VECDor Fellowship Site Directors:
K.M. Venkat Narayan, MD, MPH, MBA (Emory University)
V. Mohan, MD, PhD, DSc (MDRF)
Site Contact: Mark Hutcheson
Site specialties: diabetes, cardiometabolic diseases, eye diseases
MDRF, established in 1996, is a full-fledged non-profit research center focused on the epidemiology of diabetes and its related complications. Emory University and MDRF are partners in the Global Diabetes Research Center (GDRC), which is based in Atlanta, Georgia and Chennai, India. The goal of the GDRC is to develop world-class, population-based basic and epidemiological diabetes research, low-cost interventions, translational science, and public health programs and policies.
- MDRF is designated as an Advanced Centre for Genomics of Type 2 Diabetes by the Indian Council for Medical Research (ICMR). ICMR is the apex organization in India for the formulation, coordination, and promotion of biomedical research and is one of the oldest medical research bodies in the world.
- The World Health Organization (WHO) has designated MDRF as a collaborating Centre for Non-communicable Disease (NCD) Prevention and Control and as a Sentinel Health Monitoring Centre for NCDs for its collaborative project with ICMR on NCD risk factor surveillance.
- MDRF has been recognized as a Scientific and Industrial Research Organization (SIRO) by the Department of Scientific and Industrial Research (DSIR) of the Ministry of Science and Technology since 1996. This recognition entitles MDRF to receive administrative support from DSIR to promote and encourage scientific research activities and to apply for national and international research grants.
- MDRF is involved in numerous epidemiological and translational studies, including the MDRF-WDF rural diabetes telemedicine project; the Chennai Urban Rural Epidemiology Study (CURES); the Sentinel Surveillance System for Cardiovascular Diseases in Indian Industrial Populations; the Centre of Excellence (COE) Center for Cardiometabolic Risk Reduction in South Asia (CARRS) Surveillance Study; the ICMR-INDIAB Study, founded by the ICMR to determine the nationwide prevalence of diabetes and pre-diabetes; and the Diabetes Community Lifestyle Improvement Program (DCLIP).
- The MDRF basic science unit, located at Siruseri on the outskirts of Chennai, houses facilities for extensive basic and clinical research, following international standards, in diabetes and related complications. This includes:
- Departments for epidemiology, translational research, nutrition research, and clinical trials, located in central Chennai
- A state-of-the-art Molecular Genetics Department specializing in genotyping and sequencing technology and quality control procedures that is currently developing high-throughput procedures for most genetic investigations, in addition to developing functional genomics studies
- A clinical trials team that has successfully completed 125 GCP trials, with 12 currently ongoing
- The American Diabetes Association chose MDRF to collaboratively organize a postgraduate course in diabetology that has been offered to more than 4,000 clinicians in India and surrounding countries.
- MDRF’s excellent research work is obvious from its track record of more than 1000 scientific papers, articles and chapters published in well-reputed national and international journals and textbooks and more than 500 oral and poster presentations given at various national and international conferences.
On average, 4-5 international research fellows from the US, Canada, Europe and other regions, often including Fulbright Scholars, are working at MDRF at any given time. MDRF is also part of the World Diabetes Federation (WDF) Peer Support Programme, a South-South programme that supports researchers on WDF projects to spend time at MDRF.
MDRF is recognized by the Tamil Nadu Dr. M.G.R. Medical University and The University of Madras for conducting courses leading to the award of a Ph.D. degree. Doctors with an MD degree or post-graduate students with M.Phil. or M.Sc. degrees are eligible to complete their Ph.D. courses at MDRF. A total of 30 students have attained their doctoral degree, and 24 are currently working towards their doctoral degree.
MDRF also offers the following training programs:
- Short-term research training program: This three- to six-month training program on diabetes and its complications is conducted annually for undergraduate and graduate students, as well as those in health professional courses, in order to provide exposure to opportunities in diabetes-related research careers.
- Summer internship program: Each summer, this program provides a one-month, full-time training program targeted at undergraduate and postgraduate students. The purpose of the internship is to develop and expand research capacity among graduate students to expand the basis forclinical practice in diabetes.
- Short-term internship in nutrition and dietetics: One-month internships are available for dietitians through the DMDSC to promote exposure to the depth and breadth of current dietetic practice as a pillar in diabetes management.
- MDRF-ADA postgraduate course in diabetology: The American Diabetes Association (ADA) chose MDRF to collaboratively organize a postgraduate course in diabetology that has been offered to more than 4,000 clinicians in India and neighboring countries since its inception in 2002.
MDRF has more than 150 full-time faculty and staff members, including scientists, postdoctoral fellows, research fellows, research assistants, and administrative staff working in two locations (Siruseri and Chennai). The basic science unit in Siruseri houses the departments of Molecular Genetics, Cell and Molecular Biology, Ocular Research, Food and Nutrition Research, Molecular Immunology and Transcriptomics, Research Biochemistry, and Data Management and Biostatistics, as well as laboratories for radioisotope, stem cell, and tissue culture work. Departments whose research requires direct contact with patients and community members (Diabetology, Clinical Trials, Epidemiology, and Translational Research) are located near the main hospital in central Chennai. MDRF is attached to the headquarters for Dr. Mohan’s Diabetes Specialties Centre (DMDSC), a tertiary diabetes care chain that now has grown to 20 centers and more than 1000 staff, with a database of more than 25,000 patients. DMDSC performs routine and specialty laboratory tests in a facility that is ISO-certified and NABL- and CAP-accredited for its quality. Departments at MDRF that often house VECDor trainee projects are detailed below:
The Epidemiology Department at MDRF was started with the objective of studying the distribution and determinants of diabetes and its complications in the population. The team is involved in field survey and studies aimed at determining the prevalence of diabetes and related disorders. The department has well-trained epidemiologists and facilities for handling very large data sets. They have carried out several major epidemiological studies that have provided significant indigenous data on diabetes and other NCDs.
