current diabetes research

Use of Online Communities among People with Type 2 Diabetes: A Scoping Review

• Arantxa Bujanda-Sainz de Murieta
• Nelia Soto-Ruiz
• Paula Escalada-Hernández

Diabetes, SGLT-2 Inhibitors, and Urinary Tract Infection: a Review

• Reza Pishdad
• Paul G. Auwaerter
• Rita R. Kalyani

Diabetes Technology in People with Type 2 Diabetes: Novel Indications

• Shubham Agarwal
• Rodolfo J. Galindo
• Marconi Abreu

Mapping Lifestyle Interventions for Gestational Diabetes Prevention: A Scoping Review

• Armando Peña
• Alison M. Miller
• Christina M. Scifres

Exploring Technology’s Influence on Health Behaviours and Well-being in Type 1 Diabetes: a Review

• Reid D. McClure
• Meryem K. Talbo

Lessons and Applications of Omics Research in Diabetes Epidemiology

• Henry C. H. Tam
• Ronald C. W. Ma

A Systematic Review of the Effects of Provider Bias on Health in Youth and Young Adults with Type 1 Diabetes

• Sara E. Wetter-Wren
• Alexandra C. Himelhoch
• Kimberly A. Driscoll

Polyagonists in Type 2 Diabetes Management

• H. A. Dissanayake
• N. P. Somasundaram

Factors Influencing Medication Adherence Among Adults Living with Diabetes and Comorbidities: a Qualitative Systematic Review

• Kendall Gow
• Amineh Rashidi
• Lisa Whithead

Exploring the Mechanistic Link Between Obesity and Heart Failure

• Chiadi E. Ndumele

Imeglimin: the New Kid on the Block

• Sandeep Chandra Shrestha

Impact of the Neighborhood Food Environment on Dietary Intake and Obesity: a Review of the Recent Literature

• Candice A. Myers

Obesity and Severity of Menopausal Symptoms: a Contemporary Review

• Alisha Clark
• Brooke Aggarwal

Positive Psychology Interventions for Improving Self-management Behaviors in Patients with Type 1 and Type 2 Diabetes: a Narrative Review of Current Evidence

• Nelson C. Y. Yeung

Workplace Interventions for Type 2 Diabetes Mellitus Prevention—an Umbrella Review

• Katarzyna Wnuk
• Jakub Świtalski
• Mariusz Gujski

Correction to: The T1D Index: Implications of Initial Results, Data Limitations, and Future Development

• Graham D. Ogle
• Gabriel A. Gregory
• Trevor John Orchard

How Could Taxes on Sugary Drinks and Foods Help Reduce the Burden Of Type 2 Diabetes?

• Alan Reyes-García
• Isabel Junquera-Badilla
• Ana Basto-Abreu

Sexual Function and Satisfaction in the Context of Obesity

• Sean M. McNabney
• Nana Gletsu-Miller
• David L. Rowland

The T1D Index: Implications of Initial Results, Data Limitations, and Future Development

• Gabriel A Gregory

Sarcopenic Obesity and Cardiometabolic Health and Mortality in Older Adults: a Growing Health Concern in an Ageing Population

• Sasiwarang Goya Wannamethee
• Janice L. Atkins

Team-Based Approach to Reduce Malignancies in People with Diabetes and Obesity

• Samuel Yeung Shan Wong
• Thomas Yuen Tung Lam

The Effectiveness of Cognitive Behavioral Therapy for Depression Among Individuals with Diabetes: a Systematic Review and Meta-Analysis

Models Predicting Postpartum Glucose Intolerance Among Women with a History of Gestational Diabetes Mellitus: a Systematic Review

• Yitayeh Belsti
• Joanne Enticott

Variations in the Design and Use of Attention Control Groups in Type 2 Diabetes Randomized Controlled Trials: a Systematic Review

• Casey A. Droske
• Triniece N. Pearson
• Valerie G. Press

Does COVID-19 Infection Increase the Risk of Diabetes? Current Evidence

• Rachel Wong
• Hsin-Chieh Yeh

Challenges and Opportunities in Diagnosis and Management of Cardiometabolic Risk in Adolescents

• Dedeepya Konuthula
• Marcia M. Tan
• Deborah L. Burnet

Is Diabetes Mellitus a Predisposing Factor for Helicobacter pylori Infections?

• Om Saswat Sahoo
• Rhiti Mitra
• Oindrilla Mukherjee

The Impact of New and Renewed Restrictive State Abortion Laws on Pregnancy-Capable People with Diabetes

• Ajleeta Sangtani
• Lauren Owens
• Lauren Oshman

Sleep Apnea, Obesity, and Diabetes — an Intertwined Trio

• Soumya Kurnool
• Karen C. McCowen
• Atul Malhotra

Comparative Analysis of Clinical Practice Guidelines for the Pharmacological Treatment of Type 2 Diabetes Mellitus in Latin America

• Paula Andrea Taborda Restrepo
• Jorge Acosta-Reyes
• Rafael Gabriel

Prevalence of Diabetes in Patients with Hyperuricemia and Gout: A Systematic Review and Meta-analysis

• Jinguo Jiang
• Tingjing Zhang

Using Mixed Methods Research in Children with Type 1 Diabetes: a Methodological Review

• Sara L. Davis
• Sarah S. Jaser

Glucometrics: Where Are We Now?

• Kelly Engle
• Grace Bacani
• Kristen Kulasa

Implementation of Continuous Glucose Monitoring in Critical Care: A Scoping Review

• Eileen R. Faulds
• Kathleen M. Dungan
• Molly McNett

Surgical Management of Diabetic Macular Edema

• Jamie Prince
• Dipen Kumar
• Alice Yang Zhang

Team-Based Diabetes Care in Ontario and Hong Kong: a Comparative Review

• Emaad Mohammad
• Xiaolin Wei

Youth-Onset Type 2 Diabetes: Burden of Complications and Socioeconomic Cost

• Isabella Marranzini Rodriquez
• Katie L. O’Sullivan

Correction: Applying Behavioral Economics Theories to Interventions for Persons with Diabetes

• Susana R. Patton
• Christopher C. Cushing
• Amy Hughes Lansing

Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment

• Sabrena F. Noria
• Rita D. Shelby
• Kishore M. Gadde

The Role of Habit Formation and Automaticity in Diabetes Self-Management: Current Evidence and Future Applications

• Jenine Y. Stone
• Lindsay S. Mayberry
• Shelagh Mulvaney

Correction: Implementation of Psychosocial Screening into Diabetes Clinics: Experience from the Type 1 Diabetes Exchange Quality Improvement Network

• Sarah Corathers
• Desireé N. Williford
• Osagie Ebekozien

Recent Rates of Substance Use Among Adolescents and Young Adults with Type 1 Diabetes in the USA

• Rachna Sannegowda
• Karina Villalba
• Rachel M. Wasserman

Implementation of Psychosocial Screening into Diabetes Clinics: Experience from the Type 1 Diabetes Exchange Quality Improvement Network

Psychosocial Assessment Tools for Youth with Type 1 Diabetes: a 10-Year Review

• Trevor Bell
• Elizabeth Hazel

SHORT Syndrome: an Update on Pathogenesis and Clinical Spectrum

• Naama Fisch Shvalb

Cellular Senescence in Obesity and Associated Complications: a New Therapeutic Target

• Akilavalli Narasimhan
• Rafael R. Flores
• Laura J. Niedernhofer

Systemic and Ocular Adverse Events with Intravitreal Anti-VEGF Therapy Used in the Treatment of Diabetic Retinopathy: a Review

• Jason A. Zehden
• Xavier M. Mortensen

Social Care Recommendations in National Diabetes Treatment Guidelines

• Benjamin Aceves
• Laura M. Gottlieb

Growth Hormone and Counterregulation in the Pathogenesis of Diabetes

• Xuehong Dong
• Mary-Elizabeth Patti

Potential Clinical Applications for Continuous Ketone Monitoring in the Hospitalized Patient with Diabetes

• Michelle Jaromy
• Joshua D. Miller
• Find a journal
• Publish with us
• Track your research

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Entire Site
• Research & Funding
• Health Information
• About NIDDK
• Research Programs & Contacts

Clinical Research in Type 2 Diabetes

Studies in humans aimed at the prevention, treatment, and diagnosis of Type 2 Diabetes and the mechanistic aspects of its etiology.

The Clinical Research in Type 2 Diabetes (T2D) program supports human studies across the lifespan aimed at understanding, preventing and treating T2D. This program includes clinical trials that test pharmacologic, behavioral, surgical or practice-level approaches to the treatment and/or prevention of T2D, including promoting the preservation of beta cell function. Studies may also advance the development of new surrogate markers for use in clinical trials. Studies can be designed to understand the pathophysiology of T2D, including the role of gestational diabetes and metabolic imprinting on the development of T2D, as well as factors influencing the response to treatment. The program also encompasses epidemiologic studies that improve our understanding of the natural history and pathogenesis of T2D, and the development of diagnostic criteria to distinguish type 1 and type 2 diabetes, especially in the pediatric population. The program also supports research to understand and test approaches to accelerate the translation of efficacious interventions into real-world practice and adoption; and to address health equity by reducing health disparities in the incidence and/or clinical outcomes of T2D.

NIDDK Program Staff

• Shavon Artis Dickerson, Dr.P.H., M.P.H. Health Equity and Implementation Science
• Henry B. Burch, M.D. Clinical studies utilizing existing digital health technology for the prevention and treatment of type 2 diabetes, clinical and basic science studies involving non-neoplastic disorders of the thyroid, clinical studies involving medical and novel dietary treatment of type 2 diabetes.
• Maureen Monaghan Center, Ph.D., CDCES Health Psychology, Behavioral Science, Clinical Management of Diabetes
• Jean M. Lawrence, Sc.D., M.P.H., M.S.S.A. Type 2 diabetes risk and prevention after gestational diabetes; Studies of adults with diabetes/pre-diabetes using secondary data and observational designs, and natural experiments
• Hanyu Liang, M.D., Ph.D. Hepatic Metabolism; Insulin Resistance; Type 2 Diabetes; Obesity; Bariatric Surgery
• Barbara Linder, M.D., Ph.D. Type 2 diabetes in children and youth; human studies of metabolic imprinting
• Saul Malozowski, M.D., Ph.D., M.B.A. Neuroendocrinology of hypothalamic-pituitary axis, neuropeptide signaling and receptors; hormonal regulation of bone and mineral metabolism; HIV/AIDS-associated metabolic and endocrine dysfunction
• Pamela L. Thornton, Ph.D. Health Equity and Translational Research; Centers for Diabetes Translation Research (P30) Program
• Theresa Teslovich Woo, Ph.D. Human behavior, developmental cognitive neuroscience, and brain-based mechanisms involved in obesity and diabetes

Recent Funding Opportunities

Notice of special interest (nosi): supporting the exploration of cloud in nih-supported research, notice of special interest: womens health research, heal initiative: studies to enable analgesic discovery (r61/r33 - clinical trial not allowed), pilot studies of biological, behavioral and social mechanisms contributing to hiv pathogenesis within the mission of niddk (r21 clinical trial not allowed), support for research excellence (sure) award (r16 clinical trial not allowed), related links.

