Q&A: Diabetes in pregnancy researcher recommends combining family with career
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Fidelma Dunne, MD, PhD, FRCP, FRCPI, describes herself as a wife, mother, grandmother, sister and daughter who draws satisfaction from her family and from her career in endocrinology.
Her special interest in diabetes in pregnancy. She currently leads the investigation into use of metformin in pregnancy in the Early Metformin in Gestational Diabetes (EMERGE) trial program.
“There is nothing else that ever interested me other than becoming a doctor, so I never applied to do any other university courses,” Dunne, professor at the School of Medicine at the National University of Ireland and consultant endocrinologist at Galway University Hospitals group, told Healio. “I have really enjoyed my career in this field and always start the day with enthusiasm and renewed energy.”
Dunne is recipient of the Norbert Freinkel Award for outstanding scientific achievement in the understanding and treatment of diabetes and pregnancy from the American Diabetes Association.
In an interview with Healio, Dunne talked about how she got into the field of diabetes in pregnancy, predictions for the future treatment of diabetes in pregnancy, and who she is outside of medicine.
Healio: What was the defining moment that led you to your field?
Dunne: I first got exposed to diabetes in pregnancy in clinical practice as part of my training in the United Kingdom. Unlike other areas of training, I was impressed by the youth of the population and their motivation to have good control in contrast to other diabetes groups. I also liked the fact that attention to detail and regular review led to good outcomes. I was intrigued by the care of two patients at one time and the concept of pregnancy programming for future health. My mentor in that clinic was exceptional, and after a few sessions, I had caught the bug for this work. After a number of years, I began to see problems with the health care process impacting outcomes and a myriad of unanswered clinical questions, and that led me on the clinician–scientist pathway for the last 25 years.
Healio: What area of research in diabetes most interests you right now and why?
Dunne: Having completed the EMERGE randomized trial of metformin in gestational diabetes in pregnancy last year, I am now enthusiastic to carry out the prospective follow-up program of this randomized population. Although metformin was effective and safe in the EMERGE trial, it is important to have longitudinal follow-up of both mother and offspring to examine cardiometabolic and mental health of the mother and body composition of the offspring. In addition, through our biobank and working with collaborators, I would like to explore for novel cardiometabolic markers in these women.
Healio: What do you think will have the greatest influence on your field in the next 10 years?
Dunne: There are a number of areas, really. In diabetes in pregnancy, there will be transformation with the use of hybrid closed-loop pumps and improvement in perinatal outcomes. Life for women with gestational diabetes will be easier as CGM will be the norm and will replace fingerstick testing. Metformin will likely become first-line treatment for gestational diabetes instead of insulin, with greater global affordability and reach. In type 1 diabetes, immunotherapy to slow down or prevent disease in those at risk will be common while, in type 2 diabetes, more effective weight management therapies will emerge.
Healio: Who are you outside of your job? What interests you outside of endocrinology?
Dunne: I’m a human being, wife, mother, grandmother, daughter and sister. My husband is in business. I have three grown-up daughters: a first singleton who is a nephrologist and twin daughters who are both speech and language therapists. The advice I give to junior colleagues is that having a profession together with having a family is the best scenario. It is very hard, but both are so rewarding. Combine both, if possible, because you get satisfaction from being a physician-scientist, being a clinician, but at the same time being a mother and raising children is a wonderful privilege. To do both you need a lot of juggling and plenty of highly paid help. I would recommend a housekeeper with a car who can keep house, do the shopping, prepare meals, take children to school and do the after-school activities, etc. This leaves you free to do fun things with family when you are free.
Outside endocrinology, I am also busy. I help care for my elderly mother, aged 88 years, on a rotation with my sisters on weekends. I also help where I can with two adorable twin granddaughters, the lights of my life now and my new project. I am a daily walker and enjoy holidays that include coastal or hill walking. I love wine tasting, good food and restaurants. I started playing bridge after COVID-19 and do a class weekly. When I retire, I would like to do more of this.
Healio: Whom do you admire and what would you ask that person if you had 5 minutes them?
Dunne: In my field, I admire Boyd E. Metzger, MD, professor at Northwestern Feinberg School of Medicine in Chicago. This year, he is celebrating his 90th birthday. He has been an influential and thought-provoking person in the field since I first got involved and was the principal investigator of the landmark Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study and is still research active. If I was starting off my career and had 5 minutes with him, I would ask him about career pitfalls that he encountered, both in clinical practice and in research, so I could avoid them, and his secrets for being an outstanding mentor.
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