Research into the immunopathogenesis of type 1 diabetes spans both basic and clinical research, with major emphasis on genetic animal models of type 1 diabetes and on type 1 diabetes of humans. The Barbara Davis Center's faculty has pioneered islet biochemistry, immunobiology of islet beta cell transplantation, identification of individuals at risk for developing type 1 diabetes, and trials for the prevention of diabetes and its complications. Locally, the Center initiated DAISY (Diabetes Autoimmunity Study in the Young), which screened and genotyped newborns and their families in the Denver area and continues to follow subjects for antibody positivity and development of type 1 diabetes. With the screening of more than 30,000 newborns for genetic risk of type 1 diabetes at birth, the first study addressing the development of autoimmunity in children from the general population continues to publish new findings in collaboration with the Colorado School of Public Health. The BDC also follows the largest, longest standing national cohort of twins with diabetes in the U.S., with the BDC Twin Family Study.
Research into new therapeutic approaches and prevention of complications to Type 1 diabetes includes pioneering clinical introduction of insulin analogs, continuous glucose monitoring with feedback, control of insulin pumps and epidemiologic studies of micro and macrovascular complications.
The research division is home to the Diabetes and Endocrine Research Center, an NIH-funded program that facilitates diabetes research by providing biomedical core facilities, pilot and feasibility grants, and education and training programs for faculty, research fellows, graduate and undergraduate students. The NIDDK-supported Diabetes Endocrinology Research Centers (DERCs) and Diabetes Research and Training Centers (DRTCs) are part of an integrated program of diabetes and related endocrinology and metabolism research. Centers provide increased, cost-effective collaboration among multidisciplinary groups of investigators at institutions with an established, comprehensive research base in diabetes and related areas of endocrinology and metabolism.
Internationally, the BDC is one of six centers worldwide participating in TEDDY (The Environmental Determinants of Diabetes in the Young), one of whose founders and principal investigators is our Clinical Director, Dr. Marian Rewers. Additionally, clinician researchers at the BDC, including our Executive Director, Dr. George Eisenbarth, were seminal players in the development of TrialNet, a network of 18 clinical centers working in cooperation with screening sites throughout the U.S., Canada, Finland, United Kingdom, Italy, Germany, Australia, and New Zealand. This network is dedicated to the study, prevention, and early treatment of type 1 diabetes and includes the Natural History Study and several intervention studies under the direction of Dr. Peter Gottlieb in the Adult Clinic. A Stem Cell Endowment Fund for the BDC was initiated in 2008, with funding to be partially matched by the Gates Frontiers Fund, a $6 million regenerative medicine and stem cell initiative created by the Charles C. Gates family for programs at the Anschutz Medical Campus.
Other international programs with which BDC researchers are affiliated include T1DGC (Type 1 Diabetes Genetics Consortium), the Brehm Coalition, the ITN (Immune Tolerance Network, which includes several intervention studies), the NIH, the Juvenile Diabetes Foundation Autoimmunity Prevention Centers, and the CACTI Study (Cardiovascular and Arteriosclerosis Complications in the Young).
For a list of affiliated studies and requirements for participation see the Center’s Web site for clinical studies: http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/Clinical/Pages/default.aspx.
The Center’s research division has been designated a Juvenile Diabetes Research Foundation (JDRF) BDC Autoimmune Prevention Center (APC), an international collaborative research network of five centers worldwide. The APC supports translational diabetes research and provides additional core facilities for access to human clinical material, immunoassay and lymphocyte phenotyping. Research faculty investigators at the BDC were the first to clone T cells causing type 1 diabetes. T cells play a major role in autoimmunity, both in its development and in its regulation. A key focus in research at the BDC has been the role the immune system plays in the development of diabetes and in the discovery of key islet cell antigens that the immune system attacks to destroy functioning β cells, which produce insulin. Two major antigens were discovered by BDC researchers in the laboratory of its Director of Research, one as recently as the fall of 2007: ZnT8, the zinc transporter.
The BDC also works with pharmaceutical companies to test new insulins, new insulin delivery systems, and state-of-the-art glucose sensing systems, including the new continuous glucose monitoring (CGM) devices. The BDC continues to be actively involved in efforts to increase insurance coverage for insulin pumps, CGMs, and other new technologies associated with improvement in diabetes care and outcomes. Research is under way to “close the loop” with continuous glucose monitors enabled to stop insulin delivery in pumps to reverse nocturnal hypoglycemia.
A more detailed summary of research at the Center can be obtained by consulting the Barbara Davis Center's Web site at www.barbaradaviscenter.org.