NIDDK Director's Update Spring 2015

Research Updates

Early blood glucose control lengthens life in people with type 1 diabetes: People with type 1 diabetes who intensively control their blood glucose (blood sugar) early in their disease are likely to live longer than those who do not, according to NIH-funded research. The findings are the latest results of the Diabetes Control and Complications Trial (DCCT) and its follow-up, the Epidemiology of Diabetes Control and Complications (EDIC) study. Results were published online Jan. 6 in the Journal of the American Medical Association.

Drug activates brown fat: A team of investigators funded in part by NIDDK has successfully activated brown adipose tissue and increased energy expenditure in 12 lean adult men using mirabegron, a drug that stimulates β3-adrenergic receptors. Brown adipose tissue, often called brown fat, consumes calories from fat and sugar to generate heat and is normally activated when a person is exposed to cold. The results published in the January issue of Cell Metabolism.

Pathways underlying the benefits of calorie reduction: A team led by Drs. Christopher Hine and James Mitchell at the Harvard School of Public Health set out to determine the molecular mechanisms by which calorie restriction can bring health benefits. The researchers induced surgical stress in mice by temporarily halting blood flow to the liver. The team found that mice that had their diet restricted by 50 percent for a week before the surgery showed less liver damage than mice provided with unlimited food. Results appeared online on Dec. 23, 2014, in Cell.

Chronic high blood sugar may be detrimental to the developing brain of young children: Young children who have long-term high blood sugar levels are more likely to have slower brain growth, according to researchers at centers including the National Institutes of Health. Researchers did not find significant cognitive differences between the healthy children and those with type 1 diabetes, but they believe a continuing study with the same groups of children may show changes there as well. The findings were published online in the journal Diabetes.

Discovery provides insight into immunity: Researchers from the intramural NIDDK Laboratory of Molecular Biology have determined the crystal structure of the RAG1-RAG2 protein complex, which initiates DNA rearrangement to generate millions of antibodies and T-cell receptors that defend against infection. The structure allows scientists to analyze more than 60 human mutations that lead to immune deficiencies, laying the groundwork for understanding whether and how variations in RAG1 and RAG2 genes affect the diversity of antibodies in each person and the implications for diseases. The findings were published online in the journal Nature.

SMAD3 negatively regulates serum irisin and skeletal muscle FNDC5 and PGC-1α during exercise: Beige adipose cells are a distinct type of fat cell that represents a powerful target for treating obesity. Mice lacking the protein SMAD3 are protected against diet-induced obesity due to browning of their white adipose tissue, leading to increased energy expenditure. The researchers demonstrated a new association between irisin – an exercise-induced skeletal muscle hormone – and SMAD3 signaling in skeletal muscle. Results appeared online in the Journal of Biological Chemistry.

Eylea outperforms other drugs for diabetic macular edema with moderate or worse vision loss:

Photo of retina as seen through a dilated pupil
Image courtesy of the National Eye Institute
Illustration showing the retina as seen through a dilated pupil.

In an NIH-supported clinical trial comparing three drugs for diabetic macular edema (DME), Eylea (aflibercept) provided greater visual improvement, on average, than did Avastin (bevacizumab) or Lucentis (ranibizumab) when vision was 20/50 or worse at the start of the trial. However, the three drugs resulted in similar average improvement when starting vision was 20/40 to 20/32. Investigators found no major differences in the safety of the three drugs. The trial was funded by the National Eye Institute (NEI) and NIDDK, both part of NIH. Results were published online in the New England Journal of Medicine.

Effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: In the NIH-supported Diabetes Prevention Program (DPP), intensive lifestyle and metformin were found to prevent or delay type 2 diabetes in women with a history of gestational diabetes. This study evaluated the impact of intensive lifestyle intervention and metformin intervention over 10 years in women with and without a history of gestational diabetes in the DPP/Diabetes Prevention Program Outcomes Study. In women with a history of gestational diabetes, both lifestyle and metformin were highly effective in reducing progression to type 2 diabetes during a 10-year follow-up period. Among women without such history, lifestyle but not metformin reduced progression to diabetes. The results were published in the Journal of Clinical Endocrinology and Metabolism.

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