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ARRA Investments in Novel Therapies for Diabetes


Public Health Burden
Diabetes affects nearly 24 million people in the U.S.  The most common forms of the disease are type 1 diabetes, in which the body loses its ability to produce insulin; and type 2 diabetes, which is due to a combination of insulin resistance and insufficient insulin production.  Diabetes can lead to the development of disease complications affecting the eyes, kidneys, nerves, heart, and other organs.

Preventing and Treating Diabetes
There is no known way to prevent type 1 diabetes; current therapies to treat type 2 diabetes are limited.  A variety of ARRA-funded grants are exploring new diabetes prevention and treatment approaches:
  • A clinical trial testing whether a protein called xenin-25—either alone or in combination with another protein called GIP—can enhance insulin production in people with type 2 diabetes.1
  • A study comparing the effects of resistant versus rapidly-digested starches on levels of insulin and blood fats in people with insulin resistance.  This knowledge could facilitate the development of dietary recommendations for preventing type 2 diabetes.2
  • A pilot study examining whether treating sleep apnea can prevent type 2 diabetes in overweight or obese adults with pre-diabetes.3
  • A study in mice testing novel ways of refining a therapy for preventing type 1 diabetes by modifying the dendritic cells of the immune system.4
  • Research in mice to develop a vehicle to deliver a specific gene that may prevent type 1 diabetes.5
  • Research in mice to convert T cells of the immune system, which destroy insulin-producing cells in type 1 diabetes, to a different T cell type (regulatory T cells) to prevent or delay the disease.6
  • Research to develop an implantable self-cleaning glucose sensor to continuously monitor blood glucose levels. This device could be used by people with both type 1 and type 2 diabetes.7
  • Research to identify genes that regulate insulin production, which can potentially be targets for new diabetes therapies.8
Bariatric Surgery for Treating Type 2 Diabetes
People with type 2 diabetes who have undergone bariatric surgery have shown significant improvements in health. However, several questions remain about this treatment approach for type 2 diabetes that require well-controlled studies. A variety of ARRA-funded grants are exploring this topic, including pilot studies looking at different approaches and collecting different types of data (in addition to measures of weight loss and blood glucose control) that can be used to inform larger trials:
  • A pilot study comparing different bariatric surgical procedures with a non-surgical weight loss program in moderately obese people with type 2 diabetes.  Endpoints will include measuring markers for heart health.9
  • A pilot study comparing gastric bypass, gastric banding, and a structured, non-surgical weight loss program for the treatment of type 2 diabetes in moderately obese people.  Endpoints will include levels of physical activity and data collected from psychosocial questionnaires.10
  • A pilot study comparing two different bariatric surgical procedures with each other and with a non-surgical weight loss program for treating moderately obese people with type 2 diabetes.  Endpoints include data from food records and an economic analysis.11
Preventing and Treating Diabetes Complications
Because it is difficult for people with diabetes to achieve the tight blood glucose control that is associated with reducing their risk of complications, research on new prevention and treatment strategies is ongoing.  Several ARRA-funded projects are developing new therapies to prevent and treat complications, such as:
  • Research to develop a treatment for diabetic eye disease by using stem cells from a person’s own blood, treating them, and returning them to the person to repair blood vessel damage in the eye.12
  • Research to develop a cell-based therapy for healing chronic wounds that uses stem cells from people’s own fat tissue and delivers them to open wounds using an aerosolized spray.13
  • A study to develop molecular markers that correlate with healing of diabetic foot ulcers.14
  • A clinical trial testing the ability of omega-3 fatty acid (fish oil) supplements to reduce markers of kidney damage in people with diabetes and kidney disease.15
  • A study to understand mechanisms of painful nerve damage associated with type 1 diabetes.16
  • Research to investigate how platelets communicate with other blood cells in people with and without type 2 diabetes, which can inform new therapies for heart-related complications.17



  1. 1RC1DK086163-01 -- A proof of concept clinical trial of xenin-25 in the treatment of type 2 diabetes -- Polonsky, Kenneth (MO)
  2. 1RC1DK086472-01 -- Effects of resistant starch on lipid and glucose metabolism in insulin resistance -- Krauss, Ronald (CA)
  3. 1RC1HL100046-01 -- Effective treatment of sleep apnea in prediabetes to reduce cardiomatabolic risk -- Tasali, Esra (IL)
  4. 1R21DK080216-01A2 -- Integrating beta cell antigenic epitopes into DC-based T1D immunotherapy -- Xia, Changqing (FL)
  5. 1R03HD061469-01 -- Prevention of diabetes by PDNA encoded with IL-10 -- Singh, Jagdish (ND)
  6. 1R21AI076394-01 -- Generating regulatory T-cells by a JAK-STAT5 inhibitor: a novel approach -- Davoodi-Semiromi, Abdoreza (FL)
  7. 1R21DK082930-01A2 -- Self-cleaning sensor membranes to improve glucose monitoring in vivo -- Grunlan, Melissa (TX)
  8. 1RC1DK086290-01 -- Whole genome RNA-interference screen for novel regulators of the insulin promoter -- McManus, Michael (CA)
  9. 1RC1DK086918-01 -- Comparative effectiveness of medical therapy vs. bariatric surgery for obese T2DM -- Lautz, David (contact); Goldfine, Allison (MA)
  10. 1RC1DK086037-01 -- A randomized trial to compare surgical and medical treatments for type 2 diabetes -- Courcoulas, Anita (PA)
  11. 1RC1DK086132-01 -- Lifestyle modification versus bariatric surgery for type 2 diabetes -- Sarwer, David (PA)
  12. 1RC1EY020341-01 -- A cellular approach to the treatment of diabetic maculopathy -- Bartelmez, Stephen (CA)
  13. 1R41AR056896-01 -- Cell sprayer for chronic wound therapy -- Katz, Adam (VA)
  14. 1RC1DK086364-01 -- Development of the cellular biomarker for diabetic foot ulcers -- Tomic-Canic, Marjana (FL)
  15. 1R21DK080372-01A2 -- Omega 3 fatty acid supplementation in diabetic kidney disease -- Miller, Edgar (MD)
  16. 2R01NS045602-06A2 -- Mechanisms of spinal plasticity in diabetic neuropathic pain -- Pan, Hui-Lin (TX)
  17. 1RC1HL100051-01 -- Microparticles as messangers of communication between blood and vascular cells -- Phipps, Richard (NY)


 
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