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Epigenetic modifications induced by glycemic variability

imageNitasha Bakhru, M.D., one of STSI’s clinical scholars, talks with a potential participant in her novel pilot study in which continuous glucose monitoring will be used to help determine the effects of hyperglycemia and glycemic variability on epigenetic regulators of gene expression in type 1 diabetes.  She describes the palm-sized glucose sensor device as well as an example of an online record of glucose measurements produced by continuous monitoring.

Nitasha Bakhru, M.D., the Wireless Health Scholar at Scripps Translational Science Institute (STSI) and an Endocrinology Fellow at Scripps Clinic, will soon begin a pilot study that will use continuous glucose monitoring to evaluate the effects of hyperglycemia and glycemic variability (GV) on epigenetic markers of pro-atherogenic gene expression in type 1 diabetes. 

Dr. Bakhru will monitor type 1 diabetics and healthy individuals (“controls”) via a palm-sized glucose sensor device that has a wire whose width equals two human hairs and that goes just under the patient’s skin

This study, which encompasses the West Wireless Health Institute as well as STSI and the Scripps Clinic, may help determine the impact of glycemic variability on an individual’s “epigenetic signature”.

Numerous clinical trials have underscored the health benefits of maintaining blood glucose within a certain range in order to prevent diabetes-related complications such as retinopathy and nephropathy. However, few have examined the effects of marked glycemic variability on surrogate markers of such complications. Dr. Bakhru’s study is designed to determine whether these and other epigenetic changes occur in human patients with type 1 diabetes.  Demonstration of epigenetic modifications resulting from glycemic variability may prompt clinicians to evaluate glycemic variability as well as mean glycemia (hemoglobin A1c) in their patients with type 1 diabetes.