Dr Usha Ayyagari

Research and Publication

• At Oxford University, U.K. I was a NIHR (National Institute for Health Research) and EFSD (European Foundation for the Study of Diabetes) clinical research fellow working in clinical diabetes research.
• I was also a sub-investigator in numerous multicentre, and multinational trials in both diabetes and endocrinology. During this period I gained experience in performing physiological studies including insulin-glucose clamp studies, DEXA scans, and anthropometry, writing grant applications and research protocols, setting up clinical trials, applying for ethics, R&D and MHRA approval, patient screening and recruitment to clinical trials, and staff recruitment.
• We undertook a pilot study of the n-of-1 methodology in type 1 diabetes, a series of single-subject, randomised, crossover studies, where patients serve as their own control, comparing efficacy, tolerability and acceptability of interventions. They provide evidence for personalised therapeutic choices. Patients served as their own control comparing two basal insulin analogues. Patient satisfaction (primary outcome) with the n-of-1 methodology was assessed by qualitative measures (visual analogue scales, free text boxes, semi-structured interview). Secondary outcomes were ΔPAID, ΔITSQ, ΔWHO-5, ΔHbA1c, ΔGRADE. As a part of this study we used CGMS to determine patient glucose profiles to titrate insulin therapy and for patient education.
• As part of the systems biology investigation of glucose metabolism and beta cell function, we proposed to study the effect of Sitagliptin on glucose response in non-diabetic and type 2 diabetic individuals using a eu- and 3-step hyperglycaemic clamp in a randomised double blind cross-over study. The Phenotypic Characteristics in Type 2 diabetes as Indices of Beta-cell Failure study aimed to understand the factors influencing the rate of beta cell failure, to analyse the association between beta cell failure and phenotypic, anthropometric, biochemical and radiological characteristics, to identify individual and clusters of characteristics in those who fail fast and those who fail slowly, and to undertake hypothesis testing of these characteristics to develop a risk assessment model for fast vs. slow failure.                       International Publications

Book chapters

• Matthews DR, Ayyagari U, Dyson P. "Clinical features, lifestyle management, and glycaemic targets in type 2 diabetes mellitus." Oxford Textbook of Endocrinology and Diabetes. New York,
• NY: Oxford University Press Matthews DR, Ayyagari U. “The role of antidiabetic agents and new perspectives” Birth, life, failure and rescue of the pancreatic Beta-cell in human type 2 diabetes. John Wiley & Sons, 2009.
• Papers
• The effect of glibenclamide on insulin secretion at normal glucose concentrations. Riefflin A, Ayyagari U, Manley SE, Holman RR, Levy JC. Diabetologia. 2015 Jan;58(1):43-9.
• Thyrotoxic Cardiomyopathy. H Surchi, U Ayyagari. Endocrine Abstracts(2014) 34 P408 DOI:10.1530/endoabs.34.P408Addition of Exenatide to insulin therapy in individuals with type 2 diabetes in UK routine clinical practice. Price HC, Gorst C, Ayyagari U, Levy J and Holman RR. Practical Diabetes 2012 How best to control diabetes Ayyagari U, Dyson P, Matthews DR. Dialogues in Cardiovascular Medicine, 2009.
• Collaborator Quality of life in adults with congenital adrenal hyperplasia relates to glucocorticoid treatment,adiposity and insulin resistance: United Kingdom Congenital adrenal Hyperplasia Adult Study
• Executive (CaHASE). Han TS, et al; United Kingdom Congenital adrenal Hyperplasia Adult Study Curriculum Vitae U. Ayyagari Page 5 of 8Executive (CaHASE). Eur J Endocrinol. 2013 May 3;168(6):887-93. doi: 10.1530/EJE-13-0128. Print 2013 Jun.
• Glucocorticoid treatment regimen and health outcomes in adults with congenital adrenal hyperplasia. Han TS, et al; United Kingdom Congenital adrenal Hyperplasia Adult Study Executive (CaHASE). Clin Endocrinol (Oxf). 2013 Feb;78(2):197-203. doi: 10.1111/cen.12045.
• Health status of adults with congenital adrenal hyperplasia: a cohort study of 203 patients. Arlt W,et al; United Kingdom Congenital Adrenal Hyperplasia Adult Study Executive (CaHASE). J Clin Endocrinol Metab. 2010 Nov;95(11):5110-21. doi: 10.1210/jc.2010-0917. Epub 2010 Aug 18.

National and International Poster presentations:

• SfE BES Annual Conference (Society for Endocrinology British Endocrine Society) (2014): A case of severe Thyrotoxic cardiomyopathy
• Diabetes UK Annual Professional Conference (2011): Poster presentation “n-of-1 studies in diabetes”
• Diabetes UK Annual Professional Conference (2009): Poster presentation “Addition of Exenatide
• to insulin treatment I individuals with type 2 diabetes”
• Diabetes UK Annual Professional Conference (2009): Poster presentation “Addition of Exenatide to oral glucose lowering treatment I individuals with type 2 diabetes”
• Royal Society of Medicine Clinical Case Update (2008): Poster presentation “A Case of Primary Amenorrhoea”