DO - Ohio University College of Osteopathic Medicine

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Research News Survey Shows Diabetes Rates Higher in Ohio Appalachian Counties An epidemic of diabetes mellitus, or type 2 diabetes, is occurring in the United States and in other parts of the industrialized world. According to a recent survey conducted by the Appalachian Rural Health Institute (ARHI), people who live in Southeast Ohio also appear to have a higher prevalence of diabetes than other regions of the state and the nation as a whole–rates nearly equivalent to ethnic populations that have a known higher incidence of the disease–according to ARHI researchers. In a telephone survey conducted in January 2006, more than 2,220 adult residents of seven Southeast Ohio counties were asked, “Have you ever been told by a doctor or other health-care professional that you have diabetes?” and 11.3 percent answered “yes.” To compare, the Center for Disease Control's Behavioral Risk Factor Surveillance System survey, the world's largest telephone survey, reported rates of diabetes at 7.3 percent for all of Ohio and 7.7 percent for the nation when respondents were asked the same question. Please don't hang up! Help us gather information that will be used to develop diabetes services in your county. Do you have diabetes or heart disease or do you know someone who does? What kinds of clinic and education services would help you and others in your county? The Appalachian Rural Health Institute at Ohio University is running an anonymous telephone survey this week. The goal of the survey is to learn about chronic conditions such as diabetes and heart disease affecting people in Southeast Ohio. The interviewers will be gathering information that will be used to develop diabetes services in your county. You can help by taking a few moments to answer the questions. The Appalachian Rural Health Institute is a health services and research institute at Ohio University. The Institute was founded with a goal of improving the health and quality of life of underserved rural populations in Southeastern Ohio. arhi The Appalachian Rural Health Institute appalachian rural health institute “The results of this survey indicate that persons in Appalachian Ohio have prevalence rates for diabetes equivalent to those reported for high risk ethnic groups in the country,” says Frank Schwartz, M.D., director of ARHI’s Diabetes/Endocrine Center, OU-COM associate professor of endocrinology and principal investigator for the study. “Within Appalachia there are clusters of counties that are at higher risk, and they tend to be more devastated economically and have lower group socioeconomic status,” says Schwartz. Vinton County has a 12.8 percent prevalence rate, for example, which approaches rates reported in African Americans (13.3 percent) and American Indians (12.8 percent). Schwarz explains that many of Ohio’s 29 Appalachian counties have a disproportionately high number of people who live at or near poverty level, have lower education levels, suffer from obesity, and lead unhealthy life-styles. “Our study of seven counties suggests that they may also have higher prevalence rates of diabetes.” According to the Ohio Department of Health, approximately 110,000 residents in Ohio’s Appalachian counties have been diagnosed with diabetes, and an additional 30,000 remain undiagnosed, which Schwarz believes could be “a gross underestimate.” The study is part of Ohio Governor Taft’s Appalachian Diabetes Initiative, which focuses on heightening awareness and improving care and self-management, with the aim of preventing or delaying the onset of diabetes and its related complications. The study was funded by the Centers for Disease Control and Prevention, the Appalachian Regional Commission and the Ohio Diabetes Prevention and Control Program. The ARHI Diabetes/Endocrine Center was established in 2003 to spearhead Ohio University's effort to increase and improve diabetes care, clinical and basic diabetes research, diabetes education, clinical outreach and training of health care professionals in Southeastern Ohio. ARHI is a collaborative of several academic units including OU-COM, the College of Health and Human Services, the College of Arts and Sciences, the College of Communication, the Edison Biotechnology Institute and the Voinovich Center for Leadership and Public Affairs. Schwarz suggests that the seven county findings, if confirmed in all of Appalachia, could indicate that the risk for diabetes is more closely related to poverty and obesity rather than genetics. “With all of the long-term complications associated with diabetes, I see a critical need in changes to health-care policy for adequate diabetes education,” adds Schwarz. “I’m hoping that the results of this survey will lead to funding to conduct the survey in other parts of Appalachia.” –The Editors 26 www.oucom.ohio.edu
