05:32.589
Type two diabetes is sometimes

NOTE Confidence: 0.97693145

00:05:33.050 --> 00:05:34.029
pretty silent.

NOTE Confidence: 0.9294339

00:05:34.729 --> 00:05:35.930
So you see that in

NOTE Confidence: 0.9294339

00:05:35.930 --> 00:05:37.689
the silence is it was

NOTE Confidence: 0.9294339

00:05:37.689 --> 00:05:38.969
there. We did not know

NOTE Confidence: 0.9294339

00:05:38.969 --> 00:05:40.409
about it. And by doing

NOTE Confidence: 0.9294339

00:05:40.409 --> 00:05:41.150
the OGTT

NOTE Confidence: 0.99291533

00:05:41.610 --> 00:05:43.550
and the imaging, we realized

NOTE Confidence: 0.99291533

00:05:43.689 --> 00:05:45.150
that there were other issues

NOTE Confidence: 0.8587777

00:05:45.615 --> 00:05:47.055
in in in in these

NOTE Confidence: 0.8587777

00:05:47.055 --> 00:05:47.555
kids.

NOTE Confidence: 0.98216337

00:05:48.175 --> 00:05:49.154
So we started,

NOTE Confidence: 0.87015

00:05:50.015 --> 00:05:51.795
basically with type two diabetes

NOTE Confidence: 0.87015

00:05:51.895 --> 00:05:53.714
when when the NIH

NOTE Confidence: 0.9906474

00:05:54.575 --> 00:05:56.115
also was willing

NOTE Confidence: 0.9567002

00:05:56.495 --> 00:05:58.035
to give, you know, propose

NOTE Confidence: 0.9752323

00:05:59.520 --> 00:06:01.040
a study to see what

NOTE Confidence: 0.9752323

00:06:01.040 --> 00:06:02.240
would be the best way

NOTE Confidence: 0.9752323

00:06:02.240 --> 00:06:03.620
to treat type two diabetes

NOTE Confidence: 0.9752323

00:06:03.680 --> 00:06:04.339
in kids

NOTE Confidence: 0.98116904

00:06:04.720 --> 00:06:05.460
with obesity.

NOTE Confidence: 0.9072418

00:06:06.080 --> 00:06:07.540
And and and that was

NOTE Confidence: 0.9072418

00:06:07.680 --> 00:06:09.279
two thousand and two, two

NOTE Confidence: 0.9072418

00:06:09.279 --> 00:06:10.480
thousand and three that we

NOTE Confidence: 0.9072418

00:06:10.480 --> 00:06:11.779
had the first

NOTE Confidence: 0.921293

00:06:12.240 --> 00:06:12.740
big

NOTE Confidence: 0.90057456

00:06:13.225 --> 00:06:14.825
center, a group of there

NOTE Confidence: 0.90057456

00:06:14.825 --> 00:06:15.565
were thirteen,

NOTE Confidence: 0.99696606

00:06:16.425 --> 00:06:16.925
centers

NOTE Confidence: 0.99711233

00:06:17.385 --> 00:06:18.445
that the NIH

NOTE Confidence: 0.6738001

00:06:18.985 --> 00:06:19.485
selected,

NOTE Confidence: 0.9507189

00:06:20.585 --> 00:06:22.025
and and to do this,

NOTE Confidence: 0.9575835

00:06:22.425 --> 00:06:23.945
study that they wanted to

NOTE Confidence: 0.9575835

00:06:23.945 --> 00:06:25.465
do, basically. And this was

NOTE Confidence: 0.9575835

00:06:25.465 --> 00:06:27.000
the first time, large,

NOTE Confidence: 0.76263946

00:06:28.360 --> 00:06:28.860
study,

NOTE Confidence: 0.99446404

00:06:29.560 --> 00:06:31.000
to understand what is the

NOTE Confidence: 0.99446404

00:06:31.000 --> 00:06:32.360
problem of type two diabetes

NOTE Confidence: 0.99446404

00:06:32.360 --> 00:06:33.420
in such a

NOTE Confidence: 0.91177773

00:06:33.800 --> 00:06:34.620
young population.

NOTE Confidence: 0.9042551

00:06:35.480 --> 00:06:37.160
Now thirty years after you

NOTE Confidence: 0.9042551

00:06:37.160 --> 00:06:37.660
started,

NOTE Confidence: 0.9989125

00:06:38.120 --> 00:06:39.020
there's over

NOTE Confidence: 0.9046286

00:06:39.320 --> 00:06:40.700
twenty five hundred,

NOTE Confidence: 0.96560895

00:06:41.535 --> 00:06:43.214
individuals who took part in

NOTE Confidence: 0.96560895

00:06:43.214 --> 00:06:44.735
these studies. They are now

NOTE Confidence: 0.96560895

00:06:44.735 --> 00:06:46.495
in their twenties, thirties, and

NOTE Confidence: 0.96560895

00:06:46.495 --> 00:06:49.055
forties. And I'm curious what

NOTE Confidence: 0.96560895

00:06:49.055 --> 00:06:50.255
you would want them to

NOTE Confidence: 0.96560895

00:06:50.255 --> 00:06:51.074
know now.

NOTE Confidence: 0.9718295

00:06:51.535 --> 00:06:52.895
And we both know that

NOTE Confidence: 0.9718295

00:06:52.895 --> 00:06:54.029
we we care how they're

NOTE Confidence: 0.9718295

00:06:54.029 --> 00:06:54.990
doing now, which is one

NOTE Confidence: 0.9718295

00:06:54.990 --> 00:06:56.029
of the reasons I've got

NOTE Confidence: 0.9718295

00:06:56.029 --> 00:06:57.810
involved as an adult endocrinologist.

