Rutgers to conduct largest and most comprehensive study on type 1 diabetes

Oksana Yakoff, a diabetes educator, working with a patient at the Diabetes Center at Holy Name Medical Center. (Holy Name Medical Center)

Backed by a grant approaching $700,000 from JDRF, Rutgers University recently said it will conduct the largest and most comprehensive study of children at high risk of developing a life-threatening complication of type 1 diabetes.

T1D is a chronic, life-threatening autoimmune disease that can strike children and adults at any age. It requires rigorous 24/7 monitoring of blood glucose levels — even overnight — to avoid potentially lethal highs and lows in blood sugar, as well as other devastating complications like kidney, eye and nerve diseases.

JDRF, the leading global type 1 diabetes research and advocacy nonprofit, said that, together with Rutgers Center for Pharmacoepidemiology and Treatment Science, it aims to develop a tool to help clinicians identify children who are at high risk of developing diabetic ketoacidosis, which occurs when the body produces high levels of blood acid called ketones because it can’t produce enough insulin.

“Every year, nearly 27,000 children and younger adults get newly diagnosed with T1D in the U.S., out of which 30-40% of them will present in DKA — a life-threatening, but an entirely avoidable complication of type 1 diabetes,” Chintan Dave, an assistant professor with PETS and the principal investigator of the grant-backed project, stated. “If we can more accurately identify the risk factors associated with DKA at diagnosis of type 1 diabetes, we can provide timely interventions to reduce the proportion of children who present in DKA.”

The study, which begins this August and will last three years, will estimate health outcomes in children who presented in DKA at diagnosis of type 1 diabetes, identify clinical and nonclinical risk factors associated with children who experience DKA and classify patients into risk categories for DKA to identify populations who may benefit from type 1 diabetes screenings.

While its causes are not yet entirely understood, scientists believe both genetic factors and environmental triggers are involved. Its onset is sudden and is not related to diet or lifestyle. In T1D, the body’s immune system destroys cells in the pancreas that produce insulin, meaning the body produces little to no insulin to regulate blood sugar and get energy from food. There is nothing you can do to prevent T1D, and — at present — nothing you can do to get rid of it.

This complication is the leading cause of hospitalizations, morbidity and mortality among children and younger adults with type 1 diabetes in the U.S. and throughout the world.

Dave and his colleagues are using real-world clinical data from three databases to create one of the largest type 1 diabetes cohorts of its kind to better understand the factors leading to DKA at diagnosis of type 1 diabetes.

“This project will be the largest and most comprehensive undertaking of its kind,” said Dave, who also is a core faculty member of the Rutgers Institute for Health, Health Care Policy and Aging Research and an assistant professor with the Rutgers Ernest Mario School of Pharmacy. “Findings from these studies will improve our understanding of both why and which children present with DKA at diagnosis of type 1 diabetes.”

Study coinvestigators include Brian Strom, the chancellor of Rutgers Biomedical and Health Sciences; Sally Radovick, a professor of pediatrics and senior associate dean for clinical and translational research at Robert Wood Johnson Medical School; and Jason Roy, a professor of biostatistics and chair of the Department of Biostatistics and Epidemiology at the Rutgers School of Public Health.