Philip Raskin, MD
Professor of Medicine
Larissa Avilés-Santa, MD
Assistant Professor of Medicine
Principal Investigator:
Larissa Avilés-Santa, M.D.
Effects of Intensive Insulin Therapy on Cardiovascular Risk Factors in Hispanics
with Type 2 Diabetes Mellitus
Summary: This is an NIH-sponsored clinical project evaluating
the effects of intensive insulin therapy on traditional and non-traditional
(antioxidants, leukocyte adhesion molecules, PAI-1) cardiovascular risk factors
in Latin Americans with Type 2 diabetes. This study will also evaluate the possible
gender dissimilarities in cardiovascular risks previously observed, and if improvement
in glycemic control will abolish these differences. Both men and women of Latin
American origin with Type 2 diabetes mellitus will be recruited. The study lasts
3 years.
Other projects under Dr. Avilés-Santa's supervision:
1. Evaluation of Ketosis-Prone, Obese Diabetic Individuals.
Fellow in charge: Dr. María Ramos-Román. This project evaluates
the possible metabolic differences or similarities of individuals who present
with clinical signs of Type 1 diabetes, but phenotypical features of Type 2
diabetes. Antibody screening and HLA typing to rule out Type 1 autoimmune diabetes,
euglycemic insulin clamp technique, Sustacal challenge test, indirect calorimetry
and insulin withdrawal studies have been integrated in this study.
Principal Investigator:
Philip Raskin, M.D.
Comparison Of Continuous Subcutaneous Insulin Infusion (CSII) With Multiple
Daily Subcutaneous Insulin Injections In The Treatment Of Older Type 2 Diabetic
Patients
We are conducting a study to investigate the efficacy and safety of intensive
diabetes treatment in older patients with type 2 diabetes. We know from previous
clinical trials that intensive diabetes treatment, which achieves normal blood
glucose levels, effectively delays the onset and slows the progression of the
microvascular complications of diabetes. An increased incidence of hypoglycemia
accompanies intensive diabetes treatment and may be a barrier to the normalization
of blood glucose levels. In spite of the fact that diabetes is more common with
advancing age and that by the age of 75 years approximately 20% of the US population
is afflicted with diabetes, most diabetes clinical trial protocols exclude patients
over age 65 years. We are comparing continuous subcutaneous insulin infusion
(CSII or insulin pump) with multiple daily injections (MDI) to mimic the physiology
of daily insulin secretion and attempt to normalize the blood glucose levels
in the study participants. Subjects who must be 60 years or older will receive
intensive education on the various aspects of diabetes self-management and will
be closely monitored throughout the year of their study. We have just begun
enrolling patients for participation in this study so many opportunities exist
for someone who would like to be exposed to clinical trials. Opportunities will
span the areas of recruitment, patient interviewing, data collection and analysis.
They will also include performing physical examinations, administering standardized
psychological questionnaires and learning how to interpret blood glucose results
and adjust insulin doses.