News from the UMass Diabetes Center of Excellence

Meet Clinical Research Assistant Lucy Ding and learn about two studies she's involved with that are designed to help hospitalized patients living with diabetes.  One is a randomized clinical trial that provides continuous glucose monitors to people with diabetes who are currently not using one and arrive at the Emergency Room with high or low blood sugar, or other diabetes related complications. The other study is implementing a carbohydrate counting system for hospitalized inpatients with diabetes throughout the UMass Memorial Health system.

The laboratory of Jason Kim, PhD welcomes two visiting professors from Kosin University College of Medicine in South Korea. Both physician-scientists will be conducting diabetes research at UMass Chan Medical School through 2023.  

Dr. Kim’s daughters Allison and Lauren are also considering careers in medicine and science. When Lauren’s 2020 summer research internship at Harvard Medical School was canceled due to the COVID-19 pandemic, the family quickly created the Diabetes Virtual Camp to connect students and experts in a virtual internship setting.  

Dr. David Harlan has been named the new director of the JDRF Center of Excellence in New England. For nearly 40 years, Dr. Harlan has been conducting research exploring the pathophysiology underlying diabetes. He also brings years of experience as an endocrinologist with expertise in diabetes and metabolism. A renowned basic and clinical investigator, his current research is focused on beta cell biology and the anti-beta cell immune response. The Center is genetically modifying beta cells with the goal of making them invulnerable to the immune system when infused as a therapy into a person with type 1 diabetes.

Tammy Nguyen, MD, PhD is a vascular surgeon-scientist who is interested in understanding why people living with diabetes have trouble getting foot wounds to heal. This career development grant will provide $150,000 over the next three years for her project “Exploring How the Diabetic Immune System Contributes to Non-Healing Ulcers.” Dr. Nguyen is studying the effect of type 2 diabetes (T2D) on the development of the immune system to design targeted therapies to combat poor wound healing for people with T2D. She developed a novel method to collect and expand human stem cells directly from the bone marrow of donors both with and without T2D who underwent lower extremity amputation for non-healing wounds.

The 4th UMass Diabetic Health Clinic for Worcester’s homeless population was a multidisciplinary outreach event with providers from the Diabetes Center of Excellence, vascular surgery, podiatry & more. They volunteered to examine people, provided information & resources and scheduled follow-up appointments if needed. SEE PHOTOS

Despite attending an American Diabetes Association-recognized education program at the UMass Memorial Health Diabetes Center of Excellence (DCOE), some people still struggle to keep their blood glucose within a healthy range. The DCOE piloted a Care Coach Program in collaboration with Shields Health Care Group to provide supplemental support to help them manage blood glucose levels. The first participants successfully lowered their A1c and demonstrated a reduction in the distress caused by their diabetes by implementing behavioral, lifestyle, and medication changes, thanks to more frequent contact with a diabetes expert.  

Endocrinologist Mark O'Connor, MD, led the largest genome-wide meta-analysis study ever done using a recessive model for Type 2 diabetes.  It identified 51 loci associated with diabetes, including five that were undetected by past additive analyses.  The results were published in the journal Diabetes demonstrating that recessive models can identify new genetic risk factors for T2D, including variants with large effect sizes.  

The Czech Lab is using genetic engineering to investigate a therapeutic approach to Type 2 diabetes.  Sarah's research involves the modification of genes of adipocytes to increase fat burning and improve their metabolic function as a potential therapy.  When she joined the lab in 1998, their focus was to learn about the interactions taking place within adipocytes, particularly insulin signaling and GLUT4 trafficking. She was part of a team of scientists who developed a novel small interfering RNA (siRNA) delivery system. Learn more about Sarah and her research.

Proteomics and metabolomics are advancing the understanding of insulin signaling focusing on fat cells (white and brown adipocytes).  The Guertin Lab describes how integrating the two ‘omics techniques is critical to clarifying adipocyte insulin action in Type 2 diabetes.  Their article raises questions for future investigation with important implications for understanding and treating insulin resistance, obesity and metabolic diseases such as Type 2 diabetes.  

Two third year medical students at UMass Chan worked with the UMass Diabetes Center of Excellence to launch an elective course called Management and Care of Patients with Type 1 and Type 2 Diabetes. 

The Maehr Lab is interested in how immune cells are trained by the thymus, which is the organ that educates our body’s immune system to defend against infection.  For some unknown reason, white cells called T lymphocytes or T cells, destroy the insulin-producing beta cells in the pancreas of people with Type 1 diabetes. Richard Siller, PhD, a postdoctoral researcher, is developing functional thymic cells from human stem cells, that will be used to study the role the thymus plays in that autoimmune attack.  Learn more about Richard and his research.

New legislation has been introduced to the United States Senate including a $35 per month insulin co-pay cap for people with Medicare, employer-sponsored coverage, or insurance purchased on the Affordable Care Act marketplace. The Affordable Insulin Now Act also requires commercial insurers to exclude insulin from the deductible. Read reactions to the bill from Dr. Samir Malkani, Clinical Chief of the UMass Diabetes Center of Excellence and Cheryl Barry, RN, Manager of Diabetes Education.  

