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Teaming Up to Extinguish Diabetes and Obesity

February 01, 2018

Helping others has always been a powerful motivator for John, who has been a firefighter for 29 years. Intimately familiar with risking life and limb to assist others, John didn’t hesitate to take up another kind of heroism when a clinical research ad in his doctor’s office caught his eye. The research study was to observe glucose levels in the brain relative to in the blood, comparing patients with type 2 diabetes to healthy participants and those with obesity. Having been diagnosed with type 2 diabetes six years prior, John was an ideal participant.

“It was new ground, and I’m all about trying new things and different experiences,” John said. “It was a learning experience, and some of the things that I did made me really look and see where I need to do a better job taking care of myself.”

Even though he wouldn’t receive new medications or immediate relief from his diabetes—an increasingly common and chronic condition—John knew his contribution could advance the researchers’ knowledge, inching their discipline closer to developing a new treatment or remedy. “Given the nature of what I do for a living, and just because of who I am, I like helping people,” he said. “And if this is something on the way to helping people, then that helps me too.”

Janice Hwang, MD, assistant professor of medicine (endocrinology) at the School of Medicine and the primary study doctor on the trial, has no doubt that volunteers like John are helping both investigators like herself and the broader public. “As investigators, we rely on talking to participants and patients to hear what’s concerning them and how they experience the disease. Without that piece of it, we can’t design studies that are beneficial,” she said. “ We can’t discover anything without the help and motivation of volunteers who have a particular disease. I see it as a partnership to move the field forward.”

Dr. Hwang was inspired to study metabolic diseases when, as a physician-in-training, she saw just how prevalent they were. “The vast majority of patients in the hospital that I would see would have either obesity or diabetes,” she said. “And even if they weren’t admitted to the hospital for that particular reason, obesity and diabetes definitely impacted their disease and the treatment course. It made me want to try to understand the mechanisms driving these diseases, because I believe that if you don’t understand—to the best of your ability—the true underlying mechanisms, then it becomes really hard to develop targeted therapies.”

While producing targeted therapies is a common goal for investigators and volunteers alike, studies like Dr. Hwang’s are still aiming to pin down the biological mechanisms behind the diseases. Dr. Hwang and her collaborators found that participants with obesity had a reduced rise in brain glucose levels compared to lean participants at equivalent increased blood glucose concentrations. The brain glucose response was even more reduced in participants with type 2 diabetes. These findings may help investigators understand the mechanisms driving eating behaviors and neurocognitive symptoms associated with those diseases.

“We know very little about the long-term implications of diabetes and obesity on the brain. But the brain has always been this black box because it’s so hard to study in humans in a non-invasive way.” That her study was able to do so is thanks to Yale’s Magnetic Resonance Research Center’s state of the art scanning technology and, of course, the group of volunteers willing to spend time inside it. John is glad he was one of them.

“The staff at the Research Unit were really friendly, and we laughed a lot,” John said. “It was interesting to see the process.” His advice to others considering participating in clinical research? “Give it a try. You have nothing to lose; if anything, you can learn something about your illness.”

Dr. Hwang also valued the study, and the opportunity it presented to further the partnership between investigators and volunteers. “Having participants like John come out and be advocates—symbols that everyone can be involved in research and in helping others understand these mechanisms that affect the majority of Americans—I think that’s really huge,” she said.

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Submitted by Zachary Restifo on March 04, 2021