Setting Their Sights on Diabetes
Smart technologies, cellular therapy, and genetic analysis are just three of the ways that faculty at the University of Virginia School of Medicine are sparking hope for the 1.6 million Americans who are living with Type 1 diabetes. Together, their work is representative of UVA Health’s effort to move society closer to diabetes becoming a manageable condition.
Most recently, the U.S. Food and Drug Administration approved what’s being called the artificial pancreas. Created by Boris P. Kovatchev and his team at the UVA Center for Diabetes Technology, the innovation is a mathematical algorithm implemented in an insulin pump or a smart phone app that interacts with a noninvasive continuous glucose sensor to regulate blood sugar levels.
“What’s unique about the artificial pancreas is that it’s a closed-loop system,” Kovatchev says of the solution that pairs an insulin pump and blood glucose monitor with a smart algorithm. “This means that the device is regulating a person’s blood sugar around the clock, whether they sleeping, eating, or going to work or school.”
In addition to technological approaches, UVA’s comprehensive team of diabetes researchers and clinicians are also looking for answers within the human cell.
For example, Dr. José Oberholzer, who directs UVA’s Charles O. and Judith S. Strickler Transplant Center, is improving how to encapsulate healthy hormone-producing cells—called islets—and transplant them into patients with Type 1 diabetes.
“When transplanted islets perform as planned, some patients with diabetes can live without insulin injections or medications for years,” says Oberholzer. “That comes as a surprise to some people, but cellular therapies can transform lives, and I’m excited to contribute to that transformation.”
Oberholzer is currently working with an international network of collaborators, with the future goal of conducting first-in-human trials of his method at UVA.
Similarly, Dr. Stephen Rich, who directs UVA’s Center for Public Health Genomics, is working to uncover the specific genes and cell types that trigger diabetes. Rich and his team have accumulated about 60,000 DNA samples from individuals with Type 1 diabetes and their family members—as well as people without the disease—to identify genes that may be associated with risk for the disease.
“A decade ago we knew of only about 20 genes that may be associated with increased risk for developing diabetes, but our research now shows that number to be more than 70,” says Rich. “While some of these sites have relatively small impacts on risk, they contribute to our understanding of the underlying biology of the disease, including potential unknown mechanisms and potential therapeutic or interventional targets.”
Rich and his team also recently started offering a genetic test to screen children for Type 1 diabetes in hopes of providing early intervention. The project, Precision Individualized Medicine for Diabetes, is expected to reach 100,000 children across the Commonwealth.
“Our community screening project for high genetic risk of Type 1 diabetes, followed by autoantibody testing, is unique—no other place in the world is attempting this approach,” says Rich.
Philanthropic support has been the driving force behind these discoveries and innovations in the battle against diabetes. Ten years ago, Paul and Diane Manning provided generous support through their family foundation to create Launchpad for Diabetes Innovation, an initiative that has funded 42 projects and opened doors to innovative ideas for diagnosing, treating, and, hopefully, one day curing diabetes.
Support for such early-stage research is rare. Additional philanthropic support will help UVA attract and retain leading-edge investigators and provide them with larger awards to accelerate their work.
“One of the great aspects of the LaunchPad is that projects can get funded quickly,” says Oberholzer. “You have a thorough and competitive peer review, but then it moves fast. Initiatives like the LaunchPad are accelerators of research, and that’s important for so many future patients.”
