Type 1 Diabetes Unit
The Type 1 Diabetes Unit of the Institute for Diabetes, Obesity and Metabolism (IDOM) will
bring together investigators studying the immunologic and metabolic mechanisms involved
in the etiology and treatment of type 1 diabetes, including the complications of hypoglycemia
and micro-vascular disease. This will involve a multi-disciplinary collaboration across the
basic and clinical science departments of the schools of Nursing and Medicine, the Children’s
Hospital of Philadelphia, and the Wistar Institute, the Monell Chemical Senses Center, and
the Abramson Cancer Center. A monthly seminar will be organized by rotating topics
covering all aspects of type 1 diabetes research and care, and will be delivered by Unit
members and invited guests. [link to seminar schedule; link to member list] New research
initiatives by IDOM members will be supported by an annual pilot and feasibility grant
award. [link to pilot grant award]
Type 1 diabetes (T1D) is caused by an autoimmune process that selectively destroys the
insulin producing β-cells of the pancreatic islets, resulting in severely dysregulated glucose
homeostasis. T1D afflicts nearly 2 million people in the United States, usually starting in
childhood or young adulthood, and its incidence is increasing. The environmental trigger(s)
that initiate the disease process remain unknown, and attempts to curtail the autoimmunity
early in the course of disease have so far met limited success in patients. Modern insulin
analogs and delivery systems now allow for greater flexibility in patients’ dietary and exercise
habits, but do not eliminate the blood glucose excursions that lead to life-threatening
hypoglycemia and vascular damaging hyperglycemia in many patients. In adults, T1D
remains a leading cause of blindness, kidney failure, and amputation, and additional strategies
are needed to prevent or slow the development of these micro-vascular complications.
Current trials of adjuvant medical therapy, “closed-loop” insulin delivery systems, and
transplantation of pancreatic islets offer substantial hope for the future.
An essential mission of this unit is the translation of advances made in the basic sciences to
improvements in the clinical care of patients with T1D. [link to clinical studies] This mission
already began at Penn in the early 1970s when Dr. Clyde Barker led one of the first research
teams that successfully transplanted islet cells in an animal model of T1D. Since then, Penn
investigators have aggressively studied both the autoimmune process responsible for the
development of T1D, and the alloimmune barriers to successful transplantation of isolated
islet or whole pancreatic tissue. This work has contributed to the successful application of
immunosuppressive strategies in patients with T1D at Penn who have received whole
pancreas transplants since the 1980s and isolated islet transplants since 2001. Additional
strategies that may either improve the function of islet β-cells or promote their regeneration
are under active investigation in multiple laboratories at Penn.
The T1D Unit plans on working in concert with its partner units within IDOM. Examples of
important areas of collaboration include the critical role of insulin secretory defects in both
type 1 and type 2 diabetes, the impediment of obesity on achieving optimal glucose control in
T1D, and the impact of hyperglycemia on the development of cardiovascular complications.
Finally, the translation of progress in the basic sciences to clinical studies will utilize the
support of the Patient-Oriented Research Unit.