Our Research (Overview)
The Diabetes and Obesity Center of Excellence (DOCE) is committed to research into the causes, consequences and treatment of diabetes and obesity. Because of dramatic increases in their prevalence, diabetes and obesity have become among the most common and costly health problems in the U.S. and other developed countries. Two-thirds of the adult U.S. population is overweight and one-half of those individuals – one-third of the adult population – are obese. The prevalence of type 2 diabetes (formerly known as “adult-onset”) has also increased markedly in recent decades not only among adults, but in children as well. Although type 1 diabetes is less common, it is a potentially devastating disorder affecting both children and adults and, while treatments for both types of diabetes exist, neither is curable and effective treatments for obesity have yet to be developed. Metabolic complications associated with diabetes and obesity include inflammation and impaired lipid metabolism that, together with elevated blood glucose levels, accelerate the progression of atherosclerotic vascular disease, the leading cause of death in the U.S.
At the molecular, cellular and physiological level, mechanisms underlying these diseases are highly integrated and interactive and, therefore, are difficult to study in isolation. This fact poses a formidable challenge to investigators and heightens the need for multidisciplinary research programs capable of pursuing a variety of interrelated scientific questions simultaneously.
Commitment to precisely this type of multidisciplinary investigative approach is a major goal of our Center and is advanced by supporting Center investigators through enhanced training, core research support services, and by creating interactive networks of investigators that bring a variety of different types of expertise to a focused research effort.
The Center draws upon the expertise of a wide range of investigators with complementary interests in diabetes, obesity, inflammation, lipid metabolism and atherosclerosis. Members of the Center’s faculty conduct both basic research to clarify the mechanisms causing diabetes and obesity and their consequences, and translational research to transform their research findings into clinical solutions.
Basic research at the Center focuses on the multiple aspects underlying the pathogenesis of obesity and diabetes. The regulation of body weight involves hormones, such as ghrelin, leptin and insulin that act upon neurocircuits in the hypothalamus and other brain areas. Our studies have helped to develop and test the hypothesis that defects in the central nervous system (CNS) may unbalance the homeostasis of both energy balance and glucose metabolism and thus favor the progression of obesity, insulin resistance and type 2 diabetes. Clinical consequences of both type 1 and type 2 diabetes and their link to cardiovascular disease are also being investigated, with special emphasis on how these diseases affect the metabolism of cholesterol and lipoproteins, and how they disrupt cellular functions of macrophages and endothelial cells. The Center also aims to understand how the insulin-secreting pancreatic beta cell works and how its function is impaired in diabetes, and to identify autoimmune markers and mediators of type 1 diabetes.
The cure of any disease depends on a fundamental understanding of its causes. Only by identifying the elements involved in the initiation and progression of a disease can a cure be found. An excellent example is cell-based therapy to treat diabetes. The goal is the implantation of insulin-producing cells to permit insulin delivery for type 1 diabetes patients without the need of immunosuppression. The successful implementation of this therapeutic approach requires application of a truly multidisciplinary approach involving stem cell biology, developmental, cellular and molecular biology of the pancreatic beta cell, immunology, and transplantation biology. We are building this comprehensive expertise at the Diabetes and Obesity Center of Excellence. Other areas of translational focus include study into the mechanisms whereby bariatric surgical procedures ameliorate diabetes, development of diagnostic testing to predict future development of type 1 diabetes, and the use of proteomic analysis of lipoproteins to gauge risk of heart attack.