Dr. Henry Rodriguez, an internationally recognized leader in the field of juvenile, or Type I, diabetes, did his homework before joining the USF Diabetes Center as medical director this summer.

He was impressed by the leadership of Dr. Jeffrey Krischer, director of the USF Diabetes Center and the Pediatric Epidemiology Center, who has attracted millions of dollars in National Institutes of Health research funding and made USF a data and technology coordinating hub for nearly every major center worldwide conducting Type I diabetes research.

He saw the potential to partner with the nearby Jaeb Center for Health Research, a Tampa-based, free-standing nonprofit coordinating center for multicenter trials and epidemiological research, including Type 1 diabetes.

And, he was attracted by the chance to work with Tampa Bay area hospitals, physicians and other providers to help fill a growing need for children with diabetes and their families to participate in leading clinical trials and raise the standard of care for diabetes and related complications.

“The opportunity to help build a comprehensive program at the USF Diabetes Center was too good to pass up,” said Dr Rodriguez, a pediatric endocrinologist who came to USF this August from Indiana University and Riley Hospital for Children in Indianapolis, IN, where for 11 years he directed a clinical center known for expertise in diabetes and immunology.

“Overwhelming” is how Dr. Rodriguez describes the enthusiastic reception from the diabetes community to USF’s initiatives in search of a cure for Type 1 diabetes. “I’m excited about sharing our passion and expertise with like-minded diabetes care providers locally, statewide and nationally to accelerate the development of new therapies and improve the lives of people with diabetes,” he said.

A Stellar Background in Diabetes

Dr. Rodriguez comes to USF with a stellar background in diabetes research, care and education. At Indiana University he was local lead investigator on one national and two international multi-center trials investigating the causes of type 1 diabetes. Working with the Department of Transplant Surgery, he conducted a pilot trial to determine if the autoimmune destruction of pancreatic islet cells of Type 1 diabetes could be halted using a monoclonal immunosuppressant, Daclizumab.

Dr. Rodriguez has served the American Diabetes Association (ADA) and the Juvenile Diabetes Research Foundation (JDRF) at both the local and national levels. He was a longstanding member of the Indiana ADA Summer Camp medical staff committee, former chair of the national Pediatric Diabetes Interest Group, and is a member of the ADA Research Grant Review Committee. He served as the JDRF Indiana State Chapter Board president and is currently a member of JDRF’s national Outreach and Medical Affairs Committees. Dr. Rodriguez was a member of the 2006 international consensus committee for pump therapy in children, and visited China in 2007 as a member of the Project HOPE China Pediatric Diabetes Assessment Team.

“Dr. Rodriguez is definitely a leader in the field of Type 1 diabetes research. The University of South Florida is lucky to have him,” said George Huntley, immediate past board chair, American Diabetes Association. “He’s more than a doctor and scientist; he’s an outstanding citizen who gets involved in volunteering his time and reaching out to the diabetes community.”

In Indiana, Dr. Rodriguez was a terrific champion and medical volunteer for the ADA’s summer camp that served nearly 200 children with diabetes, Huntley said. “He’s able, in an open and engaging way, to explain a very complex disease like Type I diabetes in language that kids and parents can understand — and make it seem a little less scary…. He’s great with kids; the bow tie helps.”

Dr. Rodriguez received his MD degree from Albany Medical College in New York in 1987. He completed his residency in pediatrics at the University of Miami and Jackson Memorial Hospital in Miami, followed by fellowship training in endocrinology at the University of California San Francisco. He was a faculty member at UCSF before joining Indiana University, where most recently he was associate professor of pediatrics in Pediatric Endocrinology/Diabetology and director of the Pediatric Diabetes Clinical Program at the James Whitcomb Riley Hospital for Children.

Building a Better Diabetes Center

Type 1 diabetes is one of the most common and serious chronic diseases in children and teens, although it can strike at any age. In Type 1 diabetes, the body does not produce insulin. The disease develops when the body’s immune system mistakenly attacks the beta cells in the pancreas that make insulin – a hormone that keeps blood sugar levels stable. Without enough insulin, glucose builds up in the blood and leads to long-term complications like vision loss, nerve damage, cardiovascular disease and kidney damage. People with Type 1 must test their blood several times a day to check their glucose (blood sugar) levels. Treatment requires a life-long commitment to daily insulin injections and significant lifestyle changes.

The disease is best managed, Dr. Rodriguez said, when long-term relationships are forged between families and the team of practitioners who equip those families with the skills to cope with the daily challenges of regulating the child’s blood sugar while maintaining quality of life.

Under Dr. Rodriquez’s leadership, the USF Diabetes Center continues to strengthen the foundation laid by Dr. John Malone and Dr. Anthony Morrison and the research of Dr. Krischer. The center’s multidisciplinary team has expanded to ramp up its clinical care and diabetes education programs and advance clinical and translational research.

Over the last year the team has grown from five to 12 members, adding pediatric and adult endocrinologists, nurse practitioners and other health professionals. Brant Burkhardt, PhD, a senior researcher at Children’s Hospital of Philadelphia Research Institute, will join the team this January to conduct diabetes-related immunology research, and USF is recruiting a physician-researcher specializing in adult endocrinology, a research nurse coordinator, and additional staff that will bring the number of Diabetes Center personnel to 18 in 2011.

