Edmond RyanEdmond Ryan, MD

Office:     362, Heritage Medical Research Centre
Mail:        University of Alberta, Edmonton AB T6G 2S2
Phone:     780-407-3636
Fax:         780-492-6702
Email:      edmond.ryan@ualberta.ca

 

 

 

 

 

Current Position

Professor, Department of Medicine, Division of Endocrinology

 

Research Area

Pregnancy and diabetes, type 2 diabetes

 

Research Goals

 

For general diabetes the main goal over the coming years will be to create an application that assists patients in the management of their type 1 diabetes.  Such an application could have widespread use, be available on smart phones and could have a profound impact on the management of diabetes.

 

In Diabetes and Pregnancy, Dr. Ryan is involved in the reorganization of the Diabetes and Pregnancy clinic to have it function on a more team based basis that will improve throughput and improve patient care.  He is also involved in the NIH Consensus Conference on the Criteria for Diagnosing Gestational Diabetes.

 

Current Research Activities

 

Dr. Edmond Ryan has a keen interest in diabetes and pregnancy and has studied the role of placental hormones in the etiology of gestational diabetes and beta cell function in women with a history of gestational diabetes.  He played a major role in the development of the Canadian Diabetes Association Guidelines for Diabetes in Pregnancy. 

 

He is currently studying beta cell mass in type 1 diabetes during pregnancy. He was also involved with the first islet transplant in Edmonton in 1990.  He has been closely involved with the current islet transplant program up until December 2006. 

 

Dr. Ryan has been instrumental in developing tools to assist the quantification of the severity of glycemic lability and hypoglycemia as part of the assessment of patients for islet transplantation. He has also been involved in diabetes prevention studies. 

 

Human Studies

  1. Intelligent Diabetes Management
  2. Metformin in Women with Type 2 Diabetes in Pregnancy Trial (MiTy Trial)
  3. MiTy Kids
  4. Islet Mass in pregnant Type 1 diabetes subjects

 

  1. Intelligent Diabetes Management

Type 1 Diabetes Management: controlling the glucose in Type 1 diabetes is always a challenge.  Decisions have to be taken at each mealtime as to how much insulin needs to be taken.  This decision is based on a formula based on the amount of food consumed, the proposed activity, the ambient glucose and the previous response taking into account the background insulin.  In the follow up visits in the diabetes clinic advice is given by the diabetes team to the patient on changes that should be made to either the carbohydrate ratio, the correction system, the basal insulin or the insulin dose but in an ideal world individuals would make these decisions themselves at each mealtime.  However, this is daunting.

 

By combining with the machine learning computer experts from computing science we hope to create a computer program that will facilitate this decision making and allow for improved control for people with Type 1 diabetes.

 

The study is recruiting people with Type 1 diabetes for information to generate the algorithms for the machine learning process.  We also have been short listed for full CRIO grant application for the project. Contact info – www.idmuofa

  1. MiTy

This CIHR funded study is examining the role of metformin in Type 2 diabetes women who are pregnant.  The primary outcome is to see if blood glucose control is improved and the dose of insulin required is less whether there will be less weight gain and improved outcomes for the baby.  The study is approved by Ethics and is funded by CIHR and is currently recruiting patients at both the Royal Alexandra Hospital and Grey Nuns Hospital pregnancy and diabetes clinic sites.

 

  1. MiTy Kids

The study is looking at the offspring of women who were enrolled in the MiTy study.  The follow up will be over a number of years.  The study is funded by CIHR and is yet to begin.

  1. Islet Mass in pregnant Type 1 diabetes

Traditionally it was felt that people with Type 1 diabetes had no surviving insulin secreting cells but this has now been shown to be incorrect.  Pregnancy may be an ideal opportunity for some regeneration of beta cells given the relatively immune suppression associated with pregnancy and the ongoing excellent glycemic control that is typically striven for during pregnancy.  We are measuring C-peptide secretion after arginine in women with type 1 diabetes during the course of pregnancy in post partum to see if we can document if there is any recovery of beta cell function.  Demonstration of such recovery could open the door for further research in the area of regeneration of islets in people with type 1 diabetes.  Status is ongoing and recruiting.

Other Activities and Affiliations

 

Director of the Muttart Diabetes Research and Training Centre.

Member of the advisory committee to the ADI

Member of the subcommittee of the Canadian Diabetes Association Clinical Practice Guidelines 2013, Diabetes and Pregnancy section.

Clinical Practices

  1. – Diabetes and Pregnancy clinic, Royal Alexandra Hospital;
  2.  Intensive Diabetes Education and Assessment clinic, University of Alberta Hospital;
  3. Outpatients Endocrine Clinic, University of Alberta Hospital.

