Emory Report
December 6, 2004
Volume 57, Number 14


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December 6 , 2004
Study to develop test for early diabetes risk

BY Janet Christenbury

Employees at Emory, Grady Hospital and Morehouse School of Medicine soon could help revolutionize the way doctors screen for and treat the early stages of diabetes.

Beginning Jan. 2, 2005, a new research study will get under way to screen people for borderline or pre-diabetes, called Impaired Glucose Tolerance (IGT). IGT does not mean that a person has diabetes, but the condition often progresses into diabetes. More than 35 million Americans have IGT and do not know it.

Lawrence Phillips, professor of medicine in endocrinology, and his colleagues have been awarded $2.9 million by the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) to develop a new screening procedure to detect pre-diabetes.

“The U.S. is experiencing a dramatic rise in both type 2 diabetes and its antecedent, pre-diabetes, which is mostly identified as IGT,” Phillips said. “Progression from IGT to diabetes can be decreased, but patients can only be directed to risk-reduction programs if they are identified early. Since we don’t presently screen for IGT, many patients progress to diabetes and already have diabetes complications, including increased cardiovascular risks, when they are finally diagnosed.”

The Screening for Impaired Glucose Tolerance (SIGT) study hopes to enroll 2,100 volunteers over a three-year period. Employees from Emory, Morehouse and Grady are being asked to assist with this project because of its importance to medicine and potential benefits to individuals. The SIGT study has strong backing from the presidents/directors of the three institutions: Jim Wagner and Michael Johns from Emory and the Woodruff Health Sciences Center, Andrew Agwunobi from Grady and James Gavin from More-
house, who have directed supervisors to allow employees adequate time off to participate in the study, which is also open to employees’ family members.

Volunteers will be asked to make two visits to the General Clinical Research Center, either at Emory Hospital (ground floor, G-wing) or Grady (8A). The first visit will take a little more than an hour and will involve taking blood samples, drinking a sugar drink and having repeat blood samples one hour later (glucose challenge test). This visit can be done any time of the day between 7 a.m. and 5 p.m.

The second visit will take a little more than two hours. That visit will consist of taking blood samples, drinking a sugar drink, repeating blood samples one and two hours later (oral glucose tolerance test), checking cholesterol and other heart risk measures, giving a urine sample to assess kidney function, taking body measurements, and filling out questionnaires on family history and health risks. This visit must be conducted before 11 a.m. since fasting is required to complete testing.

Study participants will receive their test results and an explanation of what they mean. Those who have pre-diabetes or a risk of heart problems will learn the next steps they and their doctors can take. Depending on test results, study participants may also be offered an opportunity to enroll in additional research studies, which will analyze cardiovascular and diabetes risks in more detail, and may include evaluation of new treatments for pre-diabetes.

“Diabetes has no symptoms in its early stages, and in some cases it can take up to 10 years to diagnose,” Phillips said. “We need a screening test to help recognize the earliest symptoms, which in turn will help with preventive therapies. The SIGT study will help develop this new test.

“The new test will not only identify people at risk of IGT,” he continued, “it will also mean healthier employees, less time off of work and lower health care costs. We hope screening for pre-diabetes will soon be as common as screening for cancer through mammograms or prostate cancer exams.”

Study organizers want to enroll participants across a wide range of demographics: young and old (ages 18 to 70), men and women, African-American and Caucasian, heavy and thin. Participation in the study is confidential.

Although the study will not begin until Jan. 2, scheduling for appointments is already under way. To participate, please call the Emory Health Connection at 404-778-7777. Additional information will also be available at the SIGT website www.med.emory.edu/research/GCRC/SIGT.