Event focuses on collaborations, diabetes’ link to cardiology
With a celebration of teamwork in action, the annual Capra Interdisciplinary Healthcare Symposium highlighted wide-ranging investigations by members of the UT Southwestern School of Health Professions and the Medical School. The 2023 event in February featured the theme “Collaborate: Interdisciplinary Research Impacting Metabolic-Related Diseases.” More than 200 participants attended.
The keynote presentation, “The Evolving Story of Diabetocardiology,” was given by Darren McGuire, M.D., Distinguished Teaching Professor of Internal Medicine.
Dr. McGuire, a cardiologist, shared with attendees how he saw the evolution of diabetes medicines through the lens of cardiovascular complications. As a resident in the 1960s, he studied ischemic preconditioning, in which briefly pinching off blood to the heart can prevent damage in subsequent heart attacks. He thought preconditioning stimulated growth of new blood vessels – but instead found it was mediated by a cell-membrane channel that was also affected by sulfonylurea drugs, which were the only diabetes treatments besides insulin available at the time.
“I decided this was my niche, but we had no data to guide what we were doing,” he said. “So, I set out to learn how to do large-scale randomized clinical trials.”
Dr. McGuire described how he went to Duke University for a fellowship, where he worked with Robert Califf, M.D., now Commissioner of the Food and Drug Administration; Dr. Califf hosted regular “think tank” meetings at which top researchers would gather and discuss how to solve important medical problems.
During his fellowship, Dr. McGuire listened to a talk by Dr. Califf on the cardiovascular safety of diabetes drugs. Later, Dr. Califf asked him to prepare summaries of the 13 presentations – which led to Dr. McGuire working so closely with the participants that he became co-author on two research papers.
Over decades, Dr. McGuire saw diabetes research across the nation evolve from simplistic monitoring of blood glucose to a sophisticated investigation of effective clinical goals and molecular mechanisms. For instance, a later think tank led to using levels of glycated hemoglobin (A1C) to test diabetic control.
In the 1960s, a diabetes medication could go on the market after only a few months of testing, he told symposium attendees. But millions of people began taking these pharmaceuticals, and sometimes serious side effects arose: amputations, liver toxicity, heart failure, and macular edema. The FDA then “flipped the switch” and required that every new diabetes medicine be tested for cardiovascular safety, Dr. McGuire said. The new, larger trials – one involving 15,000 patient-years in contrast with the 300 of earlier tests – showed finer details on the outcomes of various drugs. Some pharmaceuticals caused increased deaths from cardiovascular or other problems; some therapeutics were safe but ineffective, and others lowered blood A1C levels while also reducing cardiovascular deaths.
“Now we’re getting statistical superiority (of new drugs), not just safety,” Dr. McGuire told symposium attendees.
Following the keynote speech, the symposium included presentations by students honored for abstracts in two categories: completed/ongoing studies and proposed research.
The Capra Symposia were founded in 1998 by J. Donald Capra, M.D., and Patricia Capra, Ph.D. Dr. Donald Capra, who died in 2015, was Director of the Molecular Immunology Center, then became President of the Oklahoma Medical Research Foundation. Dr. Patricia Capra, who retired from UTSW’s Department of Rehabilitation Counseling, attended this year’s gathering via videoconference.
“By recognizing creativity and collaboration among students, our dream is that our students will go on to engage in more grants and research in the future,” said Staci Shearin, M.P.T, Ph.D., Associate Professor and chair of the Feb. 8 event’s research advisory committee. “I love that students get to participate. It’s a prime time in their journey to foster a multidisciplinary approach.”