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Elizabeth Mayer-Davis: leader in adolescent diabetes
Perspectives
L Kastleman/University of North Carolina at Chapel Hill
Profile Elizabeth Mayer-Davis: leader in adolescent diabetes
See Editorial page 2163 For more on the SEARCH for Diabetes in Youth Study see https://www.searchfordiabetes. org/dspHome.cfm
2184
“Doing a lot of seemingly different things that are actually connected”, is the way that Elizabeth Mayer-Davis describes working life as Chair of Nutrition at the University of North Carolina at Chapel Hill, NC, USA. She is currently prioritising research into glycaemic control and weight management in type 1 diabetes; and soon hopes to be working on a trial to investigate how an automated insulin delivery system (the so-called bionic pancreas) will impact on diet and bodyweight. “When it comes to research, I try and see where the gaps in research lie, and work out where I can make a difference”, she says. Mayer-Davis traces her career roots to her fascination with nutrition and energy metabolism in biology class at high school in Philadelphia. With a bachelors degree in dietetics from the University of Tennessee, she began her professional life as a clinical dietician in cardiac rehabilitation and diabetes medicine at Saint Luke’s Hospital of Kansas City. “Before long I felt deeply troubled, forcing educational messages to people in poor health about how to make food choices and how to cook. I did not feel that I had the right to impose on people’s lifestyles in this way, unless the scientific basis was truly compelling”, she says. She moved to the University of Colorado to pursue an academic career, and was immediately drawn to epidemiology under Richard Hamman. “Dick was an incredible influence on my career; he opened my eyes to epidemiology, and to a career in diabetes research”, she says. Mayer-Davis gained a Masters there in 1986, before moving to the University of California, Berkeley for her PhD. She collaborated with researchers at Kaiser Permanente, investigating the heritability verses environmental drivers of insulin resistance and weight control, and the potential effect of lifestyle interventions such as diet and physical activity. It was while working on the Insulin resistance and atherosclerosis study (IRAS), with its focus on ethnic subpopulations, that she became drawn to health disparities across diverse ethnic groups, a characteristic of her research emphasis ever since. IRAS was coordinated from Wake Forest University in North Carolina, which became her home for 3 years in the late 1990s, before she moved to South Carolina to be nearer her young stepchildren. “I didn’t have a job to go to, but received a warm welcome from the Arnold School of Public Health at the University of South Carolina”, she says. Working in the Department of Epidemiology and Biostatistics and serving as Vice Chair, she became Professor there in 2002, while maintaining her collaborative relationships across the country. “For me nutrition requires crossover into many spheres, including basic science, medicine, epidemiology, clinical trials, and policy; a constant bridging across specialties to try and understand why people respond differently to advice about nutrition”, she says. It was during
her time in South Carolina when one of her PhD students raised awareness of a potential increase in type 2 diabetes among young people, seemingly related to the widespread prevalence of obesity in rural communities in the state with limited access to health-care services. Mayer-Davis and her team set up pilot work in two counties, the prelude to what became her signature research programme: the SEARCH for Diabetes in Youth Study. This large, multicentre national research programme has led the way in paediatric and adolescent diabetes since the turn of the millennium. She moved to the University of North Carolina as Professor of Nutrition in 2008, becoming the Cary C Boshamer Distinguished Professor of Nutrition and Medicine 2 years ago. Her time in North Carolina has seen the ongoing development of the SEARCH programme; she is helping the next generation of diabetes researchers to take SEARCH forward, while retaining a strategic role. Mayer-Davis is leading the FLEX research programme, motivated by SEARCH data, which highlighted poor glycaemic control in young people with type 1 diabetes, especially in AfricanAmerican and ethnic minority adolescents. FLEX has received funding from the National Institutes of Health and will assess the efficacy of self-management in adolescents with type 1 diabetes. “Rather than following a one-size-fits-all curriculum, our approach focuses on helping the adolescent understand their own experiences with diabetes and its challenges, working towards solving the day-to-day barriers that get in the way of managing the disease”, she explains. In 2011, while serving as President of the American Diabetes Association, she was invited to join an advisory group to the US National Prevention Council established by former President Barack Obama, a result of implementation of the Affordable Care Act. “This was a great opportunity to input my knowledge and experience in diabetes prevention, weight management, and nutrition into a cross-sectoral committee to help move forward policy to promote health and disease prevention”, she says. But with the recent change in US political administration, the committee has disbanded. Reflecting on her career to date, it has been the longterm impact of the SEARCH programme that she feels has had most influence. “Only through the accumulation of data over many years have we been able to identify more nuanced characteristics relating to type 1 diabetes, especially in the illumination of key high-risk groups such as AfricanAmerican and ethnic minority adolescent populations who bear a tremendous burden of disease. It is the power of the SEARCH programme that is driving a lot of diabetes research today, and will continue to do so in the future”, she says.