View related clinical trials from ClinicalTrials.gov.

Study sections conduct initial peer review of applications in a designated scientific area. Visit the NIH’s Center for Scientific Review website to search for study sections.

Research Resources

NIDDK makes publicly supported resources, data sets, and studies available to researchers to accelerate the rate and lower the cost of new discoveries.

• Ancillary Studies to Major Ongoing Clinical Studies to extend our knowledge of the diseases being studied by the parent study investigators under a defined protocol or to study diseases and conditions not within the original scope of the parent study but within the mission of the NIDDK.
• NIDDK Central Repository for access to clinical resources including data and biospecimens from NIDDK-funded studies.
• NIDDK Information Network (dkNET) for simultaneous search of digital resources, including multiple datasets and biomedical resources relevant to the mission of the NIDDK.

Additional Research Programs

Research training.

NIDDK supports the training and career development of medical and graduate students, postdoctoral fellows, and physician scientists through institutional and individual grants.

Diversity Programs

The NIDDK offers and participates in a variety of opportunities for trainees and researchers from communities underrepresented in the biomedical research enterprise. These opportunities include travel and scholarship awards, research supplements, small clinical grants, high school and undergraduate programs, and a network of minority health research investigators.

Small Business

Small business programs.

NIDDK participates in the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs. These programs support innovative research conducted by small businesses that has the potential for commercialization.

Human Subjects Research

NIDDK provides funding for pivotal clinical research, from preliminary clinical feasibility to large multi-center studies.

Translational Research

NIDDK provides funding opportunities and resources to encourage translation of basic discoveries into novel therapeutics.

Meetings & Workshops

Supports researchers with tools to enhance scientific rigor, reproducibility, and transparency, and provides a big data knowledge base for genomic and pathway hypothesis generation.

Providing education and training for the next generation of biomedical and behavioral scientist

Stay informed about the latest events, or connect through social media.

Learn about current projects and view funding opportunities sponsored by the NIH Common Fund .

Registration is required at eRA Commons and grants.gov and can take 4 weeks.

New Report Highlights Diabetes Research Advances and Achievements

Today, the American Diabetes Association® (ADA) released its 2023 Research Report , highlighting investments in advancing diabetes research and clinical practice. ADA research grants focused on innovative projects with high impact and helped researchers establish collaborative networks to move their innovations into the hands of people living with diabetes.

“Research at the ADA is the engine that drives clinical advances by catapulting them into practice. 2023 has brought many prominent achievements. We are incredibly proud of our legacy of highlighting science and eager to build on this research to move even closer to a world free of diabetes and all its burdens,” said Charles “Chuck” Henderson, the ADA’s chief executive officer.

The report highlights include:

• Support behavioral and mental health of people with diabetes
• Tackle the epidemic of youth-onset type 2 diabetes
• Improve the lives of women living with diabetes
• Increased investment in early career researchers by expanding funding opportunities for postdoctoral fellowship awards to ensure these researchers can stay within the field of diabetes.
• Takeaways from the 2023 Scientific Sessions, where researchers from all over the world shared the latest progress and study results with the global diabetes community.
• Identify and address disparities in access and outcomes for Hispanic/Latino communities
• Implement virtual interventions for those living with type 1 diabetes
• Improve outcomes for the deaf community through specially designed diabetes self-management education and support (DSMES)

In addition, the report provides an update on the Pathway to Stop Diabetes® (Pathway) program, which pairs talented early-career scientists with mentorship from world-renowned diabetes scientists to drive research innovation free from traditional project constraints. This year, through the Pathway program, ADA dedicated over $4.8 million dollars in new grant funding to support breakthroughs in translation and clinical science, technology, care, and potential cures in the field of diabetes.

To learn more about the ADA’s research findings and ongoing areas of study, visit professional.diabetes.org .

About the American Diabetes Association The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 83 years, the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we aim to improve the quality of life for the over 136 million Americans living with diabetes or prediabetes. Diabetes has brought us together. What we do next will make us Connected for Life ® . To learn more or to get involved, visit us at  diabetes.org  or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook ( American Diabetes Association ), Spanish Facebook ( Asociación Americana de la Diabetes ), LinkedIn ( American Diabetes Association ), Twitter ( @AmDiabetesAssn ), and Instagram ( @AmDiabetesAssn ). 

Contact Virginia Cramer for press-related questions.

Curing Diabetes

Our research progress.

Nanotechnology and combined strategies to enhance local immunomodulation for treatment of Type 1 Diabetes

In the quest to enhance the lives of those suffering from T1D, Dr. Diana Velluto, Research Assistant Professor in the Department of Surgery at the Diabetes Research Institute, University of Miami School of Medicine, is making incredible advances. Her work centers on the use of innovative nanotechnology to transform how we approach diabetes treatment.

First-ever Dynamic Analysis of Pancreatic Regeneration in Human T1D

A groundbreaking technique has been established which has allowed scientists from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine to culture live sections of the pancreas for nearly two weeks. The scientists have used the living pancreas sections to chart the first dynamic single-cell map of the regenerative pathways of the pancreas.

New Discoveries Offer Hope in the Fight Against T1D

In a momentous breakthrough, researchers at the Diabetes Research Institute (DRI) have revealed pivotal revelations that may transform our strategy for averting and postponing the emergence of type 1 diabetes (T1D).

Revolutionizing Transplantation: Re-igniting a New Beacon of Hope in Immunotherapy

Another significant step is being achieved by researchers at the DRI on the lengthy journey to bring islet cell transplantation closer to reality for individuals with type 1 diabetes.

How Do Research Discoveries Translate into Clinical Cures?

Scientific research drives discovery into novel biological pathways that regulate normal bodily functions and can indicate alterations that may play a role in autoimmunity, cancer and other diseases. Understanding of the cells, molecules and genes involved in these pathways can lead to the development of drugs, cell therapies, devices and other technologies that might enable prevention, modification, or reversal of disease. But how do scientists take laboratory findings and translate them into people?

Inside Our Labs: New T1D Therapies

August 2022 – Dr. Giacomo Lanzoni is an Assistant Professor at the Diabetes Research Institute, University of Miami Miller School of Medicine. His research is focused on developing stem cell-based therapies for Type 1 Diabetes. In this disease, insulin-producing pancreatic islet beta cells are lost due to an autoimmune attack.

Inside Our Labs: Islet Transplantation

June 2022 – The Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine in Miami, Florida first began performing clinical islet transplantation in 1985. Since then, our center has blossomed into one of the largest independent centers worldwide, with 57 transplant recipients totaling 101 islet infusions since the year 2000.

Inside Our Labs: Treg Therapy and other Autoimmune Therapies

May 2022 – Dr. Bayer’s lab focuses on Treg therapy and other autoimmune therapies. The main overarching goal of their current work is to better understand autoimmune-targeted treatments and how it can lead to diabetes reversal or late-stage development treatment. They focus on understanding the mechanisms by which the immune system provides immune regulation to maintain health and prevent disease.

Inside Our Labs: Mechanisms of Islet Transplant Immune Tolerence

April 2022 – Dr. Abdulreda’s DRIF funded project entitled “Mechanisms of Islet Transplant Immune Tolerance” aims to understand immune pathways that contribute to graft rejection or immune tolerance. Currently, islet transplantation requires continual immunosuppressive treatment to reduce the chance of islet graft rejection.

COVID-19, Diabetes and Mesenchymal Stem Cells: Groundbreaking Findings Bring New Hope

February 2022 – At the DRI, we have been studying Mesenchymal Stem Cells and their immunomodulatory properties for more than a decade. These cells can function as potent inhibitors of inflammation, can modulate immunity, and can stimulate Regulatory T cells (Tregs). Intense studies are ongoing at our Institute to use these cells to fend off autoimmunity in type 1 diabetes and to limit progression of diabetes complication.

2020 Long-Term Culture of Human Pancreatic Slices Reveals Regeneration of Insulin-Producing Cells

DRI scientists developed a method allowing for the long-term culture of “pancreatic slices” to study the regeneration of the human pancreas in real time. The results, published Nature Communications, demonstrate for the first time that extended cultures of near-intact human pancreatic tissue retain the ability of the live organ to replenish insulin-producing beta cells. The use of this system as a model to study pancreatic regeneration could have important therapeutic implications for the treatment of diabetes.

2019 Long-Term Islet Transplant Recipients Show Near-Normal Glucose Control

Using continuous glucose monitoring (CGM), DRI scientists show that a small group of islet transplant recipients who were insulin independent for an average of 10 years have blood sugar levels that are similar to those without type 1 diabetes.

2019 Engineered ‘Suicide Genes’ Prevent Tumors in Stem-Cell Derived Beta Cells

For the first time, DRI scientists engineer a stem cell line containing two ‘suicide genes’ that induce cell death in all but the desired insulin-producing cells. This double fail-safe approach, published in Stem Cell Reports , opens the door to advancing cell-replacement therapies for people living with type 1 diabetes.

2018 DRI Launches POSEIDON Study to Assess Impact of Omega-3 and Vitamin D in Type 1 Diabetes

Several scientific reports have suggested that high-dose omega-3 fatty acids and vitamin D may have a beneficial effect on autoimmune conditions, like type 1 diabetes. DRI researchers will formally test the effects of this intervention in children and adults newly diagnosed and in those with longer-standing T1D to evaluate any benefit on reducing inflammation, halting autoimmunity, and increasing insulin sensitivity and secretion.

2018 DRI Scientists Identify Unique Pancreatic Stem Cells

DRI scientists confirm the existence of progenitor cells (pancreatic stem cells) within the large ducts of the human pancreas that can be stimulated to develop into glucose-responsive beta cells. The findings, published in Cell Reports , could pave the way to regenerating a person’s own insulin-producing cells in type 1 diabetes patients.

