Podcast: Understanding the Genetic Imprint of Type 2 Diabetes in African Americans
Podcast with Dr. Kandis Boyd Wyatt
Faculty Member, Transportation and Logistics, American Public University
and Dr. Maurice Fluitt
Assistant Professor, Howard University College of Medicine
Type 2 diabetes disproportionately affects African Americans. In this episode, APU business professor Dr. Kandis Boyd Wyatt interviews Dr. Maurice Fluitt about his work in epigenetics, which is research into how the expression of genes can be changed without changing DNA.
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Learn how genetic imprinting helps understand complex diseases like diabetes and why it’s so important to educate the public about this research. Dr. Fluitt also discusses how COVID-19 has affected people with diabetes, why it’s so important to listen to your body and why people shouldn’t be afraid to go to their doctor with any health concerns.
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Dr. Kandis Boyd Wyatt: Welcome to the podcast. I’m your host, Kandis Boyd Wyatt. The goal of this podcast is to highlight our local heroes in our community, who are champions of important issues affecting us all on a national and international scale from the classroom to the meeting room to the board room.
Today, we’re going to add to that very important discussion, happening both nationally and internationally, regarding the importance of understanding the genetic imprint behind many diseases affecting the community.
So today, I’m proud and honored to introduce Dr. Maurice Fluitt, who is a global speaker and also a biomedical scientist and educator. So today, Dr. Fluitt will talk about the importance of maintaining a healthy lifestyle during these trying times and the genetics of diabetes. Dr. Fluitt, welcome to the podcast and thank you for joining me.
Dr. Maurice Fluitt: Good morning, Dr. Boyd. Thank you for having me. It is certainly a pleasure to be here and share this morning on such an important topic of diabetes, genetics of diabetes, and even its context in our current society and culture. So thank you again for having me.
Dr. Kandis Boyd Wyatt: The pleasure is all mine. So let’s go ahead and start our discussion. There are so many critical conversations happening today that pertain to health.
So you’ve been communicating the importance of health for several years, and I’m sure today’s audience can benefit from you sharing your story. So can you start by telling us about yourself?
Dr. Maurice Fluitt: Yes. So I am a mentor, I am an educator, I am a scientist, and most particularly, I am a geneticist. And so simply what that means is, I study genes. I study the functions of genes and how they contribute to disease.
My particular area of expertise is in Type 2 diabetes. So understanding the genetic causes or the underlying genetics of Type 2 diabetes, and really focusing in on how that affects in particular African-Americans as a population that is most likely to be affected by Type 2 diabetes.
And of course, we know it’s several components that contributes to that. You have the environmental piece, you have the genetic piece, and you have all of these sort of factors working together to create a perfect storm as you will, or if you will, that leads to the development of Type 2 diabetes over time.
And so I landed on this journey, I actually started in high school. I remember in 11th grade, we had to do a project on a disease. And my project of choice, ironically, was Type 2 diabetes.
And it really became a really special place, or a really special niche for me because on my father’s side of my family, many of his siblings actually have Type 2 diabetes or had passed away from Type 2 diabetes.
My dad actually passed away from complications due to Type 2 diabetes when I was in 11th grade. And so that kind of spearheaded this interest in wanting to know how the disease could really wreak such havoc on the body over time.
And so no matter how you treat it, no matter how you manage it, it seemed like at that time, over time, it just progressively got worse. And so it really kind of made me curious in the sense of understanding the physiology and then also the genetic underlyings of Type 2 diabetes.
Dr. Kandis Boyd Wyatt: Wow. Thank you so much. Thank you for sharing that.
Now some of our listeners may be a little, might be novices when it comes to the medical world and the medical terminology. So I heard you say, Type 2 diabetes. Can you help us understand first, what’s the difference between Type 1 diabetes and Type 2 diabetes? And then can you help us understand the concept of a genetic imprint?
Dr. Maurice Fluitt: Yes. So there are two types or two main types of diabetes. I have Type 1, and you have Type 2. Type 1, typically, it is referred to as juvenile diabetes. And so it typically presents earlier, much earlier in life. It is where your body doesn’t produce the hormone insulin. Insulin helps to regulate your blood sugar. So after you eat, normally your body is able to produce insulin to help your body sort of take up that glucose and utilize that glucose in a way that is healthy.
And Type 2 diabetes, your body produces insulin, but your body doesn’t respond to insulin. So in the scientific or medical community, we call it insulin resistance.
And so your body’s able to produce insulin, but your body is not able to respond to insulin. And so later, eventually what happens, you exhaust this insulin production and your body doesn’t make enough insulin. And so that’s typically why people with both Type 1 and Type 2 end up on insulin.
In regards to genetic imprint, that is a really exciting term that has really emerged over the last few years, really understanding. And it goes really to understanding the genetics of Type 2 diabetes. But what it refers to is, in a sense, is what genes are responsible for Type 2 diabetes or development of diabetes in general.
