Biological markers | Characterization of obese individuals | Lifestyle and menopause | Diabetes and cystic fibrosis | Diabetes and inactivity | External artificial pancreas | Physical activity and diabetes | Resistance training and diabetes | Pharmaceutical industry collaborations
The various research projects performed with PROMD, both academic and pharmaceutical, focus on the optimization and advancement of knowledge in the treatment of diabetes and obesity, the benefits of weight training and the prevention of cardiovascular disease, among other topics.
Identification of biological markers of beta cell function and mass, as well as the efficacy of therapy This is a joint project with the Centre Hospitalier Universitaire de Montréal and Caprion Proteomics Inc. The objectives of the study are:
Characterization of obese individuals with no metabolic complicationsObesity is a chronic disease that affects approximately 20% of the population. Despite having a large amount of body fat mass, some obese individuals do not develop the problems generally associated with obesity, such as hypertension, hypercholesterolemia, diabetes, and heart disease. Our research will enable us to better characterize these individuals and to better understand the genetic factors that give these obese individuals a protective profile.
Lifestyle changes in the early stages of menopause The objective of this project is to study the effects of a 12-month lifestyle modification program, with or without exercise, on body fat mass, sensitivity to insulin, and metabolic profile during the early stages of menopause in women who are overweight or obese and at high risk of developing diabetes. These data play an important role limiting the risk of the appearance of diabetes in the years after menopause.
Diabetes secondary to cystic fibrosis Cystic fibrosis is the most common autosomal recessive disease in the Caucasian population. In recent years, the life expectancy of people with cystic fibrosis has gradually improved and has now topped the 40-year mark. As a result, new and major complications, such as diabetes (high blood glucose levels) secondary to cystic fibrosis, have emerged. The pathophysiology of diabetes secondary to cystic fibrosis is not yet understood. Our laboratory is attempting to shed light on the mechanisms involved in the development of diabetes secondary to cystic fibrosis, as well as the correlations between elevated blood glucose levels and changes in weight and pulmonary function.
Type 1 diabetes: aspects related to inactivity, improved nutrition, and new treatment approaches Type 1 diabetes is a chronic disease that affects approximately 0.5% of Canadians. Individuals with diabetes depend on insulin injections to control their glycemia (blood glucose levels) and thereby limit the appearance and severity of complications (eyes, nerves, kidneys, and cardiovascular disease). Despite the benefits of regular physical exercise, there is a high prevalence of inactivity in this population. Our research shows that adults with type 1 diabetes face barriers in the practice of physical activity. We are therefore seeking to target certain aspects of inactivity in adults with type 1 diabetes and suggest a program that would promote physical activity specific to this population that does not increase the risk of hypoglycemia (abnormally low glucose levels). At the same time, we are trying to determine the impact of exact estimates of glucose (sugar) content in their diet on their glycemic control in order to improve control of their disease and quality of life. More recently, we have been trying to improve treatment with insulin pumps thanks to new technologies.
Type 1 diabetes: Development of an external artificial pancreas Type 1 diabetes accounts for approximately 10% of all cases and is usually diagnosed during childhood. Type 1 diabetes is generally treated by intensive insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion pump. Despite available treatments, more than 60% of patients with type 1 diabetes present unbalanced diabetes. Wide variations of glucose concentrations are observed and can lead to serious complications due to frequent hypoglycemia and hyperglycemia. Recent developments in continuous glucose sensors and insulin pumps have increased research on the external artificial pancreas to prevent hypoglycemia and improve diabetes control. Several research projects on the external artificial pancreas are planned at the PROMD research platform. The objective of these projects will be to evaluate the efficacy of the external artificial pancreas to regulate glucose levels following a meal, during exercise and at night-time.
Impact of a physical activity program with or without nutritional intervention in type 2 diabetics To improve the control of diabetes, blood pressure and lipid profile (blood fat levels), the Canadian Diabetes Association recommends lifestyle changes that target weight loss through calorie restriction combined with moderate to intense physical activity. However, the effects of various methods of calorie restriction that target weight loss remain to be elucidated. In the framework of this research project, we wish to study the effect of 2 strategies for attaining the same caloric deficit, i.e. a supervised hypocaloric diet combined with advice on exercise or a combination of a hypocaloric diet with a supervised exercise program. We hope to determine whether procedures for administering a nutrition and/or exercise program reduce the risk of cardiovascular complications, for example in terms of losing body fat mass, a major element in the health profile.
Impact of resistance training on the incidence of diabetes de novo post-kidney transplant: a pilot project In kidney-transplant patients, cardiovascular disease (e.g. infarction or “heart attack”) is 3 to 5 times more frequent than in the general population. The appearance of a new diabetes (high blood glucose levels) after a kidney transplant is a major contributor to the increased risk of cardiovascular disease in transplant patients. Post-transplant diabetes may also contribute to reduced survival of the transplanted kidney and an increase in infections. It is therefore crucial to try to prevent the appearance of this diabetes. There are currently no studies that show whether weight training could reduce the risk of developing post-transplant diabetes. We hope to demonstrate the efficacy of an adapted weight training program in reducing the risk of developing diabetes in post-kidney transplant patients.
Finally, we hope to validate the use of devices that evaluate physical activity and energy expenditure (accelerometers).
Several research projects are underway in conjunction with the pharmaceutical industry on the following subjects: