BADERC-Enrico Cagliero

Enrico Cagliero, M.D.

New Therapies for type 1 and type 2 diabetes

My research focus is on clinical care in the area of treatment of type 1 and type 2 diabetes. I am currently engaged in the following projects:

1. Islet Transplantation in Type 1 Diabetes: I am the co-principal investigator of the Clinical Trial Team of the Juvenile Diabetes Foundation Center for Islet Transplantation at Harvard Medical School, and the PI of the 2active protocols that have been approved at the participating institutions, Massachusetts General Hospital, Brigham and Women's Hospital and the Beth Israel Deaconess Medical Center. We have performed 13 transplants in 7 type 1 diabetic patients using the Edmonton type immunosuppression, some in patients recipients of renal allografts and some as islets alone. Our center is participating in the Immune Tolerance Network trial of islet transplantation

2. Cardiovascular Complications of Diabetes: I am the principal investigator of the Reduce Trial, a randomized, placebo controlled trial of rosiglitazone in insulin-treated type 2 diabetic patients. The major goal of the study is to examine the effects of the insulin sensitizing agent rosiglitazone on cardiovascular disease (CVD) risk factors and glycemic control in type 2 diabetic patients and we will test the hypothesis that reducing insulin resistance with rosiglitazone will result in improved CVD risk profile. We are currently enrolling patients in the study.

3. Diabetes and Schizophrenic Disorders: I have been collaborating with Dr. David Henderson and Dr. David Goff of the Department of Psychiatry on a few epidemiological studies on the high incidence of diabetes, diabetic ketoacidosis in patients with schizophrenic disorders. We are also looking at the mechanisms underlying these observations and have identified the role of some atypical antipsychotic agents in inducing insulin resistance.

4. Clinical Care for Type 2 Diabetic Patients in Primary Care Practices: I have been collaborating with Dr. James Meigs of the General Medicine Division on assessing and improving the care for type 2 diabetic patients in primary care. We have studied the level of care received by patients in primary and specialist care at Massachusetts General Hospital, and recently completed a randomized trial of a web-based diabetes management application (that we designed in collaboration with the Laboratory of Computer Sciences) that showed improvements in outcomes of diabetes care. I am currently the co-PI (with Dr. Meigs) of a more comprehensive intervention that will integrate the diabetes management application for providers, with case managers, pharmacists and direct patient self-management assessment.

References:

1. Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM: Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 2002, 112:487-490

2. Grant RW, Cagliero E, Murphy-Sheehy P, Singer DE, Nathan DM, Meigs JB: Comparison of hyperglycemia, hypertension, and hypercholesterolemia management in patients with type 2 diabetes. Am J Med 2002, 112:603-609

3. Meigs JB, Cagliero E, Dubey A, Murphy-Sheehy P, Gildesgame C, Chueh H, Barry MJ, Singer DE, Nathan DM: A controlled trial of web-based diabetes management: the MGH diabetes primary care improvement project. Diabetes Care 2003; 26:750-757

4. Grant RW, Hamrick HE, Sullivan CM, Cagliero E, Meigs JB: Impact of population management with direct physician feedback on care of patients with type 2 diabetes. Diabetes Care, in press

5. Blake DR, Cagliero E: Islet transplantation: a viable therapy for type 1 diabetes? Endocrinology Rounds 2002, 1:1-4Cagliero E: Atypical Antipsychotic Agents-Induced Diabetes Mellitus: How to Treat It? Curbside Consultant 2002,1:3-4

6. Cagliero E: Rheumatic manifestations of diabetes mellitus. Curr Rheum Reports 2003; 5:189-194

7. Shapiro J, Hering B, Ricordi C, Dimercurio B, Lindblad R, Cagliero E, Brendel M, Robertson RP, Berney T, Oberholzer J, Secchi A, Brennan D, Ramos E, Viviano L, Ryan E, Lakey J: International multicenter trial of islet transplantation using the Edmonton protocol in patients with type 1 diabetes. Am J Transplan 2003;3 (Suppl 5):152

8. Grant RW, Cagliero E, Dubey AK, Gildesgame C, Chueh HC, Barry MJ, Singer DE, Nathan DM, Meigs JB. Clinical inertia in the management of Type 2 diabetes metabolic risk factors. Diabet Med. 2004 Feb;21(2):150-5.

9. Huang ES, Gleason S, Gaudette R, Cagliero E, Murphy-Sheehy P, Nathan DM, Singer DE, Meigs JB. Health care resource utilization associated with a diabetes center and a general medicine clinic. J Gen Intern Med. 2004;19:28-35.