NOTE Confidence: 0.9629325

00:06:58.589 --> 00:06:59.470
But are there things that

NOTE Confidence: 0.9629325

00:06:59.470 --> 00:07:00.430
you would want them to

NOTE Confidence: 0.9629325

00:07:00.430 --> 00:07:02.270
know? Yeah. This is very

NOTE Confidence: 0.9629325

00:07:02.430 --> 00:07:04.370
the continuity of this problem

NOTE Confidence: 0.9629325

00:07:04.430 --> 00:07:06.370
is very important because, unfortunately,

NOTE Confidence: 0.9768345

00:07:07.365 --> 00:07:08.805
up to twenty one, the

NOTE Confidence: 0.9768345

00:07:08.805 --> 00:07:10.885
pediatrician gets out from the

NOTE Confidence: 0.9768345

00:07:11.045 --> 00:07:12.405
so I cannot connect with

NOTE Confidence: 0.9768345

00:07:12.405 --> 00:07:13.305
them anymore.

NOTE Confidence: 0.9976874

00:07:13.685 --> 00:07:15.285
So having a person in

NOTE Confidence: 0.9976874

00:07:15.285 --> 00:07:15.945
the field,

NOTE Confidence: 0.90401316

00:07:16.645 --> 00:07:17.145
endocrinologist

NOTE Confidence: 0.8119051

00:07:17.685 --> 00:07:19.065
and knows and knows metabolism,

NOTE Confidence: 0.8119051

00:07:19.205 --> 00:07:20.405
I think, is important. And

NOTE Confidence: 0.8119051

00:07:20.405 --> 00:07:21.785
if we can and

NOTE Confidence: 0.9030236

00:07:22.085 --> 00:07:23.310
our goal is to reach

NOTE Confidence: 0.9030236

00:07:23.310 --> 00:07:25.090
out to these people particularly

NOTE Confidence: 0.90831083

00:07:25.949 --> 00:07:26.430
in,

NOTE Confidence: 0.9945935

00:07:26.830 --> 00:07:28.689
some aspects of the problem

NOTE Confidence: 0.9945935

00:07:28.830 --> 00:07:30.050
to see if we can

NOTE Confidence: 0.9485242

00:07:30.830 --> 00:07:32.270
see where are they. Are

NOTE Confidence: 0.9485242

00:07:32.270 --> 00:07:34.189
they having problems? And is

NOTE Confidence: 0.9485242

00:07:34.509 --> 00:07:35.469
and some of them have

NOTE Confidence: 0.9485242

00:07:35.469 --> 00:07:36.930
developed type two diabetes

NOTE Confidence: 0.98909825

00:07:37.535 --> 00:07:39.635
and other issues now because,

NOTE Confidence: 0.98016095

00:07:40.255 --> 00:07:40.835
you know,

NOTE Confidence: 0.8996688

00:07:41.215 --> 00:07:42.495
they have their own family,

NOTE Confidence: 0.8996688

00:07:42.495 --> 00:07:44.815
they have, the obesity does

NOTE Confidence: 0.8996688

00:07:44.815 --> 00:07:45.715
not go away,

NOTE Confidence: 0.99725944

00:07:46.895 --> 00:07:48.354
and the type two diabetes

NOTE Confidence: 0.99725944

00:07:48.415 --> 00:07:49.074
as well.

NOTE Confidence: 0.97431284

00:07:49.500 --> 00:07:50.860
So it would be very

NOTE Confidence: 0.97431284

00:07:50.860 --> 00:07:52.080
important to have,

NOTE Confidence: 0.98859876

00:07:52.460 --> 00:07:53.740
based on what we saw

NOTE Confidence: 0.98859876

00:07:53.740 --> 00:07:55.660
when they were adolescent, what's

NOTE Confidence: 0.98859876

00:07:55.660 --> 00:07:57.120
happening now also,

NOTE Confidence: 0.94787115

00:07:57.660 --> 00:07:59.420
and what best how best

NOTE Confidence: 0.94787115

00:07:59.420 --> 00:08:00.860
we can treat them. I

NOTE Confidence: 0.94787115

00:08:00.860 --> 00:08:01.755
would love to know where

NOTE Confidence: 0.94787115

00:08:01.755 --> 00:08:02.415
they're doing,

NOTE Confidence: 0.9653202

00:08:02.794 --> 00:08:03.995
you know, some of them

NOTE Confidence: 0.9653202

00:08:03.995 --> 00:08:05.115
I know because they come

NOTE Confidence: 0.9653202

00:08:05.195 --> 00:08:06.735
they have other younger

NOTE Confidence: 0.93257594

00:08:07.514 --> 00:08:08.955
brothers and sisters that are

NOTE Confidence: 0.93257594

00:08:08.955 --> 00:08:10.014
still in my clinic.

NOTE Confidence: 0.9791908

00:08:10.794 --> 00:08:12.735
But those that have, matured,

NOTE Confidence: 0.942814

00:08:13.435 --> 00:08:14.875
they have kids, they're on

NOTE Confidence: 0.942814

00:08:14.875 --> 00:08:15.695
their own.

NOTE Confidence: 0.9640727

00:08:16.060 --> 00:08:17.820
And that's important because also

NOTE Confidence: 0.9640727

00:08:17.820 --> 00:08:19.520
you don't wanna, you know,

NOTE Confidence: 0.79022515

00:08:20.220 --> 00:08:20.940
have this,

NOTE Confidence: 0.9722619

00:08:21.500 --> 00:08:22.860
type two diabetes and go

NOTE Confidence: 0.9722619

00:08:22.860 --> 00:08:24.539
into pregnancy and things like

NOTE Confidence: 0.9722619

00:08:24.539 --> 00:08:27.120
that. It's another very important

NOTE Confidence: 0.9722619

00:08:27.180 --> 00:08:28.380
area that I don't see

NOTE Confidence: 0.9722619

00:08:28.380 --> 00:08:29.680
a lot of work there.

NOTE Confidence: 0.9722619

00:08:29.925 --> 00:08:31.044
So there is a great

NOTE Confidence: 0.9722619

00:08:31.044 --> 00:08:31.445
deal of,

NOTE Confidence: 0.96796846

00:08:32.725 --> 00:08:33.225
research.