And there are several genes that have been identified. What is really interesting is that when you begin to break it down by race or ethnicity, you sort of lose some of that power that these genes have to predict one’s risk of developing Type 2 diabetes.
And so if we move a little bit further in talking about genetic imprint, the focus, at least in my area of research is really understanding what are those sorts of ethnic specific signatures or ethnic specific imprints.
So for example, I focus in on an area of research that is known as epigenetics. It’s a big, big word, but simply what it means, it really means how your genes can be modified, how the expression of your genes can be changed, without actually changing your DNA.
And so think of it in a sense of a light switch. How, when you go into a room, you cut the light on, you cut the light off. And so in this case, the light switch itself would be considered one of those epigenetic modifiers, but you don’t change the wiring, if that makes sense. So, pretty much how can I turn on and off a gene without changing the actual sequence of the gene itself or the sequence of DNA itself.
And so that’s what we refer to when we talk about genetic imprinting. Which is, it has been really big in cancer and understanding cancer and now has made its way into really understanding some of those complex diseases like diabetes.
Dr. Kandis Boyd Wyatt: Wow, thank you so much. So in a perfect world, what training would be needed to help people succeed in becoming more versed in genetic imprinting?
Dr. Maurice Fluitt: So in a perfect world, it really sort of starts early. And so we will look at some of the middle school and high school science curriculum, really introducing this idea of genetics and really sort of at a most basic level, understanding genetic imprinting.
But then also having people like myself or people, clinicians, or established researchers, who’ve done the work, who are familiar with the work, being able to go out into the community and sort of translate what it is that they’ve actually found or discovered or study in a way that it makes sense to the community.
And so that has always been one of the challenges with science and especially the hard sciences, is being able to effectively communicate the work that we do to the community at large. How does it impact the community at large?
One of my mentors always shares with me, you know, you have to understand that we’re brokers of the work that we do, and we have the responsibility to communicate the work that we do to the people that we serve. And so they may not understand what it is that we’re saying.
So we have to find creative means and creative ways to be able to successfully communicate to them what it is that we do. And so really it goes back to again, looking at starting that pipeline of middle school and high school, but then also understanding our responsibility as scientists and physicians to effectively communicate to the people that we serve.
Dr. Kandis Boyd Wyatt: I think that’s a great response. The information is only as useful as the ability for you to translate it in a way that people can understand. So that’s great.
So let’s talk about our current situation and the global pandemic. So how has COVID-19 shined a new light on the importance of physical health?
Dr. Maurice Fluitt: This is an excellent question. So COVID-19 has definitely shined the light on just some of the disparities that we see in particular in certain communities; ironically enough, diabetes falls into that category. So persons with diabetes tend to fare worse if they contract COVID-19. And so what this global pandemic has really shined on is that, the importance of taking care of oneself, getting your regular checkups.
There are a lot of people who contracted COVID-19 and didn’t realize that they had underlying conditions. So they just happened to contract this virus. And all of a sudden they’re finding out that they have hypertension, they have Type 2 diabetes, all of these things that sort of add fuel to the fire of COVID-19, right?
So it really is getting the checkups, checking in with your family, but also practicing healthy behaviors, practicing a healthy lifestyle. So watching what we’re eating, exercising on a regular basis, even if it’s a 30-minute walk a day, just small steps to kind of minimize or reduce that burden that we see with COVID-19.
Dr. Kandis Boyd Wyatt: So I want to go back to something you said earlier. You mentioned genetics and the ability to start teaching these concepts at the high school level. So what changes do you think should be made to curriculum to make students at all levels more aware of the importance of physical health?
Dr. Maurice Fluitt: I think that has been a challenge for some time to really highlight the importance of physical health. I think with [the] Obama administration and with First Lady Obama, that’s something that she sort of put at the forefront, that really placed emphasis on the importance of physical health at all levels of schooling. I think that’s something that needs to continue.
And so down from diet, down from activity at school and at home. And I think those sort of practices, those two worlds, kind of have to merge. Because really our kids spend time at school, but a big part of their learning occurs at home. And so really having parents sort of practice or demonstrate those healthy behaviors.
And so if that is increasing physical activity at school, whether through P.E., whether through recess, whether providing some sort of period where there could be some sort of activity besides sitting at a desk.
And then also at home, parents allowing their children to play or going on family walks or exercising and minimizing their television time and watching what it is that we actually consume. I think those sorts of practices help and stress of the importance of physical activity at a younger age and sort of planting those seeds. And over time, what we’ll see is, we’ll see that people will become more healthier and healthier.
Dr. Kandis Boyd Wyatt: So you also mentioned earlier that it’s really important to know how to translate this information in a way that the community can understand it. So what are some of the critical soft skills that are needed to help others understand physical health issues?
Dr. Maurice Fluitt: So it’s interesting because typically when you think of the personalities of scientists and particularly in my field of genetics, they don’t always have those soft skills to be able to interact with people.