2017 DRI Scientists Identify New Metabolic “Signature” as Potential Key Biomarker for Type 1 Diabetes Development

Currently, there is no good biomarker to detect whether the immune attack on the beta cells is underway. DRI researchers mapped out the biochemical changes that occur during type 1 diabetes onset, which is important not only for preventing the disease, but also for monitoring the recurrence of immune attack. This first-ever longitudinal study in experimental models was published in the Journal of Proteome Research .

2017 Novel Tissue-Engineered Islet Transplant Achieves Insulin Independence

DRI researchers report on the first trial participant to receive an islet transplant within a tissue-engineered scaffold, demonstrating that islets transplanted within this BioHub platform can successfully engraft and achieve insulin independence. The trial tests the omentum as an alternative transplant site. The one-year findings are published in the prestigious New England Journal of Medicine (NEJM) .

2016 Researchers Develop and Test “Biological” DRI BioHub Platform

The DRI develops and tests a bioengineered scaffold to house insulin-producing cells. This biological platform, which uses the recipient’s own plasma combined with thrombin, offers the opportunity to incorporate helper cells, nutrients, and local immune protection. These preclinical experiments are the basis for FDA submission for a Phase I/II clinical trial. The work is featured on the cover of the journal Diabetes .

2016 Novel Protocol Achieves 100 Percent Disease Remission in Experimental Models

DRI’s Dr. Allison Bayer and her team have developed a novel protocol demonstrating that adoptive Regulatory T cell (T reg) therapy can reverse the disease and reset autoimmunity in experimental models, achieving disease remission in 100 percent of the recipients. Importantly, the therapy was directed specifically at halting the destruction of the beta cells while the normal immune responses remained intact.

2015 DRI Researchers Convert Pancreatic Exocrine Cells into Insulin-Producing Endocrine Cells Using a Single Protein, BMP-7

Researchers successfully convert non-insulin producing cells into insulin-producing cells using a single agent, BMP-7 (bone morphogenetic protein-7), which is already clinically approved by the FDA. Their published findings in Diabetes demonstrate for the first time that non-endocrine tissue can be reprogrammed to respond to blood glucose without the use of any genetic manipulation, representing a safer method to increase the supply of islets for transplant into people with T1D.

2014 DRI Pioneers New Encapsulation Technology

DRI researchers demonstrate that their unique cell coating process allows efficient encapsulation of islets without compromising viability and function of the cells. The team’s novel method for “shrink wrapping” each cell had been designed to specifically address what are considered to be the limitations of traditional cell encapsulation strategies. The results of their study earn the cover position in Proceedings of the National Academy of Sciences .

2013 DRI Introduces Plans for BioHub Mini Organ

Scientists unveil their plan for the DRI BioHub, a bioengineered “mini organ” designed to mimic the native pancreas. The platform technology will contain thousands of insulin-producing cells that manage blood sugar levels in real time, plus other components that keep the cells healthy and viable long term. The DRI will focus on three primary areas: the development of a new transplant site; the development of a reliable supply of islets; and the ability to sustain the cells’ function without the need for harsh, systemic anti-rejection drugs.

2012 DRI and Collaborators Use Stem Cells to Eliminate Immunosuppression

Scientists from the Diabetes Research Institute (DRI) University of Miami Miller School of Medicine and DRI Federation center at Xiamen University (China) show that the use of mesenchymal stem cells (MSC) in kidney transplant recipients may replace a powerful anti-rejection drug. The results are published in the Journal of the American Medical Association (JAMA) .

2010 Researchers Identify Master Regulatory Genes in Pancreatic Islets

The DRI’s molecular biology team is the first to identify a disproportionately higher number of genes, called miR-7, in pancreatic islets compared to the non-islet tissue of the organ. These master regulatory genes are also found in fetal endocrine cells during development and play a central role in islet cell development, as well as in maintaining this endocrine function (as opposed to developing into other tissue). The findings are published in BMC Genomics .

2010 Study Shows Recurrence of T1D, Need for Multiple Strategies

Scientists show recurrence of type 1 diabetes may occur in patients after kidney-pancreas transplantation. Despite use of immunosuppression and continuous function of the kidney and exocrine portion of the transplanted pancreas, researchers identified the presence of autoimmune cells known to target insulin-producing cells. This study demonstrates the need to block the immune response to foreign tissue and prevent autoimmunity. The findings are published in Diabetes .

2010 DRI Performs Auto-Islet Transplant after Pancreas Trauma

DRI researchers report on the success of an islet auto-transplant performed after severe trauma. Walter Reed Army Medical Center surgeons remove the damaged pancreas from a soldier wounded in the Middle East. The tissue is sent to DRI where islets are isolated and sent back for transplant into the same patient, preventing diabetes. The findings, published in the New England Journal of Medicine , indicate that islet isolation and auto-transplant in cases of severe abdominal trauma can be performed using a remote processing center.

2008 Researchers Pioneer “Living Window” to Observe Islets in Real Time

DRI researchers develop novel method to monitor healthy islets in a living experimental model. For the first time, researchers can obtain real-time imaging of functioning islets transplanted in the anterior chamber of the eye. The clear “window” allows researchers to witness the islets in the same model over time as nerves and blood vessels develop and immune reactions occur. The work is featured on the cover of Nature Medicine .

2007 Invention Supplies Critical Oxygen, Increases Beta Cell Growth

Scientists at the DRI design and test a new cell culture device that closely mimics the natural oxygen environment, demonstrating a dramatic increase in beta cell development from an embryonic mouse pancreas. The findings were published in the journal Stem Cells .

2006 Discovery Shows that Human and Animal Islets Differ Dramatically

Scientists from the DRI’s islet physiology team discover that the internal structure of a human islet cell is dramatically different from the more often studied rodent islet – a striking finding that argues for the importance of studying human islets if medical research is to benefit people living with diabetes. The findings were published Proceedings of the National Academy of Sciences (PNAS) .

2006 Islet Transplantation Improves Patients’ Quality of Life

A Diabetes Research Institute study shows type 1 diabetes patients’ quality of life and sense of well-being improve following islet transplantation despite having to take harsh anti-rejection drugs. The findings were published in the American Journal of Transplantation .

2005 DRI Develops Safer Method for Turning Stem Cells into Insulin-Producing Cells

Scientists report for the first time that protein technology can be used to promote pancreatic cell differentiation. DRI’s Stem Cell and Molecular Biology teams use this technology to show how stem cells can be progressively educated along the pathway leading to functional beta cells. The findings, published in Diabetes , open a promising new avenue of research that might enable the development of more insulin-producing cells for transplant in the future.

2003 DRI Performs First Successful Islet Transplant in Asia

Espousing its philosophy of global collaboration, the Diabetes Research Institute was asked to send members of its clinical cell transplant team to Shanghai’s First People’s Hospital to assist the Chinese team with both the islet isolation and transplantation efforts. Receiving telephone guidance from the DRI’s senior faculty, the DRI team in China was able to overcome every technical obstacle encountered, despite the formidable distance, technology, and language barriers.

2001 New Islet Transplant Protocol Leads to Insulin Independence

Using a new combination of anti-rejection drugs and improved culture media for islets, the DRI’s cell transplant team performs a series of “islets alone” transplants in study participants with long-standing type 1 diabetes. The recipients are able to discontinue insulin therapy for more than a year following islet transplantation.

1999 DRI Study Results Ignite Global Interest in Islet Transplantation

Using monthly injections of a monoclonal antibody, DRI is the first to show that transplanted islets reverse diabetes in pre-clinical models without the need for any other anti-rejection drug. The recipients remain insulin independent for over one year post-transplant and emerging rejection episodes can be reversed using this antibody. Even after discontinuation of the antibody, many subjects remain off insulin with glucose responsiveness for several months. The results are published in Proceedings of the National Academy of Sciences.

1997 Researchers Identify Cells that Regulate Autoimmunity

The DRI’s immunogenetics team publishes new findings related to insulin production in the thymus and its role in the development of type 1 diabetes. The Nature Genetics paper describes how this type of insulin might play a key role in the immune system’s ability to recognize insulin molecules as “self”. Scientists believe that the amount of thymic insulin might determine either susceptibility to or protection from diabetes.

1995 Islet Transplant Patient Insulin Independent for Five Years

Biopsies show intact, functioning human islet cells in the liver of a patient who was completely insulin independent for five years following an islet transplant.

1990 Organ Transplant Patients Become Insulin Independent After Receiving Islets

Nine patients receive islet cells in conjunction with their multi-organ transplants. This study, published in The Lancet , demonstrates that islets can produce insulin independence in patients who had previously been pancreatectomized.

1988 Invention Expands the Number of Clinical Islet Transplantation Trials

Camillo Ricordi, M.D., develops an automated method for isolating large numbers of islets from a single donor pancreas. This technology leads to expansion of clinical trials in cell therapy for the treatment and cure of type 1 diabetes. The findings were published in the journal Diabetes .

1987 Researchers Discover New Method for Visualizing Islets, Improving Outcomes

DRI’s Rodolfo Alejandro, M.D., identifies a chemical that differentiates islets from non-islet tissue of the pancreas during the isolation process. This zinc-binding substance (dithizone) is absorbed only by islets, giving them a distinctive red color. This discovery enables researchers to optimize the cell separation process for improved clinical outcomes. It was also shown that the use of this substance does not interfere with islet function in vitro or in vivo. The findings were published in Transplantation .

1985 DRI Performs First Clinical Islet Transplants

Based upon results obtained in preclinical transplant models, DRI researchers begin the first human pilot clinical trial in patients with type 1 diabetes. The results of the pioneering study appeared in Advanced Models for the Therapy of Insulin-Dependent Diabetes .

1984 Successful Islet Transplant in Dogs Restores Natural Insulin Production

DRI researchers conduct the first successful transplant of healthy islets into dogs with diabetes, restoring long-term natural insulin-production and normalizing blood sugar levels. Previously, these experiments were only successful in the rodent model. The findings were published in the journal Diabetes .

1978 DRI Develops Gold-Standard Treatment for Pregnant Women with Type 1 Diabetes

Using newly developed self-glucose monitoring and individualized algorithms for intensive insulin therapy, DRI researchers demonstrate that tight blood sugar control in women with type 1 diabetes during pregnancy can result in successful, full-term deliveries with normal birth weights. The study results were published in Diabetes Care .

