ANN ARBOR, MI - Experts at the University of Michigan Medical School are already national leaders in the fight against diabetes, a family of diseases that has reached epidemic proportions and threatens to kill or disable millions in future decades.

But a new center launched this month will unite their efforts, increase communication, encourage scientific cooperation within and beyond U-M — and accelerate progress against diabetes and its complications.

The new Michigan Comprehensive Diabetes Center will provide an “umbrella” for the U-M's many diabetes researchers and patient care providers, who seek better scientific understanding and treatment for all forms of diabetes and the harmful effects they can wreak on the kidneys, heart, nerves, eyes, limbs and immune system. Under that umbrella will be five U-M centers devoted to studying different aspects of diabetes, as well as clinical diabetes experts throughout the U-M Health System.

The MCDC joins the ranks of other comprehensive U-M centers that focus on major medical issues, including cancer, cardiovascular diseases, depression, eye diseases and geriatrics. Like them, it will take a comprehensive approach involving laboratory and clinical research, patient care, education and outreach.

Peter Arvan, M.D., Ph.D., will serve as the MCDC's interim director. He is the chief of the Metabolism, Endocrinology & Diabetes Division of the Department of Internal Medicine at the U-M Medical School, and the William K. and Delores S. Brehm Professor of Type I Diabetes Research.

In November, 2004, the Brehms gave $44 million to the U-M to fund research, facilities and faculty positions aimed at accelerating the search for a cure for Type 1 diabetes, sometimes called “juvenile” diabetes. Part of their gift will support the MCDC.

The rest of the initial budget for the MCDC will come from U-M Medical School, says Dean Allen S. Lichter, M.D., but donations and grants will be essential to providing a base of funding that will allow the MCDC to support research and education.

The MCDC is being launched as a virtual center within the Medical School, and will be housed in existing and planned facilities. In July, the U-M Board of Regents approved the construction of a new building that will house both the Brehm Center for Type 1 Diabetes Research and Analysis and the MCDC, as well as eye research and care.

“Diabetes and its complications are a major public health issue, and today's obesity epidemic will create even worse problems related to Type 2 diabetes in the future,” says Arvan. “The more coordinated we are today, the better the impact tomorrow on science, on patient care and on the lives of people with diabetes and their families.”

The MCDC will be led by an operating committee that will include the leaders of the five U-M centers already devoted to diabetes research:

• The Michigan Diabetes Research and Training Center (MDRTC), led by William Herman, M.D. The MDRTC is one of only five such centers in the United States funded by the National Institutes of Health. Since 1977, the MDRTC and its sister centers have carried out basic and clinical research, developed clinical and educational programs, and prepared research and education materials for health-care professionals and people with diabetes. Herman, a noted diabetes epidemiologist, was recently installed as the Stefan S. Fajans/GlaxoSmithKline Professor of Diabetes in the Department of Internal Medicine. He is also a professor of Epidemiology in the U-M School of Public Health.
• The Juvenile Diabetes Research Foundation Center for the Study of Complications in Diabetes, led by Eva Feldman, M.D., Ph.D., the Russell N. DeJong Professor of Neurology. The JDRF Center, founded in 2000, performs laboratory research to find new ways to understand and treat two of the most devastating complications of diabetes: diabetic neuropathy (progressive nerve damage) and retinopathy (progressive damage to the eye).
• The Brehm Center for Type 1 Diabetes Research and Analysis, founded in 2004 as part of the Brehm gift and currently in development; a search for a director is now under way. The center, and the new facility in which it will be housed, will focus the U-M's research efforts in fighting a disease that affects more than 1.3 million Americans.
• The U-M Center for the Animal Models of Diabetes Complications Consortium, founded in 2001 and headed by Frank (Chip) Brosius, M.D., chief of nephrology and professor of internal medicine and of molecular & integrative physiology. U-M is part of a national consortium, sponsored by the National Institutes of Health and the Juvenile Diabetes Research Foundation, that is developing and testing new animal models of diabetic complications to help researchers better test new theories and treatments. Currently, none of the well-established animal models of diabetes (such as specially bred mice) develop complications that closely mimic those of humans.
• The Michigan Center for Metabolism, a proposed new center to be headed by Charles Burant, M.D., Ph.D., associate professor of internal medicine and of molecular & integrative physiology, that will focus research on the metabolic pathways that regulate blood sugar and fat (lipid) levels, and insulin resistance, a phenomenon common in people with diabetes or a high risk of developing diabetes.

Arvan plans to establish a new Diabetes Grand Rounds lecture series that will bring diabetes researchers and clinicians together each week for lectures by speakers from U-M and around the country. He also hopes to begin a grant program that will encourage researchers from different disciplines to cooperate on projects. The MCDC will also help find resources and research space for the recruitment of new diabetes scientists to U-M. An executive committee of Medical School leaders will guide operations.

Arvan notes that the number of Americans with diabetes has skyrocketed, from 5.8 million in 1980 to 13.8 million in 2003. Michigan has an especially high rate of diabetes; 600,000 Michiganders — about 8 percent of the population — currently have the disease, up from 345,000 in 1994. Long-term complications of diabetes, including kidney disease and kidney failure, blindness, uncontrolled tissue infections leading to amputation, cardiovascular disease and neuropathy, affect millions nationwide and cost billions of health care and lost productivity dollars each year.

All forms of diabetes involve the failure of the body to deal with sugar in the blood, due to problems with the pancreas and the hormone called insulin that it produces. People with Type 1 diabetes develop it in childhood or young adulthood because of still-unknown causes, and rely on injections of insulin to stay alive. Type 2 diabetes typically arises in adulthood and is closely linked with obesity and blood sugar levels. Not all Type 2 patients require insulin injections. Diet, exercise and medication to control blood sugar are crucial to preventing complications in all diabetes patients.

Written by Kara Gavin

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