Drs. Callaghan, Hinder and Feldman will collaborate on a pair of National Institutes of Health-funded studies that will explore the beneficial effects of diet, exercise and bariatric surgery
October 2, 2018
ANN ARBOR, Mich. — The University of Michigan Program for Neurology Research & Discovery (PNR&D) has received a pair of grants worth a total of $2.9 million from the National Institutes of Health to pursue how obesity and diabetes adversely affect the nervous system, it was announced today (Tuesday, Oct. 2) by Eva Feldman, M.D., Ph.D., director of the PNR&D.
The studies will explore how lifestyle interventions – diet, exercise and surgical weight loss – affect how obesity and diabetes damage nerves, a condition known as neuropathy, and how obesity and diabetes contribute to early problems in thinking, a condition known as mild cognitive impairment.
Neuropathy, nerve damage in the extremities due to obesity and Type 2 diabetes, is a primary focus for PNR&D investigators. Recent PNR&D research has centered on the different roles that excess fats in the blood stream (dyslipidemia) and excess sugar in the bloodstream (hyperglycemia) play in neuropathy. Findings from the PNR&D laboratory have been used to support new 2017 guidelines in patient care by the American Diabetes Association.
“Historically, high levels of sugar in the bloodstream were thought to cause neuropathy in diabetic patients,” said Feldman, the Russell N. DeJong Professor of Neurology. “Based on research by Dr. Brian Callaghan and Dr. Lucy Hinder in our laboratory, we have discovered in the last decade that excessive fat is just as damaging to nerves.” Feldman continues, “In parallel, we see that obesity and high blood levels of lipids also affect how a person thinks and can contribute to early problems with thinking, language and judgment, a disorder known as mild cognitive impairment.”
Eighty percent of individuals with mild cognitive impairment develop Alzheimer’s disease or dementia within seven years.
Dr. Callaghan’s five-year clinical trial will test the effects of high-intensity exercise and bariatric surgery in preventing both neuropathy and mild cognitive impairment in overweight individuals. Dr. Hinder’s two-year study will identify how fats and sugars are regulated in overweight and diabetic patients and how these changes correlate with diabetes-mediated injury of nerves and the brain.
This research will define how overweight and diabetic patients respond to lifestyle interventions, and specifically how diet, exercise and bariatric surgery can reverse or prevent nerve and brain damage.
Type 2 diabetes is a global epidemic with a continually rising incidence. Thirty million Americans have type 2 diabetes and 80 million Americans have pre-diabetes. Among these groups, over 39 million have neuropathy. Neuropathy is strongly associated with poor quality of life secondary to incapacitating pain and increased mortality. Over 60% of Americans are either overweight or obese, and obesity is an epidemic in America. Children and adolescents are among the group most highly at risk. Obesity increases the risk of diabetes, Alzheimer’s disease, neuropathy, along with heart disease and cancer.
Publications related to this research include:
- Diabetes and obesity are the main metabolic drivers of peripheral neuropathy
- Better diagnostic accuracy of neuropathy in obesity: A new challenge for neurologists
- Prevalence of and risk factors for diabetic peripheral neuropathy in youth with Type 1 and Type 2 diabetes
- Dietary reversal of neuropathy in a murine model of prediabetes and metabolic syndrome