NICHD has a large and active research portfolio on diabetes, its associated conditions, and its treatments. NICHD supports and conducts research on many aspects of diabetes and gestational diabetes, as well as on the mechanisms of insulin, obesity’s role in diabetes and chronic disease, diabetes management in children, and other topics.
The institute also works closely with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Institute that leads NIH research on diabetes, and with other agencies and organizations to further researchers’ understanding of the mechanisms and possible controls for diabetes, as well as its long-term effects on health.
The NICHD studies diabetes, including gestational diabetes, within the context of preventing and managing chronic disease and its long-term health effects, and of understanding the developmental origins of health and disease.
Some of the Institute’s diabetes research addresses these important goals:
- Type 1 Diabetes Mellitus (T1DM):
- Investigating treatments that can prevent or slow the onset of T1DM in those at high risk for the condition, including infants at high genetic risk
- Testing non-invasive ways to monitor children with T1DM for episodes of hypoglycemia
- Investigating a combination insulin-delivery and glucose-sensing system that can mimic normal pancreatic beta-cell function
- Understanding the genetic risk factors that lead to T1DM and detecting the earliest gene-expression changes in those genetically at high risk for the condition
- Identifying determinants of health outcomes and testing the efficacy of behavioral intervention for youth with T1DM and their families
- Type 2 Diabetes Mellitus (T2DM):
- Defining and reversing metabolic risk factors early in development that contribute to T2DM
- Identifying the genetic risk factors for T2DM and exploring treatments to prevent or stop its onset in those who are at high genetic risk
- Exploring the relationship between normal development, factors in the environment, and T2DM
- Understanding disparities in the prevalence and course of T2DM, its precursors, and its associated outcomes
- Gestational Diabetes Mellitus (GDM):
- Understanding the mechanisms of GDM
- Defining treatments and management parameters that improve health outcomes for mother and baby
- Identifying biomarkers that might indicate GDM and complications such as preeclampsia
- Examining the health effects on the baby both in the short- and long-term
- Investigating ways to improve and manage delivery of macrosomic infants
Institute Activities and Advances
The NICHD research portfolio includes sizable efforts on diabetes within the context of preventing chronic disease and of understanding the early origins of health and disease. Projects on diabetes, its risk factors, and its associated conditions and outcomes are spread across multiple organizational units and include several large international clinical studies. Some of this research is described below.
The Pediatric Growth and Nutrition Branch (PGNB) supports research on multiple aspects of type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). Research priorities include developing methods for detecting potential diabetics in childhood and for developing successful techniques of immunomodulation to prevent or mitigate the body's immune attack on the pancreatic beta cell. Branch research has also pioneered immunogenetic methods that stratify levels of risk for T1DM. In addition to projects led by individual investigators, the PGNB also supports several large, long-term clinical studies and networks in the United States and abroad. Visit the Other Activities and Advances section for details on these projects.
Besides the PGNB, other NICHD extramural and intramural research units support and conduct research on diabetes. One of these is the extramural Population Dynamics Branch (PDB), which supports research and research training in demography, reproductive health, and population health.
The Institute’s Pregnancy and Perinatology Branch (PPB) seeks to promote healthy pregnancy, labor, delivery, and infancy by supporting research on multiple topics within each of these critical development periods. PPB research addresses high-risk pregnancies that result from a variety of conditions, including gestational diabetes, as well as studies of safe delivery and neonatal health outcomes. Like the PGNB, the PPB also supports large-scale research studies and networks in addition to projects led by individual investigators.
Researchers in the Division of Intramural Population Health Research are leading multiple studies of diabetes management in adolescents. One of these studies is exploring the effectiveness of a family-focused management plan on diabetes outcomes. Another examines the effect of a program to promote healthful eating. Visit the Division’s Social and Behavioral Sciences Branch to learn more about these studies. In addition, the Division’s Epidemiology Branch is examining Gestational Diabetes Mellitus (GDM) - Epidemiology, Etiology, and Health Consequences to address critical data gaps and to improve detection and management of the condition.
Other Activities and Advances
The PGNB supports multiple ongoing research trials and networks that focus on understanding diabetes. Some of these projects include:
- DirecNet , the world’s first research network devoted to studying children with T1DM
- The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, examining the health effects of gestational diabetes in women and their offspring (Find Hyperglycemia and Adverse Pregnancy Outcomes Study PubMed Articles). With the NIDDK, the PGNB launched the HAPO Follow-up Study (HAPO-FUS) in 2013, which will measure the height, weight, blood pressure, body fat, blood sugar, insulin, and blood fats of 7,000 of the original HAPO mothers and their children, who are now 8 to 12 years old, to determine whether there is a long-term effect of the hyperglycemia during pregnancy.
- Trial to Reduce the Incidence of TIDM in the Genetically at Risk (TRIGR), the first large trials designed to ascertain if a simple nutritional intervention during infancy can delay or prevent the onset of Type 1 diabetes in children at high genetic risk of this condition. Results from a small pilot study of 230 genetically at-risk infants were highly encouraging. This research showed a 50% reduction in appearance of autoantibodies directed against the β cells of the pancreas in the group assigned to protein hydrolysate formula. These autoantibodies are used as markers of diabetes risk and appear to be involved in the attack on the β cells. (PMID: 21067382)
- TrialNet , a network of 14 diabetes centers dedicated to utilizing a four-prong paradigm to test the ability of biological agents to prevent type 1 diabetes in at-risk children, or to slow the course of the disease in newly diagnosed children
The PPB supports efforts to understand gestational diabetes, its symptoms, and its outcomes through the Maternal-Fetal Medicine Units (MFMU) Network. The MFMU Network studies various types of high-risk pregnancies and pregnancy outcomes, including gestational diabetes, preterm labor and birth, and preeclampsia.
The NICHD is also a sponsor of the Consensus Development Conference on Diagnosing GDM, which aims to better understand the benefits and risks of various GDM screening and diagnostic approaches by assessing the available scientific evidence. In 2013, the panel concluded that there is insufficient evidence that adopting a new diagnostic approach for GDM would provide more benefit than harm.