A conversation with Kristen Nadeau, MD, MS
Pediatric diabetes research is an area that touches Kristen Nadeau, MD, MS, professor of pediatric endocrinology at the University of Colorado Anschutz Medical Campus.
A member of the Potawatomi Prairie Band, Nadeau worked on two Native American reservations at medical school and observed a growing medical problem among the population.
“I saw the increasing rates of type 2 diabetes in the Native American population, and the first young person who was diagnosed with type 2 diabetes was occurring during that time,” Nadeau told Healio. “It was then that I realized that I wanted to get into endocrinology, especially pediatrics, as it was now clear that childhood obesity and the resulting type 2 diabetes was a new problem. croissant that really needed attention.
Nadeau, who is also director of research in pediatric endocrinology and bariatric surgery at the University of Colorado, co-chair of the NIH Diabetes Research Center Complications Core at the University of Colorado, director of the Longitudinal Framed Scholarly Activities program at the School of Medicine of the University of Colorado and Pediatrics Chair of the Scientific Advisory and Review Committee of CU CCTSI, is being honored for her work aimed at elucidating the mechanisms of insulin resistance in young people with diabetes. Nadeau is the recipient of the 2021 Award for Outstanding Scientific Achievement at Scientific Sessions of the American Diabetes Association. The prize is awarded annually for diabetes research that demonstrates independent thinking and originality.
Nadeau recently spoke with Healio about some of the most interesting studies she has been involved in, the two people she admires the most, and some of her hobbies and interests outside of medicine.
Healio: Have you ever had the good fortune to be a witness or to have been part of a medical history in the making?
Nadeau: Right at the start of my pediatric endocrinology fellowship, I took part in the TODAY study, a national study of young people with type 2 diabetes. By participating in this study for about 17 years, I learned how critical is type 2 diabetes in young people, how difficult it is to treat, and how it also looks different from type 2 diabetes in adults. . The RISE study – a study comparing young people directly to adults – reveals how much work remains to be done and what a big problem it is. We need to know more about what goes on with the endocrine system during puberty and how this makes the development and progression of type 2 different for young people.
Healio: What would you advise a medical student today?
Nadeau: Try to pick an area that you really love and that gets you out of bed in the morning. Some people try to focus on work-life balance in order to feel happy overall. Not to minimize it, but if you find something that you are passionate about and love, then the job doesn’t have to be a chore; you don’t feel like you need anything else to balance if you really like what you’re doing.
One way to try to do this is to find activities and things that you can get involved in that are what we call a “three-way win” – something that helps advance your scientific career, but it is. is also something your family could be involved with. with and benefit from, and something that you get personal satisfaction from, like advocacy. We don’t have enough time in the day to do everything, and so finding things that you can be passionate about helps advance all parts of what makes you a great person.
The other thing I would say to medical students is to make sure you start your research question with a hypothesis, but have an open mind. You never know what you are going to find. If you try to prove your hypothesis and prove what you think is the correct answer, you may actually come across information that just isn’t correct. Try to be open-minded to what you might find, and it can actually take you in different, but exciting, directions.
This is what we found regarding insulin resistance in type 1 diabetes. We initially had a study design in which we tried to compare people with type 1 diabetes, which we believe had no insulin resistance, to those with type 2 diabetes with similar glycemic control, but with insulin resistance. We found out that we were totally wrong because people with type 1 diabetes were found to be insulin resistant, but the discovery of insulin resistance in type 1 diabetes opened up a whole new opportunity. .
HealioWho do you admire the most and what would you ask that person if you had 5 minutes for them?
Nadeau: Taking inspiration from my Native American roots, I would choose two people because they accomplished something similar simultaneously. In 2018, Rep. sharice david of Kansas and the Rep. Deb Haaland of New Mexico were simultaneously elected as the first Native American women to Congress, so they were the first two at the same time. Sharice Davids, in addition to being a Native American woman, is also part of the LGBTQ community. These women are truly trailblazers in their region and are amazing examples of advocacy for underserved people. Deb Haaland is now the US Secretary of the Interior, so for the first time we have a Native American overseeing the Office of Indian Affairs. What I would like to ask them is how they continue to live as the first Aboriginal women and how they find the courage to lead in an area where they may have views that are different from those of the people around them.
Healio: What are your hobbies and interests outside the practice of medicine?
Nadeau: I’ve always had a passion for trying to encourage children – and especially girls, as they seem to be more affected by type 2 diabetes – to be physically active. I have done this over the years through activities like soccer and basketball training. As my kids got a little older, I hated seeing girls mostly starting to drop out or kids not participating when the time intensity was higher, costs increased and travel became necessary.
More recently I have tried working with martial arts. The good thing about the martial arts that I have participated in is that they are multigenerational so young kids, middle aged people, old people all do it together and focus on meeting where as people find themselves and the advancement of their individual goals. rather than having to make a team. And I love how often kids can teach adults, more than the other way around, giving kids leadership and confidence-building opportunities. Thanks to COVID-19, being able to continue martial arts online has allowed me to continue. I got my black belt during COVID-19, which I’m most proud of, and I’m working on getting instructor status to keep me motivated, but also to help work with the kids. We also recently launched a scholarship to help provide funding to underserved children to access martial arts and leadership training.
Healio : Are you currently working on any interesting research and, if so, what?
Nadeau: Three major areas of interest at the moment. One is trying to see if we can use adjunct therapies in type 1 diabetes to fight insulin resistance, cardiovascular disease, and obesity in type 1 diabetes. Blood sugar control is important, but we are also thinking about all of the other ways to reduce the risk of cardiovascular disease and other complications of type 1 diabetes, especially when obesity is also present. We currently have another study that is looking at bromocriptine, another type 2 diabetes drug, in type 1 diabetes and thinking about next steps for other similar approaches to try and improve insulin resistance in it. type 1 diabetes.
We also learned how serious type 2 diabetes can be in young people. In the area of prevention, we are investigating whether improving sleep in young people or improving depression in young people can help prevent diabetes, especially in young people who have difficulty with eating and drinking. ‘exercise, to find other ways to help them.
The latter is on the other end of the spectrum of young people who already have complications from diabetes. We are looking at the role of bariatric surgery in treating young people with type 2 diabetes and, in particular, trying to understand why it seems to work well. We’re trying to figure out why weight loss surgery seems to work, because if there are other ways to mimic the results of surgery, we might avoid having to do something as invasive as surgery.