Joslin Diabetes Center held the fifth reunion of the 50-Year Medalist Study in early June, celebrating those who have lived with diabetes for over 50 years. 2015 marked the tenth year since the origin of the 50-Year Medalist Study, which follows the Medalists’ daily habits and biological information to better understand the progression of type 1 diabetes.
“We’ve made huge strides,” said George King, M.D., Research Director of Joslin Diabetes Center. Dr. King credited the impressive advances to the support of the more than 1,000 patients who have participated in the study since its inception in 2005. The reunion invited the Medalists to come together, and researchers were excited to present their new findings following the last Medalist Study reunion two years ago.
Jennifer Sun, M.D., M.P.H, unveiled a newfound protein which is secreted from cells in the eye: RBP3. This protein is higher in those with little to no proliferative diabetic retinopathy. A lack of RBP3 has been shown to cause the loss of photoreceptor cells and other abnormalities in the retina. In lab studies when RBP3 was overexpressed in diabetic rats, there were many positive results, such as a reduction of retinal thinning, decreased electrical signals in the eye, and less parasite cell death. These results led researchers to believe that RBP3 could play a protective role in diabetic retinopathy. Hopefully in the future, RBP3 could be a new therapeutic target to protect patients from diabetic retinopathy.
Liane Tinsley, M.P.H, discussed another potential protective factor. Kidney and eye disease are typically present together in diabetes. The researchers noted a few rare cases within the Medalist group, however; four percent of the Medalists had only kidney disease with no sign of eye disease. Within those patients, they saw something else unexpected: despite their poor lipid profile, they were less likely to develop cardiovascular disease. They hypothesized that there could be a common protective factor in both cardiovascular and eye disease, and are moving forward with more experiments in hopes they discover it. Dr. King stressed that the medalists were crucial in this discovery, because the rarest of the rare were needed to identify this scarce phenomenon.
Stephanie D’Eon, M.S., A.T.C., spoke about physical activity and cholesterol, stating that there is limited research on exercise and diabetes because patients worry about inducing hypoglycemia. Despite this, research done on the medalists has shed some light on the gendered risks of cardiovascular disease. Findings showed that women with an HDL of greater than 60mg/dl are two times more protected against cardiovascular disease. On the other hand, physically active men are four times more protected against cardiovascular disease than those who are not physically active. D’Eon noted that physical activity does not necessarily mean strenuous exercise—simply getting up and moving around multiple times a day qualified. A twelve week exercise study for medalists has recently begun to see if increasing solely a patient’s physical activity can increase their protection against cardiovascular disease.
Hillary Keenan, Ph.D., revealed that medalists are at twelve times higher risk for bone fracture. Despite this, osteoporosis rates in Medalists are similar to rates among a non-diabetic population. Researchers are still looking to discover if a protective factor against osteoporosis differs with age.
Dr. Keenan also explained that the medalists have low rates of complications, and continue to produce insulin despite having diabetes for over 50 years. To understand more, researchers are looking at genetics on an individual level. They are sequencing genes to try to find protective factors for complications, as well as looking at the whole genome to try and find differences between Medalists who resist complications and those who do not to pinpoint genetic variations. The Medalist Study is a huge boon genetically, because multiple generations can be studied. In one extremely rare case, it was found that the precise genetic cause of a family’s diabetes was an insulin molecule stuck in the endoplasmic reticulum of a beta cell. This single gene mutation was passed down between generations. While such specific genetic causes are uncommon, researchers are hoping to uncover more variations to better understand the disease.
The true spirit of the event was made clear when Joslin President and CEO John Brooks III took the stage. “All of you have made this possible,” Brooks told the medalists. The 50-year Medalists’ dedication to the program over the last ten years has progressed diabetes research immensely. The discoveries made by the Medalist Study will aid future diabetics in preventing complications and living a healthier life.
Learn more about Joslin’s 50 Year Medalist program.
This article was first published on June 29, 2015