Dr. Judy Kersten’s research increases our understanding of the link between diabetes and cardiovascular disease
June 2008 CVC UPBEAT - It is well-known that diabetes, a metabolic disorder that affects the way our bodies use digested food for energy, is a major cause of kidney failure, heart disease and stroke. The National Diabetes Information Clearinghouse of the National Institutes of Health (NIH) estimates 20.8 million people in the United States (about 7% of the population) have diabetes. Of those, 14.6 million have been diagnosed, and 6.2 million have not yet been diagnosed. In 2005, 1.5 million people aged 20 or older were diagnosed with diabetes. (1)
The two main types of diabetes are Type 1 - an autoimmune disease that destroys the insulin-producing cells in the pancreas, and Type 2, the most common form that is most associated with older age, family history, obesity, physical inactivity and certain ethnicities.
How does diabetes affect the cardiovascular system? Most of the food we eat is broken down into glucose, the form of sugar in the blood and the body’s main fuel source. After digestion, glucose enters the bloodstream and insulin, a hormone produced by the pancreas, allows glucose to enter the cells. Diabetes develops when the pancreas does not make enough insulin, or the cells in the muscles, liver and fat do not use the insulin properly. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose levels damage nerves and blood vessels, leading to heart disease, stroke and other complications. (2)
Experimental results from the laboratory of Judy Kersten, MD, Professor and Vice Chair of Anesthesiology and Professor of Pharmacology & Toxicology, have established the role that increased blood glucose concentration plays in increasing heart damage during heart attack and decreasing blood flow through the heart’s collateral vessels. These vessels are a source of alternative blood flow to the middle layer of the heart. As a result of Dr. Kersten’s work, there has been increased attention paid to aggressive control of blood glucose concentration in hospitalized patients undergoing anesthesia and surgery.
Dr. Kersten is investigating the mechanisms whereby increased blood glucose concentrations interfere with the cardioprotective signaling in the heart. She is attempting to identify the role of increased blood glucose to impair associations between heat shock proteins and endothelial nitric oxide synthase, two proteins that are cardioprotective. If these mechanisms can be understood, it may be possible to design new therapies to restore normal cardioprotective signaling to the heart and decrease death and injury due to both Type I and Type 2 diabetes.
Dr. Kersten is currently one of only a few physicians invited to serve on the Guideline Committee of the American Heart Association and the American College of Cardiology to recommend best practices that will reduce cardiovascular risk in diabetic and other patients undergoing non-cardiac surgery.
References
(1, 2) National Diabetes Clearinghouse. National Institutes of Digestive Disease and Kidney Disease of National Institutes of Health.