An initiative at the University of Utah Health has an ambitious aim: To become the leading diabetes and metabolism research center in the West and one day cure the disease that affects almost 10% of the U.S. population.

The Diabetes and Metabolism Research Center (DMRC), created in 2014 with an investment by the senior vice president for health sciences, encompasses more than 100 clinicians, researchers and educators from across 26 departments and eight colleges.

They want to develop novel ways to prevent, treat and maybe even cure diabetes and related complications, as well as investigate the basic metabolic mechanisms underlying chronic diseases.

40% of Americans are obese and 10% have diabetes.

“The goal was to catalyze research across the translational spectrum in the broad areas of diabetes and metabolism,” said Bridget Hughes, associate director of U of U Health’s Diabetes Strategic Initiatives.

U of U Health put in the resources to grow an already strong research presence in diabetes and metabolism because, despite the rise of diabetes and obesity in our state and across the country, national funding hasn’t kept pace with the problem.

In Utah, 7.5% of adults (145,000) report having Type 2 diabetes and 23.5% are obese.

But, despite the high prevalence of diabetes and obesity across the nation, federal funding for these areas has been undersupported. The National Institutes of Health funds cancer research at about six times the amount it funds diabetes or obesity research, even though the prevalence of diabetes and obesity is much more common and contributes to a number of other chronic diseases.

The DMRC is accelerating research in the field by recruiting faculty who work on diabetes, metabolism or obesity; providing seed grants for innovative projects; developing new technologies and catalyzing collaboration through seminars and interest groups.

The initiative is already proving its worth.

The DMRC has contributed toward the startup costs of research labs for 10 faculty recruits in such departments as biochemistry, internal medicine and physical therapy. Those faculty have garnered more than $33.5 million in extramural research funding and published more than 43 peer-reviewed articles.

Science that matters

One DMRC recruit is Marcus Pezzolesi who left one of the best diabetes centers in the country—Harvard Medical School’s Joslin Diabetes Center—to dig into the genetics of diabetes. Jointly recruited by U of U Health’s nephrology department and the DMRC, Pezzolesi was sold on the university’s rich genealogical resources in the form of the Utah Population Database, along with being on the vanguard of electronic health records as an early adopter.

The resources are allowing his lab to accelerate the discovery of genes linked to diabetes and diabetic complications.

“What we’re hoping to do is identify novel genes and pathways that contribute to diabetes and diabetic complications,” said Pezzolesi. “We want to take our findings and translate them to improved patient care.”

Pezzolesi’s lab is focused on discovering genes connected to rapid loss of kidney function. Combining data from health records with pedigrees from the Utah Population Database, he identified 51 families at high risk of rapid decline, particularly among first-degree relatives. He’s begun whole genome and whole exome sequencing on samples from these families. And he’s created a new Utah Diabetes Database that includes records on 350,000 patients with diabetes, by combining the U’s health records with those at Intermountain Healthcare. It’s a resource he wants other researchers to tap.

The study on rapid kidney loss was spurred on in part by a DMRC seed grant. The initiative has spent $1.4 million on such grants—meant to develop new hypotheses and preliminary data that would lead to additional research—which has generated $17 million in extramural funding

Michelle Litchman an assistant professor in the College of Nursing, received one of the seed grants to explore diabetes management in the “real-world” by monitoring social media postings. Published in the JMIR Public Health and Surveillance, her study surveying photos on Instagram found that most individuals were not wearing their continuous glucose monitor (CGM) in an FDA-approved manner—on their abdomen. Instead, they wore the device on a number of alternative sites, and one of them—on the arm—worked as well as the approved site. Using Twitter, she saw that patients are “hacking” insulin pumps and continuous glucose monitors to create an artificial pancreas system, a patient innovation that was featured in the Journal of Diabetes Science and Technology. Her research is providing clinicians with a better understanding of emerging ways in which patients are using diabetes technology.

The DMRC also uses its funds to help develop new methodologies and encourage new research through the Metabolomics Core Support Program. Metabolomics—the study of the unique chemical fingerprint called metabolites that are the product of chemical reactions—can help researchers understand the disease and develop new treatments.

Bhagirath Chaurasia, a research assistant professor in the Nutrition and Integrative Physiology department, received a metabolomics core seed grant which helped him develop a new technique to analyze ceramides, a type of fat that is emerging as a key player in developing diabetes and fatty liver disease. In an upcoming study, Chaurasia and others found that by blocking an enzyme in genetically modified mice, they were able to resolve fatty liver disease and insulin resistance. The technique was used in numerous grant submissions and awards and is being used by other U investigators.

Pezzolesi, Litchman and Chaurasia, and the rest of the DMRC faculty are collectively taking a comprehensive approach to understanding diabetes and metabolism by researching cellular metabolic mechanisms, genetic factors contributing to metabolic diseases; causes and prevention strategies for diabetes and its related complications; new therapeutic approaches to treat diabetes and obesity; and strategies for improving health behaviors to prevent and manage chronic diseases.

“I’m honored to be working with the outstanding scientists and clinicians in the DMRC,” said Scott Summers, DMRC co-director and professor and chairman of the Department of Nutrition and Integrative Physiology.

“Our researchers are developing new therapeutics, dissecting the genetics of diabetes, and advancing new clinical and community programs, always striving to relieve the burden of this awful disease. It is the thrill of a lifetime to work alongside these dedicated professionals.”

Banner image: Marcus Pezzolesi is investigating the genetics of diabetes and diabetic complications. Credit: Kristan Jacobsen