OU-COM Participates in First-of-a-kind Prehypertension Drug Study A pioneering six-year study on postponing or preventing hypertension has shown that a new drug, if introduced while a patient is prehypertensive, can reduce that patient’s risk of developing hypertension. OU-COM was one of 71 sites participating in the nationwide clinical trial. The Trial of Preventing Hypertension, or TROPHY, study is groundbreaking. “It’s the first study to examine the potential to change the natural history of hypertension through early pharmacological intervention in patients diagnosed with prehypertension,” principal investigator Stevo Julius, M.D., professor of internal medicine and physiology at the University of Michigan, Ann Arbor, says. Prehypertension, according to the Centers for Disease Control and Prevention, is defined as a systolic blood pressure of 120-139 mmHg or a diastolic blood pressure of 80-89 mmHg. Persons with prehypertension are at greater risk to advance to hypertension. Hypertension or high blood pressure raises the risk for heart disease and stroke, both leading causes of death in this country. About one in three adults in this country has hypertension. Patients in the TROPHY study had blood pressures of 130-139 (systolic) and 89 or lower (diastolic); or 139 (systolic) and 85-89 (diastolic). Untreated patients, age 30 to 65, were enrolled in a four-year, multicenter, randomized study. The study demonstrated that beneficial anatomic or physiologic changes were occurring in patients taking candesartan that lasted even after the medication was discontinued, says OU-COM Dean Jack Brose, D.O. “Because of this study, I think we have shown we can compete with larger sites in terms of the number of patients we recruit and how well we follow the research protocols,” Brose says. Then assistant dean for clinical research, Brose served as principal investigator at OU-COM. Other participating physicians were Jay Shubrook, D.O. (‘94); Robert Gotfried, D.O.; and Chris Simpson, D.O. OU-COM managed its trial and made day-to-day decisions about patient health and participation, as did each of the other 70 sites. However, OU-COM so successfully recruited patients that Julius flew Brose and research nurse Lori Arnott to Michigan to meet with researchers from a select few other top recruitment sites. They discussed the ways they had recruited patients, which was shared with the other participating sites. The college enrolled 25 patients in the study and retained 23 throughout the four-year process. Patients reported “excellent” satisfaction with their participation in the clinical trial. The reason for this, says Brose, was the first-rate care that the college’s research nurse staff–Arnott; Cammie Starner; Lynn Petrik, R.N.; and Rosemary Vance–provided. The research nurses also administered routine blood pressure checks and educated patients on healthy living. Patients were evaluated every three months. “Most loved being involved with the study,” says Starner. “We did a great job of following up on them. Any suspected adverse events were dealt with quickly.” Prehypertension patients were identified with the help of local physicians. During the study, about half the patients received a placebo while the others received candesartan. After two years, those on candesartan were switched to a placebo. In March, Brose and Starner flew to Atlanta to share in the unveiling of the results at the American College of Cardiology’s 55th annual Scientific Session. The study showed that after two years, patients who had received candesartan were almost 67 percent less likely to develop hypertension. After four years, when all patients had been on placebo for two years, patients who had been on candesartan were almost 16 percent less likely to develop hypertension. Brose says the study not only showed candesartan helped prevent hypertension, it showed that patients who went off the experimental drug after two years were still less likely to develop the potentially fatal condition. “I’m very pleased that we helped contribute to this landmark study,” says Brose. “We rank right up there with the best clinical research sites in America.” Currently, OU-COM is involved in other clinical trials, including several diabetes trials, a dyslipidemia trial and a prevention trial. –Jennifer Kowalewski summer 2006 27
Page 1 and 2: DO perspectives from the college of
Page 3 and 4: DO the college of osteopathic medic
Page 5 and 6: Noteworthy Ronald Moomaw, D.O (‘8
Page 7 and 8: photo provided by Julianna Batizy-M
Page 9 and 10: Opportunities With 32 active donor-
Page 11 and 12: For nearly 10 years, Robin Thomas,
Page 13 and 14: director of the hospital’s medica
Page 15 and 16: CME S A V E T H E D A T E James D.
Page 17 and 18: WWhen Mary Kruszewski, D.O. (‘88)
Page 19 and 20: Anita Showalter, D.O., (‘93) whos
Page 21 and 22: . ........ From Diapers to Driver
Page 23 and 24: compared to a 15 percent growth in
Page 25 and 26: “I think pediatrics is growing be
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Page 31 and 32: Frontlinesby Maureen Harmon Mission
Page 33 and 34: from the Syrian border (where Al-Qa
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Page 39 and 40: Congratulations Class of 2006

DO - Ohio University College of Osteopathic Medicine

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