Type 1 diabetes is referred to as "juvenile diabetes". Type I diabetes ensues when the immune system attacks and destroys the cells in the pancreas that make insulin. With insufficient insulin, the body can no longer regulate the level of sugar in the bloodstream, resulting in high blood glucose levels. Diabetes can be kept under control somewhat by regularly monitoring blood glucose level and by injecting the correct dose of insulin (insulin replacement therapy). Over time, however, even minor fluctuations in blood glucose levels can lead to a host of long-term complications, including heart disease, kidney failure, nerve damage, especially those nerves in the retina, poor circulation, gangrene and early death.

The Type I diabetes research at TPIMS includes:

• Drs. Kumar and Sercarz's work to understand why the immune system attacks and destroys the insulin-secreting cells;
• Drs. Houghten, Kumar, Pinilla, Sercarz, and Wilson's design and testing of strategies to re-educate the immune system so that it recognizes the pancreas tissue;
• Dr. Davies' transplantation work on the growth of new islet tissue in culture in order to replace the destroyed islets by islet transplantation.

For many years research in the Davies' laboratory has focused on understanding that part of the immune system that actively prevents diseases like type I diabetes and multiple sclerosis in healthy individuals. The idea is that if we understand how the body normally works to prevent these diseases we should be able to replace or enhance these characteristics in patients with disease in order to either, reverse ongoing disease, or, prevent the progress of disease in individuals who are in the early stages of disease, or, inhibit the development of a disease in individuals who have a family history of that disease, and are therefore considered, "at risk." Recently, the Davies' group has identified a way of enhancing a characteristic in the body that is linked to protection from type I diabetes. Current work focuses on how this protective characteristic can be controlled.

Cachexia is the dramatic weight loss seen in patients with chronic illness including type I diabetes, multiple sclerosis, HIV, cancer, and in ageing individuals with failure to thrive syndrome. In all patients with cachexia the result is severe skeletal muscle loss and immobility. In cancer patients, cachexia also leads to an inability to respond effectively to therapy resulting in poor prognosis. Recently, the Davies' laboratory has identified a factor that inhibits both the incidence and severity of cachexia in cancer and in type I diabetes. By better understanding the way this factor works, Dr. Davies' laboratory hopes to identify information that might be used to develop new therapeutic strategies and drugs to treat cachexia in cancer as well as type I diabetic patients. The long-term goal is to increase both survival and quality of life for patients with chronic illnesses.

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