Winter 2012 NIDDK Director's Update
When he received the prestigious Lasker Award a few weeks ago, liver transplantation pioneer Dr. Thomas Starzl said that the honor was for work shared by many, including his courageous patients. He thanked the research and clinical staff he worked with, and he said “the team is what counts.”
NIH Director Dr. Francis Collins congratulates NIDDK employees on
the year's achievements and NIDDK Director Dr. Griffin P. Rodgers on
his election to the American Academy of Arts and Sciences. Editor's note: See Commendations and Commencements section for more
on Rodgers' election.
Working with the extraordinary staff, researchers, and grantees of NIDDK, I am continually reminded of the truth of that statement.
In our intramural labs, this last year brought discoveries that were published in the top scientific journals and will echo through healthcare research and practice in the years to come. Extramurally, NIDDK grantees produced a wealth of healthcare discovery, including findings that intensive blood glucose control reduces kidney disease, that a newly identified muscle hormone may reduce obesity and type 2 diabetes, and that an intensive lifestyle intervention yielding weight loss and increased fitness can slow the decline of mobility in adults.
In 2012, we also encouraged the public’s interest in and understanding of science. We reached hundreds of children and their families at the USA Science and Engineering Festival. We talked to D.C. public school students about the dramatic effect just one person can have in improving public health. We also voiced this message through our participation in NIH’s recent Celebration of Science, an event that brought together more than a thousand diverse leaders to commit energy to future discoveries.
In this issue of the NIDDK Director’s Update, check out some of our community’s activities over the last few months. You’ll find more about Dr. Starzl’s work, as well as stories about a multicenter trial soon to begin recruitment, a new research funding opportunity to find ways to lengthen life for people on hemodialysis, reflections on a research career from a longtime intramural scientist, and many other snapshots from our team.
As this calendar year closes, we thank you for your interest in and contributions to NIDDK and its mission of bettering public health, both this year and in the years to come.
In good health,
Griffin P. Rodgers, M.D., M.A.C.P.
Director, National Institute of Diabetes and Digestive and Kidney Diseases
NIH grantee Dr. Thomas E. Starzl wins Lasker award
|Dr. Thomas E. Starzl, winner of a 2012 Lasker award for his pioneering efforts in organ transplantation, is congratulated by NIDDK Director Dr. Griffin P. Rodgers at the Lasker Awards ceremony on Sept. 21. |
Photo credit: Ellen Jaffe
Dr. Thomas E. Starzl, distinguished service professor of surgery at the University of Pittsburgh School of Medicine and a longtime NIDDK grantee, received the 2012 Lasker-DeBakey Clinical Medical Research Award – shared with Dr. Roy Calne, University of Cambridge emeritus – for his work developing liver transplantation, an intervention that has restored normal life to thousands of people with end-stage liver disease.
Lasker awards are given for major advances in the understanding, diagnosis, treatment, cure and prevention of human disease. Starzl is the first person to perform a human liver transplant. He is a former NIDDK Method to Extend Research in Time (MERIT) awardee and has served on the NIDDK Digestive Diseases Advisory Board. He also earned a 2004 National Medal of Science.
“Dr. Starzl is a pioneer in the world of transplantation, and his work has saved thousands of lives,” said NIDDK Director Dr. Griffin P. Rodgers. “This award is a most fitting recognition of his many years of unwavering commitment to teaching, research and clinical practice.”
Receiving the award on Sept. 21, Starzl said, “Transplantation services are not provided by single individuals. The team is what counts, and it is on behalf of my research and clinical teams — first in Denver and then in Pittsburgh — that I accept this prize. And by the way, the prize could have gone to one of those courageous kidney, liver, or heart recipients who faced the great unknown in the early years and chose to run the uncharted gauntlet of transplantation instead of giving up. Win or lose, these were the heroes.” NIDDK launches large study of diabetes drug combinations
By Amy F. Reiter
If metformin is no longer enough to help manage a person’s type 2 diabetes, a health care provider may turn to one of several FDA-approved glucose-lowering drugs to use in combination with metformin. But while short-term studies have tested the
effects of such combinations, there have been no long-term studies of which combination works best and has fewer side effects. Until now.
