About Us
Our Research - Kidney & Pancreas Transplantation
PROJECT 1: The recurrence of auto-immunity in patients with type 1 diabetes and end stage renal disease who undergo a K/P transplant
PROJECT SUMMARY:
In studying the recurrence of auto-immunity in patients with type 1diabetes (T1D) and end-stage renal disease who undergo a kidney-pancreas transplant, we have noted that a small number of patients (5%) will return with hyperglycemia. This ultimately reflects a selective loss of islet cells, which is what leads to type 1diabetes in the first place. For this project, we are collaborating with the team at the Diabetes Research Institute at the University of Miami, particularly Dr. Alberto Pugliese, and also the team at the Diabetes Research Institute in Seattle (Virginia Mason Institute) and have been supported by an NIH RO1 grant since 2005, as well as a JDRF Fellowship for 2 years. We have recently applied for an ARRA Grant and are in the process of competitive renewal revision for our NIH RO1 grant. A list of our current publications over the last 2 years is included (1-5).
What is hyperglycemia?
Hyperglycemia, or high blood glucose (sugar), is a serious health problem for those with diabetes. Hyperglycemia develops when there is too much sugar in the blood. In people with diabetes, there are two specific types of hyperglycemia that occur.
Fasting hyperglycemia is defined as a blood sugar greater than 90-130 mg/dL (milligrams per deciliter) after fasting for at least 8 hours.
Postprandial or after-meal hyperglycemia is defined as a blood sugar usually greater than 180 mg/dL. In people without diabetes postprandial or post-meal sugars rarely go over 140 mg/dL but occasionally, after a large meal, a 1-2 hour post-meal glucose level can reach 180 mg/dL. Consistently elevated high post-meal glucose levels can be an indicator that a person is at high risk for developing type 2 diabetes.
When a person with diabetes has hyperglycemia frequently or for long periods of time as indicated by a high HbA1c blood test, damage to nerves, blood vessels and other body organs can occur. Hyperglycemia can also lead to more serious conditions, including ketoacidosis -- mostly in people with type 1 diabetes -- and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) in people with type 2 diabetes or in people at risk for type 2 diabetes.
It's important to treat the symptoms of hyperglycemia promptly to prevent complications from diabetes.
GOAL:
Ultimately, we hope that insights from treating our patients will translate to possible prevention or cure of Type 1 Diabetes in children who are newly diagnosed with the disease.