And so one of the things that I found in my young career is just being approachable. Having a smile, wearing a smile, listening to people, taking the time to listen to what they’re saying, hearing what they’re saying, and then providing information for them, or being able to answer their questions. I’ve found that to be really helpful.
And so it really is in a sense, providing a friendly demeanor. Yes, you’re smart, yes, you know this information, that can be intimidating, but when you’re interacting with someone who is not familiar with the work that you do, they’re essentially going to be the stakeholder in continuing or advancing your work. And so it really befits us all to be able to effectively communicate to them. And so practicing our communication, being well versed, or becoming familiar with their community, their lifestyle.
I think one of the reasons why I’ve had success in such a young career is that I’ve been able to sort of build that bridge or connect with diverse people, and understanding people who come from diverse walks of life. So everyone’s not going to be fortunate to understand what it is that we do, but how can I make them feel comfortable enough and trust me enough so that they can buy into what I do.
Dr. Kandis Boyd Wyatt: Thank you. So I wanted to talk about preconceived notions. Because as you mentioned before, some people may say, “Oh, I don’t look sick; I don’t think that I’m sick.” This might be a taboo subject for some people.
So what are some inherent biases that you’ve encountered? And then how would you suggest one identifies them and addresses these issues when it pertains to physical health?
Dr. Maurice Fluitt: So listen to your body. That is the biggest thing that you can do. And I know often, especially as men, we don’t always listen to our body.
And so our body could be telling us to slow down, our body could be telling us, “maybe I shouldn’t eat any more of this.” And we’ll keep going, or we’ll push it off as something else because a fear that we have of doctors.
I know for me, it is the fear of like, I’m going to go to the doctor, they’re going to be like boom, you have Type 2 diabetes. That has been a fear of mine, but listening to what it is that your body is saying and not being afraid to go in. Because the reality is, oftentimes the earlier you’re able to catch something, the earlier you’re able to intervene on a disease, the more likely you are to be able to manage it in a much better way.
I remember a couple of years ago, I was at a conference and I just felt like my arm was just tingling for like three days straight. And I remember when I came back home, I didn’t want to go to the doctor because I was concerned that it was going to be something serious. But when I went to the doctor, he just highlighted that it is stress, it was stress-related.
So again, it goes back to listening to your body, laying aside the pride, there could be fear, there could be reservation there, but at the end of the day, the goal is to be as healthy as possible. And the only way to do that is to listen to what your body is saying, not what you’re telling yourself in your mind, that you’re fine. Listen to what your body is saying.
Dr. Kandis Boyd Wyatt: Yeah, that’s a great point. Now I know that we have a lot of resources out there on the internet that people use and sometimes misuse to self-diagnose. So what are some resources you have used or provided in the past to help individuals become more aware of how to address physical health issues?
Dr. Maurice Fluitt: I always caution the use of that, because you can always misdiagnose or self-diagnose. When you do search for those resources, it’s always important to use reputable resources. So in the case of like diabetes, the American Diabetes Association.
WebMD is a pretty decent source to utilize, but I would always encourage people to check in with their physician, check in with their primary care doctor. You should have a relationship with them where you’re able to check in and let that be sort of the authoritative voice. So you may go with this idea, these are the symptoms that I’m having, I looked it up and this is what I’m thinking, but finalize that with your physician.
Dr. Kandis Boyd Wyatt: Okay, great. Well, Dr. Fluitt, thank you for sharing your expertise and your perspective on this issue. And thanks for joining me again for this podcast.
Dr. Maurice Fluitt: Thank you for having me.
Dr. Kandis Boyd Wyatt: And thank you to our listeners for joining us. So you can learn more about these topics and more by signing up for the bimonthly newsletter. So until our next podcast, be well and be safe.
About the Speakers
Dr. Kandis Y. Boyd Wyatt, PMP, is a professor at American Public University who has over 25 years of experience managing projects that specialize in supply chain management. She holds a B.S. in meteorology and an M.S. in meteorology and water resources from Iowa State University, as well as a D.P.A. in public administration from Nova Southeastern University.
Maurice B. Fluitt, Ph.D., is an Assistant Professor at the Howard University College of Medicine in the Division of Endocrinology and Metabolism.
He earned his Bachelor of Science in Biology and Allied Health from Chowan University (Murfreesboro, NC) and his Ph.D. in Genetics and Human Genetics from Howard University. After completing his doctoral studies, he was awarded the competitive NIH-TL1 postdoctoral fellowship through the Georgetown Howard Universities Center for Clinical and Translational Sciences to investigate the role of microRNAs in diabetic nephropathy at Georgetown University Medical Center. He was later awarded a highly competitive post-doctoral fellowship from the American Diabetes Association to continue his post-doctoral studies at Georgetown University.
His current research aims to investigate the role of microRNAs as markers, mediators, and potential innovative therapies for Type 2 diabetes mellitus and its cardio-renal complications, with the goal of understanding the genetic imprint of Type 2 diabetes and its complications.
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