ADA FUNDS VITAL SDI NEUROPATHY RESEARCH

Over 90% of people with diabetes develop neuropathy, a life-spoiling and potentially life threatening condition that can affect every system in the body. The Strelitz Diabetes Institutes' research on neuropathy investigating the underlying causes of the condition and peoples' pre-disposition to developing it has been energized by two substantial grants from the American Diabetes Association.

The first grant, received late last year, provides $270,000 to investigate the metabolic causes of neuropathy. It has long been thought that good blood sugar control could diminish the possibility of developing neuropathy. However, studies indicate that despite good control, 30% - 40% of people with diabetes develop nerve damage.

Strelitz Diabetes Institutes' researchers believe that oxidative stress, the reduced blood flow and oxygen delivery to the nerves, is an important predictor of neuropathy development. Researchers believe that oxidative stress happens first, even before people develop diabetes.

Dr. Aaron I. Vinik explains, "That's why people who don't have diabetes will develop neuropathy. We are hoping to develop a marker for people who will develop neuropathy and diabetes. Physicians may someday be able to recognize people pre-disposed to developing the condition."

The second grant builds on the metabolic study of neuropathy by providing funds to research the mechanism for the reduced blood flow in the fingers and toes of people with Type 2 diabetes. Providing $400,000 over four years, this grant is a contribution from the Thomas R. Lee Estate for research in the Hampton Roads area. Mr. Lee, a Norfolk businessman, died in February of 1998.

In their search to find ways to treat, or even reverse neuropathy, Dr. Vinik says, "We believe that microvascular blood flow is the 'life blood' of the nerves and other tissues. There is an abnormality in the microvascular blood flow of people with Type 2 diabetes that is a significant factor in the damage of the nerves in the eyes, kidneys and other tissues that cause devastating complications and is a significant factor in many of the 65,000 amputations each year."

Dr. Vinik's team will investigate the microvascular mechanism of blood flow by measuring production of nitric oxide in the tissues that open small blood vessels. They hypothesize that there is a defect in the mechanism of nitric oxide production that causes blood flow to diminish and nerve damage to occur.

Dr. Vinik anticipates that these studies of the relationship between nitric oxide production and the regulation of the blood vessels will lead to new therapies for neuropathy.

A third grant has just been received from the ADA for the Strelitz Diabetes Institutes' proven track record of training people for leadership in clinical care, teaching and administration. The ADA has granted a national mentorship award providing $35,000 per year for four years to allow a selected physician for specialty training in neuropathy at the Institutes. The SDI currently has two foreign fellows, from Turkey and Korea, working in neuropathy and has over the years trained many scientists and clinicians who have become medical leaders throughout the world.