The build out of 10,000 square feet of space on the Morsani Center for Advanced Healthcare’s fifth floor will begin this month to accommodate the expanding USF Diabetes Center. The new space will house several exam rooms, including two that include provisions for drug infusion therapy; encounter rooms where the center’s clinical psychologist and other staff can meet with patients and family members; a teaching kitchen where the center’s dietitian and invited chefs can demonstrate how to prepare healthy meals; a dedicated phlebotomy room and laboratory for preparing patient samples, a multimedia center with kiosks and computers; and a playroom. The new center is scheduled for completion in April.

Research in Pursuit of a Cure

The USF Diabetes Center is an affiliate site for the Type 1 Diabetes TrialNet Study Group, which is looking for ways to prevent, delay and reverse the progression of Type 1diabetes. With Dr. Rodriguez’s arrival, USF plans to compete for a spot as a full-fledged clinical research center to recruit and enroll patients in TrialNet, a network jointly funded by NIH, the American Diabetes Association and the Juvenile Diabetes Research Foundation. TrialNet is one of many national and international Type 1 diabetes clinical trials coordinated by the USF Pediatric Epidemiology Center.

The USF Diabetes Center recently became the first study site in the greater Tampa Bay area to join the T1D Exchange, a new national multicenter trial administered by the Jaeb Center for Health Research. The Exchange aims to promote a better understanding of Type I diabetes and accelerate new treatments through collaborative research and data sharing. USF is one of more than 60 sites nationwide that will contribute to a repository for patient data, a biobank, and an interactive Web site with mobile capacity for researchers, clinicians and patients.

Dr. Rodriguez’s research focuses on trying to better understand the autoimmune response that destroys the pancreatic cells that make insulin. He and other researchers want to find and develop therapies that might prevent the disease in those at high risk or halt the attack in those who recently developed symptoms of the disease. The goal is to preserve patients’ ability to make some insulin and reduce their susceptibility to long-term damage.

The autoimmune process doesn’t happen overnight, but over several years. Most children newly diagnosed with Type 1 diabetes still have some functioning insulin-producing cells “If we can intervene with effective treatment earlier in the disease process,” Dr. Rodriguez said, “we might be able to stop further destruction of beta cells before the disease progresses to the point where they become ill – perhaps even before the child needs insulin at all.”

While only 5 to 10 percent of all diabetes diagnosed is Type 1, Dr. Rodriguez said, “finding a cure for Type 1 would have a tremendous impact on Type 2.”

In Type 2 diabetes, a disease frequently linked with obesity, the individual is not able to produce enough insulin to compensate for the body’s resistance to insulin’s normal effects. However, many people diagnosed with Type 2 eventually develop beta cell failure and cannot produce insulin. So, Dr. Rodriguez said, research benefitting those with Type 1 will certainly also help people with the more common form of diabetes.

Arresting a Diabetes Epidemic

The Centers for Disease Control and Prevention estimates that by 2050 as many as one in three adults could have diabetes. While the projection is based mostly on increases in Type 2 diabetes, children currently diagnosed with Type 1 diabetes who will be adults by that time are no doubt part of the picture.

“Type 1 diabetes is increasing for reasons we don’t entirely understand,” Dr. Rodriguez said, “and, of most concern, is its rise in younger age groups – particularly children younger than age 5.”

While everyone with Type 1 diabetes is born with a genetic predisposition for the disease, genes alone are not enough. Even when one twin gets Type 1 diabetes, his or her identical twin (born with the same set of genes) develops the disease only half the time.

Researchers continue to investigate the interplay between genetics and the environment that may determine who gets the disease and who doesn’t. Multicenter epidemiological, or population-based, studies like those overseen by Dr. Krischer’s USF team will be critical in determining whether certain childhood infections, diet or other environmental factors are linked to increased risk of autoimmunity and Type 1 diabetes.

“We may find environmental exposures that trigger the autoimmune process in one individual may be different than what triggers the disease in another, depending on how the person is (genetically) hardwired,” Dr. Rodriguez said.

Among the advances in Type 1 diabetes research and care Dr. Rodriguez foresees over the next five to 10 years are:

• New technologies will offer patients greater convenience and safety, less pain and more accurate information to manage their diabetes. One promising line of investigation is “smart” insulin, a chemically-modified insulin shown in preclinical studies to sense and adapt to fluctuating blood sugar levels and deliver insulin to the body as needed.

• Drugs currently used to treat lymphoma, rheumatoid arthritis, multiple sclerosis and other immune-mediated disorders may offer the potential to preserve insulin production in people newly diagnosed with Type 1 diabetes.

• Development of cocktails of molecules that stimulate beta cells to regrow could help researchers unravel regulatory pathways and make new insulin-producing cells available to those with diabetes.

• Investigation and refinement of ways to replace non-functioning beta cells through transplantation or cell therapies will continue. Progress in genetic engineering may one day lead to animal islets (a more readily accessible supply of insulin-producing cells) that will not be recognized as foreign by the immune system, and therefore transplanted without the risk of rejection and a lifelong regimen of immunosuppressant drugs.

Dr. Rodriguez is optimistic that new discoveries will lead to better treatments than daily insulin therapy – and eventually a cure.

“I do believe that the children born today who develop Type 1 diabetes will see a cure within their lifetime,” he said.

Story by Anne DeLotto Baier, and photos by Eric Younghans, USF Health Communications