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Researchers are looking for participants with diabetes who don’t fit into the Type 1 or Type 2 categories
Washington University’s Medical School in St. Louis is part of a national research network designed to discover rare forms of diabetes as a first step towards providing more effective treatments.
Most people diagnosed with diabetes have either Type 1, which is treated with insulin injections because patients cannot make their own insulin, or Type 2, where patients either do not make enough insulin or do not respond well to the insulin the body produces. People with type 2 diabetes are treated with medication.
However, an increasing number of patients do not fall into these two general categories and require more accurate diagnosis and more personalized treatment. The Rare and Atypical Diabetes Network (RADIANT), funded by the National Institutes of Health (NIH) National Institute for Diabetes and Digestive and Kidney Diseases, will involve approximately 2,000 people nationwide who are screened for unusual forms of diabetes.
“We are looking for new and different forms of diabetes, particularly among immigrants and minorities who have been reported to be more common atypical forms of diabetes,” said Dr med. Fumihiko Urano, lead researcher at the Washington University Clinic Page? ˅. “We’re also looking for rare types of diabetes that result from certain gene mutations. With the help of precision medicine, we now have tools to identify these rare forms of disease and potentially treat them more effectively. “
Urano, Samuel E. Schechter Professor of Medicine and Professor of Pathology and Immunology, plans to enroll 200 patients with diabetes at the Washington University site over the next year. He and the other network researchers intend to build a comprehensive database of genetic, clinical and descriptive data on previously unidentified forms of diabetes in order to provide doctors and researchers with more information about these forms of the disease and to enable them to identify atypical forms of diabetes to be recognized more quickly. as well as developing new or more individual treatment strategies.
Eligible are people diagnosed with type 2 diabetes before puberty, people with type 2 diabetes who are not overweight, and people with a family history of diabetes, especially people from families in which most family members have Diabetes diagnosed before puberty was age 18. Investigators are also looking for people with very abnormal cholesterol or lipid levels and an unusual distribution of body fat, as well as people whose diabetes appears to be growing and waning. People who are not eligible for the study include people who are highly likely to have a known form of diabetes and pregnant women.
Subjects are asked to complete surveys and take measurements of height, weight, and blood pressure. They will also undergo genetic testing and be asked to provide detailed family histories to researchers.
Next, experts review surveys and test results to determine whether a person’s diabetes can be considered atypical or rare.
Most people with atypical diabetes are diagnosed with Type 1 or Type 2 diabetes at least initially, but they tend to experience different disease progression, complications, or unusual reactions to standard diabetes medication.
Urano has experience in the treatment of an extremely rare and atypical form of diabetes known as Wolfram Syndrome. This disorder has blood sugar problems, but unlike more common forms of diabetes, it is caused by a single genetic mutation and involves serious vision, balance, and other neurological problems.
As part of the RADIANT study, researchers will select specific participants to collect detailed clinical and biological information through a wide range of tests, including genome sequencing, blood draws, and physical exams. Participants may receive additional specialized tests based on the specific characteristics of their form of diabetes.
Family members of enrolled participants may also be invited to participate in the study, especially if the condition appears to be inherited. Members of minority groups are particularly encouraged to apply for the study, as various forms of atypical diabetes – although rare – are more common in minorities than in Caucasians.
“It is extremely frustrating for people with atypical diabetes when their diabetes seems so diverse and difficult to manage,” said study project scientist Christine Lee, MD, of the National Institute for Diabetes and Digestive and Kidney Diseases of the NIH. “With RADIANT, we want to help patients and the wider health community by finding and studying new types of diabetes to see how and why diabetes can be so different.”
Urano added, “Our goal is to further clarify diabetes in its many different forms.” By focusing on rare forms of diabetes, the study aims to help us better understand the spectrum of diabetes, to improve the lives of people with these rare forms of diabetes, and to help the people who care for them. “
Nationwide, the study is led by researchers from the University of South Florida, Baylor College of Medicine in Houston, and the University of Chicago.
For more information, people with forms of diabetes that appear to be different from the usual types of the disorder can call Stacy Hurst at 314-747-3294, email AtypicalDiabetes@wustl.edu, or visit www.atypicaldiabetesnetwork.org for more information and how to participate.
This study is supported by the National Institutes of Health (NIH) National Institute for Diabetes and Digestive and Kidney Diseases. Permit numbers U54 DK118638 and U54 DK118612.
The 1,500 faculty physicians at Washington University School of Medicine are also medical staff at Barnes-Jewish and St. Louis Children’s Hospitals. The School of Medicine is a leader in medical research, teaching, and patient care and is among the top 10 medical schools in the country according to the US News & World Report. The School of Medicine is affiliated with BJC HealthCare through its affiliation with the Barnes-Jewish and St. Louis Children’s Hospitals.