Beginning recruitment in early 2013, the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study aims to understand the effect and safety of four approved, widely used diabetes drugs in combination with metformin, the most common first-line medication for type 2 diabetes.
“Type 2 diabetes progresses slowly, over a long period of time,” said Dr. Myrlene Staten, the project scientist and NIDDK senior advisor for diabetes translational research. “This study will help us understand how different medications affect the disease over time and help health care providers make better choices for their patients’ long-term care.”
The goal of this large trial is to understand which combinations of medications are most likely to maintain goal glucose (blood sugar) levels over time, to identify the most effective means of treating type 2 diabetes in patients if metformin alone is not enough. To that end, the study will compare drug effects on glucose levels, adverse effects, diabetes complications and quality of life over an average of nearly five years. As well, researchers are welcome to propose ancillary studies using the data from GRADE (see Funding Opportunity Announcement PAR-12-265
for submission information).
“The key is that we’re looking at all of these drugs as a secondary therapy, head-to-head and over a long period of time,” Staten said.
Dr. David Nathan of Massachusetts General Hospital and Dr. John Lachin of the George Washington University are co-principal investigators of the grant supporting GRADE. Nathan will chair the study group, and Lachin will lead the study’s coordinating center. GRADE aims to enroll about 5,000 patients at 37 sites. A website for the study will be online shortly. Five questions with NIDDK intramural researcher Dr. Enrico Cabib
Following a 63-year research career, including 45 years in NIDDK’s Laboratory of Biochemistry and Genetics, Morphogenesis Section, Senior Investigator Dr. Enrico Cabib retired in November. Prior to his departure, Cabib talked with Krysten Carrera about his career and accomplishments. How did you become a researcher?
I was born in Italy and moved to Argentina when I was sixteen years old to escape anti-Semitic persecution. I decided to study chemistry at the University of Buenos Aires, and I worked for my Ph.D. in a private research institute. I continued working there for several years as a post-doc under the guidance of my mentor, Luis Leloir, who later received a Nobel Prize. After ten years of independent research, I came to NIDDK in 1967. What work are you best known for?
I am known for the work I’ve done with the yeast cell wall. The yeast cell is perfect for study because of its simplicity, and the cell wall is what gives the cell its shape and is a growing, dynamic structure, thus is a good model for morphogenesis. Working with yeast is also useful because it is a fungus. Fungal infections have been increasing in recent times, mainly because there are more people with suppressed immune systems, such as AIDS patients. Understanding how the yeast cell wall functions helps us to develop drugs for patients with fungal infections. This is a great example of how basic science yields unexpected applications. What have been the biggest changes at NIH since you first stepped on campus in 1967?
NIH was a simpler place. Compared to now, there was very little administration; I remember there being only three or four people, including one administrative officer, for all of NIDDK. Back then, the only training we investigators had to take was about radioactivity. What will you miss most about NIH?
I will definitely miss the people and spending time in the lab. I really love to work with my hands. What is your advice for scientists at the beginning of their careers?
They should not get into science unless they feel it is their real vocation. That’s what happened to me; after a few months at the bench, I knew that’s what I wanted to do for the rest of my life. Also, they shouldn’t get discouraged if something doesn’t work, because in science, persistence is as important as intelligence. Look, I’m 87 years old. I am not terribly smart, but I am persistent, and any success I’ve had has been a product of that persistence. NIDDK sets aside funding to study interventions to lengthen life for people on hemodialysis
By Bill Polglase
More than 400,000 people are currently treated by hemodialysis under Medicare’s End-Stage Renal Disease (ESRD) Program. Hemodialysis removes toxins and water from the blood when diseased kidneys cannot. Average life expectancy on hemodialysis is just a few years, although individual patients can live much longer.
To jump start research to help people lead longer, healthier lives on hemodialysis, NIDDK has set aside $1.5 million for Novel Interventions to Reduce Morbidity and Mortality of Hemodialysis Patients. This new program encourages academia and industry to collaborate on pilot and feasibility studies to identify interventions that appear promising enough to be tested in full-scale clinical trials.
Potential approaches to improve well-being and survival and reduce complications could include changing infection control methods and how dialysis is administered, treating depression and improving social support, and using anti-inflammatory treatments.