The Diabetes Center of Excellence received a UMass Center for Clinical and Translational Science pilot grant for a collaborative Type 1 diabetes project with Worcester Polytechnic Institute. A novel tool has been created to improve the removal of individual pancreatic islets from human pancreas slices. Improving the tool will allow our scientists to extract single islets from living pancreas slices for more in-depth investigation of the insulin producing beta cells and immune cells, to better understand the autoimmune attack that occurs in people with Type 1 diabetes.  LEARN MORE

The laboratories of Michael Czech, PhD and Silvia Corvera, MD, understand the important role that fat cells play in diabetes development and progression. They’re exploring a cell therapy by manipulating the genome of adipocytes (fat cells) to increase fat burning and improve the metabolic function.  In a newly published study in Nature Communications, Emmanouela Tsagkaraki, MD, PhD, led a team of scientists who removed cell samples from humans, converted white adipocytes into brown-like cells in the lab, reproduced and multiplied those cells, and transplanted them into specialized mice to test the therapeutic approach. The data indicates the process enhanced and improved glucose metabolism.  Learn more about Emmanouela and her research.

The Maehr laboratory is focused on the thymus, the major organ involved in educating the immune system.  They're using human pluripotent stem cells to develop functional thymic epithelial cells that will be used to study the role the organ plays in the Type 1 diabetes autoimmune attack. A newly published study in Nature Communications examined changes in gene expression & cellular behaviors that occur during the development of several organ domains including the thymus.  

New insulin pumps, infusion devices, continuous glucose monitors, glucagon delivery devices and new smartphone apps continue to become available to help with diabetes management. Learn about the latest technology and tools providing improved self-care options for people living with both type 1 diabetes and type 2 diabetes.   

A recently published gene analysis study from the laboratory of Yong-Xu Wang, PhD, uncovered a physiological brake to protect the thermogenesis process in adipose tissue, providing new insights into mechanisms that sustain whole-body energy balance and tissue stability.  Their research is investigating cellular and molecular mechanisms to convert white adipocytes into brown-like adipocytes, as a potential Type 2 diabetes therapy.   

The Diabetes Center of Excellence at UMass Chan Medical School received a $250,000 donation from the Arthur M. and Martha R. Pappas Foundation.  The funds will be used to purchase and maintain a state-of-the-art flow cytometer to characterize cells and their functional and signaling properties.  It will provide quantitative data on immune cell and pancreatic islet cell phenotypes to facilitate the analysis of samples and greatly expand our research team’s capacity to rapidly screen experimental samples. 
FULL STORY & VIDEO ABOUT DR. ARTHUR PAPPAS

Animal models of Type 1 diabetes (T1D) have provided valuable insights for decades, however rodent experiments have not provided an understanding of the root cause of how the disease develops in humans. The research team at the UMass Diabetes Center of Excellence continues to gain new knowledge of the disease by recreating human immune systems inside of unique “humanized” mice to investigate human cells and tissues. A newly published manuscript in Molecular Metabolism emphasizes the concept that T1D pathogenesis is far more heterogeneous than has previously been widely appreciated by the broad diabetes research community.  

In an article featured in Worcester Medicine, UMass DCOE Nurse Practitioner Nancy Sidhom describes the benefits of continuous glucose monitors (CGM) and how the constantly improving technology is helping people living with diabetes like never before. From a nursing perspective, education is the center point of every patient encounter. CGM use has led many patients to reduce insulin use, revamp dietary choices, create exercise habits and effectively instill long-sought behavior change. Historically, CGM therapy was reserved for patients with Type 1 diabetes. Fortunately, CGM therapy is now widely covered for patients with Type 1 and Type 2 diabetes. 

The Czech Lab is targeting genes that promote fatty liver and inflammation in obesity and diabetes with short-interfering RNA (siRNA)-induced RNAi as a potential therapy for nonalcoholic steatohepatitis (NASH).  It's a severe liver disorder characterized by accumulating triglycerides and severe inflammation.  In a newly published study in the scientific journal Molecular Therapy, Batuhan Yenilmez, PhD, led preclinical studies using “humanized mice” from the Brehm Lab. The humanized model was used to show that their compound can successfully target human mRNA in vivo.  

Dr. Guilherme is approaching his 27^th anniversary working in the laboratory of Michael Czech, PhD at UMass Chan Medical School.  One of his career highlights thus far was his involvement in the development of small interfering RNA (siRNA) screens as a therapeutic tool to address cellular and molecular mechanisms of inflammation, obesity and diabetes. Another was the Czech Lab's discovery of a molecular motor they found to be essential for insulin stimulation of glucose transport into fat cells.  He's excited for future research to determine what additional hormones adipocytes are secreting, then studying those to determine if mutating or deleting them may offer therapeutic potential for people struggling with obesity, diabetes or cardiovascular disease.  Learn more about Adilson and his research.

Newly published research conducted in the laboratory of Jennifer Wang, MD, investigated the relationship between viral infections and type 1 diabetes (T1D). A significant number of viruses have been associated with T1D, including enteroviruses, such as Coxsackievirus.  The Wang Lab conducts extensive research using a unique rat model of T1D to study viruses as a possible trigger of the disease. The study defined how deleting components of the innate immune antiviral response alters immune cells to protect against autoimmunity.

A collaborative research team including UMass Diabetes Center of Excellence co-director Dale Greiner, PhD, developed and tested an enhanced microencapsulation device intended to protect transplanted human islets into people with Type 1 diabetes.  This newly published study showed proof-of-concept by providing a glucose-sensing, insulin-secreting encapsulation device that holds more cells and demonstrated greater cell survival than previous MEDs.  It also provided enhanced nutrient transport that ultimately led to a rapid reduction of hyperglycemia.