Professor James Best
Chair of Medicine, St Vincent's Hospital
Head of School of Medicine
| telephone | +61 3 8344 6581 |
| facsmilie | +61 3 8344 6894 |
| jdbest @ unimelb.edu.au |
Profile
Jim Best has had a long association with the University of Melbourne, graduating in the Faculty of Medicine in 1972. He trained in Endocrinology at St Vincent' Hospital and in diabetes research at the University of Washington, Seattle, USA . Having worked as an Endocrinologist at St Vincent's from 1982 to 1989, he joined the University of Melbourne staff as Deputy Head of the Department of Medicine (St Vincent's Hospital) and in 1999 was appointed as Professor of Medicine and Head of Department. He has also been Deputy Dean of the Faculty from 2004 to 2006 and subsequently Associate Dean (Resources). In 2007 he was appointed as Head of School (Medicine).
Jim has taught extensively during his career, especially on the topic of diabetes and metabolism, as well as on the medical interview. He was actively involved in development of the current MBBS curriculum, particularly the subject "Nutrition, Digestion and Metabolism". His research has involved physiological and molecular studies of glucose disposal, as well as studies of lipid biochemistry and epidemiological and clinical studies of risk factors for cardiovascular disease in diabetes. He is CIA for the NHMRC Centre of Clinical Research Excellence in Clinical Science in Diabetes.
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Professional Activities:
Chair of the NHMRC Research Committee, Member of Council of the NHMRC.
Qualifications
MBBS, MD, FRACP, FRCPath, FRCP Edin
Major Grants
- PEACH Study - Patient Engagement and Coaching for Health: An Intensive Treatment Intervention for Patients with Type 2 Diabetes in Disadvantaged Communities (NHMRC Program Grant 2005 - 2008 $500,000) D Young, J Furler, C Walker, M Vale, J Best, L Segal, P Dunning, R Audehm.
- NHMRC Centre for Clinical Research Excellence #454461 (2006-2010, $2m) Clinical Science in Diabetes. J Best, K O’Dea, H Taylor, T Kay, A Jenkins, D Young
- The Health 2020 Cohort Study (Health 2020). NHMRC Enabling Grant #396414 (2006- Health outcomes monitoring and evaluation: learning about activity, nutrition, diet and social factors - HOMELANDS. (NHMRC Program Grant, 2005-2009, $7,071,000) K O’Dea, W Hoy, K Rowley, J Best, Z Wang.
- Cellular mechanisms and physiological roles of GLUT12 mediated glucose transport in glucose homeostasis. (NHMRC Project Grant, 2005-2007, $491,500) S Rogers, J Best, J Proietto, J Favaloro.
Selected Publications
- The FIELD study investigators (Writing Committee: Keech, A., Simes, A.J., Barter, P., Best, J.D., Scott, R., Taskinen, M-R., Forder, P., Pillai, A., Davis, T., Glasziou, P., Drury, P., Kesaniemi, A., Sullivan, D., Hunt, D., Colman, P., d'Emden, M., Whiting, M., Ehnholm, C. and Laakso, M.) Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet 366: 1849-1861, 2005.
This is the largest clinical study ever completed in type 2 diabetes, involving 9,795 people from Australia, New Zealand and Finland. The results provide an evidence base for the use of the drug fenofibrate in type 2 diabetes; evidence was lacking despite widespread use of the drug for over 20 years in the management of dyslipidaemia. Further information about management of type 2 diabetes and prevention of microvascular and macrovascular complications will be derived from continuing analysis of the results, as has occurred with other major trials of this nature. It is one of the most significant clinical trials in type 2 diabetes.
- Rogers, S., Macheda, M.L., Docherty, S.E., Henderson, M.A., James, D.E. and Best, J.D. Identification of a novel glucose transporter like protein - GLUT12. Am. J. Physiol. Endocrinol. Metab. 282: E733-E738, 2002.
This paper reports the discovery of a novel glucose transporter protein in a human breast cancer cell line. It was also present in human tissues that are insulin sensitive and has an intracellular location in the basal state. These findings make it potentially relevant in the pathogenesis of type 2 diabetes and in the progression of cancer. At the time of the discovery, all human glucose transporters were thought to be known. The discovery has led to further significant findings on regulation of translocation and so activation of the transporter and to national and international collaborations to elucidate its role in human pathophysiology. In particular, recent development of a GLUT12 knockout mouse should help to define its role.
- Vale, M.J., Jelinek, M.V., Best, J.D., Dart, A.M., Grigg, L.E., Hare, D.L., Ho, B.P., Newman, R.W. and McNeil, J.J. Coaching patients on achieving cardiovascular health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch. Intern. Med. 163: 2775-2783, 2003.
Guidelines for management of cardiovascular disease risk factors set treatment targets, but many studies have shown low rates of implementation of guidelines and achievement of treatment goals, even in high risk patients with existing cardiovascular disease. This study followed a single centre trial of a novel approach to supporting patients in a self-management program, developed by the authors. The program, which works in a co-operative way with treating doctors, led to better outcomes for patients in terms of risk factor reduction. This research has had a significant impact on healthcare delivery for patients as more than 10 hospitals in 3 Australian states are now running the program, using ‘coaching’ to reduce risk factors in patients with proven coronary heart disease. The success of the program has led to a number of other trials using this approach for self-management of other chronic diseases.
- Rowley, K., Walker, K.Z., Cohen, J., Jenkins, A.J., O’Neal, D., Su, Q., Best, J.D. and O'Dea K. Inflammation and vascular endothelial activation in an Aboriginal population: relationships to coronary risk factors and nutritional markers. Med. J. Aust. 178: 495-500, 2003.
Indigenous Australians have very high rates of cardiovascular disease, significantly reducing life expectancy. There are also increased rates of diabetes and kidney disease, both of which are linked with cardiovascular disease. The reasons for this increased risk are complex and are likely to include poor nutrition. This study shows that low levels of anti-oxidant vitamins that result from poor nutrition can be linked with vascular dysfunction, a surrogate measure of atherosclerotic vascular disease. The significance of this paper is that it paves the way for intervention studies to improve nutrition as a means of reducing cardiovascular disease risk in this vulnerable population.