University of Cincinnati, Ohio

My name is Bob Cohen and I'm an endocrinologist specializing in diabetes at the University of Cincinnati (UC).

UC's Diabetes Centeris the only comprehensive adult diabetes center in the region and works closely with patients' primary health care providers to ensure the creation of a coordinated care plan.

Our team approach gives people with diabetes a better understanding of how medications, diet, exercise, sleep and other factors work together. For example, we offer self-management education classes on topics including how to monitor blood glucose, guidelines for dining out, how to read food labels, the benefits of increased physical activity, and psychologically adjusting to living with diabetes, among others. The goal is for the individual to control their diabetes rather than the diabetes controlling them.

My colleagues and I are also active diabetes researchers. I'm the principal investigator for the Cincinnati site for the National Institutes of Health (NIH) ACCORD (Action to Control Cardiovascular Research in Diabetes) trial. ACCORD, which began in 2001, is an eight-year study testing whether tight blood sugar and tight blood pressure control along with combination therapy for blood fats will reduce heart attacks and strokes in people with type 2 diabetes.

My research lab is also exploring a hypothesis we call the glycation gap. We believe, at times, there are mismatches or gaps between glycated hemoglobin (hemoglobin is a protein in the red blood cells that carries oxygen from the lungs to the tissues) or hemoglobin A1c (used most often to test for diabetes), and other information about blood sugar control. We think these gaps may tell us more about the risk for diabetes complications such as blindness, kidney damage, nerve damage, and heart attacks in an individual.

We're trying to understand what causes these mismatches and how common they are. We hope that figuring that out will give people with diabetes more accurate information about their blood sugar control and may tell us who has the greatest risk and needs the most aggressive intervention, and perhaps lead us to some new strategies for prevention.

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