News & Research

    Sanford Research/University of South Dakota, Vermillion, South Dakota

Treatment of the low thyroid state occurring after myocardial infarction in diabetes

General Research Subject: Type 2 Diabetes

Focus: Clinical Therapeutics/New Technology\Pharmacologic Treatment of Diabetes or its Complications, Integrated Physiology\Muscle

Type of Grant: Clinical Scientist Training Award

Project Start Date: July 1, 2010

Project End Date: June 30, 2013

Diabetes Type: Type 2 diabetes

Research Description

Diabetic patients have an unusually high incidence of heart attacks and higher death rates as a result. Low thyroid function is very common in diabetics. Low thyroid function also results from a heart attack. Recent evidence suggests that low thyroid function itself promotes increased scar tissue, loss of small blood vessels, and abnormal growth of contracting muscle cells in the heart. Interestingly, similar tissue changes occur in the surviving part of the heart after a heart attack and are largely responsible for progression to heart enlargement, heart failure, and death.

Nonetheless, physicians are hesitant to treat low thyroid function occurring after a heart attack because they believe it may actually cause more damage to the heart. Emerging evidence from animal experiments suggests this is not true. Thyroid hormone treatment of heart attacks in rats for one month prevented the decline in heart function and the detrimental tissue changes noted above. Diabetic individuals who suffer a heart attack are likely to benefit even more by thyroid hormone treatment because diabetes itself causes increased blood vessel disease and scarring of the heart. The proposed experiments will examine the potential benefits of thyroid hormone treatment of heart attacks induced in diabetic rats. Therefore, positive results from these experiments will likely lead to a dramatic improvement in care for diabetics who suffer a heart attack.

Research Profile

Mentor: Anthony Gerdes    Postdoctoral Fellow: Nathan Weltman

What area of diabetes research does your project cover?  What role will this particular project play in preventing, treating and/or curing diabetes?

Diabetic patients have an unusually high incidence of heart attacks and higher death rates as a result. Low thyroid function is very common in diabetics. Low thyroid function can also result from a heart attack. Recent evidence suggests that low thyroid function itself promotes increased scar tissue, loss of small blood vessels, and abnormal growth of contracting muscle cells in the heart. Interestingly, similar tissue changes occur in the surviving part of the heart after a heart attack and are largely responsible for progression to heart enlargement, heart failure, and death. Nonetheless, physicians are hesitant to treat low thyroid function occurring after a heart attack because of the belief that it may in fact cause more damage to the heart. Emerging evidence from animal experiments suggests this is not true.

Diabetics who suffer a heart attack are likely to benefit even more by thyroid hormone treatment because diabetes itself causes increased blood vessel disease and scarring of the heart. The proposed experiments will examine the potential benefits of thyroid hormone treatment of diabetic rats with and without a heart attack. Therefore, positive results from these experiments will likely lead to a dramatic improvement in care for diabetics who suffer a heart attack.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

Diabetic patients have an unusually high incidence of heart attacks and higher death rates as a result. Understanding the relationship between diabetes and cardiovascular disease will allow further exploration of clinically meaningful treatment options. Thyroid hormone treatment provides an exciting, yet novel approach to treating cardiac events in the diabetic population. Deciphering the exact mechanisms by which thyroid hormone exerts its beneficial cardiac and survival effects has many future implications. Thyroid treatment represents a non-invasive, inexpensive, and commercially available treatment option which has the potential to prevent or attenuate cardiovascular disease in diabetic patients. Therefore, thyroid hormone represents an economical and therapeutically meaningful treatment for cardiac disease in the diabetic population

Why is it important for you, personally, to become involved in diabetes research?  What role will this award play in your research efforts?

As an MD, PhD student, I am given the unique opportunity to directly implement the knowledge learned in the laboratory setting into clinically meaningful therapeutic measures.  Currently, there is a large separation between the knowledge learned in the basic sciences and the translation to appropriate new measures of patient care. It is my intention as a research based academic cardiologist to help improve a gap that is in dire need of closure. As the incidence of diabetes continues to increase, it is increasingly important to develop our understanding of the relationship between diabetes and cardiovascular disease.

As a future clinician, this knowledge potentially could be implemented as safer and more efficacious treatment options. This award serves as an integral part of my research progress. The aforementioned project will serve as the foundation of my doctoral thesis, and will allow my further exploration of the complex relationship between diabetes, cardiovascular disease, and low thyroid levels.

In what direction do you see the future of diabetes research going?

As the incidence of diabetes continues to rise, there is an ever growing need to understand the relationship between diabetes and cardiovascular disease. The relationship between cardiovascular disease and diabetes represent a major healthcare challenge, with an ever increasing economic burden. It is increasingly important that we understand diabetes both at the basic science and clinical level. Future diabetic research should aim to efficiently translate discoveries made in the laboratory into clinically meaningful treatment strategies. As a future physician scientist, it is my intention to help narrow the current gap between basic and clinical sciences.