June 27, 2008
NIH Podcast Episode #0061
Balintfy: Welcome to the 61st episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health--the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode: the importance of discussing alternative medicines with your regular doctor; and we’ll talk to an NIH director about his very prestigious award. But first, how pesticide exposure may increase diabetes risk. That's next on NIH Research Radio.
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Long-term Pesticide Exposure may Increase Risk of Diabetes
Balintfy: If you or someone you know has used a particular type of pesticide for more than 100 days in your life, that may have increased your risk for developing diabetes. Wally Akinso reports on a recent study from two NIH institutes.
Akinso: Long-term exposure to pesticides may increase the risk of diabetes according to a study conducted by researchers at the National Institute of Environmental Health Sciences and the National Cancer Institute.
Sandler: We found that there were 7 pesticides that appeared to be associated with an increase in the chances of getting diabetes.
Akinso: Dr. Dale Sandler is the chief of the Epidemiology Branch at the NIEHS and the co-author of the study.
Sandler: The seven were organochlorine insecticides, called Aldrin, chlordane and heptachlor and they were also some other chlorinated pesticides as well.
Akinso: The licensed pesticide applicators that used chlorinated pesticides on more than 100 days in their lifetime were at greater risk of diabetes. The association between specific pesticides and incident diabetes ranged from a 20 percent to a 200 percent increase risk according to Dr. Sandler.
Sandler: The results suggest that pesticides play a small role in increasing the chances of developing diabetes along with the more well known risk factors which are being overweight, not getting enough exercise, or even getting older and having a family history of diabetes. They also suggested that people who are overweight and also use these specific types of pesticides have the greatest chance of developing diabetes.
Akinso: Dr. Sandler said the findings provide scientists with an important clue for further research. This is Wally Akinso at the National Institutes of Health Bethesda, Maryland.
NCCAM presents: Time to Talk
Balintfy: Are you taking a complementary or alternative medicine – that could be anything from herbal medications to acupuncture. Now are you also talking about those treatments with your doctor? Wally Akinso reports that experts say it’s time to talk.
Akinso: The National Center for Complementary and Alternative Medicine has launched an educational campaign to encourage the discussion of complementary and alternative Medicine. The campaign, Time to Talk, is designed to encourage patients and their health care providers to talk openly about all health care practices. Dr. Josephine Briggs, the Director of NCCAM, talked about the importance of the campaign.
Briggs: It's very important that health care providers and patients talk about these issues to ensure safe and good health care. We found in our survey that 20 percent of AARP respondents were taking more than five prescription medicines. So that means that the chance of some interactions and the need for discussion is all the greater in people with a lot of medication use. It's very important that health care providers know about CAM use so they can really be partners in health care. This is something docs need to know about, other health care providers need to know about, and patients need to talk about.
Akinso: NCCAM and the AARP partnered on a consumer telephone survey to measure and understand communication practices between patients age 50 or older and their physicians. The survey confirms that patients and physicians often do not discuss the use of complementary and alternative medicine. Dr. Briggs says tips are available for patients to initiate the talking process with health care providers.
Briggs: Our health care campaign includes tips for patients. It suggests that people write down a list of what their using—drugs and other modalities, and go to the doctor's office prepared to tell their doctor what is going on with their health care.
Akinso: For more information about the campaign including tips, a toolkit, and many other resources visit www.nccam.nih.gov. This is Wally Akinso at the National Institutes of Health Bethesda, Maryland.
Balintfy: When we come back, an interview with an NIH director who was recently awarded the Presidential Medal of Freedom. Stay tuned.
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Balintfy: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases was honored by President George W. Bush with the Presidential Medal of Freedom at a White House ceremony recently. I talked to Dr. Fauci about what that means.
Anthony Fauci: Well it's an extraordinary experience and an extraordinary honor. It's actually quite humbling when you think of the fact that your life's work has been publicly honored by the President of the United States and a medal that's given to people. When you look at the track record and the history of the people who have gotten the Medal of Freedom, it really is very humbling. It also reminds me that despite all that we've accomplished with HIV, which is the primary reason for my getting the Presidential Medal of Freedom, it also reminds you about how much more we need to do.
Balintfy: What do you feel remains to be done?