NOTE Confidence: 0.910287

00:08:33.605 --> 00:08:35.324
We are, I think, in

NOTE Confidence: 0.910287

00:08:35.324 --> 00:08:36.665
a moment in

NOTE Confidence: 0.9157284

00:08:37.125 --> 00:08:39.125
research and in science now

NOTE Confidence: 0.9157284

00:08:39.125 --> 00:08:40.425
to understand that

NOTE Confidence: 0.99903786

00:08:40.885 --> 00:08:41.385
overweight

NOTE Confidence: 0.9980087

00:08:41.765 --> 00:08:43.065
and obesity

NOTE Confidence: 0.96247286

00:08:43.889 --> 00:08:45.410
is there and is not

NOTE Confidence: 0.96247286

00:08:45.410 --> 00:08:47.029
gonna go away. The key

NOTE Confidence: 0.96247286

00:08:47.170 --> 00:08:48.610
issue is why. It's always

NOTE Confidence: 0.96247286

00:08:48.610 --> 00:08:50.129
the weight that has to

NOTE Confidence: 0.96247286

00:08:50.129 --> 00:08:50.790
go down

NOTE Confidence: 0.9388969

00:08:51.170 --> 00:08:52.370
in order to see that,

NOTE Confidence: 0.9388969

00:08:52.370 --> 00:08:54.230
you know, your glucose tolerance

NOTE Confidence: 0.9388969

00:08:54.290 --> 00:08:54.949
is better.

NOTE Confidence: 0.94906193

00:08:55.889 --> 00:08:57.410
The the liver is doing

NOTE Confidence: 0.94906193

00:08:57.410 --> 00:08:57.910
better.

NOTE Confidence: 0.96785325

00:08:58.804 --> 00:09:00.404
And and so that's that

NOTE Confidence: 0.96785325

00:09:00.404 --> 00:09:01.705
would be a major step.

NOTE Confidence: 0.9936688

00:09:02.165 --> 00:09:03.684
And the goal our goal

NOTE Confidence: 0.9936688

00:09:03.684 --> 00:09:05.065
is really to stop

NOTE Confidence: 0.8974161

00:09:05.445 --> 00:09:07.225
the diabetes, type two diabetes

NOTE Confidence: 0.8974161

00:09:07.285 --> 00:09:08.485
in youth because it's a

NOTE Confidence: 0.8974161

00:09:08.485 --> 00:09:10.184
it's a silent disease.

NOTE Confidence: 0.9593429

00:09:11.700 --> 00:09:13.059
And if you don't take

NOTE Confidence: 0.9593429

00:09:13.059 --> 00:09:14.580
good care, you're gonna they're

NOTE Confidence: 0.9593429

00:09:14.580 --> 00:09:16.580
gonna have most likely some

NOTE Confidence: 0.9593429

00:09:16.580 --> 00:09:18.339
issues later on, you know?

NOTE Confidence: 0.9593429

00:09:18.339 --> 00:09:19.620
And I believe also from

NOTE Confidence: 0.9593429

00:09:19.620 --> 00:09:21.620
your work, a side message

NOTE Confidence: 0.9593429

00:09:21.620 --> 00:09:23.380
that comes through is that

NOTE Confidence: 0.9593429

00:09:23.380 --> 00:09:24.740
not all children are equally

NOTE Confidence: 0.9593429

00:09:24.740 --> 00:09:26.245
at risk and we never

NOTE Confidence: 0.9593429

00:09:26.245 --> 00:09:27.304
want to overtreat

NOTE Confidence: 0.99913806

00:09:27.845 --> 00:09:29.144
those who never needed

NOTE Confidence: 0.93955463

00:09:29.445 --> 00:09:30.885
it. Yeah. It it was

NOTE Confidence: 0.93955463

00:09:30.885 --> 00:09:31.385
clearly

NOTE Confidence: 0.9241117

00:09:31.764 --> 00:09:33.285
that it was that the

NOTE Confidence: 0.9241117

00:09:33.285 --> 00:09:35.605
disease of diabetes would start

NOTE Confidence: 0.9241117

00:09:35.605 --> 00:09:36.824
after they had,

NOTE Confidence: 0.8984828

00:09:37.204 --> 00:09:39.225
the early puberty adult puberty.

NOTE Confidence: 0.96589196

00:09:39.800 --> 00:09:40.920
So they were the mean

NOTE Confidence: 0.96589196

00:09:40.920 --> 00:09:41.980
age was thirteen.

NOTE Confidence: 0.9605391

00:09:42.759 --> 00:09:43.500
You seldom

NOTE Confidence: 0.87302476

00:09:43.879 --> 00:09:45.819
was seeing, you know, very

NOTE Confidence: 0.87302476

00:09:46.040 --> 00:09:47.259
early diabetes

NOTE Confidence: 0.91523236

00:09:48.040 --> 00:09:50.279
in pre pubertal kids. It's

NOTE Confidence: 0.91523236

00:09:50.279 --> 00:09:51.720
very rare. But it was

NOTE Confidence: 0.91523236

00:09:51.720 --> 00:09:53.579
there when they were in

NOTE Confidence: 0.91523236

00:09:53.639 --> 00:09:54.620
in adolescence.

NOTE Confidence: 0.9820563

00:09:56.275 --> 00:09:56.775
Prediabetes

NOTE Confidence: 0.937571

00:09:57.155 --> 00:09:57.955
is very,

NOTE Confidence: 0.9661281

00:09:58.355 --> 00:09:59.235
easy for,

NOTE Confidence: 0.91567093

00:09:59.795 --> 00:10:01.255
for kids, particularly,

NOTE Confidence: 0.91056657

00:10:01.555 --> 00:10:03.155
I would say boys, going

NOTE Confidence: 0.91056657

00:10:03.155 --> 00:10:04.435
back to normal. So we

NOTE Confidence: 0.91056657

00:10:04.435 --> 00:10:05.315
have a paper in in

NOTE Confidence: 0.91056657

00:10:05.315 --> 00:10:05.975
the Lancet

NOTE Confidence: 0.87771213

00:10:07.155 --> 00:10:08.130
showing that,

NOTE Confidence: 0.8884326

00:10:09.170 --> 00:10:10.929
after two years, what was

NOTE Confidence: 0.8884326

00:10:10.929 --> 00:10:12.390
happening to the cohort?

