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Diabetes epidemiology expert looks to future of diabetes treatment

Just as the best treatment strategies fit the needs of each individual patient, career paths must also be individualized. Elizabeth Mayer-Davis, PhD, illustrates that when she says, “You don’t have to have a straight-line path.” By following her own course from clinical nutrition to epidemiology, Mayer-Davis became the Cary C. Boshamer Distinguished Professor of Nutrition and Medicine and chair of the department of nutrition of the Gillings School of Global Public Health and the School of Medicine at the University of North Carolina at Chapel Hill. For her work in epidemiology of diabetes in adolescents and young adults, Mayer-Davis is the 2019 recipient of the American Diabetes Association’s Kelly West Award for Outstanding Achievement in Epidemiology.

Elizabeth Mayer-Davis

Mayer-Davis spoke with Endocrine Today about avoiding a straight-line career path and how to deal with the parallel growth of diabetes treatment and diabetes prevalence.

What was the defining moment that led you to your field?

Mayer-Davis: My defining moment was many years ago when at my first job as a dietitian, I noticed a lot of people coming to various clinics in the hospital with diabetes and various complications of diabetes. I wondered, “Why are all these people showing up, and why do I see some repeat people coming back to these different clinics or coming across clinics?” In particular, as a dietitian, I wondered whether or not the advice I was giving, which was according to the dietary recommendations for people with diabetes, would actually improve the outcomes for these people, primarily because I felt like I didn’t have the right to impose a change in diet unless we had a good degree of confidence that that change would actually lead to improved health outcomes. That defining moment was a moment of having many, many questions and not having a way to really find the answers beyond a little bit of what was in the literature.

What area of research most interests you right now and why?

Mayer-Davis: Right now, what interests me most is addressing the emerging problem of overweight and obesity in individuals living with type 1 diabetes. There is a real need to understand and address simultaneously underlying energy dysregulation, clinical and medical aspects of type 1 diabetes management, and the behavioral-psychosocial aspects of living with type 1 diabetes and trying to manage blood sugar during the day and during the night and at the same time manage weight — one can be counterproductive to the other. This is a very complex problem and one that is really important for long-term health for people with type 1 diabetes. That’s the area that I’m really focusing on now in my work.

What advice would you offer a student in health sciences today?

Mayer-Davis: The best career advice really has to do with owning your own path. I could create a career path that would allow me to do the kind of work that I wanted to do and has the kind of day-to-day life and family life that I wanted to have. It was really up to me to think through what I wanted that path to look like and then to make decisions accordingly. That’s different than following a straight-line path that many people might follow. You don’t have to have a straight-line path.

What do you think will have the greatest influence on your field in the next 10 years?

Mayer-Davis: Probably the devices that are being developed now in terms of hybrid closed-loop and closed-loop systems for treatment of type 1 diabetes. That’s really going to change the field a lot, and already the field is rapidly changing — because of continuous glucose monitoring at this stage — in a positive way.

The other thing that’s going to have the greatest influence on the field is the changing demography and social circumstances in the U.S. We are continuing to have an increase in type 2 diabetes, and we’re also seeing an increase in type 1 diabetes. We have many vulnerable populations around the world who will be increasingly experiencing the effects of diabetes. That’s the counter. On one hand, we have what will be improved treatment for diabetes. On the other hand, it’s going to be tremendously important in terms of public health to grapple with the marked increase in numbers of people living with diabetes, not just in the U.S. but around the world.

What are your hobbies/interests outside of your field?

Mayer-Davis: They’re all pretty much active things: gardening, hiking, biking, kayaking. Cooking, but really the first are all those outdoor activities. - by Phil Neuffer

Just as the best treatment strategies fit the needs of each individual patient, career paths must also be individualized. Elizabeth Mayer-Davis, PhD, illustrates that when she says, “You don’t have to have a straight-line path.” By following her own course from clinical nutrition to epidemiology, Mayer-Davis became the Cary C. Boshamer Distinguished Professor of Nutrition and Medicine and chair of the department of nutrition of the Gillings School of Global Public Health and the School of Medicine at the University of North Carolina at Chapel Hill. For her work in epidemiology of diabetes in adolescents and young adults, Mayer-Davis is the 2019 recipient of the American Diabetes Association’s Kelly West Award for Outstanding Achievement in Epidemiology.

Elizabeth Mayer-Davis

Mayer-Davis spoke with Endocrine Today about avoiding a straight-line career path and how to deal with the parallel growth of diabetes treatment and diabetes prevalence.

What was the defining moment that led you to your field?

Mayer-Davis: My defining moment was many years ago when at my first job as a dietitian, I noticed a lot of people coming to various clinics in the hospital with diabetes and various complications of diabetes. I wondered, “Why are all these people showing up, and why do I see some repeat people coming back to these different clinics or coming across clinics?” In particular, as a dietitian, I wondered whether or not the advice I was giving, which was according to the dietary recommendations for people with diabetes, would actually improve the outcomes for these people, primarily because I felt like I didn’t have the right to impose a change in diet unless we had a good degree of confidence that that change would actually lead to improved health outcomes. That defining moment was a moment of having many, many questions and not having a way to really find the answers beyond a little bit of what was in the literature.

What area of research most interests you right now and why?

Mayer-Davis: Right now, what interests me most is addressing the emerging problem of overweight and obesity in individuals living with type 1 diabetes. There is a real need to understand and address simultaneously underlying energy dysregulation, clinical and medical aspects of type 1 diabetes management, and the behavioral-psychosocial aspects of living with type 1 diabetes and trying to manage blood sugar during the day and during the night and at the same time manage weight — one can be counterproductive to the other. This is a very complex problem and one that is really important for long-term health for people with type 1 diabetes. That’s the area that I’m really focusing on now in my work.

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What advice would you offer a student in health sciences today?

Mayer-Davis: The best career advice really has to do with owning your own path. I could create a career path that would allow me to do the kind of work that I wanted to do and has the kind of day-to-day life and family life that I wanted to have. It was really up to me to think through what I wanted that path to look like and then to make decisions accordingly. That’s different than following a straight-line path that many people might follow. You don’t have to have a straight-line path.

What do you think will have the greatest influence on your field in the next 10 years?

Mayer-Davis: Probably the devices that are being developed now in terms of hybrid closed-loop and closed-loop systems for treatment of type 1 diabetes. That’s really going to change the field a lot, and already the field is rapidly changing — because of continuous glucose monitoring at this stage — in a positive way.

The other thing that’s going to have the greatest influence on the field is the changing demography and social circumstances in the U.S. We are continuing to have an increase in type 2 diabetes, and we’re also seeing an increase in type 1 diabetes. We have many vulnerable populations around the world who will be increasingly experiencing the effects of diabetes. That’s the counter. On one hand, we have what will be improved treatment for diabetes. On the other hand, it’s going to be tremendously important in terms of public health to grapple with the marked increase in numbers of people living with diabetes, not just in the U.S. but around the world.

What are your hobbies/interests outside of your field?

Mayer-Davis: They’re all pretty much active things: gardening, hiking, biking, kayaking. Cooking, but really the first are all those outdoor activities. - by Phil Neuffer

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