Diabetes is a life-long disease that affects more than 23 million Americans, and occurs because the body is unable to produce enough insulin, or because our bodies cannot use insulin efficiently.
Insulin is necessary for cells to take up glucose to use for energy, and when they cannot do so glucose builds up in the bloodstream. This is dangerous as high blood glucose can cause serious and sometimes life-threatening complications. The two main forms of diabetes are type I and type II, and they have different causes.
In type I diabetes, the body’s immune system mistakenly attacks the insulin-producing cells in the pancreas; this is called an autoimmune disease. As a result, the body cannot produce enough insulin to control the level of glucose in the blood. Type I diabetes is usually detected in children and is also known as juvenile diabetes. Although we do not completely understand the cause of type I diabetes, we know that inherited genes and environmental factors play a role in the initiation and the progression of the disease. This form of diabetes can be partly controlled by regularly monitoring blood glucose levels, and by injecting insulin. Over time, however, the inadequate control of blood glucose causes many complications, including heart disease, kidney failure, nerve damage, muscle wasting, and early death.
About 90% of people with diabetes have the second form, type II. In this case, the body may not produce enough insulin, or insulin is produced but cells cannot use it efficiently – this is called insulin resistance. Type II diabetes is becoming increasingly common due to poor diets and insufficient exercise, but it can often be managed by a combination of insulin, medications, and a healthier lifestyle.
There is no cure for diabetes, and research must focus on replacing the insulin-producing cells, stopping the immune system from attacking the new insulin-producing cells, or finding ways to help cells use insulin more efficiently. Torrey Pines Institute scientists are performing research in each of these areas, and are working to find new treatment options for people with diabetes.
Principal Investigators are working on the following challenges in the area of Type I and Type II Diabetes:
- Understanding how genetic factors control the onset of type I diabetes.
- Discovering how to grow new insulin-producing cells in the laboratory for transplatation to replace cells destroyed by immune attack.
- Designing and testing new strategies to re-educate our immune system, so that it no longer recognizes the pancreas as foreign.
- Understanding the connection between obesity, insulin resistance, and type II diabetes.
- Understanding how high levels of lipids in the blood impair our cell’s ability to take up glucose and respond to insulin.
TYPE I DIABETES
Dr. Valeria Judkowski and Dr. Clemencia Pinilla are investigating the natural peptide antigens that trigger the CD4 T cell autoimmune attack on the pancreas. Their groups have used animal models of Type I diabetes and the Institute’s peptide libraries to optimize and improve antigen discovery tools that could be used to identify antigens in human type I diabetes, as well as in other autoimmune disorders, and infectious diseases.
TYPE II DIABETES
Dr. Alan Kleinfeld is investigating how blood levels of free fatty acids (FFA) are regulated by their uptake and release from adipocytes (fat cells). His group is interested in understanding whether the elevated FFA levels may impair the body's ability to regulate blood glucose and to respond to insulin. This work may help identify new drug targets for treating insulin resistance and type II diabetes.