Diabetes Institute celebrates opening
The institute unites basic sciences, clinical research, training and patient care to work to prevent and treat diabetes and its complications.
The UW Medicine Diabetes Institute celebrated the opening Sept. 10 of new UW Medicine South Lake Union facilities that bring basic science, clinical research, education, and patient care into proximity.
Members of the Institute are from many different fields. Among their varied goals are understanding how the different forms of diabetes emerge, why the condition harms many parts of the body, and what might be done better to prevent or treat diabetes and its serious complications. These can include vision loss, problems for expectant moms and their babies, peripheral nerve damage, infection risks, feet and hands that are injury-prone, kidney disease and heart disease.
People with diabetes have blood sugar levels that rise too high. It’s diagnosed by measuring the percentage of sugar-coating on the proteins that carry oxygen in the blood. Type 1 diabetes is thought to be, at least in part, an immune disease that destroys cells in the pancreas that secrete insulin. Insulin helps cells turn certain sugars into energy.
People with Type 2 diabetes either do not make insulin well or their cells don’t use it properly. Other forms of diabetes can occur during pregnancy, can be induced by steroid medications, or can be atypical presentations of the disease.
Dr. Michael Schwartz and Dr. Stephanie Page, both professors of medicine in the Division of Endocrinology, co-direct the UW Medicine Diabetes Institute. The UW School of Medicine’s national leadership in diabetes research, training and care goes back historically to the late 1940s to the first chair of medicine, noted endocrinologist Dr. Robert H. Williams.
As for the formation of the UW Medicine Diabetes Institute, Schwartz and Page said at the opening that it was over six years in the making and is the culmination of efforts of numerous colleagues and supporters.
Diabetes researchers collaborating with UW Medicine Diabetes Institute come not only from the UW health sciences schools, but also from the Puget Sound Veterans Administration, Seattle Children’s, and several other medical and research institutions.
The main components of the UW Medicine Diabetes Institute are:
Metabolism Program, headed by Gregory Morton, research professor of medicine
Pancreatic Islet Cell Program, headed by Rebecca Hull, research associate professor of medicine
Clinical Research Unit, headed by Ellen Schur, associate professor of medicine, General Internal Medicine
Complications of Diabetes Program, headed by Karin Bornfeldt, professor of medicine
Multidisciplinary Clinics, directed by Subbulaxmi Trikudanathan
A few of the numerous examples of what UW Medicine diabetes researchers and clinicians are especially noted for are:
What controls body weight? Because excess an excess body mass index and food choices are among the factors that can contribute to the onset some forms of diabetes, and make it difficult to control after diagnosis, the complex topics of what controls food intake, what influences body weight, and why a healthy weight can be difficult to maintain are covered in many research projects. These include brain mechanisms that promote hunger or fullness, as well as those involved in sensing and protecting fat stores, chemicals that might influence these mechanisms , why some cancers result in loss of body fat and muscle strength, how overeating might damage weight control mechanisms in the brain, and what appears in imaging scans of the brain in anticipation of a meal.
How can obesity be treated? Several studies have been undertaken to find useful answers for this often difficult-to- manage condition, including the effects of bariatric surgery on weight and diabetes control, and the search for new medications that might help in weight reduction without causing intolerable side effects.
How do cells that secrete insulin work, and can lost or damage be restored by stem-cell derived pancreas cells? Basic biochemistry research on the formation and activation of secretory granules in cells, and projects in regenerative medicine, are setting new directions in the science of diabetes, and may point to potential therapeutics.
The role of mitochondria in diabetes and its complications: Researchers are looking problems stemming from the actions of mitochondria – which scientists have found have many more functions beyond being power stations in cells – in the development of diabetes and its sequels, such as the weakening of the heart.
Can kidney damage from diabetes be reversed? Diabetes is one of the leading causes of kidney failure and the need for dialysis or organ transplant. Studies are underway in small animal models to see if kidney problems can be repaired.
In clinical care, among areas of special note are:
Helping people with diabetes who also have depression or anxiety: Mood disorders can contribute to poor control of diabetes, to diabetes care burnout. The condition can also provoke diabetes distress, a feeling of denial, fear, guilt, and worry, and a sense of the burden of disease management. Depression is more common in people with diabetes, and also can increase their risk of dementia, according to studies conducted by UW School of Medicine researchers. UW Medicine has been a longstanding leader in the mental health support of people with diabetes.
Growing into adulthood with childhood-onset diabetes: UW Medicine and Seattle Children’s pediatric, adolescent and adult medicine physicians, social workers and other counselors have taken a special interest in helping older teens transition into adult diabetes care. Research and experience has shown that, as older teens move on to college or employment, they sometimes do not receive the medical care or diabetes management assistance they need as independent young adults. Transition services help older teens with diabetes navigate challenges with school and jobs, driving, relationships, and insurance and financial issues, such as medication costs and food insecurities. The Adolescent and Young Adult Clinic are headed by pediatrician Kate Weaver and internist Faisal Malik.
The keynote speaker at the opening was Dr. Rudy Leibel from the Naomi Berrie Diabetes Center and Columbia University in New York City. He exhorted current diabetes investigators, clinicians and trainees to think big in their goals, to watch for unexpected talent, and to not let the limitations of current technologies stand in the way of dreams for the future of diabetes research and clinical advances.
People over age 18 with and without diabetes will soon have the chance to join the COVERED Registry as Community Volunteers Engaged in Research to End Diabetes. The directory will connect people interested in learning about new and ongoing opportunities to become research participants with researchers studying diabetes and related disorders. Stay tune for details.