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UTHSC’s Dagogo-Jack Writes First Comprehensive Textbook on Prediabetes

Dr. Samuel Dagogo-Jack
Dr. Samuel Dagogo-Jack

Samuel Dagogo-Jack, MD, DSc, chief of the Division of Endocrinology, Metabolism, and Diabetes at the University of Tennessee Health Science Center, literally wrote the book on prediabetes.

After more than 25 years of research into prediabetes and its progressive disease state, diabetes, Dr. Dagogo-Jack has written the first comprehensive textbook on prediabetes. Titled “Prediabetes: A Fundamental Text,” the book was published by the American Diabetes Association on July 27, and sold out that day.

The A.C. Mullins Endowed Chair in Translational Research, Dr. Dagogo-Jack traces his research interest in prediabetes to the late 1990s, when he was the principal investigator on a diabetes prevention study at Washington University in St. Louis. The study enrolled people with prediabetes and tested various interventions, including medication and lifestyle changes, to determine their effect on the progression to diabetes.

When he joined the faculty of the University of Tennessee Health Science Center in the early 2000s, he continued as the principal investigator on that study, which is ongoing today and has published more than 100 findings.

Dr. Dagogo-Jack has continued to lead numerous studies on prediabetes and diabetes with funding amounting to more than $20 million from the National Institutes of Health and the American Diabetes Association to try to understand the origin and progression of the disease.

“The best we get from changes in diet and exercise is about a 60% reduction (in the progression to diabetes),” he said. “It occurred to me that we need to understand why people develop prediabetes, because finding them in the prediabetic state and then intervening with lifestyle interventions is great, but people with diabetes or prediabetes were born with normal blood sugar and something happens during their lifetime that changes that.”

Considering that there are more than 90 million people in the United States with prediabetes and 30 million with diabetes, Dr. Dagogo-Jack has made it his goal to determine why people develop prediabetes and to find ways to intervene earlier.

In 2006, he received a grant from the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK), a branch of the National Institutes of Health (NIH), for a study of people with normal blood sugar, watching them for the five years to see who developed prediabetes and why. This study titled, “Pathobiology of Prediabetes in a Biracial Cohort” (POP-ABC), aimed to determine how and why blood sugar drifts from normal levels to prediabetes among high-risk African Americans and Caucasians whose parents have type 2 diabetes. More than 100 of the volunteers developed prediabetes during the study, and many new insights were gained regarding the roles of race, weight gain, diet, exercise, insulin sensitivity, insulin secretion, and energy expenditure on the development of the condition.

Based on the strength of the findings from his POP-ABC study, Dr. Dagogo-Jack was awarded another grant from the NIDDK in 2013 to continue the study under a new name, “Pathobiology and Reversibility of Prediabetes in a Biracial Cohort” (PROP-ABC). The PROP-ABC study included an intervention component to determine if prediabetes can be reversed with lifestyle modification.

With the mountain of information gathered over decades, along with that from other researchers around the world, Dr. Dagogo-Jack began thinking about the fact that there was no definitive resource for others similarly interested in prediabetes, and certainly nothing to help translate the science related to it to frontline health care workers treating those with the condition. “A comprehensive textbook did not exist,’ he said.

He had identified a problem, and in the typical style of a scientific investigator, he set out to solve it.

COVID-19 gave him time to get his thoughts together, compile his observations and those of researchers from around the globe, and write the book. “The pandemic lockdown provided me uninterrupted hundreds of hours to put into the work,” he said.

Prediabetes: A Fundamental Text
“Prediabetes: A Fundamental Text”

The book, his seventh, explores the pathophysiology, complications, management, and reversal of prediabetes. There is evidence-based information translating the multimillion-dollar research studies and observations of scientists for use by the health care community, patients, and even young people at risk for or with prediabetes.

Dr. Dagogo-Jack approached the American Diabetes Association with his idea for the book. He has volunteered for 25 years with the organization that is the global authority on diabetes, and served as its president, Medicine and Science, in 2015.

“I pitched it to the Books Department, and they told me that they had it as Number 1 on the to-do list to go looking for an author for a book on prediabetes, and my name had come up, but they didn’t know if I had time,” he said. “And so, it was providential that I was actually emailing them to find out about their interest, and they said, ‘look no further, we are totally interested.’ ”

Dr. Dagogo-Jack hopes the information he has compiled and logically presented will help clinicians, researchers, public health practitioners, policy makers, and the public better understand prediabetes, and by extension diabetes, which afflicts 463 million people globally.

“The fact that nobody wakes up suddenly with type 2 diabetes, but that people actually slide from normal glucose, through prediabetes, for several years before reaching the diabetes stage is knowledge that ought to be shared with the widest possible audience,” he said. “A greater understanding of prediabetes as a condition, I think, is our best bet for bending the curve on the diabetic pandemic that preceded the COVID-19 pandemic and likely will continue, even after we’ve defeated the viral pandemic that is all over the world. By focusing early on what we can do to prevent diabetes, I think I make a modest contribution to the overall health of society, regarding the pervasive nature of the diabetes problem.”

Robert Gabbay, MD, PhD, chief scientific officer for the ADA, said the time is right for Dr. Dagogo-Jack’s book. “With diabetes and prediabetes cases continuing to rise at alarming rates, ‘Prediabetes: A Fundamental Text’ could not come at a better time,” he said. “I applaud Dr. Dagogo-Jack’s leadership and valuable contribution to the field of diabetes to help change the trajectory.

Prediabetes: A Fundamental Text,” is available through the American Diabetes Association, Amazon, and other booksellers.