Richard Lane www.thelancet.com Vol 389 June 3, 2017
L Kastleman/University of North Carolina at Chapel Hill
Profile Elizabeth Mayer-Davis: leader in adolescent diabetes
See Editorial page 2163 For more on the SEARCH for Diabetes in Youth Study see https://www.searchfordiabetes. org/dspHome.cfm
2184
“Doing a lot of seemingly different things that are actually connected”, is the way that Elizabeth Mayer-Davis describes working life as Chair of Nutrition at the University of North Carolina at Chapel Hill, NC, USA. She is currently prioritising research into glycaemic control and weight management in type 1 diabetes; and soon hopes to be working on a trial to investigate how an automated insulin delivery system (the so-called bionic pancreas) will impact on diet and bodyweight. “When it comes to research, I try and see where the gaps in research lie, and work out where I can make a difference”, she says. Mayer-Davis traces her career roots to her fascination with nutrition and energy metabolism in biology class at high school in Philadelphia. With a bachelors degree in dietetics from the University of Tennessee, she began her professional life as a clinical dietician in cardiac rehabilitation and diabetes medicine at Saint Luke’s Hospital of Kansas City. “Before long I felt deeply troubled, forcing educational messages to people in poor health about how to make food choices and how to cook. I did not feel that I had the right to impose on people’s lifestyles in this way, unless the scientific basis was truly compelling”, she says. She moved to the University of Colorado to pursue an academic career, and was immediately drawn to epidemiology under Richard Hamman. “Dick was an incredible influence on my career; he opened my eyes to epidemiology, and to a career in diabetes research”, she says. Mayer-Davis gained a Masters there in 1986, before moving to the University of California, Berkeley for her PhD. She collaborated with researchers at Kaiser Permanente, investigating the heritability verses environmental drivers of insulin resistance and weight control, and the potential effect of lifestyle interventions such as diet and physical activity. It was while working on the Insulin resistance and atherosclerosis study (IRAS), with its focus on ethnic subpopulations, that she became drawn to health disparities across diverse ethnic groups, a characteristic of her research emphasis ever since. IRAS was coordinated from Wake Forest University in North Carolina, which became her home for 3 years in the late 1990s, before she moved to South Carolina to be nearer her young stepchildren. “I didn’t have a job to go to, but received a warm welcome from the Arnold School of Public Health at the University of South Carolina”, she says. Working in the Department of Epidemiology and Biostatistics and serving as Vice Chair, she became Professor there in 2002, while maintaining her collaborative relationships across the country. “For me nutrition requires crossover into many spheres, including basic science, medicine, epidemiology, clinical trials, and policy; a constant bridging across specialties to try and understand why people respond differently to advice about nutrition”, she says. It was during
her time in South Carolina when one of her PhD students raised awareness of a potential increase in type 2 diabetes among young people, seemingly related to the widespread prevalence of obesity in rural communities in the state with limited access to health-care services. Mayer-Davis and her team set up pilot work in two counties, the prelude to what became her signature research programme: the SEARCH for Diabetes in Youth Study. This large, multicentre national research programme has led the way in paediatric and adolescent diabetes since the turn of the millennium. She moved to the University of North Carolina as Professor of Nutrition in 2008, becoming the Cary C Boshamer Distinguished Professor of Nutrition and Medicine 2 years ago. Her time in North Carolina has seen the ongoing development of the SEARCH programme; she is helping the next generation of diabetes researchers to take SEARCH forward, while retaining a strategic role. Mayer-Davis is leading the FLEX research programme, motivated by SEARCH data, which highlighted poor glycaemic control in young people with type 1 diabetes, especially in AfricanAmerican and ethnic minority adolescents. FLEX has received funding from the National Institutes of Health and will assess the efficacy of self-management in adolescents with type 1 diabetes. “Rather than following a one-size-fits-all curriculum, our approach focuses on helping the adolescent understand their own experiences with diabetes and its challenges, working towards solving the day-to-day barriers that get in the way of managing the disease”, she explains. In 2011, while serving as President of the American Diabetes Association, she was invited to join an advisory group to the US National Prevention Council established by former President Barack Obama, a result of implementation of the Affordable Care Act. “This was a great opportunity to input my knowledge and experience in diabetes prevention, weight management, and nutrition into a cross-sectoral committee to help move forward policy to promote health and disease prevention”, she says. But with the recent change in US political administration, the committee has disbanded. Reflecting on her career to date, it has been the longterm impact of the SEARCH programme that she feels has had most influence. “Only through the accumulation of data over many years have we been able to identify more nuanced characteristics relating to type 1 diabetes, especially in the illumination of key high-risk groups such as AfricanAmerican and ethnic minority adolescent populations who bear a tremendous burden of disease. It is the power of the SEARCH programme that is driving a lot of diabetes research today, and will continue to do so in the future”, she says.
Richard Lane www.thelancet.com Vol 389 June 3, 2017