News Around NIDDK

NIDDK tackles COVID-19 through research, funding, and clinical care

By Katie Clark

Across NIH, including NIDDK, people are working hard to better understand, treat, and stop COVID-19 and its spread.

Many NIDDK intramural scientists have turned their expertise to combatting the pandemic through research. Below are some of their recent publications:

• Visualizing speech-generated oral fluid droplets with laser light scattering
• The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission
• Perspective article: COVID-19 pandemic, coronaviruses, and diabetes mellitus
• Guidance: endocrinology in the time of COVID-19, management of Cushing’s syndrome
• Is SARS-CoV-2 also an enteric pathogen with potential fecal-oral transmission: a COVID-19 virological and clinical review

As well, several staff from the NIDDK Phoenix Epidemiology and Clinical Research Branch have volunteered to provide clinical care, including for COVID-19 patients, and have implemented surge preparations at the Phoenix Indian Medical Center.

NIDDK is also supporting COVID-19-related research through grant funding that closed in early June pertaining to urgent supplements for coronavirus research and for research about coronavirus and HIV co-infection, as related to the diseases in NIDDK’s mission. NIDDK Division Directors Drs. William Cefalu, Stephen James, and Robert Star also discussed “Opportunities for Research for COVID-19 in the Mission of NIDDK” in a commentary in Diabetes Care that published online in May.

To subscribe to NIH’s updates on COVID-19, please visit www.nih.gov/health-information/coronavirus. For information on NIH grants and COVID-19, go to https://grants.nih.gov/policy/natural-disasters/corona-virus.htm. 

For more information on COVID-19, visit the Centers for Disease Control and Prevention (CDC) coronavirus webpage.

Managing chronic diseases during uncertain times

Extra planning needed for people with diabetes and chronic kidney disease
By Heather Martin

Coping with the coronavirus pandemic would be challenging in the best of situations. For people with chronic medical conditions such as diabetes and chronic kidney disease (CKD), whom the Centers for Disease Control and Prevention stated may be at higher risk for severe illness from COVID-19, the challenges can feel insurmountable.

“Thankfully, people with chronic medical conditions have tools to help maintain their health, even during difficult times,” said NIDDK Director Dr. Griffin P. Rodgers. “When chronic conditions are managed effectively, the risk of many other illnesses or complications is lower.”

Along with following public health guidelines, Rodgers recommends taking time to prepare, keeping in virtual touch with health care providers, and adapting as much as possible to maintain normal diabetes or chronic kidney disease management plans and avoid sickness.

Unfortunately, having a cold, the flu, or an infection can raise blood glucose levels (blood sugar levels), which can make it harder to manage diabetes. Being sick also puts stress on the body, releasing hormones to manage the stress and fight the illness. Higher hormone levels can also cause higher blood glucose levels.

During uncertain times, extra planning is needed to manage chronic medical conditions. “Obtaining some level of physical activity on a regular schedule and adhering to a healthy eating pattern prescribed for diabetes control is going to help a person stay healthy,” said Dr. William Cefalu, director of the NIDDK Division of Diabetes, Endocrinology, and Metabolic Diseases. “Physical activity can also help alleviate the stress many of us are experiencing.”

Preparedness

Another part of managing any chronic medical condition is preparing in advance for the unexpected. Cefalu recommends packing a specialized “go-kit” for emergencies including:

• At least one week’s worth of medical supplies and equipment
• Contact information for healthcare providers and emergency contacts
• Medication list with doses and dosing schedules
• Allergy list
• Information about any medical device used
• At least a three-day supply of any foods needed to manage your condition (e.g., low sodium or potassium)

Having copies of recent lab work, insurance card, and photo ID is also helpful.

For people with diabetes, Cefalu recommends also including:

• Blood glucose meter, lancets, and testing strips
• If you use a continuous glucose monitor, make sure you have all items necessary (sensor, transmitter, etc.)
• Insulin, syringes, and an insulated bag if insulin is normally used
• If on a pump, make sure you have adequate supplies (e.g. infusion sets, reservoirs to hold insulin, batteries)
• Glucagon kit if insulin is used or if recommended by a doctor
• Glucose tablets and other food or drinks to treat low blood glucose
• Antibiotic cream or ointment
  

The Diabetes Disaster Response Coalition (DDRC), a coordinated effort from non-governmental diabetes organizations, developed a specialized preparedness plan for people with diabetes and shares relevant COVID-19 information.

