Diabetes research is filled with ‘great promise’

It doesn’t require much prompting to get Michael Burton to express his enthusiasm for progress in research of diabetes.

Burton, the CEO of the Diabetes Research Institute Foundation, points to new understanding of diabetes and the potential of new breakthroughs for those struggling with the disease. About 38 million Americans have diabetes, and about 5-10% of those patients have Type 1 diabetes, according to the Centers for Disease Control and Prevention.

“I don't think there's any doubt that these are times of great progress and promise in the field of diabetes research and care,” Burton says. “I think that we are poised to make great discoveries, and to translate them into new therapies for people who are having to navigate this disease.”

Burton and Matthias von Herrath, MD, scientific director of the Diabetes Research Institute, spoke with Chief Healthcare Executive® just as the American Diabetes Association began its 84th Scientific Sessions in Orlando over the weekend.

Obviously, GLP-1 drugs have commanded enormous attention, both for treatment of diabetes and obesity, as 2 million Americans were taking those medications in 2021, according to the association. Just before the conference kicked into high gear, Burton and von Herrath discussed other promising pathways that could make a big difference down the road.

Researchers are as anxious for progress as patients, von Herrath says.

“We want this as soon as we can,” he says. 

(See part of our conversation in this video. The story continues below.)

Diabetes and the immune system

Over the past 50 years, the Diabetes Research Institute has contributed to greater understanding and treatment of the disease, Burton says.

“That's a proud history. There's no question about that,” he says. “But I think the future is every bit as bright, and brighter.”

Burton points to the contributions made with the transplantation of islet cells, which produce insulin and can help patients avoid the need for insulin injections. Scientists at the Diabetes Research Institute are also making progress in the regeneration of beta cells, as outlined in a study published by Cell Metabolism last fall.

Researchers are aiming to make strides in the understanding of diabetes and the immune system, Burton says. “This is where the action is,” he says.

“How can we interact with the immune system in ways that allow us to defeat this disease? Because in many ways, one of the great limiters right now is the immune response. So we have these amazing approaches to stem cell transplantation, we have these amazing approaches to beta cell regeneration. But if we can't figure out how to modulate the immune system, suppress the immune system, it's going to be very difficult to make progress,” Burton says.

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Burton says he’s thrilled that von Herrath is working with the institute, with his expertise in immunology and the focus on understanding diabetes and the immune system. In addition to his work at the institute, von Herrath is also the vice president and senior medical officer at Novo Nordisk, makers of the diabetes drug Ozempic.

For patients with Type 1 diabetes, their immune system attacks the beta cells. Researchers want to find a way to cover the beta cells “with a Harry Potter cloak … to keep the immune system at bay,” von Herrath says.

The institute’s researchers are looking at ways to prevent diabetes without subjecting patients to other terrible side effects.

“The Holy Grail is to learn how to do this without systemic immune suppression, so you can circumvent side effects such as heightened risk for cancers, heightened risk for infections,” von Herrath says.

• Read more: Patients with diabetes need more than glucose monitoring systems

Taking the best shot

Much like Burton, von Herrath doesn’t try to suppress his enthusiasm for research in unlocking diabetes.

He likens the work to doing detective work in “Clue,” the mystery game.

“When we study the human pathology of diabetes, we are technology-wise, so advanced … you can reconstruct the murder scene of the islet (cell), so to speak, much better. It is really like a ‘Clue’ game,” he says.

Since joining the Diabetes Research Institute in February 2023, von Herrath says he has enjoyed the collaborative environment among researchers. He says scientists are engaging with each other routinely.

“Because we get along well, we love to talk to each other,” von Herrath says. “We don't have to agree all the time. But we inspire each other.”

The institute is focused on finding ways to accelerate trials, and that includes focusing on promising avenues of research, von Herrath says.

“There's a big theme at the institute, that we want to create platforms that can shorten the time to clinic, by de-risking approaches,” von Herrath says. “This is quite important, because the trials are complicated and long in prevention of diabetes and islet replacement. So you want to have the proper shots on goal. You don't want to have 50 shots on goal and sort it later. You want to sort it first, and then deliver your most efficient shots on goal.”

The Diabetes Research Institute Foundation is also seeing more collaboration in the nonprofit world, Burton says.

“Advocacy organizations, foundations, the total community is focused on defeating Type 1 diabetes,” Burton says.

“It's such a complicated disease,” he continues. “That kind of collaboration is absolutely required. There is no one organization that is going to cure this, is going to solve this. An organization may bring an incredibly important discovery to the field, but it's going to be lots of organizations that come up with the answer.”

The foundation is working with other organizations and philanthropists “who have been affected by this disease, and want to make a difference,” Burton says.