Dr. Lorraine Lipscombe, associate professor, Department of Medicine, University of Toronto; physician, Endocrinology and Metabolism, Women’s College Hospital; director, U of T Novo Nordisk Network for Healthy Populations, University of Toronto; member, Diabetes Canada Board of Directors
• Identifying and reducing the risk of type 2 diabetes after pregnancy
• Testing a lifestyle program for new mothers with gestational diabetes to reduce their risk of type 2 diabetes
• Developing a tool that predicts a woman’s risk of developing diabetes in the next five years
• Creating community-based interventions for diabetes prevention
Dr. Lorraine Lipscombe at a glance:
• Appointed inaugural director of the U of T Novo Nordisk Network for Healthy Populations (2021)
• Received a Diabetes Investigator Award from Diabetes Canada (2018)
• Joined Women’s College Hospital in 2006, and was appointed director of the Division of Endocrinology (2017)
• Appointed associate professor in the Faculty of Medicine, University of Toronto (2014)
• Awarded the CIHR New Investigator Award (2012)
• Received medical degree from McGill University, Montreal (1998)
How did you get interested in diabetes?
I was initially involved in hormone research while studying psychology, and in particular mothers and how hormones affect their behaviour. I wanted to take this further and care for people who have problems with hormones, so I went to medical school. In my first year, I worked with a diabetes researcher who was studying type 1 diabetes and exercise, and I realized diabetes was an area I wanted to focus on.
How did that evolve to working with new mothers at risk of diabetes?
While using diabetes patient databases for research, I realized we were not doing enough to highlight people at risk of the disease so we could prevent it.
Also, in working with mothers who had gestational diabetes, I saw that we didn’t have the resources available to help them reduce their risk of developing diabetes later in life. [Women with gestational diabetes are seven times more likely to get type 2 diabetes compared to those without.]
What initiatives are underway to improve this situation?
Based on input from both experts and patients, we developed a health coaching program conducted over the phone that new mothers could access, three to six months after their baby’s birth. We recruited women from four Toronto hospitals in our pilot study and most were very satisfied, with 90 per cent saying they would recommend the program to others because it helped them reach their diet and fitness goals. We think our data is good enough to support expanding this program to a larger group of women at risk. We are now completing a larger trial to test the effectiveness of this program on reducing diabetes risk factors.
During the telephone coaching, a certified diabetes educator [CDE] contacts the patient by phone 12 times over six months, and each call lasts up to 20 minutes. Initially, the focus is on goal setting and education; later, it’s about seeing if patients have achieved their diet and fitness goals and how to address challenges along the way. Because the CDEs come from existing diabetes resource centres, this program is very sustainable from a health-care cost perspective [there is no fee for patients to access this program].
What other projects are you working on?
We’re developing a prediction tool that will calculate a woman’s individual risk of diabetes based on factors such as ethnicity, age, weight, and blood sugar levels in pregnancy. We’re hoping to complete it in the next two years and, with the support we received from Diabetes Canada, we are expecting to offer it across Canada.
I am also leading a new research network at University of Toronto that will design and test community-based interventions to improve diabetes prevention and management, with a focus on high-risk vulnerable populations in the city of Mississauga.
What is your ultimate goal in terms of your diabetes research?
My goal is to find more effective ways of helping people and communities prevent diabetes through healthier lives rather than just giving them pills once they get the disease.
The last word
“We know that we cannot prevent type 1 diabetes and but we can try to reduce the risk of developing type 2 diabetes. It’s really exciting to see how we may be able to End Diabetes though prevention in women who have gestational diabetes” — Dr. Seema Nagpal, vice president, Science & Policy, Diabetes Canada
Did you know?
2021 marks the 100th anniversary of the discovery of insulin. Today, more Canadians have diabetes than ever before. Diabetes or prediabetes affects one in three Canadians. One in two young adults will develop diabetes in their remaining lifetime. We cannot wait another 100 years to End Diabetes. Visit 100 Years of Insulin to learn more, including how you can support those living with or at risk for the disease.
This article appeared in Diabetes Dialogue, Summer 2019.
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