General inflammation is a key factor in the progression of cardiovascular disease, as is malnutrition and depression, and all have been linked to increased mortality in hemodialysis patients. Recently, several interventions have been suggested for improving survival rates. However, NIDDK’s effort will be the first to assess such interventions through well-designed, definitive, randomized, controlled trials to determine safety and improve patient comfort, well-being, and long-term outcomes, said Dr. Paul Kimmel in NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases.
“This program of weighing the effectiveness of novel therapies holds the promise of moving the field forward in bold leaps,” Kimmel said. “The best potential ESRD therapies may be those that we currently shy away from as rather risky approaches. Also, partnering with the pharmaceutical industry could pave the way for Food and Drug Administration approval of new drug therapies.”
Applications were due in November and NIDDK hopes to fund three to four grants in 2013. NIDDK reaches out to American Indian, Alaska Native communities
By Krysten Carrera
On November 8, 2012, NIDDK Senior Investigator Dr. Robert Nelson, a member of the intramural Phoenix Epidemiology and Clinical Research Branch (PECRB), participated in a National Cancer Institute-sponsored webinar for Native American media. The webinar highlighted cancer, diabetes, and oral health in American Indian and Alaskan Native (AI/AN) populations. During the webinar, which coincided with Native American Heritage Month and National Diabetes Month, Nelson discussed diabetes in those groups, with an emphasis on the role of collaborative clinical research.
American Indians and Alaska Natives suffer from the highest rates of type 2 diabetes in the United States. About half of Pima Indian adults – who reside in southern Arizona near PECRB – have type 2 diabetes. Many of them also suffer from diabetes-related complications.
“Researchers face significant challenges in dealing with the type 2 diabetes epidemic in Pima Indians and many other tribes,” Nelson said. “But American Indians’ and Alaskan Natives’ ongoing willingness to participate in clinical research trials has given us a unique opportunity to study and learn about the disease.”
Many people in these populations are not aware that they have type 2 diabetes, or are not sure how to manage it. Nelson addressed those realities by discussing the wide variety of resources designed to educate these groups about diabetes and its complications, including We Have the Power to Prevent Diabetes
, Tips for Teens with Diabetes: What is Diabetes?
, and It’s Never Too Early to Prevent Diabetes: A Lifetime of Small Steps for a Healthy Family
. These and other materials were developed by the National Diabetes Education Program
(NDEP), with AI/AN partner organizations.
“Health professionals have a responsibility to reach out to diverse audiences affected by diabetes, particularly the American Indian and Alaskan Native communities,” Nelson said. “We hope to give people the information they need to reduce the burden of diabetes and live long, healthy, and productive lives.”
NIH launches free database of drugs associated with liver injury
A free source of evidence-based information for health care professionals and for researchers studying liver injury associated with prescription and over-the-counter drugs, herbals, and dietary supplements is now available from
the National Institutes of Health. Researchers and health care professionals can use the LiverTox database (www.livertox.nih.gov
) to identify basic and clinical research questions to be answered and to chart optimal ways to diagnose and control drug-induced liver injury.
Drug-induced liver injury is the leading cause of acute liver failure in the United States, accounting for at least half of cases. It occurs at all ages, in men and women, and in all races and ethnic groups. Drug-induced liver disease is more likely to occur among older adults because they tend to take more medications than younger people. Some drugs directly damage the liver, while others cause damage indirectly or by an allergic reaction. The most important element to managing drug-induced liver injury is to identify the drug that’s causing the problem and appropriate steps to eliminate or reduce damage to the liver.
"Because drug-induced liver disease is not a single, common disease, it is very difficult to diagnose, with each drug causing a somewhat different pattern of liver damage," said Dr. Jay H. Hoofnagle, the major creator of LiverTox and director of NIDDK's Liver Disease Research Branch. "Doctors have to rule out all other causes of liver disease before saying that a patient has drug-induced injury liver."
