EUniWell Open Lecture Series: Metabolic trajectories before the diagnosis of type 2 diabetes
Lecturer: Dr. Ádám Tabák
Moderator: Prof. Miklós Kellermayer
Related EUniWell Arena: 1) Health and Well-being; 2) Individual and Social Well-being
About this lecture:
Metabolic trajectories before the diagnosis of type 2 diabetes – further insights into the natural history of metabolic diseases
Highly characterised cohorts (such as the occupational Whitehall II or the currently organised Semmelweis cohorts) are the cornerstones for understanding the effects of cumulative exposures and exposure trajectories in chronic diseases. In this presentation, Dr. Ádám Tabák provides examples on the use of repeated measures from the Whitehall II observational cohort study of British civil servants to estimate trajectories of glycemic markers over ageing and preceding diabetes development. Based on the results, it seems that low insulin sensitivity is a prerequisite for the onset of diabetes, but plays a relatively small role in the immediate changes in blood glucose at the time of diabetes diagnosis. The risk associated with insulin secretion depends on the timing of measurement relative to the time of diagnosis: higher values increase the risk of diabetes if measured years/decades before diagnosis, lower values predict the short-term diabetes risk. South Asians have an increased risk of diabetes that is associated with increased insulin resistance. Our results showed that fasting glucose rises earlier and increases faster among south Asians. In contrast to whites, who could increase insulin secretion up to 7 years before diagnosis, this compensatory mechanism is hardly seen in south Asians. Overall, one can argue that epidemiological studies with multiple waves of data collection (such as the Whitehall II study) are essential for the better understanding of diabetes development.
Dr Tabák holds a medical degree and a PhD in diabetes epidemiology from Semmelweis University in Hungary. He split his time as a research professor between Semmelweis University (Department of Internal Medicine and Oncology and Department of Public Health) and University College London. His research interests include clinical aspects of diabetes mellitus including the risk factors and consequences of diabetes complications and gestational diabetes as well as the efficacy of novel diabetes medications. His research in the Whitehall study focuses on the natural history of diabetes before and after the diagnosis of diabetes using the repeated measures available in this database. He is also interested in the natural history of diabetic vascular complications.