Diabetes Trailblazer Wins Banting Award

The scientist who showed the world that type 1 diabetes is an autoimmune disease, and who continues to push the boundaries of scientific inquiry, spoke hopefully about the future of diabetes research and encouraged his audience to "pioneer the prevention of type 1 diabetes.''

Dr. George S. Eisenbarth is Executive Director of the Barbara Davis Center for Childhood Diabetes and winner of the American Diabetes Association's prestigious Banting Medal for Outstanding Scientific Achievement.

 

During today's lecture to a packed audience, he said that it is now known that type 1 diabetes, the form of the disease that results from immune destruction of insulin-producing cells in the pancreas, "is hard-wired in the genome.'' 

 

As scientists hone in on genetic and other physiologic causes, he said, it has become possible to predict who is at highest risk, and ultimately, he said, "prevention will be achievable.''

 

But, he noted, there must be more than genetics at work because "we know that type 1 diabetes incidence is doubling every 20 years in Western societies, especially for youngest-onset.''

 

Squeaky Clean

That isn't happening in developing countries, and there are various theories to explain it, including the "hygiene theory.'' This theory suggests that as infectious diseases decline because of hyper-cleanliness, our immune systems are not stimulated as much as they were in earlier generations, leading to an increase in autoimmune diseases. It's also possible there is a virus that trips the genetic predisposition, and if it could be identified might be averted with antiviral medication.

 

Whatever the environmental trigger, he said, it is likely "ubiquitous, not rare.'' 

 

Nancy Drew to the Rescue?

Diabetes risk is "determined by one's genotype,'' he said, but while research is teasing out some of the mysteries, "we're not yet at the tipping point. The list of positive (studies) in various stages of replication is small - but increasing.''

 

Among hopeful investigations are:

• the use of oral insulin
• efforts to develop a vaccine
• a study (reported at this meeting Saturday) that found a rheumatoid arthritis drug improved symptoms

What we know so far, Eisenbarth said, is that we can predict type 1 diabetes, insulin may be an autoantigen - a normal body chemical that stimulates an immune response - and drugs that suppress immune response can dramatically delay, but not halt, diabetes.

 

However, "a lot we know may be wrong,'' he said.

 

Trailblazer in Training

In announcing him as the Banting Medal winner, the ADA praised Eisenbarth, who is Professor of Pediatrics, Medicine and Immunology at the University of Colorado Denver School of Medicine, noting that "the major tenets developed as a consequence of his discoveries guide basic research, clinical diagnosis and disease therapy to this day.'' 

 

A native of Brooklyn, Eisenbarth grew up in a working class neighborhood. His mother, who worked in an electronics factory, "always assumed I would be a doctor,'' he said, and "would read to me from a science encyclopedia'' as they rowed on a lake in the Catskills.

 

His father, who had a sixth-grade education, worked as a cook at the Natural History Museum in New York, so young George got to spend time there. At the urging of a high school teacher, he applied for and won a Pulitzer Scholarship to Columbia, and was on his way.  

In his lecture Sunday, he sounded an optimistic note for the future. Thanks to new tools and technologies, scientists can "build on current successful trials and... with luck, permanently arrest'' the destruction of insulin-producing cells -- stopping type 1 in its tracks. 

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I had heard that some say the emphasis on cleanliness may be affecting our ability to fight off illnesses, but how fascinating that it could be impacting Type 1 rates, as well. Thanks for writing!

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