LiverTox has a searchable database of about 700 medications available in the United States by prescription or over the counter. Over the next few years, another 300 drugs will be added. For more information: www.nih.gov/news/health/oct2012/niddk-12.htm
Weight loss does not lower heart disease risk from type 2 diabetes:
Intervention stopped early in NIH-funded study of weight loss in overweight and obese adults with type 2 diabetes after finding no harm, but no cardiovascular benefits: An intensive diet and exercise program resulting in weight loss does not reduce cardiovascular events such as heart attack and stroke in people with longstanding type 2 diabetes. Investigators are preparing a report of the findings for a peer-reviewed publication. www.nih.gov/news/health/oct2012/niddk-19.htm "Biggest Loser" study finds modest diet and exercise can sustain weight loss:
Exercise and healthy eating reduce body fat and preserve muscle in adults better than diet alone, according to a study funded and conducted by NIDDK. The study was recently published online in Obesity and will be in a future print edition. www.nih.gov/news/health/oct2012/niddk-15.htm After diabetes during pregnancy, healthy diet linked to reduced type 2 diabetes risk:
By sticking to a healthy diet in the years after pregnancy, women who develop diabetes during pregnancy can greatly reduce their risk of developing type 2 diabetes, a study supported by the NIH has found. The study appears online in the Archives of Internal Medicine. www.nih.gov/news/health/oct2012/nichd-09.htm Family problem-solving sessions help teens better manage diabetes:
A clinic-based program for adolescents with type 1 diabetes and their families helped the teens develop the healthy behaviors needed to control their blood sugar levels, NIH researchers have found. Findings were published online in Pediatrics. www.nih.gov/news/health/sep2012/nichd-07.htm
National Diabetes Month efforts focus on taking action to reach personal health goals
In observance of National Diabetes Month, November 2012, the National Diabetes Education Program (NDEP) – an initiative of the NIH and the Centers for Disease Control and Prevention – encouraged people to take action to improve their health by helping people understand how to make positive changes that last.
To help people get started, the NDEP has tools to help people better understand how to make and sustain changes in their day-to-day life to stay healthy – whether they are living with a chronic disease such as diabetes or are looking to prevent or delay the onset of diseases such as type 2 diabetes. NDEP’s Just One Step resource can help people start this process by identifying one small step that they can take to make a change to improve their health. Once people have taken the first step or steps, NDEP’s Make A Plan tool can help with making these changes stick as part of a daily routine that can help them reach their health goals.
The NDEP provides videos, tip sheets, and other educational materials to help people take action to reach their health goals. The NDEP’s online library of behavior change resources, Diabetes HealthSense, can be found at www.YourDiabetesInfo.org/HealthSense
Planning and Grant Resources
NIDDK funding opportunities and deadlines: www2.niddk.nih.gov/Funding/FundingOpportunities/
Grants and contract notices: www2.niddk.nih.gov/Funding/FundingOpportunities/Notices/
||Robin Nwankwo, an NIDDK Advisory Council member and a diabetes educator and researcher at the University of Michigan Medical School in Ann Arbor, received the American Diabetes Association’s Outstanding Educator in Diabetes Award for her educational efforts in the field of diabetes and significant contributions to the understanding of diabetes education. |
||Dr. Thomas E. Starzl, distinguished service professor of surgery at the University of Pittsburgh School of Medicine and a longtime NIDDK grantee, received the 2012 Lasker-DeBakey Clinical Medical Research Award – shared with Dr. Roy Calne, University of Cambridge emeritus – for his work developing liver transplantation. (See the News Around NIDDK section for more.) |
||Editor’s note: NIDDK Director Dr. Griffin P. Rodgers was elected to the American Academy of Arts and Sciences Class of 2012. The AAAS is one of the nation's most prestigious honorary societies and a leading center for independent policy research. Its current membership includes more than 200 Nobel laureates and more than 100 Pulitzer Prize winners. Rodgers was inducted into AAAS on Oct. 6. |
||Dr. Robert Best joined the NIDDK intramural Laboratory of Chemical Physics (LCP) as a tenure-track investigator, beginning in October. He was previously a Royal Society University Research Fellow in the Department of Chemistry at the University of Cambridge, where his research used molecular simulations to investigate protein folding and to interpret single-molecule optical tweezer and FRET experiments. He had earlier served as an LCP research fellow under Dr. William Eaton and Dr. Gerhard Hummer. |
A Fond Farewell
||Dr. Jill P. Smith joined the NIDDK Division of Digestive Diseases and Nutrition as senior scientific advisor for Clinical and Translational Research in Digestive Diseases in September. She was previously a full professor at Pennsylvania State University College of Medicine in gastroenterology and hepatology and also in cellular and molecular physiology. Her areas of expertise include pancreatic cancer, inflammatory bowel disease, and hepatitis. |
Dr. David Davies,
|Prior to their retirements, Dr. David Davies (left) and Dr. Enrico Cabib (right) receive congratulations from NIDDK Director Dr. Griffin P. Rodgers at the 2012 NIDDK |
a senior investigator in the intramural Laboratory of Molecular Biology, is retiring from NIDDK after 51 years of service to the institute and 57 years of federal service. He is a pioneer in the field of structural biology. Davies’ work has enhanced understanding of disease and identified targets for therapy by uncovering the molecular details of protein and nucleic acid interactions needed for the process that cells undergo. Davies will continue his research as an NIDDK scientist emeritus. (Editor’s note: Learn more about Dr. Davies in the Summer 2012 issue
of the NIDDK Director’s Update.)
