University of Vermont College of Medicine, Vt.

Hello. My name is Dr. Richard Pratley. I specialize in obesity and diabetes at the University of Vermont College of Medicine.

More than two thirds of the U.S. population is either overweight or obese. Since obesity is the strongest acquired risk factor for diabetes, the current epidemic of obesity means that even more people will develop diabetes in the next several years.

Our research focuses on the link between obesity and a person's risk for developing diabetes. In particular, we are interested in looking at the behavior of fat cells. For many years, fat cells were thought of as nothing more than a storage depot. We now know that fat cells produce a wide variety of hormones and other factors that directly affect the body's metabolism and thereby increase risk for diabetes.

Our research has shown that fat cell size varies among people and is, in part, genetically determined. While obese people generally have larger fat cells than lean people, some obese people have larger fat cells than others who are comparably obese. This is important, because we have shown that large fat cells are a predictor of who will develop diabetes.

Our research has also demonstrated that fat cells from obese individuals produce a large number of factors that promote inflammation. Many of these factors are predictors of diabetes and may also increase risk for other obesity-associated diseases such as asthma and Alzheimer's disease.

To understand how fat cells are different in people at risk for diabetes we are conducting studies of fat and metabolism in men and women with a wide range of obesity and sugar tolerance. One of our studies is examining whether differences in the growth rates of fat cells are related to the risk for diabetes in obese individuals. Other studies focus on the link between fat cells and risk for Alzheimer's disease. These studies could suggest new prevention or treatment strategies for many important complications of obesity and diabetes.

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