Alka Kanaya, MD is Assistant Professor of Medicine in the Division of General Internal Medicine at UCSF and a Building Interdisciplinary Research Careers in Women's Health scholar. Dr. Kanaya is a general internist whose clinical research is focused on the relation of obesity and type 2 diabetes and the prevention and treatment of type 2 diabetes. 415-353-9753; alkak@itsa.ucsf.edu

Type 2 Diabetes and Obesity Research Program

We are in the midst of an epidemic of obesity and type 2 diabetes in the United States. Approximately 17 million Americans have type 2 diabetes and over 60% of the U.S. population is overweight or obese. Dr. Kanaya is interested in understanding the factors that explain the relationship of obesity and diabetes and in developing ways to prevent diabetes in obese persons. Her research is focused on understanding biologically active factors produced by fat tissue.

• Complications of type 2 diabetes. The consequences of diabetes arise primarily from vascular disease that affects every major organ system in the body. Dr. Kanaya published a systematic review and meta-analysis documenting that both men and women with diabetes have an elevated risk of dying of cardiovascular disease when compared with persons without diabetes. Approximately 70% of people with diabetes will die of cardiovascular disease, compared to 30% of nondiabetic persons. We know that effective management of blood pressure, lipids and glucose can lessen the vascular complications of diabetes.
  
• Prevention of diabetes. Recent studies have found that diabetes can be prevented or delayed by exercise, moderate weight loss and a healthy diet. We are testing an intervention of promoting physical activity and healthy diet to at-risk individuals through a public health department currently. We are also testing alternative therapies to prevent diabetes in high-risk individuals. We have finished a pilot study of Restorative yoga therapy in overweight and underactive adults and found that yoga is feasible and that there are favorable metabolic changes.
  
• Fat tissue. Obesity is a major risk factor for type 2 diabetes, but not all obese persons develop diabetes. Scientists have recently recognized that fat produces a large number of biologically active proteins called adipocytokines. Some of these substances may increase risk for diabetes, while others may decrease risk. Adipocytokines may also play a major role in causing cardiovascular disease among obese diabetics. Dr. Kanaya is currently measuring a variety of proteins produced by adiopcytes from participants enrolled in large studies to determine whether these substances can identify those at high risk of developing diabetes. New therapies are currently being developed to target the proteins produced in fat tissue with the goal of decreasing the incidence of diabetes.
  
• The Metabolic Syndrome. Several risk factors for cardiovascular disease cluster together: diabetes, high cholesterol, high blood pressure, and obesity. This abnormal clustering is seen in 35% of the American population. We are studying the association between the metabolic syndrome and heart disease among a high-risk ethnic group, South Asians.
  

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