Dr. Enrico Cabib,
a senior investigator in the intramural Laboratory of Biochemistry and Genetics, is retiring from NIDDK after 45 years of service to the institute and several more years at other research posts. He is widely known for his work on the yeast cell wall, work which helps in developing drugs for patients with suppressed immune systems. Cabib will be nominated for NIDDK scientist emeritus. (Editor’s note: Learn more about Dr. Cabib in the News Around NIDDK
section of this issue.)
Four members of the NIDDK Advisory Council have completed their four-year service:
||LaVarne Burton served on the NIDDK Kidney, Urologic, and Hematologic Diseases Subcouncil. Burton is president and chief executive officer of the American Kidney Fund, which educates patients and the public about the impact and importance of kidney disease. |
||Dr. Robert Flanigan served on the NIDDK Kidney, Urologic, and Hematologic Diseases Subcouncil. He serves as the department chairperson and a professor of urology at Loyola University and is a practicing physician active in multiple community health education and outreach activities.|
||Dr. John Sedor served on the NIDDK Urologic, and Hematologic Diseases Subcouncil. He is a professor of medicine and physiology at Case Western Reserve University (CWRU) and serves as the vice president for research on the MetroHealth System Campus at CWRU. He also serves as an advisor to a number of large NIDDK studies, including the Diabetic Complications Consortium and the Family Investigation of Nephropathy of Diabetes Consortium.|
||Dr. Christopher Glass served on the NIDDK Diabetes, Endocrinology, and Metabolic Diseases Subcouncil. He is a professor in the Department of Cellular & Molecular Medicine at the University of California, San Diego, and his research investigates transcriptional mechanisms that regulate the development and function of the macrophage, a cell that plays key roles in immunity and inflammatory diseases. |
||NIDDK grantee Dr. John Stokes died. He had held several roles at the University of Iowa Health Care, including professor, executive vice-chair for the Department of Internal Medicine, and director of the Division of Nephrology. Dr. Stokes also led in coordinating many seminal NIH-sponsored clinical trials in nephrology, including the Hemodialysis trial, the acute renal failure trial, the Chronic Renal Insufficiency Cohort Study and the Frequent Hemodialysis Clinical Trials.|
||Dr. Yuan-Who (Richard) Chen died on October 1, 2012. He joined the biostatistics group in the NIDDK Office of the Director in April 2009. Prior to joining NIDDK, Dr. Chen received his doctorate in biometry from the University of Texas Health Sciences Center and worked at the U.S. Food and Drug Administration for eight years. At NIDDK he provided biostatistical support to both the extramural and intramural programs and worked on several publications with intramural investigators. He has been described as a valued colleague, a wonderful collaborator, helpful, warm, and considerate.|
The next edition of the NIDDK Director’s Update will be online at www.directorsupdate.niddk.nih.gov
in March.Submission information
: The Director’s Update is published in March, May, September, and December. To submit an item for the next edition, please contact Editor Amy F. Reiter at email@example.com
. Items must be submitted six weeks before the month of publication to be considered for the next issue. Subscription information
: To subscribe to the NIDDK Director’s Update, go to www.directorsupdate.niddk.nih.gov
. The subscription box is near the top right of the page.
Page last updated: December 19, 2012