How did you get into research, why this area?
My dad is Prairie Band Potawatomi, which fueled my interest in American Indian health when I was in medical school studying pediatrics. During that time, I worked on two Native American reservations and for the first time saw kids with Type 2 diabetes and young pregnant moms with diabetes.
Type 2 diabetes was very new to the field of pediatrics in the late 1990s, and so the only way to understand what was happening was to become a researcher as well as a clinician. My research mentors were scientists and doctors focused on adult diabetes because no one in pediatric medicine had experience in this area yet. So the best we had to go on was information about the causes, prevention and treatment of older adults with Type 2 diabetes, and then apply this to kids.
The reality is that the first time Type 2 diabetes was really recognized in kids was in the late 1990s because the obesity epidemic came first. Recognition of Type 2 diabetes as a growing health issue for children and teenagers launched research specific to the problem.
Why is this important?
The most striking reason is that Type 2 diabetes and related disorders have normally been seen only in older adults. We know there is increased risk of cardiovascular disease when someone develops diabetes. So a child with diabetes will likely have high risk for cardiovascular disease much earlier in life.
This is also a serious issue because the impact on next generation is huge. When a woman has gestational diabetes the risks increase for her baby to develop diabetes at a young age. In turn that baby, possibly even as a teen or young adult, will have diabetes in her pregnancy and pass it along to her children as well in a vicious cycle
The link between obesity and inactivity and diabetes is key to why this is so important from a community health perspective.
In the past 30 years there have been significant changes in lifestyle, nutrition, and physical activity for kids. Kids today are very inactive, and girls much more so than boys. Much of this can be credited to a lack of funding in the schools for sports and activities with free transportation, safe places (like public playgrounds and communities) to engage in healthy activity, and an increase sedentary activities through technology such as video games, cell phones and the internet.
Minority and low income kids are disproportionately affected by obesity and type 2 diabetes, which makes it a big socio-economic disparity problem in our country. Adolescent girls also suffer more from type 2 diabetes than boys. And sick kids lead ultimately to sicker people in the health care system with a lot more needs because of complications from diseases like Type 2 diabetes.
It is cheaper to do prevention, and yet this is the element we are missing for Type 2 diabetes. We are working on what to do once it happens, yet even the interventions we have now are not that effective. We need better approaches to treat prevent and treat obesity and turn the tide of Type 2 diabetes and metabolic syndrome in teenagers.
What are your hopes and dreams for your research?
Frankly, I’d like to turn the clock back by 30 years when as a nation we were much healthier from a standpoint of diet and exercise. The reality is that we really may not need new innovative therapies for Type 2 diabetes – we need to teach our nation of children how to eat a healthy diet and to exercise.
In terms of my research goal, I want to reduce cardiovascular complications in kids who develop diabetes in their childhood years to decrease their morbidity and their mortality. I would also like my research to help find ways for teenagers -- and girls in particular -- to get back to exercising in ways that makes it compelling for them to do so.
My ultimate goal is for this society never to have a girl develop diabetes before she is pregnant, and for Type 2 diabetes to return to being an adult disease of aging that is never seen in children.
What can we do to report on your work in a way that can be understood and valued by the general public?
Find ways to partner with other groups and organizations that hold health fairs and events that promote the benefits of good diet, exercise and an overall healthy lifestyle.
Consider how we might have a ‘voice’ in the public policy arena around promoting healthy lifestyle through public schools, at the very least physical activity.
Finally, find ways to incorporate a women’s health speaker into the ‘curriculum’ of talks that medical students, interns and residents are required to attend in order to educate them about why women’s health is important and what research is being done.