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December 2007 Issue

Robert Smith, MD, professor emeritus of family and community medicine.
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Diabetes Research in Family Medicine Gets a Major Boost

By Jill Hafner & Katie Pence
Published December 2007

DNA is the genetic blueprint that makes us who we are.


It may determine our height, our hair color or even our chance for certain diseases.


Now, UC researchers are hoping to study DNA and broaden treatment options for patients with type 2 diabetes.


Led by Robert Smith, MD, the  new study will attempt to explain how a single gene in the human body may determine whether a patient with type 2 diabetes will respond favorably to antidiabetic drugs.


"Type 2 diabetes is one of the most commonly seen chronic diseases in family medicine," says Smith, UC professor emeritus of family medicine. "Although several anti-diabetic medications are available to control high blood sugar and delay complications, 20 to 40 percent of patients do not respond to treatment.


"We believe that genetic factors may be involved in this failure to respond," he says.


Smith's three-year research project is being fueled by a recent $1 million gift to the family medicine department by Ellen and the late George Rieveschl, PhD, both long-time supporters of the College of Medicine.


George Rieveschl, who died Sept. 27, 2007, was a vice president emeritus and 1937 alumnus of UC. He was best known for discovering the word’s first commercial antihistamine, Benadryl, while a chemistry professor at UC in 1943.


In this study, researchers will target the PPAR (peroxisome proliferative activated receptor) gamma gene in type 2 diabetes patients' DNA blood samples.


The PPAR gene controls differentiation of fat cells. Variants of this gene often influence the development of diabetes and obesity in patients.


“We hope to determine if variants in this gene influence the way patients respond to anti-diabetic treatment,” says Smith.


In 2003, George and Ellen Rieveschls funded a UC diabetes pilot project that compiled DNA information from patients in UC’s Wyoming, Forest Park and University Pointe clinical practices, but researchers found the participant numbers too small.


With new funding, the research team plans to partner with roughly 60 different family medicine practices in Greater Cincinnati and Southern Ohio to pool patient data during routine visits to their family physician.


“Expanding the study is essential to provide the necessary number of DNA samples,” says Smith. 


Researchers from the UC division of endocrinology and the department of environmental health are also lending their genetic experience to the project.


“We are most grateful to Ellen and the late George Rieveschl for their wonderful generosity and for their warm friendship over many years” says Smith, who was George Rieveschl’s family physician for nearly 30 years.


“This gift will help us move into a major study that may eventually develop a DNA test and help doctors make decisions about how to treat diabetic patients.”


Type 2 diabetes occurs when the body does not produce enough—or ignores the absorption of—insulin. Created inside the pancreas, insulin is a hormone that converts sugar, starches and other food into energy needed for the body.


The disease accounts for over 90 percent of diabetes cases and has become the fifth leading cause of death in the United States.


The UC Diabetes Center estimates that 200,000 people in Greater Cincinnati will be diagnosed with type 2 diabetes by 2010.

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