NOTE Confidence: 0.9666123

00:10:12.770 --> 00:10:13.890
Do they still have the

NOTE Confidence: 0.9666123

00:10:13.890 --> 00:10:16.050
prediabetes or not? But a

NOTE Confidence: 0.9666123

00:10:16.050 --> 00:10:16.530
good,

NOTE Confidence: 0.8681732

00:10:16.929 --> 00:10:18.690
sixty percent went back and

NOTE Confidence: 0.8681732

00:10:18.690 --> 00:10:20.050
but they were all, I

NOTE Confidence: 0.8681732

00:10:20.050 --> 00:10:21.970
have to say, white going

NOTE Confidence: 0.8681732

00:10:21.970 --> 00:10:22.470
back

NOTE Confidence: 0.96840394

00:10:23.084 --> 00:10:25.425
to, to the normal state

NOTE Confidence: 0.93143445

00:10:26.845 --> 00:10:28.204
as opposed to the African

NOTE Confidence: 0.93143445

00:10:28.204 --> 00:10:30.225
American that had full blown

NOTE Confidence: 0.8779302

00:10:30.845 --> 00:10:31.745
type two diabetes.

NOTE Confidence: 0.91080046

00:10:33.564 --> 00:10:34.384
And girls.

NOTE Confidence: 0.98174256

00:10:35.485 --> 00:10:35.985
Girls.

NOTE Confidence: 0.9235622

00:10:36.610 --> 00:10:37.570
The girls who are the

NOTE Confidence: 0.9235622

00:10:37.570 --> 00:10:38.929
most Yeah. The most at

NOTE Confidence: 0.9235622

00:10:38.929 --> 00:10:41.030
risk for the diabetes. Yeah.

NOTE Confidence: 0.95197856

00:10:41.490 --> 00:10:43.010
And your work looked into

NOTE Confidence: 0.95197856

00:10:43.010 --> 00:10:44.450
the genetics. Right? When you

NOTE Confidence: 0.95197856

00:10:44.450 --> 00:10:45.890
see in clinic, that's in

NOTE Confidence: 0.95197856

00:10:45.890 --> 00:10:47.510
in in our clinic, basically,

NOTE Confidence: 0.9981018

00:10:48.770 --> 00:10:49.750
a child with

NOTE Confidence: 0.8757995

00:10:50.130 --> 00:10:52.161
an elevated ALT and and,

NOTE Confidence: 0.8757995

00:10:52.455 --> 00:10:53.335
an old and and a

NOTE Confidence: 0.8757995

00:10:53.654 --> 00:10:55.654
and PDFF, an assessment of

NOTE Confidence: 0.8757995

00:10:55.654 --> 00:10:57.434
the fat in the liver,

NOTE Confidence: 0.8757995

00:10:57.654 --> 00:10:59.115
and you confirm it.

NOTE Confidence: 0.8167544

00:10:59.575 --> 00:11:00.554
And then then

NOTE Confidence: 0.9047227

00:11:01.015 --> 00:11:02.535
the problem is how on

NOTE Confidence: 0.9047227

00:11:02.535 --> 00:11:04.295
earth, how common is that

NOTE Confidence: 0.9047227

00:11:04.295 --> 00:11:06.110
at that age, and

NOTE Confidence: 0.9780749

00:11:06.490 --> 00:11:07.070
why why,

NOTE Confidence: 0.93771595

00:11:07.850 --> 00:11:08.809
are are the father and

NOTE Confidence: 0.93771595

00:11:08.809 --> 00:11:09.870
mother also

NOTE Confidence: 0.8550503

00:11:10.330 --> 00:11:11.550
having the same issues?

NOTE Confidence: 0.9802409

00:11:11.929 --> 00:11:14.270
And again, it's strongly dependent

NOTE Confidence: 0.9802409

00:11:14.330 --> 00:11:16.010
on the ethnic background of

NOTE Confidence: 0.9802409

00:11:16.010 --> 00:11:16.750
the kid.