Dr. Robert Star, director of the NIDDK Division of Kidney, Urologic, and Hematologic Diseases suggests that all people with chronic kidney disease should contact their health care provider if feeling ill or have any questions or concerns.

For people who are on dialysis, Star suggests including a copy of the dialysis treatment plan, nearby dialysis center phone numbers, and the federally funded kidney community emergency response (KCER) hotline number at 866-901-3773 in addition to the general items in a go-kit.

“People on dialysis for chronic kidney disease will need to check with their specific dialysis center about their plans, so they do not miss a treatment,” said Star.

For more tips on disaster preparedness for people with chronic conditions, see this previous Director’s Update article.

Coping with uncertain times

Depression is common among people with a chronic, or long-term, illness, and it can get in the way of managing the condition. People with chronic medical conditions who face disruption of their care and normal routine may have additional stress.

Common ways to lower stress and relax include deep breathing, gardening, taking a walk, meditating, listening to music, or doing a hobby. Getting enough sleep (7 to 8 hours each night) can also have tremendous health benefits, including for reducing stress levels and weight maintenance.

“Ask for help if you feel down or need help managing stress,” said Rodgers. “It’s always important to learn ways to lower stress and improve health.”

Tools to manage diabetes and CKD

NIDDK in action

Though maintaining health doesn’t erase the risk for getting other diseases, each healthy day is a day closer to better treatments for diseases, including diabetes, CKD, and COVID-19. As part of a coordinated NIH effort, NIDDK is making those days count by working to make rapid research progress related to COVID-19 and diseases in the NIDDK mission.

“We’re supporting an array of targeted research efforts that will enable us to further understand why and how COVID-19 is affecting people with conditions like diabetes and chronic kidney disease, including people of color who have been disproportionately among those most severely ill with the virus,” Rodgers said. “While we search for answers to COVID-19 and conditions in our mission, we hope by sharing what we’ve learned from research, we can help people maintain their best health, even in these uncertain times.”

Additional information:

• CDC Coronavirus (COVID-19) resources
• NIH COVID-19 resources

Read more about NIDDK efforts to combat COVID-19 throughout this issue.

NIH releases strategic plan to accelerate nutrition research

What if each of us had individualized dietary recommendations that helped us decide what, when, why, and how to eat to optimize our health and quality of life?

This precision nutrition approach is among four goals set out by the first-ever 2020-2030 Strategic Plan for NIH Nutrition Research. NIH, guided by its Nutrition Research Task Force (NRTF), armed with the insights from the nutrition science community, practitioners, the public, and others, has created a research vision to chart nutrition science discoveries over the next 10 years.

The new strategic plan calls for a multidisciplinary approach through expanded collaboration across NIH Institutes and Centers to accelerate nutrition science and uncover the role of human nutrition to improve public health and reduce disease.

NIDDK commemorates 70th Anniversary

This year, NIDDK is celebrating 70 years of advancing health through research. Coming soon, we will launch an anniversary webpage showcasing where we started, how far we’ve come, and our vision for the future. Learn about pivotal research findings and award-winning NIDDK-supported scientists, and join in the celebration by following and sharing our social media. We look forward to commemorating the achievements we’ve made together as a research community.

Getting to Know: Dr. Gregory Germino

Gregory G. Germino, M.D., is the NIDDK deputy director and the section chief of the Polycystic Kidney Disease Section in NIDDK’s Kidney Diseases Branch. He joined the NIDDK in 2009, after many years as a physician scientist and NIDDK grantee at Johns Hopkins University. Known for his high energy and poise, Germino spoke with Lisa Yuan about what it’s like to help lead one of the NIH’s largest institutes.

What does your typical day look like?

My days vary quite a bit. I get to work broadly on many different activities, which is partly what makes my job so exciting, interesting and challenging. As deputy director, I participate in trans-NIDDK and trans-NIH activities, strategize with other NIDDK leadership on transcendent issues, and meet regularly with offices in which I have direct supervisory responsibilities, such as the Technology Advancement Office and Office of Clinical Research Support. I also spend time on Mondays and Fridays, and intermittently throughout the week, working on my research and meeting with my lab.

How do you juggle so many responsibilities?

I have a history of being able to compartmentalize. As an athlete with a scholarship in college, I had to focus on running for hours every day, then come off the track, exhausted, and spend evenings in the library focusing on my studies. That ability to turn on and turn off, to focus intensely on what I need to do to be successful in each domain, has served me well in my career. I still exercise regularly to relieve stress and stay healthy.

What are your proudest career accomplishments?

