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NOTE TO EDITORS: November is National Diabetes Month

UI researchers involved in a number of diabetes studies

IOWA CITY, Iowa -- Finding new ways to treat and prevent diabetes and acquiring a better understanding of the mechanisms responsible for diabetes-related health complications are keys to research studies being done at the University of Iowa College of Medicine.

Approximately 16 million people in the United States have diabetes, but as many as a third of these people do not know they have the disease. Most people with diabetes have type 2 diabetes, which tends to occur after age 40. Type 2 diabetes is often associated with being overweight and can be treated with diet, exercise, pills or sometimes insulin.

Type 1 diabetes usually begins at a younger age. People with type 1 diabetes do not produce insulin, which is required to keep blood sugar levels normal. These people require daily insulin injections for treatment.

Learning more about diabetes through clinical studies and improved recognition of the disease is critical to better treatment and prevention of the disease.

William Sivitz, M.D., and Robert Bar, M.D., both endocrinologists in the UI Department of Internal Medicine, are leading a group of investigators involved in clinical research dealing with patients with type 1 and type 2 diabetes. The studies, conducted at the UI Hospitals and Clinics and the Veterans Affairs Medical Center in Iowa City, cover the full spectrum of problems diabetes patients can encounter.

One of the team's major research efforts is the Veterans Administration/Juvenile Diabetes Foundation (VA/JDF) Research Center. The program involves a number of studies looking at the disease at the clinical level--studies done with patients with diabetes--and the basic sciences level in the laboratory.

"These studies include looking at type 1 and type 2 diabetes while using different medications to control the blood sugar and determining how such treatments affect blood circulation," Sivitz said. "We're also investigating drugs that affect insulin sensitivity and insulin secretion."

Another research project is the Epidemiology of Diabetes Interventions and Complications (EDIC), a continuing study of a group of patients who were enrolled in the Diabetes Control and Complications Trial (DCCT). This nationwide study, which ended in 1993, had a major impact on diabetes care. It showed that intensive therapy--more than two injections of insulin a day or the use of an insulin pump-improves patients' chances of avoiding long-term complications such as eye, kidney or nerve damage.

"Intensive insulin therapy is designed to lower the blood sugar level to as close to normal as safely possible," Sivitz said. "The DCCT showed that the more we lowered the blood sugar the better the outlook in terms of long-term complications." The UI was one of 29 centers around the United States and North America to take part in the study.

The researchers are following the 55 Iowa DCCT patients--all now advised to adhere to an intensive therapy regimen--for 10 years to learn more about what happens to the disease over this period. The patients receive annual checkups and undergo comprehensive exams to determine the health of their cardiovascular and nervous systems, eyes and kidneys.

Other diabetes studies the UI and VA researchers are conducting look at different types of treatments. These include new forms of insulin and new oral medications for diabetes. The researchers also are studying ways to lower cholesterol in diabetes patients.

"We are working on several studies with our colleagues in pediatric endocrinology on humalog for children," Bar said. "Humalog is a fast-acting form of insulin that has been available for the past two years. It's already known to be effective. We're interested in finding out the best ways to use it."

Patients in the diabetes studies receive free care and medications, plus relevant diabetes education, nutrition counseling and compensation for participating in the studies.

For more information on UI diabetes-related clinical research studies, contact the VA/JDF Diabetes Research Center at (319) 356-4879.