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Jerry P. Palmer, M.D.

Metabolism, Endocrinology and Nutrition

Professor of Medicine
Section Head, VA Puget Sound Health Care System
Director, Diabetes Endocrinology Research Center


My research focuses on the immunology of the type 1 diabetes disease process in humans. The dual role of T cells in mediating the beta cell destruction of this disease, but also in mediating protection against beta cell destruction is being investigated. We are participating in TrialNet which is testing the ability of immunomodulatory therapies to preserve beta cell function in recently diagnosed type 1 diabetes patients and the ability to prevent or delay clinical type 1 diabetes in high risk individuals. Approximately 20-30 percent of typical type 2 diabetes patients have anti-islet antibodies similar to type 1 diabetes. We are investigating the genetic, immunologic, and metabolic components of the diabetes disease process in these antibody positive type 2 patients to determine whether this is type 1 diabetes at an older age or a different disease process.


Brooks-Worrell BM, Starkebaum GA, Greenbaum C, and Palmer JP:  Peripheral blood mononuclear cells of insulin-dependent diabetic patients respond to multiple islet cell proteins.  J Immunol 157:5668-5674, 1996.

Brooks-Worrell BM, Juneja R, Minokadeh A, Greenbaum CJ, and Palmer JP:  Cellular immune responses to human islet protein in antibody positive type 2 diabetic patients.  Diabetes 48:983-988, 1999.

Brooks-Worrell B, Gersuk VH, Greenbaum C, and Palmer JP:  Intermolecular antigen spreading occurs during the pre-clinical period of human type 1 diabetes.  J Immunol 166:5265-5270, 2001.

Juneja R, Hirsch IB, Naik RG, Brooks-Worrell Bm, Greenbaum CJ, and Palmer JP:  Islet cell antibodies and glutamic acid decarboxylase antibodies but not the clinical phenotype help to identify type 1½ diabetes in patients presenting with type 2 diabetes.  Metabolism 50:1008-1013, 2001.

Naik RG, Palmer JP:  Latent autoimmune diabetes in adults (LADA).  Rev Endocr Metab Disord 4:233-241, 2003.

Palmer JP, Fleming GA, Greenbaum CJ, Herold KC, Jansa LD, Kolb H, Lachin JM, Polonsky KS, Pozzilli P, Skyler JS, Steffes MW:  C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve beta-cell function:  Report of an ADA Workshop, 21-22 October 2001.  Diabetes 53:250-264, 2004.

Brooks-Worrell BM, Greenbaum CJ, Palmer JP, and Pihoker C:  Autoimmunity to islet proteins in children diagnosed with new-onset diabetes.  J Clin Endocrinol Metab 89:2222-2227, 2004.

Fourlanos S, Dotta F, Greenbaum CJ, Palmer JP, Rolandsson O, Colman PG, Harrison LC:  Latent autoimmune diabetes in adults (LADA) should be less latent.  Diabetologia 48:2206-2212, 2005.

Palmer JP, Hampe CS, Chiu H, Goel A, Brooks-Worrell BM:  Is latent autoimmune diabetes in adults distinct from type 1 diabetes or just type 1 diabetes at an older age?  Diabetes 54:S62-S67, 2005.

Seyfert-Margolis V, Gisler TD, Asare AL, Wang RS, Dosch HM, Brooks-Worrell B, Eisenbarth GS, Palmer JP, Greenbaum CJ, Gitelman SE, Nepom GT, Bluestone JA, Herold KC:  Analysis of T-cell assays to measure autoimmune responses in subjects with type 1 diabetes:  results of a blinded controlled study.  Diabetes 55:2588-2594, 2006.

Sosenko JM, Palmer JP, Greenbaum CJ, Mahon J, Cowie C, Krischer JP, Chase HP, White NH, Buckingham B, Herold KC, Cuthbertson D, Skyler JS, Diabetes Prevention Trial-Type 1 Study Group:  Increasing the accuracy of oral glucose tolerance testing and extending its application to individuals with normal glucose tolerance for the prediction of type 1 diabetes:  the Diabetes Prevention Trial-Type 1.  Diabetes Care 30:38-42, 2007.

Chiu HK, Tsai EC, Juneja R, Stoever J, Brooks-Worrell B, Goel A, Palmer JP:  Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients.  Diabetes Res Clin Pract 2007 [epub ahead of print].

Jensen RA, Gilliam LK, Torn C, Landin-Olsson M, Karlsson FA, Palmer JP, Kockum I, Akesson K, Lernmark B, Lynch K, Breslow N, Lernmark A; Diabetes Incidence Study in Sweden (DISS) group:  Multiple factors affect the loss of measurable C-peptide over 6 years in newly diagnosed 15- to 35-year-old diabetic subjects.  J Diabetes Complications 21:205-213, 2007.

Goel A, Chiu H, Felton J, Palmer JP, Brooks-Worrell B:  T-cell responses to islet antigens improves detection of autoimmune diabetes and identifies patients with more severe beta-cell lesions in phenotypic type 2 diabetes.  Diabetes 56:2110-2115, 2007.