Current Newsletter - USC Westside Center for Diabetes

U S C
Volume 3, Issue 1
W E S T S I D E
center
for diabetes
inside this issue…
M
N o v e m b e r
2 0 0 3
N E W S L E T T E R
USC Comes to the Westside
ore than 50 guests recently
2
visited the USC Westside
Drugs: A potential new
way to improve glucose
control has some slithery
beginnings
Center for Diabetes for the
first discussion in the “USC Comes to the
Westside” scheduled series of events.
The event, held at the Regency Club in
3
Westwood on May 29, attracted a number
Welcome: Meet the
center’s newest
endocrinologist
of key leaders from the Los Angeles area.
Marc B. Nathanson, co-chair of the Westside
Center, welcomed guests to hear renowned
experts discuss the focus of the evening,
Help: The Westside Center
“Taming the Diabetes Epidemic: Preventing
offers a new way to get
and Treating Diabetes and Heart Disease in
involved and make a differ-
Future Generations.”
ence in the lives of those with
diabetes
James P. Lower, of the W.M. Keck Foundation (left), attends
the first “USC Comes to the Westside” event. Alongside
him are Westside Center Director Anne Peters Harmel and
Co-chair Marc B. Nathanson.
Buchanan illustrated how type 2 diabetes
Anne Peters Harmel, M.D., director of USC
Clinical Diabetes Programs and the Westside
Center, introduced Thomas Buchanan, M.D.,
director of the General Clinical Research Center
and professor of medicine, obstetrics and gynecology and physiology and biophysics at the
Keck School
of Medicine
of USC, and
Scott E.
Photos by Dan Avila
• Educational events for the
public
• Promising drugs in the
pipeline
• New support group
Co-chair Louis L. Gonda thanks
attendees for their involvement in
fighting diabetes.
Rosen Professor of Biology at Caltech.
Fraser, Ph.D.,
director of
the Biological
Imaging
Center and
Anna L.
prevalence has reached epidemic proportions and
talked about the ramifications associated with
developing the disease.
Fraser, meanwhile, demonstrated his work in
heart imaging and spoke of his interest in collaborating with USC researchers. He hopes to
expand his work by imaging the pancreas and
abdominal area to further understand the development of type 2 diabetes.
Westside Center Co-chair Lou Gonda closed
the event by praising USC faculty members for
their contributions and for changing and saving
lives on a daily basis. Gonda also thanked attendees for their interest and support of the
Westside Center and noted that the event gave
attendees a special glimpse into the work of
(see SERIES on back page)
New Drugs on the Horizon
Exenatide may help those not on insulin who have trouble reaching glucose targets
W
hile a future without diabetes would
be preferable to all
(and a goal that many researchers
are working on), the near future
must depend on enhancements
in drug therapy to aid in reducing the complications associated
with diabetes and to help maintain target blood glucose levels.
Exenatide is one of today’s many
new agents under development.
Exenatide is the first in a new
class of drugs that may be beneficial in treatment of type 2 diabetes. Exenatide is initially under
development by a company
called Amylin Pharmaceuticals to
improve glucose control in
patients with type 2 diabetes who
are not using insulin and not able
to achieve target blood glucose
levels with diet, exercise and oral
medications.
This drug is based on a
human hormone called GLP-1,
which is made in the gut. GLP-1
has a very short lifespan of
action, which makes it difficult
to use as therapy. Exenatide is a
similar compound to GLP-1 but
has a much longer duration of
action.
Interestingly, exenatide is
actually derived from the poisonous saliva of a huge lizard called
the gila monster. (You heard it
here first, folks!)
Exenatide is a small-butpotent amino acid chain that
exhibits several anti-diabetic, or
glucose-lowering, actions.
Clinical trials have shown that
2
USC
WESTSIDE
this compound can stimulate
insulin secretion when blood glucose concentrations are elevated,
but not during periods of low
blood glucose concentration.
Thus, it appears to be a compound that is sensitive to circulating glucose levels.
Other studies have shown
that exenatide slows stomach
emptying. This may help to
modulate the entry of ingested
nutrients from food into the
bloodstream, and thereby help to
control blood glucose levels after
eating. In addition, preliminary
data indicate that exenatide may
cause a sensation of fullness early
on and reduce food consumption—leading to reduced body
weight.
As a result of the combination of these actions, exenatide
administration can lower blood
glucose concentrations in
patients with type 2 diabetes,
resulting in a reduction of
HbA1c levels.
A number of clinical trials
today are looking at the use of
exenatide in different populations
of type 2 diabetes.
One trial is evaluating exenatide in people with type 2 diabetes who are not achieving target blood-glucose concentrations
using metformin alone.
Another trial of about 400
patients uses a similar protocol
and is evaluating the effects of
exenatide on patients who are
not achieving target blood-glucose concentrations using sul-
Exenatide traces its roots to the
poisonous saliva of this large lizard,
the gila monster.
fonylureas alone.
