Research Profile

This project will study differences in complication risk in women and men living with type 1 diabetes. There is evidence that relationships between risk factors such as blood glucose, cholesterol, and blood pressure, and risk of complications like heart, kidney, eye, and nerve disease are different in women and men, but those differences are not well understood. Women’s reproductive health factors such as menstrual periods, pregnancy, and menopause are likely to at least partially explain the differences. In order to advance understanding of how risk for complications change in women over different life stages and how their risk of complications compares to men, we will study more than 30 years of data contributed by a group of people living with type 1 diabetes.

Complications continue to have an enormous burden on people living with type 1 diabetes, in terms of quality of life, disability, and health care costs, despite improvements in insulin therapy that have led to overall reductions in complication rates. Additionally, the sex differences in risk for the complications of diabetes are not well understood. Our study aims to determine if there are certain life stages during which specific risk factors are particularly important to complication risk in women with type 1 diabetes. My hope is that the results will provide important information to improve timing of treatments to reduce diabetes complication risk across the lifespan.

In addition to having worked in type 1 diabetes research since 2005, I am also the parent of a child living with type 1 diabetes. Helping my daughter manage her diabetes and witnessing its impact on her daily life has naturally strengthened my commitment to the importance of diabetes research. In my work, I have extensively investigated relationships between blood sugar control and other clinical risk factors, genes, and complications, with the hope that we can better prevent and treat complications to improve quality of life for people living with type 1 diabetes. This ADA award will allow that prior work to be expanded to answer specific questions on why women and men have different risk and risk factors for complications, which will help to develop more targeted prevention and treatment strategies.

There has recently been a greater emphasis on engaging people living with diabetes as active participants in setting research priorities. That is a positive development that will ensure an increasing research focus on factors that affect the daily lives of people with diabetes. In addition, new precision medicine efforts, such as the American Diabetes Association Precision Medicine in Diabetes Initiative (PMDI), are providing a better understanding of how genetic, environmental, and lifestyle factors combine to affect risk for diabetes complications. That research will lead to more effective treatments that can be targeted to each individual patient’s unique risk, leading to fewer complications and improved quality of life for people with diabetes. Finally, the rapid development of new diabetes management technologies, such as automated insulin delivery and hybrid-closed loop systems, are changing not only how people manage their diabetes on a daily basis but are also likely improving prognosis in ways that we do not yet understand and will need to be the focus of future studies.