NOTE Confidence: 0.96761143

00:11:17.574 --> 00:11:19.035
Yes. Because of the genetic

NOTE Confidence: 0.96761143

00:11:19.095 --> 00:11:20.454
contributions that would have come

NOTE Confidence: 0.96761143

00:11:20.454 --> 00:11:22.535
in. Your work was also

NOTE Confidence: 0.96761143

00:11:22.535 --> 00:11:24.054
done in collaboration with others

NOTE Confidence: 0.96761143

00:11:24.054 --> 00:11:25.975
like Mary Savoy and doing

NOTE Confidence: 0.96761143

00:11:25.975 --> 00:11:27.654
the very important work with,

NOTE Confidence: 0.96761143

00:11:27.894 --> 00:11:28.634
Bright Bodies,

NOTE Confidence: 0.9997888

00:11:29.095 --> 00:11:29.595
offering

NOTE Confidence: 0.9908324

00:11:30.214 --> 00:11:30.714
exercise

NOTE Confidence: 0.9968554

00:11:31.649 --> 00:11:32.149
programs

NOTE Confidence: 0.97185504

00:11:32.690 --> 00:11:34.070
and ways of thinking about

NOTE Confidence: 0.97185504

00:11:34.370 --> 00:11:36.529
physical activity and food. I

NOTE Confidence: 0.97185504

00:11:36.529 --> 00:11:37.809
wonder where you think that

NOTE Confidence: 0.97185504

00:11:37.809 --> 00:11:39.010
plays a role in the

NOTE Confidence: 0.97185504

00:11:39.010 --> 00:11:39.510
overall

NOTE Confidence: 0.9625055

00:11:40.370 --> 00:11:41.570
lifespan. I think it would

NOTE Confidence: 0.9625055

00:11:41.570 --> 00:11:43.410
be very important to keep

NOTE Confidence: 0.9625055

00:11:43.410 --> 00:11:45.269
on go going this program

NOTE Confidence: 0.9625055

00:11:45.410 --> 00:11:47.584
because if you catch and

NOTE Confidence: 0.9625055

00:11:47.644 --> 00:11:48.144
educate

NOTE Confidence: 0.96905863

00:11:49.084 --> 00:11:50.865
the family and the kids

NOTE Confidence: 0.96905863

00:11:50.925 --> 00:11:51.824
very early,

NOTE Confidence: 0.9775096

00:11:52.365 --> 00:11:54.045
to understand that the future

NOTE Confidence: 0.9775096

00:11:54.045 --> 00:11:55.904
can, you know, be tough,

NOTE Confidence: 0.9271797

00:11:56.605 --> 00:11:57.345
not necessarily,

NOTE Confidence: 0.99713993

00:11:57.884 --> 00:11:59.004
but if you do it

NOTE Confidence: 0.99713993

00:11:59.004 --> 00:11:59.504
early,

NOTE Confidence: 0.9636359

00:11:59.809 --> 00:12:01.410
I think the chance that

NOTE Confidence: 0.9636359

00:12:01.410 --> 00:12:02.550
really the child

NOTE Confidence: 0.8256572

00:12:03.010 --> 00:12:03.829
would listen

NOTE Confidence: 0.97126186

00:12:04.130 --> 00:12:05.570
to Mary or, you know,

NOTE Confidence: 0.97126186

00:12:05.570 --> 00:12:06.709
the other people that,

NOTE Confidence: 0.963978

00:12:07.889 --> 00:12:09.570
are doing this program, they

NOTE Confidence: 0.963978

00:12:09.570 --> 00:12:11.490
might stay with the child

NOTE Confidence: 0.963978

00:12:11.490 --> 00:12:13.010
and the family and not

NOTE Confidence: 0.963978

00:12:13.010 --> 00:12:15.029
get to a desperate condition.

NOTE Confidence: 0.9159153

00:12:15.915 --> 00:12:17.195
It's like a sponge, the

NOTE Confidence: 0.9159153

00:12:17.195 --> 00:12:18.154
child, you know. When they're

NOTE Confidence: 0.9159153

00:12:18.154 --> 00:12:19.455
very young, they absorb

NOTE Confidence: 0.98120415

00:12:20.315 --> 00:12:21.515
what is good for them

NOTE Confidence: 0.98120415

00:12:21.515 --> 00:12:22.335
and not.

NOTE Confidence: 0.9815614

00:12:22.955 --> 00:12:23.915
And that's what we have

NOTE Confidence: 0.9815614

00:12:23.915 --> 00:12:25.275
to prepare to this new

NOTE Confidence: 0.9815614

00:12:25.275 --> 00:12:25.775
generation.

NOTE Confidence: 0.97007436

00:12:26.235 --> 00:12:27.915
There's an important window of

NOTE Confidence: 0.97007436

00:12:27.915 --> 00:12:28.415
time

NOTE Confidence: 0.9346193

00:12:28.940 --> 00:12:30.079
where we can be.

NOTE Confidence: 0.9776676

00:12:30.380 --> 00:12:31.899
Yeah. I think that window

NOTE Confidence: 0.9776676

00:12:31.899 --> 00:12:33.899
is very important because these

NOTE Confidence: 0.9776676

00:12:33.899 --> 00:12:35.339
kids, most of them are

NOTE Confidence: 0.9776676

00:12:35.339 --> 00:12:36.800
growing up. You know why?

NOTE Confidence: 0.892787

00:12:37.179 --> 00:12:39.019
And and and increasing their

NOTE Confidence: 0.892787

00:12:39.019 --> 00:12:40.079
weight? The snacking.

NOTE Confidence: 0.98298204

00:12:40.860 --> 00:12:42.720
Snacking is the big problem

NOTE Confidence: 0.98298204

00:12:42.779 --> 00:12:43.839
that they're facing.

NOTE Confidence: 0.9754968

00:12:44.140 --> 00:12:45.045
Yes. But we have a

NOTE Confidence: 0.9754968

00:12:45.045 --> 00:12:47.125
lot of environment encouragements for

NOTE Confidence: 0.9754968

00:12:47.125 --> 00:12:48.804
snacking. We have to protect

NOTE Confidence: 0.9754968

00:12:48.804 --> 00:12:50.585
them and let them understand

NOTE Confidence: 0.9754968

00:12:50.804 --> 00:12:52.345
that there are good snacks,

NOTE Confidence: 0.9671373

00:12:52.725 --> 00:12:54.265
fairly few of them,

NOTE Confidence: 0.9555519

00:12:54.885 --> 00:12:56.105
but not you cannot

NOTE Confidence: 0.97439986

00:12:56.405 --> 00:12:58.325
live on snacking. Snacking is

NOTE Confidence: 0.97439986

00:12:58.325 --> 00:12:59.940
becoming the meal for the

NOTE Confidence: 0.97439986

00:12:59.940 --> 00:13:01.540
kids now. The way our

NOTE Confidence: 0.97439986

00:13:01.540 --> 00:13:03.220
bodies see food very early

NOTE Confidence: 0.97439986

00:13:03.220 --> 00:13:04.820
in life will program how

NOTE Confidence: 0.97439986

00:13:04.820 --> 00:13:06.020
we continue to see it

NOTE Confidence: 0.97439986

00:13:06.020 --> 00:13:07.380
later on. We have to

NOTE Confidence: 0.97439986

00:13:07.380 --> 00:13:08.900
be honest because we are

NOTE Confidence: 0.97439986

00:13:08.900 --> 00:13:10.200
reaching really

NOTE Confidence: 0.9132054

00:13:11.940 --> 00:13:13.460
a sad moment, I would

NOTE Confidence: 0.9132054

00:13:13.460 --> 00:13:15.225
say. Yes, for our food

NOTE Confidence: 0.9132054

00:13:15.225 --> 00:13:16.585
environment. Yes, because they are

NOTE Confidence: 0.9132054

00:13:16.585 --> 00:13:17.565
very attracting,

NOTE Confidence: 0.93973094

00:13:18.905 --> 00:13:20.365
they're full of salt.

