New research effort will target hypoglycemia

“Everything about diabetes cuts two ways,” says William Tamborlane, M.D., professor of pediatrics at the School of Medicine. “There are good parts and there are negative parts.” Take insulin, the heart of treatment regimens for the 1 million people in the United States who have type 1, or juvenile onset, diabetes. Even as it controls the level of sugar in the blood, insulin can increase the frequency and severity of bouts of hypoglycemia.

Because it denies the brain a normal supply of its primary fuel, glucose, hypoglycemia can cause seizures, confusion and abnormal behavior. In severe cases it can damage the brain and nervous system and can occur even under a regimen of blood sugar monitoring, careful diet, exercise and insulin injections.

Now, with a $5 million, five-year grant from the Juvenile Diabetes Research Foundation International (JDRFI), researchers at Yale have launched a new effort to study hypoglycemia and seek ways to prevent it. At a press conference and luncheon in early November, researchers at Yale and JDRFI officials announced the formation of the Center for the Study of Hypoglycemia at Yale University. Building on 25 years of hypoglycemia research at Yale, the center will draw on the talents of 16 investigators in internal medicine, pediatrics, diagnostic radiology, neurosurgery, psychiatry, neurology and nursing. “You need to bring together people with different perspectives and different knowledge bases to tackle the problem,” says Robert Sherwin, M.D., the C.N.H. Long Professor of Medicine, who will lead the new center and is the president of the American Diabetes Association.

A clinical trial led by Tamborlane and Margaret Grey, Ph.D., associate dean for research at the School of Nursing, will gauge whether new technologies in glucose sensing and insulin delivery can reduce the risk of severe hypoglycemia in children receiving insulin for type 1 diabetes. Three research projects will use microdialysis, nuclear magnetic resonance and functional magnetic resonance imaging to monitor the effects of hypoglycemia on the brain. The project leaders are Sherwin, John C. Gore, Ph.D., professor of diagnostic radiology and applied physics, and Douglas L. Rothman, Ph.D., associate professor of diagnostic radiology and director of the Magnetic Resonance Center.