Research description: Since 1979, Dr. Little's research has included isolated indigenous populations, including the emergence of type 2 diabetes. Traditional risk factors for type 2 diabetes such as family history, overweight/obesity, and centralized adipose. The Oaxaca Project is the focus of much of the isolated population research although small startup projects have begun in the Blue Mountain Jamaican Maroons and Quechua of the Andes. In addition, Dr. Little is studying isolated populations in Appalachia that are experiencing emergence of type 2 diabetes.
Remission of type 2 diabetes without bariatric surgery has recently been reported. Dr. Little has conducted three retrospective studies of type 2 diabetes remission (Medicare, NHANES III, NHANES Continuous), including one dissertation. The Medicare data are longitudinal and triggers for type 2 diabetes remission were identified. Dr. Little's group is developing a type 2 diabetes registry for Kentucky with a long-term goal to include the region, and eventually offer a national resource. These data will allow a prospective analysis of type 2 diabetes remission. He is currently funded by Medicaid to analyze leading indicators of end stage complications in type 2 diabetes (e.g., renal failure, PAD/PVD leading to amputation, heart disease). These leading indicators are being developed into an algorithm to identify patients for intense case management by MCOs to delay or prevent progression to end stage disease(s). A clinical trial of these intervention methods is underway with an MCO.
In collaboration with the Division of Endocrinology at University of Louisville Medical School and Louisville Veterans Administration Medical Center, Dr. Little will analyze type 2 diabetes remission at the SNP level in the Million Veteran Program. The aim is to characterize the constellation of biomarkers that predict type 2 diabetes remission.