Type 1 Diabetes Pediatric Research and Clinical Trials

Because diabetes can require lifelong management, researchers at Children’s are investigating the earliest stages of the disease in order to understand how the disease develops and how it can be treated. Areas of research focus on:

  • how to keep the insulin-secreting beta cells alive as a method both for treatment and prevention of Type I diabetes
  • tempering autoimmune activity in Type I diabetes
  • long-term follow up of diabetic patients for quality of life
  • genetic factors for obesity, which can lead to Type II diabetes
  • genetic factors for diabetes-related kidney failure
  • predictors related to glycemic control

Diabetes Prevention clinical trial

Children’s Hospital Boston’s Diabetes Program is participating in the Diabetes Prevention Trial-Type 1 (DPT-1)—an ongoing nationwide clinical trial to determine whether type 1 diabetes can be prevented or delayed in people at risk for developing the disease. Preliminary studies conducted in animals have shown that it may be possible to prevent type 1 diabetes with oral insulin or insulin by injection.

In animal studies, low doses of insulin by injection have successfully prevented diabetes, and in human studies, insulin injections have preserved the insulin-producing cells in people with pre-diabetes or in the early stages of diabetes.

If you’re interested in participating, or have questions about the clinical trial, please contact Dr. Joseph Wolfsdorf, Director of Children’s Diabetes Program, at the Division of Endocrinology, 617-355-7476. Learn more about the trial.

Tracking type 1 diabetes in Massachusetts

In addition to developing a hospital registry, researchers are also working with the Commonwealth of Massachusetts to track the increase of type 1 diabetes in the state.

As part of the effort to understand the development of genetic diseases, Children’s has created induced pluripotent stem (iPS) cells—cells taken from patients and reprogrammed to look and function like embryonic stem cells.

Our scientists are using these iPS cells to model the genetic diseases of the patients from whom they were taken, including type 1 diabetes patients.

Does air pollution contribute to diabetes?

A link between air quality and diabetes may not seem intuitive, but a national population-based study from the Children’s Hospital Informatics Program finds a strong, consistent correlation—even after adjustment for variables like obesity.

Researchers led by John Pearson and John Brownstein, PhD, focused on fine particulates 0.1 to 2.5 nanometers in size (known as PM2.5), amain component of haze, smoke and car exhaust. They obtained county-by-county data on PM2.5 pollution from the Environmental Protection Agency (EPA), and crunched it against health data from the Centers for Disease Control and the U.S. Census.

After adjustment for known diabetes risk factors, including obesity, exercise, geographic latitude, ethnicity and population density, the level of PM2.5 pollution was strongly predictive of diabetes prevalence. Even at concentrations below the EPA safety limit, counties with highest PM2.5 levels had 20 percent more diabetes than counties with the lowest.

The findings jive with prior laboratory studies. Obese mice exposed to PM2.5 show an increase in insulin resistance, a precursor to diabetes. They also have increased blood markers of inflammation, which may contribute to insulin resistance.“We didn’t have data on individual exposure, so we can’t prove causality, and we can’t know exactly the mechanism of these peoples’ diabetes,” acknowledges Brownstein. “But pollution came across as a significant predictor in all our models.” (Diabetes Care, October.)

Autoimmune disease research collaboration

As many as five percent of Americans suffer from some form of autoimmune disease, which includes lupus, rheumatoid arthritis, multiple sclerosis and type 1 diabetes. The Immune Disease Institute, a non-profit research and educational institution, is working in collaboration with Children’s Hospital Boston to accelerate ground-breaking research in immunology and inflammation and to translate basic discoveries into the clinical setting. Their autoimmunity research centers on discovering what controls the interaction of immune cells with each other and understanding how genetic variation contributes to autoimmunity.