With a Laser Focus on Diabetes Questions
As someone whose life work is about studying a disease related to how people’s bodies convert what they eat into energy, Beth Mayer-Davis operates at peak efficiency herself. She has to, with the many roles she manages simultaneously.
As someone whose life work is about studying a disease related to how people’s bodies convert what they eat into energy, Beth Mayer-Davis operates at peak efficiency herself. She has to, with the many roles she manages simultaneously.
Both a nutritionist and epidemiologist, with 25 years working in diabetes, she is a professor of nutrition at the University of North Carolina’s Gillings School of Global Public Health and the UNC School of Medicine. She is co-chairperson of the 10-year national multi-site SEARCH for Diabetes in Youth study, which recently won five more years of federal funding, and is PI for a large NIH grant focused on the potential impact of nutritional factors on the health of youth with type 1 diabetes.
“From the nutrition perspective, diabetes of any type is basically disordered energy metabolism, so it impacts not just blood glucose but also lipids, by extension cardiovascular risks, by extension risk for kidney disease, eye disease,” she says. “So, diabetes, it turns out, is metabolically extremely interesting to anybody who’s interested in nutrition because of the core metabolic problems. And then from a clinical and public health perspective, it’s a tremendously important disease to study because it does impact almost all body systems, and it has a tremendous public health impact just because the prevalence of diabetes overall is very high.”
Mayer-Davis is also one of two co-presidents of the American Diabetes Association and serves on President Obama’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.
But that’s not all. She just added the role of leading the pilot study program, which will fund new projects each year, for UNC’s new Center for Diabetes Translation Research. The CDTR will leverage resources at NC TraCS Institute, home of UNC’s NIH Clinical and Translational Science Awards (CTSA), whose mission is to accelerate movement of discoveries into patient therapies (see more in this newsletter). The CDTR specifically has a goal of engaging researchers to move new knowledge about diabetes into clinical practice and into communities to improve health for people living with diabetes, or to prevent diabetes in those individuals at risk for developing the disease.
Her research also involves an NIH grant to study a new approach to help high-risk youth better manage type 1 diabetes through technology, such as cell phone applications, all of which involves teaching and mentoring graduate students. This grant was made possible by an NC TraCS $50K project that provided the necessary preliminary pilot and feasibility data.
Perhaps she finds the time and energy to do all of this because she takes her own advice about good nutrition, regular exercise and balancing work with a robust family life. She is mother to a blended family of five children, ranging in age from 14 to 26. She and husband Rich Davis, M.D., professor of opthalmalogy, UNC School of Medicine, and co-director of the new CDTR, enjoy cooking and bike riding together outside their place in the mountains. They also like the occasional jaunt to New York City for plays and restaurants or to visit his family and enjoy the many amenities of Chicago.
“We’re a close family and the kids get along really well,” she says.
Her interest in diabetes began early in her undergraduate days at the University of Tennessee in the dietetics program. In her brief work as a clinical dietitian, she became very interested in what drives the occurrence of complications over time in people with diabetes. She also became interested in which population groups were at high risk.
This interest led the Philadelphia native across the country through master’s work in Colorado, to her Ph.D. in epidemiology at University of California, Berkeley, and to UNC following stints at Wake Forest University and the University of South Carolina. Throughout and ever since she has weaved together her interests and training in nutrition and epidemiology and focused solely on diabetes.
She still has unanswered questions though. For one, she asks, “Why do beta cells fail, particularly around puberty (ages 10-14)?” Beta cells are the pancreatic cells that make and release insulin, the hormone that controls blood glucose levels.
As Mayer-Davis explains, around puberty the incidence of type 1 diabetes peaks and type 2 diabetes begins to emerge in high-risk youth. Type 1 is an autoimmune disease, while type 2 is a different condition that involves both insulin resistance and problems in insulin secretion. They both involve genetic susceptibility, but by different genes.
“Thus, beta cells are failing for very different reasons, but why at this particular time?” she asks.
For both, Mayer-Davis seeks answers through her studies and also continues to ask what the environmental or behavioral factors are that either contribute to diabetes, or conversely, could improve the prognosis for a child who is diagnosed. She is looking at nutritional factors -- even infant feeding practices, fish oils, vitamins D and E.
Another question she has is, why some kids who are at high risk for type 2 (minority kids and kids who are obese) don’t get diabetes and others do. She also wants to set the record straight in terms of certain misconceptions about minorities and diabetes.
“These days when you hear diabetes and overweight minority kids, you automatically think type 2, and that’s not the case. There are absolutely kids who are minority and overweight who have autoimmune-positive type 1 diabetes. And that’s a different disease to manage and those kids – any kids with type 1 diabetes – have a tough time.”
“Type 2 diabetes is also genes and environment, not just slovenly behavior,” she adds.
Her passion for helping youth with diabetes is evident in her work along the middle range of the translational continuum, between basic science and dissemination and public policy research. She looks at the nutritional factors that contribute to diabetes and potential interventions through clinical trials, such as the NC TraCS and NIH-funded “Flexible lifestyle, 3mpowering youth, eXhibiting change (FL3X)” study that seeks ways to help high-risk youth use technology to better manage their condition out in the community. Ever-present on her radar are high-risk or underserved populations.
“Diabetes is fascinating scientifically, but more important, it is critically important in terms of public health,” she says. “There are 26 million people in the U.S. with diabetes and 366 million around the world – with millions more at risk for developing the disease. We need brilliant, energetic young investigators to join the community of diabetes researchers. The CDTR, particularly through the Pilot and Feasibility Program, provides an opportunity to help junior faculty members get started in diabetes translational work, and for senior faculty members to change direction towards diabetes.”
So, for Mayer-Davis, facilitating ways for other researchers to train a laser focus on diabetes as well is yet another role she is happy to take on.