1975 DRI Researchers Reverse Diabetes in Rodents

Islet cells are successfully transplanted into rats with diabetes, restoring natural insulin production and normalizing blood sugar levels in laboratory animals. The results are published in the journal Diabetes.

back to top

Keep Up With Our Progress Toward A Cure & More

Research Projects

The Division of Diabetes Translation (DDT) conducts and supports studies, often in collaboration with partners, to develop and apply sound science to reduce the burden of diabetes and to address the research needs of DDT programs and the diabetes community.

Analyses from various studies, such as LEAD and SEARCH, to help improve diabetes surveillance and guide decision-making.

Research, including the Diabetes Prevention Program Outcome Study (DPPOS), that evaluates the success of diabetes interventions and strategies.

Reviews of the effect of type 2 diabetes-related health policies on various populations, such as the NEXT-D2 study.

Collection of the most recent publications and access to archived ones.

• US Diabetes Surveillance System
• Chronic Kidney Disease Surveillance System
• Vision and Eye Health Surveillance System
• Diabetes State Burden Toolkit
• Diabetes Prevention Impact Toolkit

To receive updates about diabetes topics, enter your email address:

• Diabetes Home
• State, Local, and National Partner Diabetes Programs
• National Diabetes Prevention Program
• Native Diabetes Wellness Program
• Chronic Kidney Disease
• Vision Health Initiative
• Heart Disease and Stroke
• Overweight & Obesity

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Biomedicines

Current Advances in the Management of Diabetes Mellitus

Chinyere aloke.

1 Protein Structure-Function and Research Unit, School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa

2 Department of Medical Biochemistry, Alex Ekwueme Federal University Ndufu-Alike, Abakaliki PMB 1010, Nigeria

Chinedu Ogbonnia Egwu

Patrick maduabuchi aja.

3 Department of Biochemistry, Faculty of Biological Sciences, Ebonyi State University, Abakaliki PMB 53, Nigeria

Nwogo Ajuka Obasi

Jennifer chukwu.

4 John Hopkins Program on International Education in Gynaecology and Obstetrics, Abuja 900281, Nigeria

Blessing Oluebube Akumadu

Patience nkemjika ogbu, ikechukwu achilonu, associated data.

Not applicable.

Diabetes mellitus (DM) underscores a rising epidemic orchestrating critical socio-economic burden on countries globally. Different treatment options for the management of DM are evolving rapidly because the usual methods of treatment have not completely tackled the primary causes of the disease and are laden with critical adverse effects. Thus, this narrative review explores different treatment regimens in DM management and the associated challenges. A literature search for published articles on recent advances in DM management was completed with search engines including Web of Science, Pubmed/Medline, Scopus, using keywords such as DM, management of DM, and gene therapy. Our findings indicate that substantial progress has been made in DM management with promising results using different treatment regimens, including nanotechnology, gene therapy, stem cell, medical nutrition therapy, and lifestyle modification. However, a lot of challenges have been encountered using these techniques, including their optimization to ensure optimal glycemic, lipid, and blood pressure modulation to minimize complications, improvement of patients’ compliance to lifestyle and pharmacologic interventions, safety, ethical issues, as well as an effective delivery system among others. In conclusion, lifestyle management alongside pharmacological approaches and the optimization of these techniques is critical for an effective and safe clinical treatment plan.

1. Introduction

Diabetes mellitus (DM) is a long-standing, complicated, and non-transmissible endocrine ailment that is growing rapidly and has posed clinical challenges globally, often linked with threats related to complicated metabolic development in patients. It is marked by elevated glucose and lipids in the blood as well as oxidative stress, which culminate in chronic complications involving diverse organs, mainly the kidneys, eyes, nerves, and blood vessels, among others, in the body. As reported by World Health Organization (WHO), DM is an outbreak prone to high malaise and death. Globally, approximately 387 million persons are affected by this disorder and it is estimated to be more than 640 million by 2040 [ 1 ].

According to a report in 2017 by International Diabetes Federation (IDF), 425 million persons suffer from diabetes mellitus out of which more than 90 percent are adults and 352 million had impaired glucose tolerance (IGT) [ 2 ]. In individuals suffering from type II diabetes mellitus (T2DM), hyperglycemia is not the only characteristic; it also involves multiple complications such as kidney failure, blindness, heart attack, stroke, and amputations of the lower limb [ 3 ]. Mounting evidence obtained from epidemiological studies has shown that T2DM is an ailment with numerous causes associated with both polygenic and various environmental factors [ 4 ]. T2DM is thus too complicated to cure due to genetic polymorphism and other numerous risk factors.

Despite the fact that most cases are a result of obesity-linked T2DM, the annual prevalence of T1DM is on the rise [ 5 ]. It has been reported that about 10 percent of people suffering from diabetes have T1DM. However, the two forms are linked with a prolonged risk of circulatory system complexities [ 6 ] and the threat of lowered blood glucose. Ample proof suggests that normoglycemia accomplishment will mitigate the risk of complications linked with DM [ 7 ]. However, hypoglycemia occurrences limit the attainment of near normoglycemia in subjects with T1DM. Diabetic individuals who are not aware of their hypoglycemic status are vulnerable to T1DM which then limits them from the attainment of the needed glycemic control. Globally, DM health centers have several individuals with T1DM who have recurrent low blood glucose and the idea of hypoglycemic unconsciousness poses critical clinical challenges. Providentially, many favorable and interesting gain ground exist in the perspective for subjects with the problem of DM, including gene therapy, as reported by Bosch and colleagues [ 8 ].

Currently, the main therapeutic regimens for T2DM are injection of insulin-like agents and oral administration of hypoglycaemic agents. However, these agents play crucial functions in T2DM treatment but are laden with side effects [ 9 , 10 ]. Insulin has taken the centerpiece for the management of unrestrained insulin-deficient DM since its invention [ 11 ]. Admittedly, due to the severe lack of beta cells, the injection of exogenous insulin is vital for survival. Notwithstanding the advances made in comprehending the etiology, effects, and continuance of DM, including the progress made in insulin development and its analogues, ensuring tight glycaemic modulation without negative side effects such as low blood glucose and gain in weight still poses significant problems [ 7 , 12 , 13 ]. Hence, this further accentuates the importance of alternative techniques or adjuncts to insulin [ 14 ].

Consequently, this narrative review exploits different alternative therapeutic regimen for the management of two forms of DM, including nanotechnology, stem cell technology, gene therapy, medical nutrition therapy, lifestyle modification and the challenges associated with these techniques.

To identify published works on recent advances in the management of DM, the literature search for this narrative review was carried out using different search engines including Scopus, Google Scholar, Pubmed/Medline and Web of Science databases. Keywords and subject headings employed include diabetes mellitus, hyperglyceamia, management of DM, T2DM, nanotechnology in diabetes, gene therapy in DM management and current treatment, etc. The titles and abstracts of the results after the search were painstakingly screened to select eligible articles for full-text reading. Articles that were found to be eligible were retrieved and full-text screening was performed independently by three of the authors to select studies for inclusion in the final analysis. Original research and review articles published between 1993 and 2022 (in English) were included. Unpublished articles and thesis were excluded. All authors confirmed the validity of the selected papers.

3. Risk Factors of Diabetes

There are several risk factors associated with diabetes. These risk factors contribute significantly to the progression of diabetes. They include but not limited to age; weight; family history of diabetes; smoking and race/ethnicity [ 15 , 16 ] (Asiimwe et al., 2020; Noh et al., 2018). While T1DM is mostly found in the young, T2DM is an adult-related condition. The risk of T2DM increases with age which is due to the deficiency of insulin secretion which develops with age, and growing insulin resistance caused by a change in body composition [ 17 ]. Increase in body weight which leads to obesity is closely associated with diabetes in a condition termed diabesity. This is because increase in body weight leads to increased insulin resistance [ 18 ].

According to the FDA, smokers are 30 to 40% more likely to come down with T2DM than nonsmokers. Smoking can also increase insulin resistance which makes the patients require more insulin for the control of their sugar level [ 19 ]. Diabetes is hereditary. Those with the family history are advised to adhere to lifestyles that reduce the risk of developing diabetes.

4. Management of Diabetes

There are several modern approaches involved in the management of diabetes. However, early diagnosis is central to achieving any targets set in DM management [ 20 ]. Each patient is treated with the aim of achieving a particular outcome. These outcomes are set out from the first day of clinic visit to ensure an individualized approach in the management of diabetes.

4.1. Internet Intervention for Lifestyle Modification in Diabetes

Lifestyle modification is an integral part of diabetes management. It is recommended for both patients in pre-diabetic and diabetic conditions, respectively. Reduced sedentary lifestyle, increased physical activities, and healthy diets are among the recommended lifestyle modifications. The right exercise may depend on the state of the patient. The exercise helps to bring down the plasma glucose level. For a healthy diet, it is recommended that diabetic subjects take a lot of vegetables, fruits, and whole grains; choose nonfat dairy and lean meats; and limit foods that are high in sugar and fat. Other lifestyle changes include stopping smoking and reduction in alcohol intake [ 21 , 22 ]. The lifestyle changes are usually individualized.

Even though the above strategies help in the effective management of diabetes, communicating or constantly reminding the subjects to complete them could be challenging. Web or internet-based program have been deployed to improve adherence to the lifestyle changes. These web-based strategies provide a viable option for facilitating diabetes self-management [ 23 ].

4.2. Nanotechnology and Diabetes

Nanotechnology involves the use of nanoparticles (<100 nm). These nanoparticles are developed through the manipulation of individual atoms or molecules in a substance. The application of nanotechnology in medicine is termed nanomedicine. Nanomedicine involves the combination of the knowledge of nanotechnology in the application of drugs or diagnostic molecules which generally improves their ability to target specific cells or tissues. Nanotechnology in diabetes research has played several roles in improving the outcome of diabetic management in diabetics through the deployment of novel nanotechnology-based glucose measurement and insulin delivery techniques [ 24 , 25 ]. Nanotechnology employs non-invasive approaches for insulin delivery and the development of a more efficacious vaccine including cell-based and gene-based therapies for T1DM [ 24 ]. The importance of nanotechnology in diabetes includes, but is not limited to, inventive diabetes diagnosis, detection of immune cell activity and beta-cell mass, monitoring of glucose level, and non-invasive insulin delivery, etc.