Scientifically, I’m proud of the work my lab has done; a number of seminal studies in our field came from our group. Our observations have broadened understanding of the mechanisms of polycystic kidney disease and of models that could lead to finding therapies or a cure. The excitement of discovery – finding something out that mankind has never known – is exhilarating.

Another one of my proudest accomplishments is mentoring. Many trainees have gone on to become successful investigators and leaders – some who faced barriers, yet are thriving professionally years later. I compare it to being a point guard in basketball, where I pass the ball down and see my trainee do a layup and get the basket! It’s one of the most satisfying parts of my career.

What energizes you?

Part of it is curiosity. Learning and doing new things constantly re-invigorates me; knowing our work not only affects results today, but potentially for the long term, and that we can change the way people think about disease and health.

And part of it is that I get to work with so many great people throughout the NIDDK who care deeply about what they do and are incredibly dedicated to the mission of NIH. It’s an ideal situation, to do work that’s impactful and enjoy it at the same time.

The COVID-19 pandemic has affected us all drastically. How do you help staff members manage workplace anxiety?

I focus on clear communication, transparency, calm and reason, as well as flexibility and accommodation. It’s important that people feel that those of us making management decisions are receptive to questions, looking for creative solutions, and accommodating people’s needs as best we can, especially in times of adversity. I give kudos to the thoughtful, hard-working people I work with, who all stepped up during this pandemic to ensure that NIDDK operations continued running well.

What would you say to someone who is considering a career in public service?

Being a public servant enables you to work on something beyond your immediate self to help the greater good, which can be incredibly satisfying. Whether it’s developing programs or making sure the lights stay on and computers are working, your job is critical to the grander mission of serving the American people. At NIDDK, our work impacts many fields of medicine and people across the U.S. and worldwide, so coming here gave me the opportunity to impact science far beyond what I could as an individual physician or researcher. I make sure that all my family and friends know I’m a proud federal employee, because public service is really a great calling.

NIDDK strategic planning update

NIDDK is continuing to develop an institute-wide strategic plan, which will present a broad vision for accelerating research into diseases and conditions within the institute’s mission. In February, the institute held the first conference calls with the NIDDK Strategic Plan Working Group. NIDDK also released a Request for Information (RFI) to gather ideas from the broader research community and the public.

For more information about the planning process, visit the NIDDK strategic plan website.

NIDDK leaders participate in Endocrine News podcast

NIDDK Director Dr. Griffin P. Rodgers and Dr. William Cefalu, director of NIDDK’s Division of Diabetes, Endocrinology, and Metabolic Diseases, participated in The Endocrine Society’s podcast, Endocrine News, this spring. They spoke with Dr. Robert Lash, chief professional and clinical affairs officer of the Endocrine Society about their careers, what’s next in diabetes and obesity research, and NIDDK’s strategic planning process. Listen to these discussions and hear advice for early-career investigators on the podcast’s webpage.

NIDDK launches a robust anti-harassment program

By Katie Clark

When NIH updated its anti-harassment policy, NIDDK senior leaders jumped at the opportunity to develop the institute’s own customized, comprehensive program.

“Supporting the workforce is a critical priority in any organization,” said NIDDK Director Dr. Griffin P. Rodgers. “At NIDDK, we are committed to creating and sustaining a work environment that is collegial, respectful and fair – where all feel welcomed and valued.”

NIDDK’s new anti-harassment program includes a wide variety of resources for all staff, including workshops and other trainings that cover many scenarios and provide guidance for all to safely speak up about an uncomfortable situation, and for supervisors to navigate discrimination or personal relationships that may need to be disclosed. NIDDK has also added customized language to employee performance reviews.

The trainings and resources that NIDDK has developed have set a precedent at NIH and have been lauded as an example of what other organizational anti-harassment programs can aspire to.

“Together with every NIDDK leader, we must implement high standards of accountability, provide necessary tools and resources for staff support and growth, foster a culture where creativity and innovation are rewarded, and one where diversity and inclusion are embraced,” said Camille Hoover, NIDDK’s Executive Officer. “The actions we take are driven by this goal – and informed by staff feedback.”

Leaders and staff at NIDDK take pride in the institute consistently ranking number one in workplace satisfaction among large institutes at the NIH, according to Hoover. “Part of this success is due to the institute’s commitment to being a progressive organization and its loyalty to addressing staff needs and responding to feedback. The NIDDK Anti-Harassment Program is an important piece of this effort," Hoover said.

To learn more about NIH efforts, visit the NIH Civil Program website.