A pharmacist's perspective on health and metabolic disease
Its been a busy few weeks, what with starting a new job at Auckland Hospital but also preparing for my PhD defence. PhD examinations are a two-part process. The first part is where your written thesis is examined. The second part is known as the Defence, (or Vivas). It is a 60-90 minute oral exam where you discuss aspects of your thesis that may need additional clarification, with your examiners.
It is an interesting process as you really have to think hard about why you chose to do things in a certain way, when you may have made the decision 2-3 years ago. At least you get the examiners comments a week before the exam to help you prepare.
I’m very pleased to say I passed, subject to some minor amendments. A big thank you to my supervisors, Grant, Caryn, and Mark, and to The Engineer and our families for all their support.
Here is the short synopsis of my thesis.
“Traditionally metabolic diseases are thought to be due to insulin resistance, where the cells in the body need higher levels of insulin (hyperinsulinaemia) to regulate blood glucose levels. Little was known about the effects of hyperinsulinaemia on the rest of the body, nor how hyperinsulinaemia should be diagnosed. My thesis shows that hyperinsulinaemia should be considered a separate condition to insulin resistance and it is actually the hyperinsulinaemia that is the earliest sign of many metabolic diseases, including obesity. As measures of insulin resistance, including fasting insulin, could not predict hyperinsulinaemia, I developed a diagnostic test based measuring insulin levels at five time points following a glucose drink and analysed the patterns. This test was developed based on previous work by, and a database collected by Dr Kraft. The results showed that fasting insulin levels could not predict hyperinsulinaemia. The most reliable diagnostic test for hyperinsulinaemia involves five blood tests over three hours following a glucose drink. A simpler diagnostic test involves just one blood test, collected two hours after the glucose drink. Once diagnosed, hyperinsulinaemia can be managed by lifestyle measures, especially carbohydrate restriction and physical activity.”