Diabetes Dateline
Winter 2007

Research News

NIH Strategic Plan Guides Type 1 Diabetes Research

The National Institutes of Health (NIH) has released a long-range plan to guide type 1 diabetes research over the next decade.

Advances and Emerging Opportunities in Type 1 Diabetes Research: A Strategic Plan outlines specific goals to make further strides in diabetes research, which has already made dramatic progress in extending life expectancy for people with type 1 diabetes.

Twenty percent of people born in the 1950s died within 20 years of a type 1 diabetes diagnosis, and 30 percent died within 25 years of diagnosis. However, only 3.5 percent of people born between 1975 and 1980 died within 20 years of diagnosis and 7 percent within 25 years.

Challenges Remain

“Research has greatly improved the length and quality of life of people with type 1 diabetes, and it has lowered the risk of developing certain serious complications, such as retinopathy and kidney failure,” said NIH Director Elias A. Zerhouni, M.D. “However, many challenges remain in combating this complex autoimmune disease. The NIH Strategic Plan sets forth a cogent, multifaceted approach to future research that soundly addresses these challenges.”

About 5 to 10 percent of the nearly 21 million people with diabetes have type 1, formerly called juvenile onset, or insulin-dependent, diabetes. Type 1 diabetes cuts about 15 years off the lives of those who have it, with early deaths due mainly to heart attacks and stroke.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the NIH developed the Strategic Plan with oversight from the Diabetes Mellitus Interagency Coordinating Committee. The document, which incorporated input from patient advocacy groups and scientific experts outside the NIH, is available at www.T1Diabetes.nih.gov/plan in two versions: one for the public and another for the scientific community.

The NIH research goals for type 1 diabetes outlined in the Strategic Plan are as follows:

• Identify the genetic and environmental causes of type 1 diabetes. Researchers continue to search for genes responsible for increasing a person’s diabetes risk. Finding all the genes will boost the ability to predict who is at risk and foster prevention efforts. Groups including the International Type 1 Diabetes Genetics Consortium and the Environmental Determinants of Diabetes in the Young are working to identify all the genetic and environmental factors responsible for diabetes.

• Prevent or reverse type 1 diabetes. Clinical trial groups, including the Type 1 Diabetes TrialNet and the Immune Tolerance Network, are testing ways to modulate the immune system to prevent type 1 diabetes and to arrest the autoimmune attack in people with newly diagnosed diabetes who still have some beta cells.

• Develop cell replacement therapy. Researchers seek to overcome remaining barriers to islet transplantation by

  • finding ways to produce an unlimited supply of islets
  • improving ways to harvest islets
  • reducing complications of islet transplantation
  • testing ways to prevent recurrent autoimmunity and immune rejection of donor islets



• Prevent or reduce hypoglycemia in type 1 diabetes. Recently approved continuous glucose monitors developed with NIH support are helping people with diabetes better control their glucose levels. This revolutionary technology is the first step toward developing an artificial pancreas. Current studies also focus on how the brain senses hypoglycemia and on controlling hypoglycemia through behavioral therapy.

• Prevent or reduce complications of type 1 diabetes. NIH researchers have found that a protein called vascular endothelial growth factor spurs development of abnormal blood vessels that invade the retina and cause diabetic retinopathy, which can lead to blindness. NIH-sponsored clinical studies are testing drugs that control new blood vessel growth in eyes. The Strategic Plan also calls for studying the role of genetic factors in developing complications, applying the tools of systems biology to the understanding of complications, and using the latest advances in drug development technology to hasten potentially valuable therapies into clinical trials.

• Attract new talent and apply new technologies to type 1 diabetes research. The NIH is encouraging interdisciplinary collaboration, creating incentives that reward research innovation and collaboration, and attracting and training new diabetes investigators. Scientists are using imaging technologies to better understand the brain’s response to hypoglycemia and to find ways to measure a person’s number of beta cells, which could help develop promising therapies.

More information about type 1 diabetes research is available at www.ClinicalTrials.gov.

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NIH Publication No. 07–4562
March 2007