While medical records identifying diabetes date back to ancient Egypt, it's a disease that to this day holds scores of unanswered questions for patients and doctors alike. Researchers across the U.S. now hope to answer those questions by shedding light on rare and under-investigated forms of the disease.
In a five-year NIH-funded study, the Rare and Atypical Diabetes Network (RADIANT) aims to screen approximately 2,000 people with atypical forms of the disease that do not match symptoms commonly associated with Types 1 and 2 diabetes.
USF Health Distinguished Professor, Health Informatics Institute Director, and Endowed Chair in Diabetes Research Dr. Jeffrey Krischer leads the RADIANT study.
"We talk about diabetes as Type 1, where the cells that make insulin are destroyed, and we talk about everything else as Type 2, in which people can still make insulin, but for some reason have very high blood sugar. But more recently, we've learned there are multiple forms of diabetes. Some are genetic, some are related to other diseases; some forms, certainly, are related to pregnancy -- and there are still others we don't understand," Dr. Krischer says.
"In hindsight, the idea that we coined these phrases 'Type 1' and 'Type 2' was probably an error. Diabetes represents a continuum. Some forms -- specifically single gene forms -- were identified over the last couple decades, and now we're seeing more. We're recognizing we have patients who are very difficult to treat and that this may be the reason why," he adds.
Researchers in 16 universities and clinical centers across the nation will use questionnaires and conduct physical exams, genetic sequencing, blood samples, and other tests to collect detailed health information about patients with atypical diabetes. In some cases, participants' family members may be invited to participate in the study, and in the instance, a participant has an unknown form of diabetes, they may undergo additional testing to draw a clearer picture of the disease.
USF is the RADIANT study coordinating center and the University of Florida in Gainesville provides its laboratory services. Dr. Krischer says the study will also utilize sophisticated data science under the guidance of Morsani College Health Informatics Institute Assistant Professor and bioinformatics expert Dr. Hemang Parikh.
By establishing a more comprehensive database on rare forms of diabetes, the RADIANT study aims to improve diagnostic criteria and identify better screening and treatment options for patients who do not share the common features of Type 1 and Type 2 diabetes.
"This new study is all about trying to understand these other forms of diabetes because we think diabetes is really a collection of different diseases -- and to prevent it or treat it, we really have to know what we're dealing with," says Dr. Krischer.
"There are some people who have been on insulin for their whole lives, and now we discover they don't really need insulin because their form of diabetes is treatable by a different method. Imagine the impact that could have on somebody who has been taking insulin for their entire life," he says.
The RADIANT study opened for recruitment on Sept. 30 for people with atypical diabetes, or rare forms of diabetes that seem inconsistent with the known Types 1 and 2. For more information on the study and how to join, visit www.atypicaldiabetesnetwork.org.
"We start enrollment for RADIANT now, and we'll be enrolling for the next four to five years, and then we'll see how we can continue -- and we certainly want to. We're grateful to be awarded the NIH funding, but the most exciting part is the results. The results make a difference in people's lives, and that's why we do this," says Dr. Krischer.
For more info:
- Rare and Atypical Diabetes Network
- NIH National Institute of Diabetes and Digestive and Kidney Diseases
- Jeffrey Krischer, PhD