Six-Month Project Update
Even though all children with T1D require insulin due to autoimmune destruction of insulin-producing cells (also called beta cells) in the pancreas, they represent a diverse group of individuals. By identifying subtypes of T1D, I hope to use this information to tailor more effective treatment for each individual child.
In the past six months, I have been working with a collaborator at UCSD, Dr. Kyle Gaulton, who is an expert in the genetics of diabetes. We have been developing a protocol to test both children with T1D and their family members in order to identify genes that influence the development of diabetes and increase its complications.
One of the goals is to profile genes that affect pancreatic beta cell survival in children with T1D. We also plan to identify immunogenetic and other factors that may accelerate diabetes onset. This project is taking place at Rady Children’s Hospital of San Diego, where I practice as a pediatric endocrinologist.
The number of children with Type 1 diabetes (T1D) is increasing worldwide, particularly in those under 5 years of age. T1D is conventionally classified as an autoimmune disease in which the immune system attacks insulin-producing cells within the pancreas. However, T1D, in fact, represents a diverse group of affected individuals. This diversity stems from several factors, including variation in the cause and course of immune system activation, in the ability of insulin-producing cells to survive this attack, and in the environment. There may be several subtypes of T1D.
As a pediatric endocrinologist and diabetes research scientist, my ability to effectively treat a specific T1D individual may be limited by our understanding of these subtypes. My goal is to gain insight into why T1D develops in order to tailor effective treatment for each individual child that I see. In recent years, there have been enormous advances in the ability to gather genetic and metabolite information, as well as the ability to analyze and interpret these vast amounts of data. My intention is to bring these new technologies to our T1D patients and apply them in the clinical setting. The specific goal of our project is to build a comprehensive clinical database and biorepository of samples from T1D patients at Rady Children’s Hospital of San Diego and then to apply innovative computational techniques in order to identify specific subtypes of diabetes. We want to learn “what type of Type 1 diabetes” each of our patients has so we can better target specific therapies for each child, improve our clinical practice, and develop novel approaches to preventing this disease.