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Research at Vanderbilt

Glucose control study gives patients new path to health

by | Posted on Thursday, Oct. 24, 2013 — 9:04 AM

Heidi Silver, Ph.D., R.D., works with Michael Rodgers, who’s taking part in a glucose control study at Vanderbilt. (photo by Joe Howell)

Michael Rodgers selects one Vanderbilt University football game to attend each year. In 2012, he hit the jackpot as he cheered on the Commodores in their 41-18 romp over the University of Tennessee Volunteers.

For Rodgers, the win on the gridiron wasn’t the best part of his day. The highlight: a glucose management message flashed on the Jumbotron that would prove to be lifesaving for the 43-year-old.

Two days later, he went to the website listed on the giant screen. Shortly after, he was admitted to a glucose control study being conducted by a multidisciplinary research team at Vanderbilt University Medical Center.

Three months prior, Rodgers visited a clinic for treatment for a cold. He was told his blood glucose level was 557. Normal fasting glucose levels are below 126.

It wasn’t until he enrolled in the Vanderbilt study that he learned just how dangerously high his glucose level was.

“Who would have thought one game would impact my life like this?” asked Rodgers. “This program literally saved my life.”

Heidi Silver, Ph.D., R.D., research associate professor of Medicine and director of the Vanderbilt Nutrition and Diet Assessment Core (VNDAC), runs the Insulin Detemir in Obesity and Metabolism (IDIOM) study. She said Rodgers is one of 66 patients who has participated in the study to date.

“What we typically hear from our study participants is very concerning,” said Silver. “The most common report of community care is that a patient is prescribed oral medications, told to lose weight, get their glucose under control and to return to the doctor in three months.

“Our patients have told us that if their glucose levels weren’t controlled by the follow-up visit, they got a higher dose of the same medication or were prescribed additional medications.”

Silver, who stressed that intervention is a key element in diabetes management, said patients didn’t report receiving referrals to a diabetes educator nor a registered dietitian. There was also no evidence that they received comprehensive teaching and counseling on how to manage their disease.

Silver and colleagues Kevin Niswender, M.D., Ph.D., and Malcolm Avison, Ph.D., are investigating the roles that certain types of insulin and dietary macronutrients play on energy balance, body composition, inflammation, brain function and clinical risk factors for cardiometabolic disease.

The IDIOM study is designed to compare how a diet with moderate caloric restriction, alone or with long-acting insulin, affects areas of the brain’s dopamine system that are involved in food intake, reward and the sense of pleasure people get from eating.

During the 26-week study, each patient undergoes comprehensive metabolic and dietary assessments, imaging for body composition and brain function, and meets weekly with a dietitian and nurse for glucose management, nutrition counseling, diet instruction and problem solving.

Judy Schmitt, 54, is another success story.

Diagnosed with type 2 diabetes in 2000, she rode the roller coaster of oral medications and weight-loss advice until her daughter urged her to find help at Vanderbilt.

“I was in denial,” admitted Schmitt. “I knew diabetes was a progressive disease, but was never told much about it. I had no education or management information. I never had anyone give me the wake-up call that Dr. Silver’s research team did.

“Talk about a slap in the face,” she exclaimed. “When I got into this study I was so thankful. For me it was an answer to prayer. I have completely changed the way I think about food and interact with food.

“There is no way you could put a price tag on the level of care that I received through this study. For the first time in awhile, I have felt positive about my future.”

Schmitt has lost 40 pounds and said she feels much better.

Rodgers, now 35 pounds lighter, agreed.

“We are the lucky ones,” he said. “I see so many people who need this life-changing help. I am just glad this study was available to me.”

“There are many people living with out-of-control glucose levels,” said Silver. “They have symptoms that they don’t recognize as being unusual or unhealthy because they have lived with it for so long.”

Silver said the infrastructure created by the study provides the continuous education, counseling and support the patients need to achieve success.

“I’ve been told how eye-opening it is when the fog clears and they begin to realize that they can feel better and be healthier,” said Silver.

“As we help them, we are gaining important scientific information to help our understanding of how insulin and diet work together and separately on the brain and the body to affect the regulation of food intake and energy balance.”

For more information, go to www.4diabetesstudy.com or call (615) 936-8898.

Contact:
Jessica Pasley, (615) 322-4747
jessica.pasley@Vanderbilt.Edu


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