			Enrico Cagliero, M.D. New Therapies for type 1 and type 2 diabetes My research focus is on clinical care in the area of treatment of type 1 and type 2 diabetes. I am currently engaged in the following projects: 1. Islet Transplantation in Type 1 Diabetes: I am the co-principal investigator of the Clinical Trial Team of the Juvenile Diabetes Foundation Center for Islet Transplantation at Harvard Medical School, and the PI of the 2active protocols that have been approved at the participating institutions, Massachusetts General Hospital, Brigham and Women's Hospital and the Beth Israel Deaconess Medical Center. We have performed 13 transplants in 7 type 1 diabetic patients using the Edmonton type immunosuppression, some in patients recipients of renal allografts and some as islets alone. Our center is participating in the Immune Tolerance Network trial of islet transplantation 2. Cardiovascular Complications of Diabetes: I am the principal investigator of the Reduce Trial, a randomized, placebo controlled trial of rosiglitazone in insulin-treated type 2 diabetic patients. The major goal of the study is to examine the effects of the insulin sensitizing agent rosiglitazone on cardiovascular disease (CVD) risk factors and glycemic control in type 2 diabetic patients and we will test the hypothesis that reducing insulin resistance with rosiglitazone will result in improved CVD risk profile. We are currently enrolling patients in the study. 3. Diabetes and Schizophrenic Disorders: I have been collaborating with Dr. David Henderson and Dr. David Goff of the Department of Psychiatry on a few epidemiological studies on the high incidence of diabetes, diabetic ketoacidosis in patients with schizophrenic disorders. We are also looking at the mechanisms underlying these observations and have identified the role of some atypical antipsychotic agents in inducing insulin resistance. 4. Clinical Care for Type 2 Diabetic Patients in Primary Care Practices: I have been collaborating with Dr. James Meigs of the General Medicine Division on assessing and improving the care for type 2 diabetic patients in primary care. We have studied the level of care received by patients in primary and specialist care at Massachusetts General Hospital, and recently completed a randomized trial of a web-based diabetes management application (that we designed in collaboration with the Laboratory of Computer Sciences) that showed improvements in outcomes of diabetes care. I am currently the co-PI (with Dr. Meigs) of a more comprehensive intervention that will integrate the diabetes management application for providers, with case managers, pharmacists and direct patient self-management assessment. References: 1. Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM: Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 2002, 112:487-490 2. Grant RW, Cagliero E, Murphy-Sheehy P, Singer DE, Nathan DM, Meigs JB: Comparison of hyperglycemia, hypertension, and hypercholesterolemia management in patients with type 2 diabetes. Am J Med 2002, 112:603-609 3. Meigs JB, Cagliero E, Dubey A, Murphy-Sheehy P, Gildesgame C, Chueh H, Barry MJ, Singer DE, Nathan DM: A controlled trial of web-based diabetes management: the MGH diabetes primary care improvement project. Diabetes Care 2003; 26:750-757 4. Grant RW, Hamrick HE, Sullivan CM, Cagliero E, Meigs JB: Impact of population management with direct physician feedback on care of patients with type 2 diabetes. Diabetes Care, in press 5. Blake DR, Cagliero E: Islet transplantation: a viable therapy for type 1 diabetes? Endocrinology Rounds 2002, 1:1-4Cagliero E: Atypical Antipsychotic Agents-Induced Diabetes Mellitus: How to Treat It? Curbside Consultant 2002,1:3-4 6. Cagliero E: Rheumatic manifestations of diabetes mellitus. Curr Rheum Reports 2003; 5:189-194 7. Shapiro J, Hering B, Ricordi C, Dimercurio B, Lindblad R, Cagliero E, Brendel M, Robertson RP, Berney T, Oberholzer J, Secchi A, Brennan D, Ramos E, Viviano L, Ryan E, Lakey J: International multicenter trial of islet transplantation using the Edmonton protocol in patients with type 1 diabetes. Am J Transplan 2003;3 (Suppl 5):152 8. Grant RW, Cagliero E, Dubey AK, Gildesgame C, Chueh HC, Barry MJ, Singer DE, Nathan DM, Meigs JB. Clinical inertia in the management of Type 2 diabetes metabolic risk factors. Diabet Med. 2004 Feb;21(2):150-5. 9. Huang ES, Gleason S, Gaudette R, Cagliero E, Murphy-Sheehy P, Nathan DM, Singer DE, Meigs JB. Health care resource utilization associated with a diabetes center and a general medicine clinic. J Gen Intern Med. 2004;19:28-35.