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Wake Forest Participating In Major Study To Reduce Heart Attacks, Strokes in Diabetics

WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center is taking one of the lead roles in a major national study testing three promising ways to reduce the risk of heart disease and stroke in adults with type 2 diabetes.

The study, known as ACCORD, for Action to Control Cardiovascular Risk in Diabetes, will have three Wake Forest clinics -- at Downtown Health Plaza, in the General Clinical Research Center (GCRC) at the Medical Center and at the Kulynych Clinic in Greensboro.

David C. Goff Jr., M.D., Ph.D., who is heading the Southeastern United States component of the study, said that among diabetics, "heart disease is the leading cause of death and a major cause of serious illness, but we don''t know how best to treat it."

He said the study is aimed at finding answers to three important questions: (1) Can deaths and serious complications of diabetes be reduced by tight control of blood sugar? (2) Can they be reduced by tight control of blood pressure? (3) Is control of both cholesterol and triglycerides better than for diabetics than just controlling cholesterol?

About 360,000 North Carolinians have diabetes, and 7,000 patients a year die from it, Goff said. The number of cases is twice as high among African-Americans and Hispanic-Americans and at least twice as high among Native Americans, so participants from those groups will be sought.

"In addition, ACCORD is an opportunity to look at the effects of treatment on memory impairment, visual loss, kidney failure and quality of life," said Goff, professor of public health sciences (epidemiology) and internal medicine (general internal medicine.). "We will look at how much it costs to establish tight control, which is important for policy purposes."

He said 55 patients from all three Wake Forest centers participated in the pilot phase of the study, where the researchers confirmed that the study is feasible. The National Heart, Lung, and Blood Institute is paying for the study, with additional support from the National Institute on Diabetes and Digestive and Kidney Diseases. The study will enroll 10,000 people, last through June 2009, and cost $270 million nationally. About $22 million is being funneled through Wake Forest to pay for the southeastern network.

Type 2 diabetes is closely linked to obesity. People with type 2 diabetes are at greater risk of cardiovascular disease, dying at rates 2 to 4 times higher than those who do not have diabetes. They also experience more nonfatal heart attacks and strokes.

Type 2 diabetes, previously called adult onset or non-insulin-dependent diabetes mellitus, is a disorder in which the muscle and fat cells do not use insulin properly. Type 2 diabetes is associated with older age, obesity, and a family history of diabetes and is most common in women with a history of diabetes during pregnancy and people who lead a sedentary lifestyle as well as in certain racial or ethnic groups.

In North Carolina, five other centers are at Duke University, the University of North Carolina in Chapel Hill, Carolinas Medical Center in Charlotte and in two Robeson HealthCare Corp. clinics in Pembroke and Fairmont. The latter two communities have substantial concentrations of Lumbee Indians in addition to African-Americans, Hispanics and whites. Goff said southeastern sites also include two in Georgia, one in Tennessee and one in New Orleans.

All sites are now seeking participants with type 2 diabetes. Patients with type 2 diabetes who volunteer to participate in the ACCORD study will undergo a variety of tests to determine if they are eligible.

The Wake Forest recruitment phone number is 1-877-BE-VITAL or 336-713-8539 for all three sites. Hal Atkinson, M.D., directs the Kulynych Clinic in Greensboro, in the Piedmont Natural Gas Building at 806 Green Valley Road, Suite 300, across from Women''s Hospital. Carolyn F. Pedley, M.D. directs the clinic at Downtown Health Plaza, 1200 M.L.King Jr. Dr. and John R. Crouse III directs the clinic in the GCRC.

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Contact: Robert Conn (rconn@wfubmc.edu), Karen Richardson (krchrdsn@wfubmc.edu) or Barbara Hahn (bhahn@wfubmc.edu) at (336) 716-4587.

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