Yale School of Medicine recently opened the Juvenile Diabetes Research Foundation (JDRF) Center for the Study of Hypoglycemia at Yale University with a five-year, $5 million JDRF grant. The funds will be used to advance multidisciplinary research into the effects of hypoglycemia—low blood sugar—on the brain and how to prevent it.
In individuals with type 1 diabetes, hypoglycemia can occur with even a careful regimen of blood sugar monitoring and insulin injections. Hypoglycemia can cause confusion, abnormal behavior and seizures. Coma and death can result in extreme cases. Normally, symptoms like lightheadedness or hunger can signal low blood sugar, but a severe episode of hypoglycemia can impede the body’s ability to detect the next hypoglycemic episode.
"We are pleased to be spearheading this cutting edge research into hypoglycemia," said David A. Kessler, M.D., Dean, Yale School of Medicine. "Diabetes extracts a high toll on individuals and families, and the JDRF center for the study of hypoglycemia at the Yale will aim to bring new discoveries and treatments to light."
Robert Sherwin, M.D., the C.N.H. Long Professor of Medicine, is director of the new center and in addition to overseeing its operation, will use microdialysis to conduct research on the complex biochemical changes that hypoglycemia causes in the brain.
"Our most accomplished researchers in pediatrics, internal medicine, diagnostic radiology and neurosurgery, among other fields, will be conducting research into the causes and solutions for hypoglycemia," said Sherwin. "Three basic research studies, including mine, will each use a different technology to help move us toward this goal."
Douglas Rothman, director and associate professor, Magnetic Resonance Center, will use nuclear magnetic resonance (NMR) to monitor the effects of hypoglycemia on the brain. NMR is a non-invasive form of imaging that does not include radiation. It produces images that enable scientists to track the way the brain uses glucose and how glucose affects neurotransmission.
The third study will use functional magnetic resonance imaging (fMRI) to monitor the effects of hypoglycemia on the brain. Led by John Gore, professor of diagnostic radiology and applied physics, this study will investigate how hypoglycemia affects different parts of the brain, especially when the brain is performing sensory and cognitive tasks. The fMRI detects changes in the blood flow to particular areas of the brain, and can map different areas of the brain affected by hypoglycemia.
A clinical study conducted by William V. Tamborlane, M.D., professor of pediatrics and director of the Children’s Clinical Research Center, and Margaret Grey, professor and associate dean for research, Yale School of Nursing, will evaluate the safety and effectiveness of a new glucose sensor manufactured by MiniMed, Inc. The sensor is used in conjunction with an insulin pump and can accurately monitor blood glucose levels at five-minute intervals for up to three days. This data can then be downloaded for analysis and used to try to prevent hypoglycemia.
"Diabetes is a devastating and unpredictable disease, and insulin is an imperfect form of life support," said Robert Goldstein, M.D., Ph.D., chief scientific officer at the JDRF. "This research should help us discover more information about how the body monitors and regulates blood sugar levels, and also create more efficient ways to prevent hypoglycemia, a frightening and dangerous complication of diabetes."