NOTE Confidence: 0.91795

00:13:20.905 --> 00:13:22.745
They know they're smarter than

NOTE Confidence: 0.91795

00:13:22.745 --> 00:13:24.345
we are, these people making

NOTE Confidence: 0.91795

00:13:24.345 --> 00:13:25.245
these foods,

NOTE Confidence: 0.93872625

00:13:25.785 --> 00:13:27.865
attracting their, their taste and,

NOTE Confidence: 0.93872625

00:13:27.865 --> 00:13:29.139
and things like that. But

NOTE Confidence: 0.93872625

00:13:29.139 --> 00:13:30.899
these are young kids. So

NOTE Confidence: 0.93872625

00:13:30.899 --> 00:13:32.420
having taken care of so

NOTE Confidence: 0.93872625

00:13:32.420 --> 00:13:33.320
many of these,

NOTE Confidence: 0.97557944

00:13:33.779 --> 00:13:35.320
children and and adolescents,

NOTE Confidence: 0.99678516

00:13:35.940 --> 00:13:37.320
through their growing years,

NOTE Confidence: 0.99823284

00:13:37.779 --> 00:13:39.320
what is your worst fears

NOTE Confidence: 0.99823284

00:13:39.459 --> 00:13:41.540
about what adulthood has for

NOTE Confidence: 0.99823284

00:13:41.540 --> 00:13:42.040
them?

NOTE Confidence: 0.9994272

00:13:42.595 --> 00:13:43.095
Well,

NOTE Confidence: 0.9734966

00:13:43.635 --> 00:13:44.835
I have to say that

NOTE Confidence: 0.9734966

00:13:44.835 --> 00:13:46.515
the experience that we had

NOTE Confidence: 0.9734966

00:13:46.515 --> 00:13:48.115
and we saw what was

NOTE Confidence: 0.9734966

00:13:48.115 --> 00:13:48.615
happening

NOTE Confidence: 0.942497

00:13:49.235 --> 00:13:50.355
in the kids that were

NOTE Confidence: 0.942497

00:13:50.434 --> 00:13:52.355
have been enrolled in the

NOTE Confidence: 0.942497

00:13:52.355 --> 00:13:53.975
today's study, basically.

NOTE Confidence: 0.9291819

00:13:55.050 --> 00:13:57.050
And you you saw that

NOTE Confidence: 0.9291819

00:13:57.050 --> 00:13:59.790
the major complication were already

NOTE Confidence: 0.9291819

00:13:59.850 --> 00:14:01.050
at the age of twenty

NOTE Confidence: 0.9291819

00:14:01.050 --> 00:14:02.030
five there.

NOTE Confidence: 0.9272854

00:14:02.490 --> 00:14:03.870
That means the kidney,

NOTE Confidence: 0.8689048

00:14:04.170 --> 00:14:05.710
some of them have severe

NOTE Confidence: 0.8689048

00:14:05.850 --> 00:14:06.345
depression

NOTE Confidence: 0.6731063

00:14:08.024 --> 00:14:08.985
the other one was,

NOTE Confidence: 0.48663434

00:14:09.785 --> 00:14:10.605
the fat ear.

NOTE Confidence: 0.8493188

00:14:12.504 --> 00:14:14.345
So these are three conditions

NOTE Confidence: 0.8493188

00:14:14.345 --> 00:14:14.904
that are,

NOTE Confidence: 0.84845144

00:14:16.264 --> 00:14:18.444
appearing at a very relatively

NOTE Confidence: 0.84845144

00:14:18.584 --> 00:14:19.725
very young age.

NOTE Confidence: 0.9478202

00:14:20.730 --> 00:14:21.710
In the thirties,

NOTE Confidence: 0.9540505

00:14:22.410 --> 00:14:24.250
twenty five, thirty years. And

NOTE Confidence: 0.9540505

00:14:24.250 --> 00:14:25.790
again, this was,

NOTE Confidence: 0.9694838

00:14:26.330 --> 00:14:27.370
thanks to the,

NOTE Confidence: 0.8818279

00:14:29.290 --> 00:14:30.830
the help from the NIH.

NOTE Confidence: 0.8818279

00:14:31.050 --> 00:14:31.550
NIDDK

NOTE Confidence: 0.95521307

00:14:32.090 --> 00:14:34.225
really embarked in, I would

NOTE Confidence: 0.95521307

00:14:34.225 --> 00:14:35.665
say, twelve years of work

NOTE Confidence: 0.95521307

00:14:35.665 --> 00:14:36.325
we did

NOTE Confidence: 0.99749136

00:14:36.785 --> 00:14:37.765
in that area

NOTE Confidence: 0.98431855

00:14:38.385 --> 00:14:39.745
to find out that these

NOTE Confidence: 0.98431855

00:14:39.745 --> 00:14:40.805
kids are

NOTE Confidence: 0.99656004

00:14:41.105 --> 00:14:42.165
marching towards

NOTE Confidence: 0.9852938

00:14:42.545 --> 00:14:43.605
early complications.

NOTE Confidence: 0.9700337

00:14:44.385 --> 00:14:45.665
So we don't want that

NOTE Confidence: 0.9700337

00:14:45.665 --> 00:14:47.265
to happen. We have to

NOTE Confidence: 0.9700337

00:14:47.265 --> 00:14:48.005
stop that

NOTE Confidence: 0.99714935

00:14:48.519 --> 00:14:49.560
because I think there is

NOTE Confidence: 0.99714935

00:14:49.560 --> 00:14:51.579
enough knowledge for us

NOTE Confidence: 0.9929793

00:14:51.880 --> 00:14:53.019
to understand and

NOTE Confidence: 0.9697945

00:14:54.120 --> 00:14:56.200
diagnose early the the issues

NOTE Confidence: 0.9697945

00:14:56.200 --> 00:14:57.959
and stop it. Yes. I

NOTE Confidence: 0.9697945

00:14:57.959 --> 00:14:59.800
I also think of where

NOTE Confidence: 0.9697945

00:14:59.800 --> 00:15:01.339
the direction needs to head,

NOTE Confidence: 0.9697945

00:15:01.399 --> 00:15:02.600
what we need to know,

NOTE Confidence: 0.9697945

00:15:02.600 --> 00:15:04.135
and what next needs to

NOTE Confidence: 0.9697945

00:15:04.135 --> 00:15:04.795
be done.