Early and accurate diagnosis of a disease may be as important as the treatment of the disease itself. Prompt diagnosis may prevent dysglycaemia and reduce the time to onset of diabetes [ 26 ]. Conventional approaches have been utilized in the different diagnostic needs in diabetes, such as detection of immune destruction that precedes T1DM and/or measurement of plasma glucose levels. However, the shortcomings of the conventional approaches which include, but are not limited to, non-early detection of the disease progression necessitate the need for a novel technology that can improve the diagnostic outcome.

The mass of the beta cell is an indication of the functionality of the beta-cell in secreting insulin. The progressive loss of the beta cells precipitates T1DM [ 27 ]. Prompt detection of the stage of beta cell loss through nanotechnology can allow for the immediate application of clinical interventions for its arrest. Magnetic nanoparticles (MNPs), for instance, have distinctive physical properties qualifying them as outstanding contrast media for magnetic resonance imaging (MRI). This can enable the early detection of the stages of beta-cell loss.

Glycaemic fluctuation should be avoided during diabetic management. Individuals have treatment goals set by their physicians. Regular or daily glucose monitoring is performed to ascertain the control achieved by the treatment and the diabetes progression [ 28 ]. However, this comes with some challenges including poor compliance as a result of the regular pricking of the patients and inability to monitor glucose levels at certain times of the day (e.g., sleeping and driving times). The overall impact is irregular monitoring of the glucose level which can lead to dangerous fluctuations that may worsen diabetic complications. To circumvent this challenge, continuous glucose monitoring (CGM) systems are essential. The implantation of biosensors (e.g., amperometric sensors) subcutaneously had been used to achieve CGM for 10 days; however, this has its drawbacks including instabilities and the need for a weekly change of the implantation [ 29 , 30 ].

Nanomedicine can overcome the aforementioned obstacles in CGM. The glucose-sensing device has three key components: a detector, a transducer, and a reporter. The detector measures the glucose level while the transducer converts the measurement into an output signal. The reporter finally processes the signal into an interpretable form. For an effective measure of the glucose level, the glucose sensors are usually made of nanoparticles in nanotechnology which are made from mainly three molecules: glucose oxidase, glucose-binding proteins, and glucose-binding small molecules [ 24 , 31 ]. The coupling of these nanoparticles as transducers enables the accurate detection of glucose in a patient-friendly and rapid manner [ 31 ].

Insulin shots are the mainstay in the management of T1DM and T2DM. The conventional approach of insulin delivery involves the use of needle injections. Even though some needles have been significantly improved to be painless during delivery, the thought of needles alone could be discouraging [ 32 ]. This significantly affects the compliance of patients to insulin use. Moreover, the lingering time between the time of glucose measurement and the insulin dosing in addition to the hindrance in the absorption of insulin ensuing the conventional subcutaneous injection, do not allow for a close plasma glucose control which leads to fluctuations and times of hyperglycemia [ 24 ]. An approach that is non-invasive will be well accepted by both patients and medical practitioners to improve compliance and the overall outcome of treatment.

To overcome the recent delivery challenges faced by the conventional approaches, microcomputer closed-loop or nano pumps are being developed to ensure the timely delivery of insulin while ensuring continuous glucose monitoring. In other words, this system is built to link insulin delivery to plasma glucose concentration. This will prevent the risk of plasma glucose fluctuations [ 26 , 33 ]. Other less invasive means of insulin delivery that involve the use of nanoparticles are also being explored to facilitate insulin delivery orally, transdermally, and/or via inhalation [ 26 ].

4.3. Medical Nutrition Therapy in Diabetes

Medical nutrition therapy (MNT) is a “nutrition-based treatment provided by a registered dietitian nutritionist.” It comprises nutrition diagnosis and therapeutic and professional counseling services that aid in the management of DM. MNT is a critical aspect of diabetes education and management. Recommendations on MNT by international collaborative groups for diabetes management have attempted to reform and provide courses for adverse nutritional transition [ 34 , 35 ]. For instance, MNT has been employed for the treatment of GDM because carbohydrate (CHO) is the main causative agent as a result of its impact on glycaemia. According to the Institute of Medicine, pregnant women require a minimum of 175 g CHO per day, and low-CHO diets already in use traditionally for the treatment of GDM have proven to be safe [ 36 ]. Moreover, MNT has been reported to be critical in the management of other types of DM and as such has significantly impacted patients, especially women and newborns [ 37 ]. Primarily, MNT ensures the maintenance of euglycemia via adequacy in weight gain in pregnancy and growth of fetus while avoiding ketogenesis and metabolic acidosis. Nonetheless, MNT is yet to establish the optimal diet in terms of energy content and macronutrient distribution, quality, and amount, among others, in DM [ 37 ]. Reports have shown that the nutritional requirements for GDM patients are the same for all pregnancy cases when their carbohydrate intake is taken into special cognizance. Currently, a low-glycemic index diet has been reported to be more favorable in the management of GDM than the traditional intervention of carbohydrates restriction even though the evidence is still restrained [ 37 ]. Caloric restrictions are very vital in the management of overweight or obesity.

Reports have charged MNT with the design of signature diet strategies that will be suitable medically as well as patient focused. By this, it is hoped that practicing diabetologists and registered dieticians (RDs) will partner to furnish nutritional guidelines based on evidence for use by MNT for the prevention and management of DM and related comorbidities [ 38 ]. Indications show that MNT may be a potent, easily available, and cheap therapeutic technique and could be an essential tool for DM prevention and management [ 35 ].

4.4. Gene Therapy and Diabetes Mellitus

Gene therapy is a technique that involves remedying the symptoms of an ailment orchestrated by a defective gene via the incorporation of the exogenous normal gene. Its advantage is that a single treatment can be used to cure any type of disease and currently, gene therapy is opening up novel treatment options in different branches of medicine [ 39 ]. At present, gene manipulation is not limited to the addition of a gene but also gene modulation and editing [ 40 , 41 ]. Gene therapy can also be explained as a method of introduction of a gene or gene manipulation within a cell as a curative regimen in the treatment of disease [ 42 ]. The objective of this approach is to remedy abnormal genes that have been implicated as the causative agent in any ailment and to successfully halt the beginning of the ailment or prevent its continuation. The gene therapy approach involves three major intervention methods: (i) delivery of a new gene into the body, (ii) substitution of the abnormal gene with a working gene, and (iii) disabling the malfunction genes responsible for the ailment [ 42 , 43 ]. Gene therapy can be further classified into somatic gene therapy or germline gene therapy. While the primary target in somatic gene therapy is the somatic cells often referred to as the diseased cells, the reproductive cells are the targets in germline gene therapy. Germline therapy halts the development of the disease in subsequent generations [ 43 ]. The application of gene therapies as trends in evolving therapeutics is due to its potential for the treatment of diverse ailments including DM, autoimmune disorders, heart diseases, and cancers among others that are difficult to manage using conventional therapies [ 44 ].

T1DM is an autoimmune ailment marked by T-cell-orchestrated self-damage of the islet beta cells responsible for the secretion of insulin. Its management is problematic and complex, particularly using conventional drugs. Thus, gene therapy is partly an emerging promising therapeutic alternative in its treatment [ 45 , 46 ]. The etiology of T1DM is multifactorial involving both environmental and genetic factors akin to any other autoimmune disease. In the recent past, researchers have favourably pointed out many genes accountable for the evolution of T1DM [ 47 ]. Thus, alteration or grappling with these genes employing gene therapy techniques will probably foster better comprehensible management of the ailment or even cure T1DM.

Even though gene therapy for DM majorly centres on T1DM, many genes have been evaluated as a probable treatment for T2DM as the ailment has a compelling genetic susceptibility [ 48 ]. About 75 independent genetic loci have been identified for T2DM via genetic linked studies and different novel therapeutic targets have also been determined [ 46 ]. Genetic loci might have a huge impact on drug response in contrast to the incidence and development of diseases whose effects are limited [ 49 ]. Many genetic loci exist with prospects for T2DM gene therapy. For instance, nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) is a good example. NLRP3 inhibition mitigates inflammation, guard against apoptosis of pancreatic b-cells including the prevention of development of T2DM in mice [ 50 ]. Hypothetically, all genes associated with the beginning, evolution, and deterioration of T2DM are probable targets. In Table 1 [ 51 ], the genes that modulate the homeostasis of glucose, ameliorate insulin synthesis or/and responsiveness, and improve diabetic mellitus-induced complications are abridged for simplicity.

Promising targets that can be employed for T2DM gene therapy.

Legend: HSP70 = heat shock protein 70; NLRP3 = nucleotide-binding oligomerization domain-like receptor protein 3; SGLTs = sodium-glucose co-transporters; GLUTs, glucose transporters; SIRT6=Sirtuin 6; FGFs = fibroblast growth factors; GPGRs = G protein–coupled receptors; GLP-1= glycogen-like peptide 1; ADPN = adiponectin; CTB APSL = cholera toxin B subunit and active peptide from shark liver; TGF-a = transforming growth factor-alpha; DKD = diabetic kidney disease [ 51 ].

4.5. Stem Cell Therapy in Diabetes

The conventional approaches in the management of DM do not resolve the causes of the ailment and are laden with adverse effects. Hence, there is a quest for a desirable different therapeutic regimen. The cellular-based therapeutic technique currently in use in DM management is based on the pancreas or islet-cell transplantation to revive the beta cells for insulin secretion. This approach is restricted due to a lack of donor organs. These problems lead to the exploration of the possibility of constructing beta cells using stem cells. The peculiar rebuilding potential of stem cells might be an important tool that could be used in the management of DM. Development of replenishable islets source using stem cells might avert the recent supply/demand problems in the transplantation of islet and furnish DM subjects with a prolonged source of beta cells for insulin secretion. Hence, in the management of DM, stem cell investigation has become a promising approach [ 52 ].

The stem cell DM therapy is aimed at the replacement of malfunctioning or damaged pancreatic cells by employing pluripotent or multipotent stem cells. This technique has exploited the ability of various kinds of stem cells including induced pluripotent stem cells (iPSCs), embryonic stem cells (ESCs), and adult stem cells using diverse methods to produce surrogate beta cells or to bring back the physiologic role of the beta cell [ 53 ].

Advancement in technology has facilitated the development of stem cells using different kinds of tissue sources such as adipose tissue, skin, bone marrow, umbilical cord blood, periosteum, and dental pulp. In searching for promising stem cells, the first organ of choice is usually the pancreas. Studies with animal models have indicated that a small number of pancreatic tissue when made available could bring back the optimum pancreatic beta-cell mass [ 54 ]. This is sequel to the differentiated beta cells from the pancreatic duct undergoing replication and dedifferentiation culminating in the formation of pluripotent cells which in turn synthesize more beta cells. Additional study suggested that these ductal cells populations could be produced in vitro and directed to produce insulin synthesizing clusters [ 55 , 56 ].

