Place of work: Unit Endocrinology and Diabetes, Department of Paediatrics, Oslo University Hospital Ullevål
Phone: +47 22118765 / +47 92233550
Current research focus
My research group – Childhood diabetes – has four main research areas. The first is the ethiology and prevention of type 1 diabetes and autoimmune diseases, especially focusing the role of viruses and the interaction with the immune system in pancreatic and thyroid tissue samples. The last years we have succeeded in detecting a low grade persistent enterovirus infection in the insulin producing pancreatic islets of patients with newly diagnosed type 1 diabetes, and also in the thyroid of patients with newly diagnosed Graves’Disease. This strongly indicates that viruses are important for the development of autoimmune diseases.
The DiViD study has got worldwide attention for its unique collection of pancreatic biopsies in live young adult patients at the onset of type 1 diabetes. We have signed material transfer and research collaboration contracts with 15 international, highly recognized laboratories, and we recently arranged group meetings in Miami in conjunction with the nPOD meeting (www.jdrf.org) to discuss the results and the next steps. Much focus has been on the role of enteroviruses, the insulitis and the role of innate immune system. The last year we have identified several viral “footprints” in the pancreatic islets. We also detected that 43% of the T-cells in the inflamed islets (insulitis) were “resident T-cells”, indicating a previous viral infection. So the evidences for a role of viruses in triggering and driving the process killing the beta-cells are steadily increasing. We were granted NOK 9 mill from the Health Region South East to start a Scandinavian multicentre, randomized trial (The DiVID Intervention Trial) to study the effect of antiviral treatment aiming to preserve endogenous insulin production at diagnosis, as measured by C-peptide. In addition to standard mixed meal tolerance tests, we will perform filterpaper blood tests for C-peptide monitoring at home.
The second research area of our group is diabetes late complications. We have long term clinical studies on microvascular complications and the influence of glycemic control and advanced glycation. Recently the risk of early atherosclerosis in childhood onset type 1 diabetes has been the focus in several of our studies, with measurement of vessel wall thickness (IVUS, IMT, MRI) and vessel elasticity, and biochemical markers, as well as clinical data and risk factors. Martin Heier is now a postdoc in San Francisco as part of the EU Scientia Fellow Program, studying HDL Cholesterol function. The 10 years follow up of the prospective study “Atherosclerosis in Childhood Diabetes” will start in 2017. This will also include eye examinations and assessment of retinal vessel calibre. The project aim to develop a new risk score for CVD in childhood onset type 1 diabetes.
In our large, nationwide clinical studies, now as part of the Childhood Diabetes Registry, we focus on important issues as intensified insulin treatment and pumps, diabetic nephropathy, diet, physical activity, quality of life and psychosocial problems and eating disturbances (together with Skrivarhaug’s Group).