NOTE Confidence: 0.96760815

00:15:05.175 --> 00:15:06.695
And you've been hard at

NOTE Confidence: 0.96760815

00:15:06.695 --> 00:15:08.395
work thinking about the medications,

NOTE Confidence: 0.9883455

00:15:09.095 --> 00:15:11.015
both for the children and

NOTE Confidence: 0.9883455

00:15:11.015 --> 00:15:12.215
for the adults as they

NOTE Confidence: 0.9883455

00:15:12.215 --> 00:15:13.175
grow up. And one of

NOTE Confidence: 0.9883455

00:15:13.175 --> 00:15:14.295
the studies you're doing is

NOTE Confidence: 0.9883455

00:15:14.295 --> 00:15:14.955
on semaglutide,

NOTE Confidence: 0.9954003

00:15:15.415 --> 00:15:16.955
which will have great impact.

NOTE Confidence: 0.9972023

00:15:17.335 --> 00:15:19.035
What things do you believe

NOTE Confidence: 0.99891686

00:15:19.410 --> 00:15:20.450
still need to be done

NOTE Confidence: 0.99891686

00:15:20.450 --> 00:15:21.970
in the field? There is

NOTE Confidence: 0.99891686

00:15:21.970 --> 00:15:23.089
a lot that we need

NOTE Confidence: 0.99891686

00:15:23.089 --> 00:15:23.829
to understand

NOTE Confidence: 0.8849208

00:15:24.290 --> 00:15:25.829
because even with this,

NOTE Confidence: 0.9857585

00:15:26.529 --> 00:15:28.690
wonderful new medication that are

NOTE Confidence: 0.9857585

00:15:28.690 --> 00:15:29.589
coming out,

NOTE Confidence: 0.99292076

00:15:30.050 --> 00:15:30.370
which,

NOTE Confidence: 0.9964988

00:15:31.170 --> 00:15:32.290
it's the first time that

NOTE Confidence: 0.9964988

00:15:32.290 --> 00:15:33.730
we we are seeing some

NOTE Confidence: 0.9964988

00:15:33.730 --> 00:15:34.630
very good

NOTE Confidence: 0.9993305

00:15:35.125 --> 00:15:36.725
improvement on the weight of

NOTE Confidence: 0.9993305

00:15:36.725 --> 00:15:37.384
a person

NOTE Confidence: 0.8966034

00:15:37.685 --> 00:15:39.045
that we never seen that.

NOTE Confidence: 0.8966034

00:15:39.045 --> 00:15:39.704
I mean,

NOTE Confidence: 0.98512214

00:15:40.324 --> 00:15:41.225
very rarely.

NOTE Confidence: 0.9871443

00:15:42.644 --> 00:15:44.324
And and and not only

NOTE Confidence: 0.9871443

00:15:44.324 --> 00:15:46.084
it's just the weight that

NOTE Confidence: 0.9871443

00:15:46.084 --> 00:15:48.084
we are addressing, for example,

NOTE Confidence: 0.9871443

00:15:48.084 --> 00:15:49.305
and this is valid

NOTE Confidence: 0.96131873

00:15:49.620 --> 00:15:51.860
both, in kids and in

NOTE Confidence: 0.96131873

00:15:51.860 --> 00:15:53.140
in adults. Of course, the

NOTE Confidence: 0.96131873

00:15:53.140 --> 00:15:54.760
adults are ahead of us

NOTE Confidence: 0.9632297

00:15:55.460 --> 00:15:57.860
because, it takes time really

NOTE Confidence: 0.9632297

00:15:57.860 --> 00:15:58.920
to convince,

NOTE Confidence: 0.92457676

00:16:00.100 --> 00:16:02.180
that there is a young

NOTE Confidence: 0.92457676

00:16:02.340 --> 00:16:04.180
a younger population that needs

NOTE Confidence: 0.92457676

00:16:04.180 --> 00:16:05.325
also some help.

NOTE Confidence: 0.9491428

00:16:06.285 --> 00:16:07.965
So we started to use,

NOTE Confidence: 0.9491428

00:16:07.965 --> 00:16:09.325
for example, in this trial

NOTE Confidence: 0.9491428

00:16:09.325 --> 00:16:10.385
that we're doing now,

NOTE Confidence: 0.54681027

00:16:12.151 --> 00:16:12.651
is,

NOTE Confidence: 0.76196694

00:16:13.405 --> 00:16:14.225
with semaglutide,

NOTE Confidence: 0.93307793

00:16:14.685 --> 00:16:16.385
like I said, Ozempicor

NOTE Confidence: 0.90659666

00:16:16.845 --> 00:16:17.745
or Wegovy.

NOTE Confidence: 0.92665005

00:16:18.285 --> 00:16:20.045
We chose Wegovy because it's

NOTE Confidence: 0.92665005

00:16:20.045 --> 00:16:21.540
the focus is on obesity.

NOTE Confidence: 0.9976967

00:16:22.000 --> 00:16:23.540
But we it's a mechanistic

NOTE Confidence: 0.9921171

00:16:24.000 --> 00:16:25.520
study that we're doing because

NOTE Confidence: 0.9921171

00:16:25.520 --> 00:16:26.560
we wanna see whether the

NOTE Confidence: 0.9921171

00:16:26.560 --> 00:16:27.060
medication

NOTE Confidence: 0.93961865

00:16:27.840 --> 00:16:28.980
is also affecting,

NOTE Confidence: 0.99932754

00:16:29.520 --> 00:16:30.660
fat in the liver

NOTE Confidence: 0.9863472

00:16:31.360 --> 00:16:32.340
and the prediabetes.