Moreover, the haemopoietic adult stem cells such as HSCs and mesenchymal stem cells (MSCs) have the potential to transdifferentiate into so many cell lineages such as the brain, liver, and lung as well as gastrointestinal tract cells [ 57 , 58 , 59 ]. A different group of researchers experimented on the multipotent differentiation of haemapoietic progenitors to replenish the beta cell number in T1DM. It was reported that the bone marrow of mouse was differentiated ex vivo into functional beta cells [ 60 ]. Relatedly, studies using the mice model indicated that cells of the bone marrow could be amenable to the pancreas as a target and that elevated blood glucose could be normalized [ 61 ]. An experiment with autologous HSCs demonstrated an improvement in T1DM and T2DM [ 62 , 63 ]. These studies furnish potential outcomes for the usage of autologous HSCs in the management of DM.

4.6. Latest Inventions in Diabetes Management

In addition to the aforementioned innovations in the management of diabetes, several drugs are still at different stages of clinical trial for eventual use. Others are ready and have been recently introduced into the market.

4.6.1. Drugs Recently Introduced

Tirzepatide: The drug was recently approved by the FDA under the trade name mounjaro for the treatment of T2DM [ 64 ]. Tirzepatide is an injectable given under the skin once in a week which targets the receptors of hormones which play central role in the metabolism of glucose. These hormones are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). While the GLP-1 reduces blood glucose by several mechanisms, including stimulating insulin secretion and suppressing glucagon release during hyperglycemia, GIP stimulates insulin release during hyperglycemia, but it also stimulates glucagon release during hypoglycemia.

Tirzepatide acts as agonist to their receptors [ 65 ], hence elongating their functions which results in blood glucose control. The efficacy of tirzepatide was established against a placebo, a GLP-1 receptor agonist (semaglutide) and two long-acting insulin analogs either as monotherapy or in combination with other antidiabetic agents [ 64 ]. In comparison to the placebo, it lowered the HbA1c by 11.6% and 1.5% as monotherapy and combination therapy, respectively. In comparison to other antidiabetic drugs, at the highest dose of 15 mg, it lowered the HbA1c 0.5% more than semaglutide, 0.9% more than insulin degludec and 1.0% more than insulin glargine [ 64 ]. Because of the efficacy therein and the once in a week dosing, tirzepatide provides a desirable paradigm shift in the management of T2DM.

4.6.2. Drugs in the Pipeline

Several drug candidates are at different phases of development for the management of DM. These are listed below.

LY3502970: LY3502970 is a partial agonist, biased toward G-protein activation over β-arrestin recruitment at the (GLP-1 receptor (GLP-1R). The molecule is highly potent and selective against other class B G-protein-coupled receptors (GPCRs) with a pharmacokinetic profile favorable for oral administration [ 66 ]. It is a product that is currently being developed by Eli lilly.

SCO-094: SCO-094 is a drug candidate identified by SCOHIA company which has a dual target of the receptors of GIP and GLP-1 [ 67 ]

Ladarixin (LDX): Ladarixin is an inhibitor of the interleukin-8 receptors CXCR1 and CXCR2, in new-onset T1DM [ 68 ]. It is a drug candidate developed by Dompe Farmaceutici. Short term LDX treatment of newly diagnosed patients with T1DM had no appreciable effect on preserving residual beta cell function [ 68 ].

5. Discussion of Major Findings

DM is a complex, progressive, and multifactorial metabolic disorder needing more complex treatments over time. Globally, researchers have worked assiduously in the discovery and development of novel drugs for the treatment of diabetes. There is significant progress in research into the cause and management of T1DM [ 69 ]. Mounting evidence indicates that modern insulin therapy in combination with glucose self-monitoring including blood pressure and lipid monitoring has profoundly improved the long-term prognosis of T1DM [ 70 ]. The literature indicates that regular exercise and improved diet may enhance the quality of life for diabetic subjects but in the absence of adequate exercise and diet, medications may help diabetic persons regulate their blood glucose level. Moreover, implantation of insulin producing cells could furnish the basal glucose level essential for maintaining glucose homeostasis in vivo and thus hinder long-term injury from occurring in different tissues regardless of hormone administration [ 71 ].

The attainment of the full potential of gene therapy technique could be obtained via the design of gene delivery vectors that are safe, efficient, and specific and/ or the development of a technique for engineering of cell, in which the stem cell seems to be of great importance. Thus, the establishment of a reliable, sensitive, and acutely monitored feedback system is needed for the generation of a safe and efficient vector to facilitate diabetes gene therapy for clinical trial. Probably, the curtailment of islet transplantation rejection is the first clinical technique to DM gene therapy approach. On the other hand, insulin gene therapy is carried out in concert with conventional insulin treatment culminating in tight glycemic regulation in the absence of fasting hypoglycemia in T1DM subjects, as reported in T1DM rats [ 72 ].

Physical activity and nutrition therapy could help individuals with DM achieve metabolic goals. Employing diverse lifestyle approaches might help. Regulation of metabolic parameters such blood pressure, glucose, glycated hemoglobin, lipids, and body weight including the assessment of life quality are critical in determining the level of treatment goals by lifestyle changes [ 73 ]. However, different countries have focused on DM management and its complications on the normalization of glycemic control as assessed by hemoglobin A1 or fasting blood glucose which only addresses the need of subjects who were already diabetic. Thus, it is imperative to design programs for the early detection of altered glucose metabolism and to carry out robust approaches for the normalization of this changed state. Furthermore, through robust prevention strategies, better diagnostic tests, early risk detection, and management of the risks will help mitigate the incidence of DM and reduce or prevent events associated with end-organ failure [ 73 ].

Besides glycemic control, multifactorial interventions using different treatment regimen, including nanotechnology, gene therapy, stem cell, medical nutrition therapy, and lifestyle modification have yielded significant results in ameliorating the impact of DM but not without some challenges. Regardless of the promising nature of nanotechnology and its projected ability to turn around the fortunes in diabetes management, it is still faced with some challenges. One of the major limitations is the cost. Most of the gadgets required for CGM, and insulin delivery are very expensive. This limits their use to the rich class even when diabetes cuts across different economic classes. More so, there is an increased risk of infection via the implantation of sensors and cannulas which increases inflammation and could be frightening sometimes [ 24 ].

Notwithstanding the merits linked with the gene therapy approach, there could equally be problems. For example, genes introduced employing a viral vector might provoke an immune response and aggravate the disease condition [ 74 ]. Additionally, gene therapy studies are still mostly carried out using animal models and their safety is yet to be validated in humans [ 46 ].

Currently, it is established that gene delivery technology is the primary hurdle for successful gene therapy. The prime factors for an effective gene delivery technique include efficiency, stability, specificity, safety, and convenience. Thus, the greatest obstacle in gene therapy is the method of delivery of the corrective gene to the target site safely and efficiently. There is, therefore, a requirement of desirable gene delivery technology or vector to furnish the therapeutic potential where required. The two main vectors currently employed are viral and non-viral vectors. The merit of the non-viral vector is that it has low immunity, a low financial burden, and its preparation is convenient but the major obstacles for its extensive use emanate from the inefficiency of delivery method and expression of gene transiently [ 75 ]. Contrastingly, reports show that viral vectors are more efficient in gene delivery as several of them use a distinct mechanism for DNA delivery to the cells. Viral vectors are arranged as viral particles having precisely the important modulated sequences of the virus and from which all the genes of the virus have been excised. These viruses, when prepared very well, are defective that after target cell infection, there is no probable replication or infection theoretically [ 76 ]. Viral DNA is integrated with the genome of the host cell, thereby bestowing the capability for sturdy therapeutic gene expression.

Despite the fact that viral vectors are more efficient in comparison to non-viral vectors as gene delivery systems, there are still challenges associated with them, including inflammation, cytotoxicity, and immunogenicity which are needed to be looked into during the construction of viral vector system [ 46 ].

Notwithstanding the huge and novel impacts recorded in the applicable areas of stem cell biology in the management of DM, it is still in its primitive stage. A lot of hurdles still hinder the progression of stem cell research technologically and ethically, including:

The use of ESCs is confronted with the formation of teratomas and the danger of malignancy [ 77 ], thus raising safety concerns. This makes it imperative for a thorough investigation and screening of the probable adverse effects prior to its deployment in clinical trials and human treatment.

The primary hurdle associated with transplantation is autoimmune rejection. This makes it necessary for a stable and appropriate regimen for immunosuppression. There is a need for the stabilization of current transplantation protocols with the standard testing module. The transplantation of stem cells needs a few experimental works to appraise the problems linked with the stability, durability, and the survival of the transplanted cell with appropriate vascular and neural support in the new microenvironment.

The challenges of scale-up problems arise after the optimization of the appropriate developmental procedures. The number of cells must be enough to cope with the requisite request for future research including clinical investigations. Hence, an efficient method is required for the maximization of the yield via an adjustment in the culture requirements. The stem cells’ scale-up ability is needed for future exploration for the provision of surplus transplanted cellular reserves in order to strike equilibrium between demand and usage.

As a result of where it is obtained from, the ESCs are the potential targets for the ethicists. Normally, ESCs are obtained from embryos not fertilized or used during ex vivo fertilization in hospitals. Informed consent is usually required in the procurement of these ESCs from the donor prior to the usage in clinical research. Sadly, though, in the majority of instances, there is the destruction of the embryo during the process of obtaining the cells from the embryo, and this questions the source of life and the ethical license to terminate the fetus. Adult stem cells are preferable to embryonic ones as the controversy about their usage is limited. The current advancement in technology in induced pluripotent stem cell research is to allow the use of ones’ stem cells for diverse uses [ 78 ]. The adult cells are reprogrammed in such cases to pluripotent conditions and thereafter transformed into working beta cells. This approach might eventually resolve the impasse linked with ESCs and contribute to further safety issues likely to be tackled later in the future.

