At Washington University, the pediatric and adult endocrine divisions collaborate and share resources to lead innovative T0-T4 research, to improve health outcomes and well-being of our patients and communities. Our program distinguishes from many others around the country in that it promotes research in transgender health and on ALL forms of diabetes in children, including type 2 and rare genetic forms of the disease.

Diabetes prevention

One of our goals is to advance scientific discoveries for diabetes prevention. Some of our investigators focus on better understanding the role of the insulin-producing beta cell and the mechanisms that lead to beta-cell failure and autoimmune-mediated destruction. We also have ongoing studies looking at novel biomarkers of pre-diabetic autoimmunity, environmental triggers of autoimmunity that cause T1D and maternal exposures during pregnancy that lead to type 2 diabetes and non-alcoholic fatty liver disease. We have been part of cardinal NIH-sponsored studies on Diabetes prevention since the early 1990’s such as the Diabetes Prevention Program Type 1 (DPT-1), TRIGR, DPPOS, PROTECT and TrialNet Studies.

New therapies

Since the discovery of insulin we have participated in many NIH and industry sponsored trials to provide new treatment strategies to our type 1 diabetes patients to achieve better glycemic targets and decrease complication rates or prevent disease progression. We are currently part of the PROTECT trial which is a phase 3 clinical trial using an immune modulatory drug on recent onset type 1 diabetes to preserve beta cell function. In addition, we are part of a phase 2 treatment trial in patients with rare genetic disorders of obesity and a study to assess the safety and tolerability of a drug in patients with Wolfram syndrome, a rare form of genetic diabetes that causes poor visual acuity, hearing loss, and neurodegeneration. For more than 15 years we have been part of the TODAY study, a nationwide study researching best treatment options for youth with Type 2 diabetes.

Complications

Long-term microvascular and neurologic complications of diabetes cause major morbidity and mortality in patients with diabetes. We have been part of studies examining ways that we can ameliorate these complications from happening. Through the DCCT and EDIC study we have been examining whether intensive treatment with the goal of maintaining blood glucose concentrations close to the normal range could decrease the frequency and severity of these complications. In addition our program has been at the forefront of assessing the neurodevelopmental consequences of diabetes and hypoglycemia.

New technologies

Our program has been involved in the development of new technologies for insulin delivery systems (insulin pumps, continuous glucose sensors and artificial pancreas), blood glucose monitoring and smart phone applications to improve glycemic targets and ultimately decrease complications and improve diabetes outcomes and quality of life.