Program Areas

Diabetes Mellitus is a complex illness caused by genetic and environmental factors that control either energy and nutrient metabolism, or the susceptibility to the development of an autoimmune process that destroys the insulin-secreting beta cells of the pancreatic islets, described further below. Morbidity and mortality are due primarily to microvascular complications in the retina, kidney and peripheral nervous system, and to atherosclerosis. Current therapies are now evolving at rapid rate, however the burden of this illness continues to increase. The research programs serviced by the Boston Area Diabetes and Endocrinology Research Center (BADERC) in aggregate, address most of major problems arising from Diabetes Mellitus and its complications, across the spectrum from laboratory-based cellular and molecular biology relevant to metabolic regulation and the function of the immune system, to animal models of autoimmunity, metabolic dysfunction and vascular disease, to translational research on human subjects.

The participating investigators are listed below, divided (somewhat arbitrarily) according to their primary research strategy and/or field of interest. A brief general overview of diabetes research is followed by summaries of individual investigator research programs.

Genetics of Diabetes and Nutrient Metabolism
Florez Soukas
Saxena Williams
Molecular Mechanisms of Metabolic Regulation and Beta Cell Function
Kahn Rosen
Brown Kim
Spiegelman
Ferran Mootha
Greka Mostoslavsky Tavakkoli
Perissi
Hotamisligil Puigserver Wagner
Neurobiology of Energy Balance
Datta Kong Lowell
Kaiser Liberles Navarro
Saper
Cardiovascular Biology
Gerszten Melero-Martin
Das Libby Rosenzweig
Immunity and Inflammation
Arnaout Kaneki Shi
Bonventre
Faustman Xavier
Clinical and Translational Investigations
Grinspoon Nathan
Pittas

Overview:
Diabetes Mellitus is a highly prevalent ailment, characterized by chronic hyperglycemia and premature deterioration of the vascular system due to accelerated atherogenesis as well as a characteristic microangiopathy, most importantly in the retina, that places diabetes as the leading cause of blindness under age 60. The microangiopathy is now recognized to be the consequence of the sustained hyperglycemia, and affects all patients with diabetes, regardless of pathogenesis of the hyperglycemia. All forms of diabetes are also accompanied by degeneration of the peripheral nervous system, another metabolic insult caused by sustained hyperglycemia, occasionally complicated by intercurrent microinfarction. Diabetes is the most prevalent cause of renal failure requiring chronic renal replacement therapy. Although occurring in only a subset of hyperglycemic patients, diabetic nephropathy is also attributable to the sustained hyperglycemia, acting through hemodynamic and metabolic factors to damage the renal glomerulus in susceptible individuals. It has been estimated that the total costs of Diabetes in the U.S. in 2002 approached $132 billion, roughly 18% of all expenditures for health care, reflecting a rate of expenditure 2.4 fold greater than the matched cohort without diabetes.  The overall goals of Boston Area Diabetes Endocrinology Research Center are to 1) provide technical and (where feasible) intellectual support to investigators who can generate the knowledge base that will enable the development of new therapies that can cure the metabolic and vasculopathic lesions that prevail in diabetes; and 2) help to promote from this knowledge base the development of ameliorative and especially, curative treatments for diabetes and its concomitant vascular diseases.