Bhavana Sosale

Position: Physician, Diacon Hospital, Center for Diabetes Care and Research, Bangalore, India

Institutional Contact: Dr S. R. Aravind, Director, Diacon Hospital, Center for Diabetes Care and Research, Bangalore, 560010, India
Phone: +91 9008998367

  • How did you become interested in research relating to Hypertension?

    I developed an interest in research related to cardiovascular risk factors and cardiovascular disease as I studied and practiced more of diabetology. In my country (India) we have more than 69 million individuals with diabetes, based on estimates from the International Diabetes Federation in 2016. Cardiovascular disease is the leading cause of death in individuals with diabetes. A large number of individuals are unaware that they have hypertension or other cardiovascular risk factors. Even when adequately treated, we are ethnically prone to develop cardiac events.

    The burden is a large public health issue. We need further research to better comprehend the intertwined mechanisms underlying the different aspects of the metabolic syndrome. The magnitude of the problem, and the need for a greater understanding to develop strategies to address the treatment gaps, triggered my interests.

  • Describe your research & the program/lab (info of your supervisor) that you are in?

    I am currently working at Diacon Hospital, Bangalore, India. We are a specialized diabetes care and research hospital. The focuses of our research include inflammation and cardiovascular risk factors in individuals with diabetes, cardiovascular risk factors in young onset diabetes and cardiovascular outcome trials of anti-diabetic drugs.

  • What do you consider to be your substantial scientific contribution so far (provide Pubmed PMID if possible)?

    Individuals with young onset diabetes (YOD), i.e., type 2 diabetes under the age of forty years often have uncontrolled diabetes in addition to multiple cardiovascular risk (CV) factors. Due to the asymptomatic nature of the disease, complications can be present at the time of diagnosis of diabetes. Awareness regarding the need for evaluation of cardiovascular risk factors, and screening for complications of diabetes at the time of diagnosis, is lacking.

    In this study, we used a comprehensive approach to evaluate 1500 individuals with new onset YOD for CV risk factors and complications of diabetes. 27.6% of the individuals were found to have hypertension (pre-existing and newly diagnosed hypertension). Other risk factors like smoking, high BMI [i.e. overweight BMI (23-24.9 kg/m2), obesity BMI (≥25 kg/m2)] and dyslipidemia were present in 24.3%, 83.2% and 62.4% of the study population. Ninety-five percent of the study population were in need of statin therapy to reduce CV risk based on (American Diabetes Association) ADA recommendations for CV risk reduction.

    The presence of CV risk factors at a young age highlights the importance of screening for CV risk factors, even at younger ages of diabetes diagnosis in India.

    Sosale B, Sosale AR, Mohan AR, R M Anjana, Kumar PM, Saboo B, Kandula S. Cardiovascular risk factors, micro and macrovascular complications at diagnosis in patients with young onset type 2 Diabetes in India: CINDI 2. Indian J Endocr Metab 2016; 20:114-18. (PMCID: PMC4743371)

  • What is your favourite manuscript from a lab or mentor other than your own (provide Pubmed PMID if possible)?

    There are a number of amazing inspiring studies and publications connecting diabetes, hypertension and cardiovascular disease. In recent times, a group of oral antidiabetic drugs called (sodium glucose co-transporter) SGLT2 inhibitors have shown additional pleotropic benefits, reduction in systolic and diastolic blood pressure and reduction of composite CV outcomes and heart failure hospitalisation. This is a landmark in the field, as they are the first oral glucose lowering drugs to demonstrate this benefit. Hence, the first two publications on the cardiovascular risk reduction with these drugs are amongst my favourite manuscripts.

    Zinman B, Wanner C, Lachin J et al for the EMPA REG OUTCOME investigators. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015;373:2117-28.

    Neal B, Perkovic V, Mahaffey K, de Zeeuw D, Fulcher G, Erondu N et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. New England Journal of Medicine. 2017; DOI: 10.1056/NEJMoa1611925.

  • What facilities are essential for your research?

    My research is mostly clinical and our hospital is equipped to conduct clinical research (research assistants, anthropometry measurements, medical histories and questionnaires, echocardiography, pulse wave analysis, ultrasound, electrocardiogram, laboratory facilities for biochemical analysis).

  • Where do your research strengths lie? Why? What are your research weaknesses? How will you improve? 

    My research strengths lie in my support group. The great team at the hospital (research assistants and the patients participating in my work) is my foundation.

    My understanding in data analysis and medical statistics, and ability to use statistical software for bio statistical computing has made a big difference to me. As a young and emerging researcher, my knowledge is limited and I still have a long way to go in understanding the links with underlying pathophysiological mechanisms and disease.

    I hope to be able to learn constantly and always remain curious.

  • Describe your unforgettable (proudest) moment in science, and the most challenging situation that you have had to overcome (lessons learnt) so far?

    I had the opportunity of attending the New England Journal of Medicine (NEJM) 200th anniversary celebrations at Harvard Medical School, Boston.  I was one of the recipients of the ‘NEJM scholar award’ during the event. The chance to meet the NEJM editorial team and pioneers in the field of cardiology like Dr. Eugene Braunwald made the experience very special.

    Another such memorable experience was winning the best paper award at the Diabetic Foot Study Group (DFSG), part of the European Association for the Study of Diabetes (EASD), at their annual conference in Potsdam, Germany. The paper was on the association of asymptomatic peripheral arterial disease and cardiovascular disease in individuals with diabetes in India.

    Both these experiences, very early in my residency have continued to linger on as fond memories to motivate me.

    Learning to deal with disappointments, and picking up and going on has been the greatest challenge so far.

  • At which conference did you first present? How was your experience?

    My first conference presentation was at the Diabetic Foot Study Group (DFSG), part of the European Association for the Study of Diabetes (EASD), at their annual conference in Potsdam, Germany. I loved the experience of learning; from losing my luggage in a non-English speaking country, to presenting my first paper and winning the best paper award!

  • What upcoming conferences will you be attending, and what is the furthest distance that you have traveled for a conference?

    I will be attending the EASD conference in Lisbon, Portugal in September 2017. Travelling to the United States to attend the American Association of Clinical Endocrinologists (AACE) conference has earned me the most travel miles so far.

  • How did you learn about ISH/NIN and its activities?

    I had a wonderful opportunity to attend the ISH Summer School for Asia and Australasia in Beijing a few years ago. It was fantastic to meet a few of the NIN committee researchers there. They introduced me to this forum.

  • What area(s) do you wish to specialize in the future?

    I hope to be able to continue my work and learning in the field of diabetes, hypertension and cardiovascular disease. I hope to understand more on the links between inflammation, endothelial function and cardiovascular risk factors in individuals with diabetes.

  • Who is your role model in Science? Why?

    Every scientist and doctor is a role model in his or her own way. I look up to everyone as someone who can teach me something. If I had to pick one person it would be Dr. Rohit Kulkarni, Kulkarni Labs, Joslin Diabetes Centre, Harvard Medical School, MA. He is a substantial contributor to the field of diabetes and is currently one of the leading scientists working on stem cells in individuals with diabetes.

  • What are your scientific goals? Advice for talented emerging scientists?

    The contribution to science involves a process committed to life-long learning. This is a message I would always like to remember and apply. I would advise every young emerging talented researcher to be patient and committed to this process.