The Translational Research Department was initiated to translate current and previous research into action in the field of diabetes and NCD prevention and control in the community. They focus on the etio-pathophysiology of diabetes (including knowledge of causation, disease dynamics, and identification of risk factors and risk groups), prevention strategies (including availability of prophylactic measures, early detection, and continuous evaluation of implemented preventive measures), and treatment measures.
The Molecular Genetics Department has a well-equipped laboratory with state-of-the-art technology specializing in genotyping and sequencing technology. They are developing high-throughput procedures for most genetic investigations in addition to developing functional genomics studies. The major goal of the Department is to find genes that cause susceptibility to diabetes using genetic techniques and to understand the molecular basis of diabetes and its related traits in order to form a rational platform for improved diagnosis and treatment of patients. As an ICMR Advanced Centre for Genomics of Type 2 Diabetes, the Molecular Genetics Department serves as a nodal centre for genomics research in India and also serves as a centre for training scientific personnel, leading to capacity building and development of basic infrastructure, and providing shared access to specialized technical resources and expertise in relation to genomics of diabetes.
The Department of Diabetology focuses on obtaining accurate prevalence data on diabetes and its complications and studying markers for atherosclerosis, insulin resistance, and diabetes prevention. Their aims are to develop novel approaches to prevention, early diagnosis, and treatment of diabetes, with the goal of initiating systematic clinical studies that can fuel innovative treatment options.
The Department of Cell and Molecular Biology is involved in studying cellular and molecular signatures, with special reference to insulin secretion, insulin action, and vascular function. The research integrates physiological and pharmacological approaches with biochemical, molecular biological, and proteomics techniques to study mechanisms underlying development and progression of diabetes, its complications, and cardiovascular diseases. This includes the identification of novel drug targets related to insulin secretion, insulin sensitization, and vascular function, and the identification of novel prognostic and diagnostic biomarkers.
The primary objective of the Department of Food and Nutrition Research is to study and evaluate the nutrition determinants of chronic diseases such as diabetes. The department also focuses on popularizing lifestyle modification by increasing awareness of the variety of food choices for individuals with diabetes and to ensure adequate, healthy, balanced diets for general population. The department has facilities to conduct both epidemiological studies and food-based clinical trials. They completed several population-based studies targeted at both rural and urban populations with the help of in-house-developed unique dietary assessment tools, such as tailored food frequency questionnaires (FFQs) and EpiNu® India software.
In addition to projects using data generated by MDRF’s many recently completed population-based studies (e.g. CURES), potential research projects for VECDor trainees can be embedded within or ancillary to the following work at MDRF:
Integrated Care for Co-morbid Depression and Diabetes in India (INDEPENDENT Study)
(NIH R01 MH100390, PIs: Ali, Chwastiak, Mohan)
Depression affects one in five people with diabetes in India, meaning that over 12 million people experience a lower quality of life and higher risk of heart disease and death. To provide better care and preventative services for people with both depression and diabetes, this project proposes to use feedback from patients in India to culturally adapt a model of combined depression and diabetes care and to evaluate this care model’s effectiveness and costs in a trial at three diabetes clinics in India. Results from this study should be useful in guiding how to incorporate mental health care into routine diabetes clinics in low-resource settings using simple adjustments.
Worksite Lifestyle Program for Reducing Diabetes and Cardiovascular Risk in India
(NIH R01 HL125442, PIs: Venkat Narayan, Prabhakaran)
This study will test the implementation, effectiveness, cost-effectiveness, and acceptability of a worksite lifestyle improvement program that includes lifestyle education classes led by trained individuals from the worksite.
ICMR-India Diabetes Study (ICMR-INDIAB)
(Indian Council of Medical Research [ICMR], PI: Mohan)
The goal of this study is to determine the national prevalence of type 2 diabetes and pre-diabetes in India by estimating the state-wide prevlaenc eof hte same and to compare the prevalence of type 2 diabetes and pre-diabetes in urban and rural areas.
(Danish Government and Government of India, PI: Mohan)
The goal of this study is to identify interactions between the gut microbiome and human host biology to elucidate novel aspects of the pathophysiology and pathogenesis of type 2 diabetes.
VECDor and MDRF staff will assist trainees in finding safe and appropriate housing options before arrival. A trainee handbook detailing health and safety risks, risk mitigation, and emergency numbers will be given to each trainee, and trainees will be expected to carry an emergency contact card at all time. The central Chennai location is adjacent to a diabetes clinic, one block from a multi-specialty hospital, and one block from a dental hospital. Trainees will be given additional information on medical care available nearby upon arrival.
Martha Ryan, MDc
Mary Foote, MD, MPH
Nida Shaikh, PhD, MS