Anthony Fauci: Well, I think the biggest challenge, there’s a scientific challenge, and it has to do with developing a vaccine. We've been quite successful in developing a whole menu of drugs that have proven to be very effective in controlling HIV infection in people who are already infected. But we know just from the numbers of the numbers of new infections each year -- in the world there are 2.5 million new infections each year -- and yet from every one person that we put on therapy, two to three people get newly infected.
So although there's great successes with therapy, numerically you're losing the game if you continue to have so many additional people getting infected. So prevention looms large as a real major challenge, and the scientific aspect of that is developing a vaccine, and vaccine has been very elusive over the last many years for a number of reasons. Most importantly, that HIV is really quite different from any other virus that we have ever tackled in our attempts to develop a vaccine because the body does not seem to naturally make a good protective immune response against HIV. Even all the great killers, small pox, measles, polio, those diseases that were scourges, the body does still make a good immune response against them, and the majority of people seem to recover. So when you make a vaccine, what you do is you mimic what the body's natural response is.
Unfortunately with HIV, the body's natural response is terribly inadequate. So that's a big scientific challenge. The big public health challenge is access to the people particularly in the low and middle-income countries to treatment, prevention and care. Because 90% of the infections occur in the low and middle-income countries, and 66 to 68% occur in southern Africa. So we have a public health issue of getting access to those people, and we have a scientific issue, the last of the big scientific issues, is to develop a vaccine.
Balintfy: What was the White House ceremony like?
Anthony Fauci: Well it was a very personal, warm type of ceremony. It wasn't one of those things that are very official. I mean, I go to the White House a lot to brief everyone from the President to the Vice President to different members of the senior staff, and it’s generally all strictly business. You go in, the people are very nice and they’re very cordial.
But this was very personal, personal about the awardees. I was one of six. There were five others who got the awards. And very warm and personal with their family members. We took pictures with the President and the First Lady, and the President took a lot of time to be very cordial with my daughters, with my wife, and chatting a bit and not just trying to get it over with but actually seeming like he was actually enjoying this. This was in many respects his day because this is the highest award that he as President awards. So he seem to be enjoying it as much as the awardees were enjoying it.
Balintfy: Who were the other awardees?
Anthony Fauci: Yeah, well, Ben Carson, who's a established neurosurgeon at Hopkins and has done ground breaking neurosurgery, particularly in babies who are conjoined at the brain, and he does excellent work on epilepsy. Congressman Tom Lantos’ widow, Tom died recently, and he was one of the big proponents of the President's Emergency Plan for AIDS Relief, which is one of the reasons why I got the award was because of the role that I played in developing that global plan. We had Larry Silverman, one of our judges here in Washington D.C., who is, you know, an extraordinary jurist.
We had General Peter Pace, who is former Commandant of the Marine corps and former chairman of the Joint Chiefs of Staff, a Vietnam War veteran, a war hero, and a person who is very much involved in the planning for the war. And we had Donna Shalala, which I found to be very interesting. Donna Shalala is truly a card-carrying, liberal Democrat, and the President was open minded enough and the administration was open minded enough to give her the award. She is the former Secretary of Health and Human Services in the Clinton administration, and she was actually my boss when she was Secretary of HHS.
So it was really very interesting that there we were the two of us on the same stage together. When years and years ago during the Clinton administration, she was the secretary of the department that I worked in and that I still work in.
Balintfy: Overall, how would you characterize the honor?
Anthony Fauci: Well, you know it's just as I mentioned: there’s so many aspects of it that are exciting and wonderful. Probably the one of the ones that is the most gratifying is to be in the company of people who are coming from different disciplines to be sitting there next to General Pace and to be sitting down next to Larry Silverman and others who made major contributions in areas that have nothing to do with what I do is a very good feeling.
Balintfy: And the other attendees probably felt the same?
Anthony Fauci: [laugh] They did, they did. They actually said that, in fact, they said about me and Ben, who are two physicians, the same thing that we were saying about them, and I also found it very interesting that two out of the six were M.D.s, and three out of the six were involved in health. So I found that very interesting.
Balintfy: Thanks and congratulations to Dr. Anthony Fauci, NIAID Director and recipient of the Presidential Medal of Freedom.
Balintfy: That’s it for this episode of NIH Research Radio. Please join us again on Friday, July 11th when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.