Appearing at regular intervals in YFile, Open Your Mind is a series of articles offering insight into the different ways York University professors, researchers and graduate students champion fresh ways of thinking in their research and teaching practice. Their approach, grounded in a desire to seek the unexpected, is charting a new course for future generations.
Today, the spotlight is on Michael Riddell, PhD, professor in the School of Kinesiology & Health Science, Faculty of Health.
Riddell, who has been living with Type 1 diabetes since the age of 14, has focused his research interests on the metabolic and hormonal responses to exercise and stress in diabetes. He has published more than 120 original research papers and 18 book chapters on the topic, and continues to research new pathways for controlling blood sugar.
Q. Please describe your field of current research.
A. My research group studies the effects of exercise and stress on diabetes. While physical activity is very beneficial for people with diabetes, it can make blood sugar control more difficult. Stress hormones also make blood sugar and weight control challenging.
We are working to develop a new therapeutic agent that helps stabilize blood sugar levels during exercise and after insulin administration. We are also assisting in the development of an exercise-smart insulin pump for active people with Type 1 diabetes (formally called juvenile diabetes, which is an autoimmune form of the disease in which the insulin producing pancreatic cells are destroyed). Finally, we are trying to understand the mechanisms by which stress hormones promote insulin resistance and central body fat deposition.
Q. What inspired you to pursue this line of research? Who or what sparked your interest in this line of inquiry?
A. My own diagnosis of Type 1 diabetes at the age of 14, and my love of sports, motivated my interest in diabetes and exercise research. Discovering that stress and stress hormones impact blood sugar control has always interested me.
My two mentors, Dr. Oded bar-Or (McMaster University) and Dr. Mladen Vranic (University of Toronto) helped guide my academic development to pursue research that both fascinated me and would ultimately help people living with diabetes.
Like many working in diabetes research and care, a personal connection to the disease is a main motivation.
Q. How would you describe the significance of your research in lay terms?
A. We hope to take the away some of the burden and uncertainty for people living with diabetes. Diabetes is a chronic disease that requires constant monitoring, measuring (food, insulin, glucose levels) and management. We are developing tools and strategies to help reduce the burden of the disease and increase patient quality of life.
Our goal is to make sure that people with diabetes live a long, happy and healthy life. We do this by helping to determine the appropriate insulin and nutritional requirements for exercise and we focus on patient education to make sure they know how to manage their own condition with new tools and therapeutics that we are developing.
Q. How are you approaching this field in a different, unexpected or unusual way?
A. One unusual way that we approach our research program is to listen to the concerns that people with diabetes have about their own diabetes management. Having met dozens of top-performing athletes (NHL hockey players, Olympians, CFL Football Players, etc.) and professionals with diabetes (doctors, nurses, kinesiologists, entrepreneurs and business people) helps inform us of the gaps in research for people living with diabetes.
I have done two high-mountain treks with other people with diabetes and I spend a fair amount of time listening to others living with diabetes talk about their struggles and successes with diabetes management in sport and exercise.
Q. How does your approach to the subject benefit the field?
A. I am trained as a physiologist – but diabetes is not just a physiological condition. It’s a complex disease that is influenced by genetics, environment and behaviour. Working with a multidisciplinary team of students and collaborators enables my research to have a bigger impact for people living with a diagnosis now, while we all wait for a cure. We are collaborating with engineers, physicians, sociologists, psychologists and other scientists to answer our research questions and help patients living with a diagnosis of diabetes.
Q. What findings have surprised and excited you? (i.e. tell us about the most interesting finding, person and/or place you encountered while pursuing this line of inquiry.)
A. I am surprised and somewhat puzzled by how intense exercise and stress promotes high blood glucose levels in diabetes. It appears that the liver dumps more glucose during intense exercise (and stress) than during milder forms of exercise (or non-stress conditions) and our muscles may have limited capacity for removal of glucose from the bloodstream in these situations.
Without proper physiological insulin replacement, blood glucose levels can rise to dangerous levels in people with diabetes. Intense exercise and some exposure to acute stressors, however, in the long run may actually be very good for diabetes control, since the body can adapt.
One of our most surprising findings is that both recurrent stress and recurrent exercise could delay Type 2 diabetes development in a genetically susceptible animal. Understanding the mechanisms for the protective effects of exercise and intermittent stress is important for new therapeutic development. Another surprising finding is the speed at which all of the benefits of exercise disappear when individuals stop being physically active. The benefits literally disappear in days.