NOTE Confidence: 0.91687626

00:16:33.135 --> 00:16:34.095
The study that we are

NOTE Confidence: 0.91687626

00:16:34.095 --> 00:16:34.995
doing hopefully

NOTE Confidence: 0.9857581

00:16:35.855 --> 00:16:37.535
will show whether, you know,

NOTE Confidence: 0.9857581

00:16:37.535 --> 00:16:38.975
the fat in the liver

NOTE Confidence: 0.9857581

00:16:38.975 --> 00:16:40.355
and and, the prediabetes

NOTE Confidence: 0.9829959

00:16:41.215 --> 00:16:43.535
are sensitive to this, the

NOTE Confidence: 0.9829959

00:16:43.535 --> 00:16:44.035
semaglutide.

NOTE Confidence: 0.93693453

00:16:45.320 --> 00:16:46.620
And, and

NOTE Confidence: 0.9031081

00:16:47.000 --> 00:16:48.200
that would be a major

NOTE Confidence: 0.9031081

00:16:48.200 --> 00:16:49.320
step, I would say, in

NOTE Confidence: 0.9031081

00:16:49.320 --> 00:16:49.980
the field.

NOTE Confidence: 0.9941758

00:16:50.840 --> 00:16:52.540
We need better medication

NOTE Confidence: 0.9324702

00:16:53.240 --> 00:16:54.520
and just like, you know,

NOTE Confidence: 0.9324702

00:16:54.520 --> 00:16:56.120
the blood pressure or other

NOTE Confidence: 0.9324702

00:16:56.120 --> 00:16:57.820
issues that we take forever,

NOTE Confidence: 0.9324702

00:16:57.960 --> 00:16:58.780
these medication,

NOTE Confidence: 0.999403

00:16:59.285 --> 00:17:00.345
We have to convince

NOTE Confidence: 0.98489255

00:17:00.885 --> 00:17:02.325
that this is totally normal

NOTE Confidence: 0.98489255

00:17:02.325 --> 00:17:04.185
to treat overweight and obesity

NOTE Confidence: 0.98489255

00:17:04.484 --> 00:17:06.265
with an injectable or none.

NOTE Confidence: 0.98489255

00:17:06.405 --> 00:17:08.325
Another big issue is the

NOTE Confidence: 0.98489255

00:17:08.325 --> 00:17:09.625
cost of the medication

NOTE Confidence: 0.95200676

00:17:10.165 --> 00:17:12.085
so that we forget about

NOTE Confidence: 0.95200676

00:17:12.085 --> 00:17:13.410
it, but many of us

NOTE Confidence: 0.95200676

00:17:13.490 --> 00:17:14.770
will never be able to

NOTE Confidence: 0.95200676

00:17:14.770 --> 00:17:15.670
afford it.

NOTE Confidence: 0.9596425

00:17:16.609 --> 00:17:17.730
So there has to be

NOTE Confidence: 0.9596425

00:17:17.730 --> 00:17:18.869
something down

NOTE Confidence: 0.7442062

00:17:19.490 --> 00:17:19.990
because,

NOTE Confidence: 0.9915836

00:17:21.250 --> 00:17:22.070
it's it's

NOTE Confidence: 0.95574874

00:17:23.250 --> 00:17:25.350
to see obesity or overweight

NOTE Confidence: 0.95574874

00:17:25.490 --> 00:17:27.270
as a disease is serious.

NOTE Confidence: 0.982029

00:17:28.095 --> 00:17:29.455
And the drug that they

NOTE Confidence: 0.982029

00:17:29.455 --> 00:17:30.195
are making,

NOTE Confidence: 0.97347516

00:17:30.815 --> 00:17:32.575
the the new drugs are

NOTE Confidence: 0.97347516

00:17:32.575 --> 00:17:34.975
all injectable and too too

NOTE Confidence: 0.97347516

00:17:34.975 --> 00:17:36.895
expensive for us for any

NOTE Confidence: 0.97347516

00:17:36.895 --> 00:17:37.795
one of us.

NOTE Confidence: 0.96095175

00:17:38.335 --> 00:17:39.295
So I don't know the

NOTE Confidence: 0.96095175

00:17:39.295 --> 00:17:41.395
future. This is happening particularly

NOTE Confidence: 0.96095175

00:17:41.535 --> 00:17:42.355
in US.

NOTE Confidence: 0.99904484

00:17:42.840 --> 00:17:44.280
In Europe, I know it's

NOTE Confidence: 0.99904484

00:17:44.280 --> 00:17:45.960
totally different. The cost is

NOTE Confidence: 0.99904484

00:17:45.960 --> 00:17:46.859
much less

NOTE Confidence: 0.99923396

00:17:47.240 --> 00:17:48.540
than what we are

NOTE Confidence: 0.84883004

00:17:48.920 --> 00:17:50.920
fighting for now here in

NOTE Confidence: 0.84883004

00:17:50.920 --> 00:17:51.740
the US.

NOTE Confidence: 0.9411855

00:17:52.359 --> 00:17:54.840
Yes. And I appreciate very

NOTE Confidence: 0.9411855

00:17:54.840 --> 00:17:55.185
much,

NOTE Confidence: 0.9569335

00:17:56.385 --> 00:17:58.465
your encouragement. I love talking

NOTE Confidence: 0.9569335

00:17:58.465 --> 00:17:59.825
to you and and to

NOTE Confidence: 0.9569335

00:17:59.825 --> 00:18:01.425
continue the research that we

NOTE Confidence: 0.9569335

00:18:01.425 --> 00:18:03.185
did because many of these,

NOTE Confidence: 0.99938285

00:18:03.585 --> 00:18:04.085
women

NOTE Confidence: 0.9905021

00:18:04.465 --> 00:18:06.145
basically need your help a

NOTE Confidence: 0.9905021

00:18:06.145 --> 00:18:06.645
lot

NOTE Confidence: 0.9976864

00:18:07.440 --> 00:18:09.779
to avoid much more complicated

NOTE Confidence: 0.86380184

00:18:11.119 --> 00:18:13.359
situation that believing in. Thank

NOTE Confidence: 0.86380184

00:18:13.359 --> 00:18:15.119
you, doctor Caprio, for this

NOTE Confidence: 0.86380184

00:18:15.119 --> 00:18:16.399
time with you. Thank you

NOTE Confidence: 0.86380184

00:18:16.399 --> 00:18:16.899
all.