A third clinical trial of 800
patients is evaluating exenatide’s
effects on patients who are currently not achieving target bloodglucose concentrations using a
combination of metformin and
sulfonylureas.
In these clinical trials, exenatide appears to be well-tolerated. Most adverse events reported
were considered mild or moderate in intensity.
These events included nausea
(the most common adverse
event) and vomiting (to a much
lesser extent). Patients who gradually increased their dose of exenatide had a clinically meaningful reduction in the incidence of
nausea compared to patients who
did not receive a gradual dose
increase.
The one major drawback is
that exenitide must be administered by injection.
While exenatide is not
approved yet for the treatment of
type 2 diabetes, the studies do
look promising. We expect exenitide may be available at the
Westside Center through clinical
trials in 2004. n
A Westside Welcome
New endocrinologist joins center team
proceeding to Mercy Hospital in Pittsburgh, Penn.
to perform his internship in general surgery. He then
moved to Los Angeles, where he worked with USC
physicians during his residency in internal medicine
at LAC+USC Medical Center. Dr. Howell then
completed a fellowship in metabolism/endocrinology
at the VA Medical Center in Seattle.
Medicine bestowed
him with the Max
Rado
Georgetown University School of Medicine before
University School of
Kerwin Pathology
Alicia
Di
Dr. Howell received his medical degree from the
Georgetown
Award.
An assistant
professor of clinical medicine
Phot
o by
William M. Howell, M.D., joined the Westside
Center’s medical staff as an endocrinologist/diabetologist in June.
at the Keck School of Medicine of USC, Dr.
Howell serves on the Ambulatory Curriculum
Committee of the Department of Medicine, as well
as on the Keck School’s Physician Wellness
Recognized for achievement throughout his
medical career, Dr. Howell has received numerous
honors. In 1992, he was elected to the prestigious
Alpha Omega Alpha Honors Society. The next year,
Committee. He also serves on the Ethics Committee
at LAC+USC Medical Center.
Dr. Howell is married and has two children. We
Supporters Assure Center’s Future
W
ho wouldn’t benefit from a few
good friends?
That’s why the Keck School of
Medicine of USC recently
established the Westside Center
Associates—a group dedicated
to supporting the USC
Westside Center for Diabetes.
The Westside Center
Associates is a select philanthropic group for contributors
who wish to ensure that the
center will continue its mission
of diabetes care, research and
education.
When supporters become
Westside Center Associates,
they help provide seed money
to fund new research that may
lead to future treatments. They
also help expand current
research projects and speed
are excited to have him on board.
results to the clinic. Financial
support also funds fellowships
for today’s leading physicians
and researchers as well as training for tomorrow’s professionals. Associates also contribute
to new equipment that is needed for advanced research and
treatment.
Membership also offers
other benefits. Associates get
VIP access and referral service
at the Westside Center and
throughout the practices of the
Keck School of Medicine of
USC. Associates are recognized
on the center’s lobby wall and
receive invitations to lectures,
meetings and other events.
Membership also offers the
opportunity to build an
endowment that will provide
lasting support for diabetes
research and care at the
Westside Center.
Associate membership is
offered at the $5,000, $10,000,
$25,000, $50,000 and
$100,000 levels, with pledges
payable over five years or less.
Contributions may be made in
a number of ways, including
gifts of stocks, personal property or real estate. They may be
made outright or through a
bequest or trust. Gifts can even
provide lifelong income for the
donor, along with the many
benefits of Associate membership.
For more information
about such Westside Center
Associate membership, please
call the Office of Development
at (323) 442-1700.
USC
WESTSIDE
3
Series: Speakers share their expertise
continued from page 1
renowned diabetes experts, as
Americans than AIDS and breast
tionally been a disease of older
USC doctors on the frontlines of
estimate that 17 million
betes has reached the younger
well as a chance to speak with
the battle against diabetes.
Every year diabetes kills more
cancer combined. Health experts
Americans have diabetes and
another 16 million are pre-diabetic, a condition
that sharply raises the risk for
developing type
2 diabetes and
USC Westside Center for Diabetes
Newsletter
Editor-in-chief: Anne Peters Harmel,
M.D.
Design: Kathy Yoshihara
Production: Alicia Di Rado
Development: David
Eshaghpour
Phone: 323-931-7525
Fax:
323-931-0987
increases the
risk of heart
disease by 50
percent.
From left, Dorit and Glenn Rotner enjoy the “USC Comes
to the Westside” event with Robbie Shipp.
Type 2 dia-
betes has tradi-
adulthood. Lately, though, diaadult population; and over the
past decade, increased obesity has
led to a diabetes epidemic in
young adults and children under
the age of 10. Yet, if the disease
is properly managed (or if those
at risk for diabetes adjust their
lifestyle before developing the
disease), patients can and do lead
normal lives.
That is where the USC
Westside Center for Diabetes
makes a difference.