David Nathan, M.D.

Clinical Research in Type 1 and Type 2 Diabetes

Dr. Nathan directs the MGH Diabetes Clinical Research Center, which focuses on the development and evaluation of innovative therapies for Type 1 and Type 2 diabetes and their complications. The Diabetes Clinical Research Center has played a leadership role in the conduct of several important clinical trials in diabetes, including the Diabetes Control and Complications Trial (DCCT) and its ongoing follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, which demonstrated the primacy of intensive metabolic control in preventing the development of complications in Type 1 diabetes; the Diabetes Prevention Program (DPP) which established the means of preventing Type 2 diabetes; the Look AHEAD study which is examining the means of preventing heart disease in Type 2 diabetes; the Immune Tolerance Network Study which explored islet transplantation as a treatment of Type 1 diabetes; the TODAY study, exploring the treatments of type 2 diabetes in children and adolescents, and most recently GRADE, a comprehensive comparative effectiveness study ot type 2 diabetes therapies. Other current single center studies promote the translation of laboratory results into new therapies and new techniques for islet transplantation, the development of an artificial pancreas for the treatment of type 1 diabetes, the immune basis of type 1 diabetes, cardiovascular disease prevention, and means of optimizing the care of Type 2 diabetes by primary care practitioners. Epidemiological studies in collaboration with the Framingham Heart Study, Baltimore Longitudinal Study of Aging, and Nurses and Physicians Health Studies explore the risk factors of diabetes and its complications and in particular the relationship between glycemia and heart disease. A host of genetics and pharmacogenetic and quality improvement studies are also ongoing.

References.

1. Florez JC, Jablonski KA, Bayley N, Pollin TI, deBakker PIW, Shuldiner AR, Knowler WC, Nathan DM, Altshuler D. Common genetic variants in the TCF7L2 gene influence progression to diabetes in the Diabetes Prevention Program. N Engl J Med 2006; 355:241-50.

2. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ for the A1c Derived Average Glucose (ADAG) Study Group. Translating the A1c assay into estimated average glucose values. Diabetes Care 2008; 31: 1473-8. PMCID: PMC2742903

3. Nathan DM, Zinman B, Cleary PA, Backlund J-Y, Genuth S, Miller R, Orchard TJ for DCCT/EDIC Research Group. Modern Day Clinical Course of Type 1 Diabetes Mellitus after 30-years Duration. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) and Pittsburgh Epidemiology of Diabetes Complications (EDC) Experience 1983-2005. Arch Int Med 2009; 169:1307-16. PMCID: PMC2866072

4. Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman H, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program. Lancet 2009;

5. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, Zinman B. Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. Diabetes Care 2009; 32:192-203. PMCID: PMC2606813

6. Nathan DM, Balkau B, Bonora E, Borch-Johnsen K, Buse JB, Colagiuri S, Davidson MB, et al. for the International Expert Committee on the Diagnosis of Diabetes. International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care 2009; 32: 1327-1334.

7. El-Khatib FH, Russell SJ, Nathan DM, Sutherlin RG, Damiano E. A bi-hormonal closed-loop artificial pancreas for type 1 diabetes. Sci Transl Med 2010; 2:27 Epub ahead of print. PMID: 204936998.

8. Zeitler P, Hirst K, Pyle L, Linder B, Copeland K, Arslanian S, Cutler L, Nathan DM, Tollefsen L, Wilfley D, Kaufman F for the TODAY Study. A clinical trial to maintain glycemic control in youth. N Engl J Med 2012; 366:2247-56. Free PMC Article

9. DCCT/EDIC Research Group. Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes. N Engl J Med 2011;365:2366-76.

10. Faustman DL, Wang L, Okubo Y, Burger D, Ban L, Man G, Zheng H, Schoenfeld D, Pompei R, Avruch J, Nathan DM. Proof-of-Concept, Randomized, Controlled Clinical Trial of Bacillus-Calmette-Guerin for Treatment of Long-Term Type 1 Diabetes. PLoS One. 2012;7(8):e41756. Epub 2012 Aug 8. PMID: 22905105. PMCID:PMC3414482

11. Nathan DM, Buse JB, Kahn SE, et al. Rationale and design of the Glycemia Reduction Approaches in Diabetes: a comparative effectiveness study (GRADE). Diabetes Care 2013; [epub 05/202013]. PMCID:PMC3714493[Available on 2014/8/1]


 

 

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