The burden of type 1 diabetes remains substantial, and more research is needed to improve the lives of people with type 1 diabetes and to find a cure. To this end, ADA-funded research continues to drive progress by funding research projects topics spanning technology, islet transplantation, immunology, improving transition to self-management and much more. For specific examples of projects currently funded by the ADA, see below.
Martin John Hessner, PhD
Medical College of Wisconsin
Project: Probiotic normalization of innate immunity in type 1 diabetes
"My passion for immunology and type 1 diabetes stems from a personal interest in autoimmunity. This award enables the translation of our rodent studies where we have delayed and prevented type 1 diabetes by modulating the intestinal microbiota, to newly diagnosed patients."
The problem: The human intestinal tract harbors billions of bacteria – collectively termed the microbiome – which representing a significant environmental contact. Evidence suggests that modern lifestyles may promote growth of an altered, sub-optimal intestinal flora. While development of type 1 diabetes (T1D) has a strong genetic basis, this potentially modifiable environmental factor may explain the increase in T1D incidence observed over the past half-century.
The project: This project extends studies of an elevated inflammatory state that is present in T1D patients as well as their healthy family members. In animal models of T1D, dietary or antibiotic protocols that promote growth of anti-inflammatory bacteria delay/prevent development of T1D. Dr. Hessner’s ADA-funded project will test whether probiotic supplementation reduces inflammation and improves insulin secretion in people newly diagnosed with T1D.
The potential outcome: This project has the potential to identify a safe, broadly applicable, environmental modifier that influences T1D progression, which is critical for development of preventive and therapeutic approaches.
Elizabeth D. Cox, MD, PhD
University of Wisconsin-Madison
Project: Identifying actionable self-management barriers for adults with T1D
“I’m a pediatrician by training, and most of my work has focused on improving the way healthcare is delivered to children with diabetes and other chronic diseases. With this grant from the American Diabetes Association, I will be able to build on what I have learned in studying kids and expand that work to improve the healthcare provided to adults with type 1 diabetes.”
The problem: Many adults with type 1 diabetes (T1D) want self-management help. The researchers have previously designed a self-management help questionnaire for youth with T1D that uses child and parent answers to understand the self-management challenges the family faces. The children and their parents then receive resources designed specifically for their needs. This has been very successful. However, no such program exists for adults with T1D.
The project: Dr. Cox now plans to institute design a self-help management program specifically for adults with T1D. Based on feedback from adults with T1D, she will design a questionnaire by working directly with adults with T1D. Following this, the researchers will then test whether the answers predict important things like how often someone checks their blood sugar, how well their diabetes is controlled, or how well their life is going.
The potential outcome: At the conclusion of this project, the Dr. Cox and her team expect to have a survey that doctors and nurses can use to recommend self-management help that might best meet the patient's needs. Being able to recommend specific types of self-management help is expected to improve the lives of adults with T1D.
Karen Cerosaletti, PhD
University of Washington
Project: Single cell RNAseq analysis of islet antigen reactive memory CD4 T cells during T1D progression and therapy
“My interest is understanding how the immune system malfunctions in type 1 diabetes so that we can more accurately predict who will develop type 1 diabetes, when they will develop it, and how we can prevent or block disease onset or progression. This grant will allow us to determine the role of T cells of the immune system in destroying pancreatic islets, resulting in loss of insulin secretion.”
The problem: Type 1 diabetes (T1D) results from immune destruction of insulin-producing islets in the pancreas. The researchers have identified a specific variant of an immune cell, called a T cell, that is found in patients with T1D but not in control people. However, it is unclear to what degree this specific immune cell type is responsible for the initiation and progression of T1D.
The project: The goal of Dr. Cerosaletti and her team is to investigate the role of this unique immune cell in people at high-risk for developing T1D and in patients recently diagnosed with T1D. She will use powerful new technologies to determine how these cells change over the course of T1D progression and assess if these cells play a role in the destruction of insulin-producing islets.
The potential outcome: The significance of this study to T1D is two-fold: the results will advance the understanding of the immune mechanisms underlying the destruction of the insulin producing islets in T1D. Further, these findings will determine the feasibility of using this unique subset of islet T cells as markers to predict or monitor disease onset and progression during T1D.
