Academic appointment: Adjunct professor, Department of Medicine, University of Minnesota
Joined the Institute: 1983
Education and training: MD, University of Chicago Pritzker School of Medicine; internship and residency, University of Chicago; endocrine fellowship, University of Chicago.
Overview/research interests:
• Systems for effective patient-centered team care
• Advanced technology for the treatment of type 1 diabetes (pumps, sensors, artificial pancreas)
• Standardizing the reporting of glucose data and shared decision-making using that data
• Studying the effectiveness of new drugs to treat type 2 diabetes and developing algorithms for type 2 diabetes care
Current research activities and funding:
National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for type 1 and type 2 diabetes:
• DCCT/EDIC (T1D) – 1983. Current Randomized Controlled Trial of Intensive vs. Standard Control and Follow Up Epidemiologic Trial, 30-plus-year study that established that glucose control prevents or reduces the complications in T1D and discovered the concept of metabolic memory (early glucose control influences future outcomes)
• ACCORD (T2D) – 2001-2014. Evaluating the cardiovascular safety of intensive glucose control in type 2 diabetes and setting new targets for glucose control in subpopulations of patients with type 2 diabetes
• GRADE (T2D) – 2014-current. Comparative effectiveness trial comparing four approved T2D medications added to metformin to see which is most effective, safe and tolerated.
• NIDDK – 2012-current. Small business grant to evaluate glucose monitor with automated insulin dosing suggestions based on evaluation of glucose patterns.
• Artificial pancreas study – 2015-current. Evaluation of Next-Generation of Hybrid Closed Loop (Artificial Pancreas) Technology in Type 1 Diabetes
Sustained contribution to evaluating advanced technology in type 1 diabetes:
• First large trial to show effectiveness of glucose sensor and insulin pump in combination
• First trial to show effectiveness of a low glucose suspend feature of an artificial pancreas
• First data on the safety and effectiveness of the first FDA-approved hybrid closed loop system (artificial pancreas)
• Development of the first standard report of glucose data and first publication of an expert panel suggested international standard for glucose reporting—the Ambulatory Glucose Profile. Development of the first website for understanding and interpreting standardized glucose data reports: www.AGPreport.org
Industry-sponsored trials to evaluate needed drugs and devices to improve diabetes care:
• New patch pump insulin delivery
• Use of continuous glucose monitors (CGMs) in patients using multiple daily injections of insulin
• Testing CGM to adjust insulin doses without needed to confirm with finger stick glucoses
• Testing if the HbA1C test is accurate in blacks vs. whites
• Testing new type 2 diabetes pills (SGLT2 inhibitors) and injectables (GLP1 agonists) in T1D and T2D
• Testing safety and effectiveness of new ultra long- and ultra short-acting insulin preparations
• Testing the cardiovascular safety of new diabetes medications