6. Conclusions

DM has become a public clinical challenge that requires urgent attention and the increasing trend in its cases is suggested to continue for more decades. Currently, there is no permanent cure for DM. Many treatment regimens have shown promising results in DM management. Yet, notwithstanding the potential of these giant treatment plans, DM remains a serious challenge that may continue to threaten public health. Thus, the problems encountered in each of these approaches need to be addressed to achieve a robust, efficient, and safe clinical management plan. There is a need for optimal metabolic regulation of glucose, blood pressure, and body weight which requires proper education and support for the improvement of diet, physical activity, and reduction in body weight. To effectively and successfully manage the control of this disease, an emphasis on public policies to reinforce health care access and resources, the promotion of a patient-centred care approach, and health-promoting infrastructures at environmental level are required.

Funding Statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author Contributions

Conception and Design: C.A., C.O.E. and I.A.; Data Collection: C.A., C.O.E., P.N.O. and N.A.O.; Data Analysis and Table Creation: C.A., P.M.A., J.C. and B.O.A. Writing the Manuscript: C.A., C.O.E., P.M.A., N.A.O., J.C., B.O.A., P.N.O. and I.A.; Vetting the manuscript for intellectual content: I.A.; Approval of the manuscript for submission: All the authors. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare that they have no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• Get Press Releases

• Media Contacts
• News Releases
• Photos & B-Roll Downloads
• VUMC Facts and Figures

Explore by Highlight

• Education & Training
• Growth & Finance
• Leadership Perspectives
• VUMC People

Explore by Topic

• Emergency & Trauma
• Genetics & Genomics
• Health Equity
• Health Policy
• Patient Spotlight
• Tech & Health

Explore by Location

• Monroe Carell Jr. Children’s Hospital at Vanderbilt
• Vanderbilt Bedford County Hospital
• Vanderbilt Health One Hundred Oaks
• Vanderbilt Health Affiliated Network
• Vanderbilt-Ingram Cancer Center
• Vanderbilt Psychiatric Hospital
• Vanderbilt Wilson County Hospital
• Vanderbilt Stallworth Rehabilitation Hospital
• Vanderbilt Tullahoma Harton Hospital
• Vanderbilt University Hospital

• Photos & B-Roll Downloads

Featured Story

VUMC performs its first combined lung and liver transplant

March 28, 2024, teams to create one-stop resource for human pancreatic data to foster diabetes research.

Leading investigators in diabetes, pancreas and islet biology, and computational biology have received $12.5 million in two five-year awards from the National Institutes of Health (NIH) to create the world’s first, integrated knowledge base of human-derived tissue- and cellular-level pancreatic information to support innovative, collaborative and reproducible research.

With growing data obtained through single cell/spatial sequencing and complex imaging technologies, several pancreas and islet phenotyping efforts in the United States and Europe are generating high-quality, multimodal datasets.

However, because that information is housed across many different resources and processed in different ways, it is challenging for investigators to discover or re-use, especially if they do not have training in computational biology.

The creation of the Pancreas KnowledgeBase (PanKbase) program will play a key role in organizing, standardizing and disseminating data and resources focused on the human pancreas.

Curated data derived across multiple modalities spanning human genetics, genomics, human islet physiology, spatial pancreatic tissue architecture and more will be available in PanKbase, following the FAIR Data Principles of findability, accessibility, interoperability and reusability. FAIR principles emphasize machine-actionability or the capacity of computational systems to find, access and reuse data with little human intervention.

The interdisciplinary PanKbase teams, one with researchers from University of Michigan, Vanderbilt University, Vanderbilt University Medical Center, Weill Cornell Medicine and the Jackson Laboratory for Genomic Medicine, and a second comprised of researchers from University of California San Diego, Stanford University, the University of Pennsylvania and the Broad Institute, together with active participation of the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) program officers, will bring extensive expertise in developing resources and knowledge portals related to the pancreas and diabetes, including:

• Common Metabolic Diseases Knowledge Portal (CMDKP), an open access data and software platform established in 2015 to interrogate the genetic basis of complex disease developed at the Broad Institute, which together with CMDGA is part of the Accelerating Medicines Partnership in Common Metabolic Diseases consortium of academic, industry and nonprofit institutions.
• Common Metabolic Diseases Genome Atlas (CMDGA), an online database of standardized genomic data from key tissues related to metabolic disease developed at the University of California San Diego. 
• Pancreatlas , the world’s first online imaging database of human pancreatic tissue developed by a Vanderbilt University Medical Center and Vanderbilt University team in 2020.
• Genomic Knowledgebase (GenomicKB) platform, an online database developed by University of Michigan researchers that uses a knowledge graph to consolidate genomic datasets and annotations from more than 30 research consortia.
• The Common Fund Knowledge Center (CFKC): a program started in 2023 that will create a knowledge network to integrate knowledge generated by Common Fund programs.

PanKbase will also have an open science component to support the generation of new insights into molecular signatures of Type 1 diabetes (T1D) and facilitate cross-organ analysis for different stages of T1D development. This approach will lay a foundation allowing the inclusion of other common and rare forms of diabetes in the PanKbase resource.

The PanKbase program will become a component of the Human Islet Research Network (HIRN), adding to the network’s existing research resources: the Human Islet Research Enhancement Center (HIREC) and the Human Pancreas Analysis Program (HPAP).

The PanKbase teams include Stephen Parker, PhD, and Jie Liu, PhD, from University of Michigan; Jean-Philippe Cartailler, PhD, from Vanderbilt University; Marcela Brissova , PhD, and Diane Saunders, PhD, from Vanderbilt University Medical Center; Shuibing Chen, PhD, from Weill Cornell Medicine; Michael Stitzel, PhD, from The Jackson Laboratory for Genomic Medicine; Kyle Gaulton, PhD, from the University of California San Diego; Anna Gloyn, DPhil., of Stanford University; Ben Voight, PhD, from University of Pennsylvania, Noël Burtt, PhD, and Jason Flannick, PhD, of the Broad Institute, and Xujing Wang, PhD, and Ashley Xia, MD, PhD, of the NIH National Institute of Diabetes and Digestive and Kidney Diseases.

The project is supported by National Institutes of Health grants U24 DK138515 and U24 DK138512 .

Related Articles

January 14, 2016

Major grants bolster vumc diabetes research.

Researchers at Vanderbilt University Medical Center have received more than $11 million in new grant support aimed at slowing the growing burden of diabetes.

By Bill Snyder

September 21, 2017

Pancreatic islets study may spur diabetes treatment advances.

Investigators in the Vanderbilt Diabetes Research and Training Center (VDRTC) and collaborators at Stanford University have discovered new insights into the molecular mechanisms of cell proliferation in juvenile human pancreatic islets, information that could lead to new treatments for diabetes.

By Jill Clendening

July 30, 2020

Pseudoislet system expected to advance pancreas and diabetes research.

The multicellular, 3-D structure of human pancreatic islets — the areas of the pancreas containing hormone-producing or endocrine cells — has presented challenges to researchers as they study and manipulate these cells’ function, but Vanderbilt University Medical Center researchers have now developed a pseudoislet system that allows for much easier study of islet function.

• News Releases

Lundquist investigator Dr. Eiji Yoshihara awarded $3 million NIH R01 grant for diabetes stem cell therapy research

Dr. Yoshihara will investigate cutting-edge transcriptional gene regulation processes

The Lundquist Institute

Dr. Eiji Yoshihara pictured at The Lundquist Institute

Credit: The Lundquist Institute

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a division of the National Institutes of Health, has granted Eiji Yoshihara, PhD, a principal investigator at The Lundquist Institute (TLI) and assistant professor at the David Geffen School of Medicine at UCLA, a five-year grant totaling $3 million. This prestigious NIH R01 grant, known for its rigorous peer-review process, is dedicated to advancing stem cell therapy research for treating diabetes.

Insulin-dependent diabetes, including autoimmune Type 1 and stress-induced Type 2, presents a significant health burden, often necessitating lifelong insulin therapy and glucose monitoring. While pancreatic islet transplantation offers a ray of hope for Type 1 diabetes, its applicability is hindered by donor shortages and the need for immunosuppression. Dr. Yoshihara's research focuses on the potential of human pluripotent stem cells (hPSCs) to create functional islet cells.

Overcoming the limitations of current stem cell-derived organoids, which are three-dimensional structures that mimic the function of an organ and include functional immaturity and heterogeneity, Dr. Yoshihara’s team aims to discover markers to differentiate mature organoids, optimizing their clinical utility. Furthermore, the research team, led by Dr. Yoshihara, will investigate cutting-edge transcriptional gene regulation processes that are anticipated to accelerate the maturation of organoids.

“Despite significant progress in stem cell-derived mini-organ technologies, we are still challenged by their functional immaturity and variability,” said Dr. Yoshihara. “There are no effective methods to differentiate between mature and immature organoids in dishes. By identifying markers to distinguish these ‘good’ and ‘bad’ organoids and developing techniques to segregate organoids of optimal quality, we aim to propel cell therapy in diabetes into a more promising future.”

Dr. Yoshihara is a renowned expert in stem cell therapy. This innovative research is supported by the NIDDK, committed to generating vital knowledge and developing treatments for chronic and costly diseases, ultimately improving patient care and health outcomes nationwide.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Original Source

City of Hope Research

• Beckman Research Institute
• Arthur Riggs Diabetes & Metabolism Research Institute
• Comprehensive Cancer Center
• Hematologic Malignancies Research Institute
• Translational Genomics Research Institute
• Irell & Manella Graduate School of Biological Sciences
• Shared Resources
• Additional Resources

City of Hope is home to some of the world’s leading research centers and institutes, where our scientists are renowned for breakthrough innovations.

Sharing our state-of-the-art equipment and resources, and the expertise to apply them to meaningful research, are crucial to the pursuit of new treatments and potential cures. 

Among the worldwide leaders in administering clinical trials, City of Hope conducts more than 400 studies annually, enrolling more than 6,000 patients.

Research Centers & Institutes

Our insights into gene therapy, recombinant DNA technology, computational medicine, biology and other fields have made us a world leader in creating greater understanding of cancer, HIV/AIDS and other life-threatening diseases.

• Department of Cancer Biology and Molecular Medicine
• Department of Cancer Genetics & Epigenetics
• Department of Comparative Medicine
• Department of Computational and Quantitative Medicine
• Department of Hematologic Malignancies Translational Science
• Department of Immuno-Oncology
• Department of Integrative Translational Sciences
• Department of Molecular Diagnostics and Experimental Therapeutics
• Department of Population Sciences
• Department of Stem Cell Biology and Regenerative Medicine
• Department of Systems Biology
• Center for Cancer and Aging
• Center for Precision Medicine
• Center for RNA Biology and Therapeutics

We offer a broad diabetes and endocrinology program combining groundbreaking research, unique treatments and comprehensive education to help people with diabetes and other endocrine diseases live longer, better lives.