Biography

Dr. Edmond Ryan received his MD from the University of Dublin and after his residency training in Ireland completed a fellowship in endocrinology and metabolism at the University of Miami.  He then moved to the University of Alberta in Edmonton and is active in diabetes care and research. He was involved with the first islet transplant in Edmonton in 1990 and was closely involved with the current islet transplant program as Medical Director until 2006.  In addition, he has been Director of the Diabetes Metabolic Centre at the University of Alberta Hospital, has a keen interest in diabetes and pregnancy.  He was the first to confirm insulin resistance in pregnancy using the euglycemic clamp, demonstrated defects in insulin secretion and action in women post GDM and has been on the pregnancy guidelines committee of the CDA since 1998.  He has a web site devoted to diabetes in pregnancy which is primarily directed to women with diabetes in pregnancy, gestational, Type 1 or Type 2 diabetes.  He is actively involved in the international debate on the diagnosis of GDM.  In collaboration with colleagues from the ADI and Computing Science is working on developing an Intelligent Diabetes Management aid for people with diabetes

 

Select Publications

EA Ryan, BW Paty, PA Senior, D Bigam, E Alfadhli, NM Kneteman, JRT Lakey, AMJ Shapiro.  Five year follow-up after clinical islet transplantation. Diabetes. 54: 2060-2069, 2005.

 

EA Ryan, BW Paty, PA Senior, JRT Lakey, D Bigam, AMJ Shapiro.  Beta-score:  An assessment of beta-cell function after islet transplantation.   Diabetes Care. 28: 343-347, 2005.

 

ME Pick, M Edwards, D Moreau, EA Ryan.  Assessement of diet quality in pregnant women using the Healthy Eating Index.  J Amer Dietetic Assoc. 105:240-246, 2005.

 

L Lemieux, EA Ryan. The need for insulin in subjects with impaired glucose tolerance of pregnancy. Can J Diabetes. 28: 196-200, 2004.           

EA Ryan, S Imes, C Wallace.  Short term intensive insulin therapy in newly diagnosed Type 2 diabetes.  Diabetes Care. 27: 1028-1032, 2004. 

 

EA Ryan, T Shandro, K Green, BW Paty, PA Senior, D Bigam, AMJ Shapiro, M-C Vantyghem.  Assessment of the severity of hypoglycemia and glycemic lability in Type 1 diabetic subjects undergoing islet transplantation. Diabetes. 53: 955-962, 2004.

 

GN Brankston, BF Mitchell, EA Ryan, NB Okun.  Resistance exercise decreases the need for insulin in overweight women with gestational diabetes. Am J Ob Gyn. 190: 188-193, 2004. 

              

BW Paty, EA Ryan, AMJ Shapiro, JRT Lakey and RP Robertson. Intrahepatic islet transplantation in type 1 diabetic patients does not restore hypoglycemic hormonal counterregulation or symptom recognition after insulin independence. Diabetes. 51: 3428-3434, 2002

 

JY Jeon, CB Weiss, RD Steadward, EA Ryan, RS Burnham, G Bell, P Chilibeck, GD Wheeler.  Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury.  Spinal Cord. 40:110-117.

 

EA Ryan, JRT Lakey, BW Paty, S Imes, GS Korbutt,  NM Kneteman, D Bigam,  RV Rajotte, AMJ Shapiro.   Successful islet transplantation: Continued insulin reserve provides long term glycemic control.  Diabetes. 51: 2148-2157, 2002.

 

EA Ryan, KR Todd, A Estey, B Cook, M Pick.  Diabetes Education Evaluation: A prospective outcome study. Canadian Journal of Diabetes. 26:113-119, 2002. 

                                   

EA Ryan, JRT Lakey, RV Rajotte, GS Korbutt,  T Kin, S Imes, A Rabinovitch, JF Elliott, D Bigam, NM Kneteman,  GL Warnock,  I Larsen, AMJ Shapiro.   Clinical outcomes and insulin secretion post islet transplantation using the Edmonton Protocol. Diabetes. 50:710-719, 2001. 

 

EA Ryan, G Nguyen. Accuracy of glucose meter use in gestational diabetes.  Diabetes Technology & Therapeutics. 3:91-97, 2001. 

 

EA Ryan, ME Pick, C Marceau.  Alternative medicines in diabetes. Diabetic Medicine. 18:242-245, 2001.

Website Links of Interes

 

Diabetes in pregnancy

Diabetes Management aid