Q. Every researcher encounters roadblocks and challenges during the process of inquiry, can you highlight some of those challenges and how you overcame them?
A. We come across roadblocks all the time. From trying to secure more funding for our research, to having journal reviewers reject our new work for publication. But that’s science. You need to believe in yourself, your work and you MUST listen to your critics – at least some of the time! Setting both professional and personal goals are important for success.
Q. How has this research opened your mind to new possibilities or new directions?
A. My research has shown me that we can do a lot for people with diabetes outside of the usual hospital or clinical visit. We have developed a number of specialty camps and retreats for people with Type 1 diabetes (like the York Diabetes Sports Camps and the Dskate hockey camp) that help educate children and adolescents and their families on exercise and diabetes management. These camps help to inform our next research areas and allow for the dissemination of our research findings on improving blood glucose management in exercise and sport.
Q. I understand you are Type 1 diabetic – can you speak to the more personal implications of your research?
A. Of course, having a disease that you also research is informative and usually motivating. I have a good understating of the disease condition and I know the gaps in research. But with that comes the responsibility of trying to help people who reach out to me because of a recent diagnosis in the family (e.g. a son or daughter with a recent diagnosis of Type 1 diabetes). This is an important responsibility that can sometimes be painful for me. I know first-hand that a diagnosis of diabetes in a family often comes with a lot of sadness, fear and sometimes even guilt. But having the ability to connect these people to a huge network of friends with diabetes (FWD) and health care experts and clinical researchers focusing on diabetes is reassuring.
Q. Are there interdisciplinary aspects to your research? If so, what are they?
A. I am interested in the way in which regular exercise and exercise sports camps can help kids with diabetes connect with each other and develop better self-care management. In our camps, we work with various health care providers (nutritionists, nurses, doctors) outside of their usual clinic visits. A clinic visit may last only 15 to 20 minutes every four to six months for a child with diabetes. Spending a week together helps to reinforce the lessons learned in these clinic visits.
Q. Did you ever consider other fields of research?
A. All the time – but not for me to work in. I enjoy research in health epidemiology and behaviour sciences as well as physiology.
Q. Are you teaching any courses this year? If so, what are they? Do you bring your research experience into your teaching practice?
A. I am teaching a fourth-year kinesiology course next term called “Advanced Physiology: Endocrinology”. Since diabetes is an endocrine disease, we talk about it for at least three to four full lectures and I like to highlight some of the research my graduate students are doing. I also teach in the first year KINE course An Introduction to Health and Fitness. That course is a lot of fun to teach in.
Q. How long have you been a researcher?
A. My first job as a researcher was at the Children’s Exercise and Nutrition Centre at McMaster University in Hamilton in the mid-1990s. We published a paper entitled “The reliability and repeatability of the blood glucose response to prolonged exercise in adolescent boys with insulin-dependent diabetes mellitus” in the prestigious journal Diabetes Care. We showed that people with Type 1 diabetes have a variable response to aerobic exercise, but that they also have some reproducibility in their own responses to the exercise. Or in other words, as a patient with diabetes you may have your own unique blood sugar responses to exercise and to stress. This was important since it meant that individual strategies could be developed and customized to each patient.
Q. What books, recordings or films have influenced your life?
A. The Discovery of Insulin by Michael Bliss is a must read for anyone doing diabetes research. It shares the story of Fredrick Banting and Charles Best and colleagues at the University of Toronto on how they managed to discover insulin in the 1920s – a Canadian discovery that saves millions of people from dying from diabetes.
What I loved about this book was the way that the author (a well-known historian) shed light on the sometimes-explosive relationships between the researchers involved. They were working under such incredible pressure and poor conditions. But, their research was exceedingly impactful. I love that book.
Q. What are you reading and/or watching right now?
A. Game of Thrones. I like stories of struggle and survival.
Q. What advice would you give to students embarking on a research project for the first time?
A. Love your research and work hard at it – even more than your supervisor does. Try to get involved in a project that means something to you or that you truly want to find the answers to.
Q. If you could have dinner with any one person, dead or alive, who would you select and why?
A. Charlie Best, co-discoverer of insulin. Or my dad – he died of cancer in 2003.
Q. What do you do for fun?
A. Mountain biking, mountain trekking or pretty much any sporting activity with other FWD (friends with diabetes).
Riddell’s upcoming book on exercise in Type 1 diabetes is called Getting Pumped! An insulin pump guide for active individuals with Type 1 diabetes.