• Department of Diabetes & Cancer Discovery Science
• Department of Diabetes & Cancer Metabolism
• Department of Diabetes Complications & Metabolism
• Department of Diabetes, Endocrinology & Metabolism
• Department of Immunology & Theranostics
• Department of Molecular & Cellular Endocrinology
• Department of Translation Research & Cellular Therapeutics
• The Wanek Family Project for Type 1 Diabetes

Recognizing our team’s accomplishments in cancer research, treatment, patient care, education and prevention, the National Cancer Institute has designated City of Hope as a comprehensive cancer center, the highest designation possible from the NCI.

• Cancer Control and Population Sciences
• Cancer Immunotherapeutics
• Center for Cancer Prevention and Early Detection
• Developmental Cancer Therapeutics
• Hematologic Malignancies
• Molecular and Cellular Biology of Cancer

Our dedicated, multidisciplinary team of health care and research professionals combine innovative research discoveries with superior clinical treatments to improve outcomes for patients with hematologic cancers.

• Cellular Immunotherapy Center
• Center for Gene Therapy
• Center for Stem Cell Transplantation
• Center for Survivorship and Outcomes
• Gehr Family Center for Leukemia Research
• The Judy and Bernard Briskin Center for Multiple Myeloma Research
• Toni Stephenson Lymphoma Center

This alliance provides City of Hope with access to TGen's innovative genomics technologies, helping physicians and researchers move research discoveries into the clinic for the benefit of patients.

Through rigorous coursework and laboratory research, you’ll be training in an academically stimulating, collaborative and diverse environment. The program develops a professionally trained scientist, prepared for a career in academia, medicine or industry.

• Ph.D. in Biological Sciences
• Ph.D. in Translational Medicine
• M.S. in Translational Medicine
• M.S. in Regulatory Affairs
• For Postdoctoral Fellows
• Eugene and Ruth Roberts Summer Student Academy

City of Hope and Beckman Research Institute offer a host of resources meeting researchers’ needs for specialized equipment, services or expert consultation. Sharing state-of-the-art equipment and resources, and the expertise to apply them to meaningful research, are crucial to the pursuit of new treatments and potential cures. They’re key pillars of our status as an NCI-designated Comprehensive Cancer Center.

• Analytical Cytometry
• Analytical Pharmacology
• Biostatistics and Mathematical Oncology
• Chemical GMP Synthesis
• Comprehensive Metabolic Phenotyping
• Design and Fabrication Laboratory
• Drug Discovery and Structural Biology
• Electron Microscopy
• Gene Editing and Viral Vector
• Hematopoeitic Tissue Bank
• Immuno-Oncology Core
• Integrative Genomics and Bioinformatics
• Light Microscopy/Digital Imaging
• Mass Spectrometry and Proteomics
• Pathology Research Services
• Population Facing Research
• Small Animal Studies
• Stem Cell Core Facility

By having world-renowned scientists, physicians, and treatment manufacturing facilities working side by side at our main campus, we’re able to quickly turn breakthrough discoveries into experimental treatments. In a given year, City of Hope conducts more than 400 clinical trials enrolling more than 6,000 patients.

Search by name or department to learn more about their research.

Research Events & Seminars

Join us in the pursuit of a cure.

The library furnishes materials and services that support the institution's clinical, scientific and educational mission. It offers an expansive collection of scientific and biomedical journals and online databases, as well as a wide array of other services.

Join one of our forward-thinking, interdisciplinary teams of investigators, renowned researchers and postdoctoral fellows.

When you donate to City of Hope, you’re providing hope, second chances and the power to heal.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals

Type 1 diabetes articles from across Nature Portfolio

Type 1 diabetes (also known as diabetes mellitus) is an autoimmune disease in which immune cells attack and destroy the insulin-producing cells of the pancreas. The loss of insulin leads to the inability to regulate blood sugar levels. Patients are usually treated by insulin-replacement therapy.

Latest Research and Reviews

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

• Z. W. Hawks
• L. T. Germine

Generative deep learning for the development of a type 1 diabetes simulator

Mujahid et al. develop a type 1 diabetes patient simulator using a conditional sequence-to-sequence deep generative model. Their approach captures causal relationships between insulin, carbohydrates, and blood glucose levels, producing virtual patients with similar responses to real patients in open and closed-loop insulin therapy scenarios.

• Omer Mujahid
• Ivan Contreras

High dose cholecalciferol supplementation causing morning blood pressure reduction in patients with type 1 diabetes mellitus and cardiovascular autonomic neuropathy

• João Felício
• Lorena Moraes
• Karem Felício

Does minimed 780G TM insulin pump system affect energy and nutrient intake?: long-term follow-up study

• Yasemin Atik-Altinok
• Yelda Mansuroglu
• Damla Goksen

Redox regulation of m 6 A methyltransferase METTL3 in β-cells controls the innate immune response in type 1 diabetes

De Jesus et al. describe the redox-mediated regulation of m 6 A writer methyltransferase 3, which blunts innate immune responses by modification of RNA sensor and editor component mRNAs during the onset of type 1 diabetes in β-cells.

• Dario F. De Jesus
• Zijie Zhang
• Rohit N. Kulkarni

Metabolomic associations of impaired awareness of hypoglycaemia in type 1 diabetes

• R. D. M. Varkevisser
• M. M. van der Klauw

News and Comment

Reply to ‘slowly progressive insulin dependent diabetes mellitus in type 1 diabetes endotype 2’.

• Maria J. Redondo
• Noel G. Morgan

Slowly progressive insulin-dependent diabetes mellitus in type 1 diabetes endotype 2

• Tetsuro Kobayashi
• Takashi Kadowaki

METTL3 restrains autoimmunity in β-cells

Activation of innate immunity has been linked to the progression of type 1 diabetes. A study now shows that overexpression of METTL3, a writer protein of the m 6 A machinery that modifies mRNA, restrains interferon-stimulated genes when expressed in pancreatic β-cells, identifying it as a promising therapeutic target.

• Balasubramanian Krishnamurthy
• Helen E. Thomas

Type 1 diabetes mellitus: a brave new world

One hundred years after the Nobel prize was bestowed on Banting and McLeod for the ‘discovery’ of insulin, we are again seeing major evolutions in the management of type 1 diabetes mellitus, with the prospect of achieving disease control beyond mere management now becoming real. Here, we discuss the latest, most notable developments.

• Pieter-Jan Martens
• Chantal Mathieu

β-cells protected from T1DM by early senescence programme

• Olivia Tysoe

Antivirals in the treatment of new-onset T1DM

• Claire Greenhill

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sealy Center on Aging

utmb.edu/scoa

Global web ALERT button

Welcome The Sealy Center on Aging at UTMB: Leading Aging Research Since 1995

Quick links.

• Texas Resource Center on Minority Aging Research (RCMAR)
• Claude D. Pepper Older Americans Independence Center (OAIC)
• World Health Organization / Pan Merican Health Organization (WHO/PAHO)
• Center for Comparative Effectiveness Research on Cancer in Texas (CERCIT)
• Health of Older Minorities Training (T32)
• Medical Student Aging Research Training (MSTAR)

Share this website:

The Sealy Center on Aging focuses on improving the health and well-being of older adults through interdisciplinary research, education, and community service by integrating the resources and activities relevant to aging at UTMB. The Center also implements our research findings in hospitals and clinics, bringing excellence and visibility to our health care system, and improving the health of older adults.

Current Events

University of Texas Medical Branch Sealy Center on Aging (SCoA) 301 University Blvd. Galveston, TX 77555-0177 Directions and Maps Phone: (409) 747-0008 Email: [email protected]

Postdoctoral Fellowship Position

Empower yourself with utmb's diabetes prevention and care program.

Are you an adult age 65+ living with diabetes? Do you want to take control of your health and live an active, fulfilling life? Look no further – UTMB's Diabetes Prevention and Care Program is here to support you!

Thanks to a generous grant from the US Department of Health and Human Services, Administration for Community Living, UTMB is proud to offer a range of evidence-based programs designed specifically for adults aged 65 and older living with diabetes.

Led by esteemed Principal Investigators Drs. Hani Serag and Hanaa Sallam, these programs are tailored to empower you to adopt healthy behaviors and thrive.

Classes Include:

• Chronic Disease Self-Management Program (for ages 65+ with diabetes and related conditions like hypertension, heart disease, stroke, or arthritis)
• Diabetes Self-Management Program (specially crafted for ages 65+ with diabetes)
• Health Coaches for Hypertension Control
• GeriFit (strength training designed for ages 65+ with diabetes)
• Walk with Ease (ideal for ages 65+ with diabetes and arthritis)

These transformative programs are available to eligible members of our community starting February 2024. Classes will be conveniently held at various locations including the Sealy Center on Aging Learning Center at the Primary Care Pavilion in Galveston (with provided parking), the Osher Lifelong Learning Institute (OLLI) in Galveston and Angleton, as well as other community sites. For those preferring the comfort of home, we also offer online sessions via Zoom. Contact Dr. Hanaa Sallam at [email protected] or Alice Williams at [email protected] or call 409-266-9647 for more information and to register today! Visit us online at www.utmb.edu/diabetes and click on the "Our Programs" tab at the top for detailed information.

Don't let diabetes hold you back – take charge of your health journey with UTMB's Diabetes Prevention and Care Program. Join us and thrive!

Learn more about Diabetes Prevention & Care

Research Programs Supported in part by the Sealy Center on Aging

The Texas Resource Center on Minority Aging Research

Claude d. pepper older americans independence center.

World Health Organization/Pan American Health Organization

Comparative effectiveness research on cancer in texas.

Health of Older Minorities Pre and Postdoctoral Training

Medical student in aging research program.

Rebeca Wong, PhD

Sheridan Lorenz Distinguished Professor in Aging and Health, Professor, Department of Population Health and Health Disparities, School of Public and Population Health; Director, WHO/ PAHO Collaborating Center on Aging and Health; Co-Director, Claude Pepper Older American Independence Center; Director ad interim, Sealy Center on Aging

James S. Goodwin, MD

George and Cynthia Mitchell Distinguished Chair of Geriatric Medicine; Co-director, Claude D Pepper Older Americans Independence Center; Senior Associate Director, Sealy Center on Aging

Social Media

UTMB Sealy Center on Aging