At City of Hope, our mission is always to ensure that advances in basic science research are rapidly translated to clinical settings so patients benefit from novel therapies. The Department of Diabetes, Endocrinology & Metabolism is conducting a number of important clinical research programs, including those described below:
City of Hope physicians are using state-of-the-art technologies (such as the glucose sensor, a subcutaneous device that provides continuous readings of blood glucose over three days) to study the blood glucose profiles of patients. Information gained from these studies can be used to develop proper drug treatment regimens and improve diabetes control.
City of Hope physicians are conducting a research study to better understand type 1 diabetes and its onset in the relatives of patients with the disease. Recent studies have shown that type 1 diabetes may be caused by the destruction of islet cells in the pancreas as a result of an allergic-type reaction in which the immune system “attacks” islet cells through an islet cell antibody. Other studies also show that the tendency to have type 1 diabetes is inherited.
Impaired glucose tolerance occurs when blood glucose levels are higher than normal, but not high enough to be judged diabetic. People with impaired glucose tolerance are usually at high risk for developing diabetes and cardiovascular disease. Nateglinide is a medication currently Food and Drug Administration (FDA)-approved for the treatment of diabetes, while valsartan is currently FDA-approved in the treatment of high blood pressure. City of Hope physicians are intrigued as to whether these drugs could be used prophylactically, and thus have developed a study to evaluate the safety and efficacy of long-term administration of the combination of nateglinide and valsartan in the prevention of diabetes and cardiovascular disease in patients exhibiting impaired glucose tolerance.
Pheochromocytomas are rare tumors of the adrenal gland that produce large amounts of catecholamines (adrenaline and related chemicals). Preferably the tumor is removed with surgery, however, this may not be successful if the tumor has spread from the adrenal gland. In these cases, patients are treated with chemotherapy or exposure to a radioactive chemical. City of Hope physicians are evaluating the effectiveness of using a radioactive metaiodobenzylguanidine (MIBG) to treat patients with malignant pheochromocytoma, which may reduce the patient’s need for antihypertensive medication and reduce the size of their tumors.
Use of Thyrogen to detect and treat thyroid cancer
Thyroid cancer is usually managed with surgery or radioactive treatment with iodine-131. Often after surgery, patients are given thyroid hormone treatment replacement medication and take radioactive iodine scanning tests to detect the return of the disease. Currently, patients must stop taking thyroid hormone treatment replacement medication before the radioactive iodine scans are performed, but this often causes physical and emotional discomfort. City of Hope physicians are providing patients with a drug called Thyrogen (thyrotropin) to those who require radioactive iodine scanning, without having to stop their thyroid hormone treatment replacement medication.
Thyrogen is approved by the FDA as part of the actual treatment of thyroid cancer. After surgical removal of the thyroid (thyroidectomy), standard treatment consists of administering radioiodine to ablate, or destroy, remnants of thyroid tissue. Thyrogen is then administered in combination with radioiodine to improve ablation of residual thyroid tissue, thus providing an important tool in preventing disease recurrence.
Clinical Research Programs
City of Hope physicians are participating in several national trials for use of new pharmacological agents in treatment of diabetic peripheral neuropathy, a common and distressing long-term diabetes complication.