A research odyssey
By MARY L. GRADY
Mercer Island Reporter Editor
December 23, 2008 · Updated 1:44 PM
It could be said that the rising epidemic of diabetes could become as serious as the scourge of AIDS that began in the 1980s.
The disease imperils millions of people and most certainly will affect the United States economy in the coming decades.
Diabetes is a serious disease that affects the body’s ability to produce or respond properly to insulin, a hormone that enables blood glucose to enter the cells of the body and be used for energy. Over time, diabetes can lead to heart and blood vessel disease, blindness, kidney failure, and foot ulcers and amputations, among other complications.
The statistics that accompany any discussion about diabetes are staggering. Nearly 24 million children and adults are now living with this disease in the U.S. and another 57 million Americans considered pre-diabetic, seriously at risk for developing type 2 diabetes. One out of every five health care dollars is spent caring for someone with diagnosed diabetes.
Researchers, scientists and health professionals have been working to cure and treat the disease for years. But now, sources of funding threaten to slow the fight against the disease.
A leader in the fight against the disease is Islander physician, R. Paul Robertson M.D. This fall, Robertson was named President, Medicine & Science of the American Diabetes Association (ADA) the nation’s largest and leading voluntary health organization in the fight against diabetes. At the same time, Robertson, an endocrinologist, is the President and Scientific Director of the Pacific Northwest Diabetes Research Institute (PNDRI) in Seattle, and a Professor of Medicine and Pharmacology at the UW.
At PNDRI, Robertson is at the apex of research on the disease. The institute is focused on developing of innovative treatments such as transplantation of healthy pancreatic tissue down to the cellular level — moving from the imagined to the possible in the management of diabetes.
Islet cell and pancreas transplantation would help people with type 1 diabetes, who need insulin daily to live. Ongoing research is focused on determining why insulin producing cells fail in people who develop type 2 diabetes.
But such precise and important work is expensive.
The uncertainty of available financial resources to work toward a cure remains a barrier. Scientists from around the world find themselves competing for shrinking funds to support the research.
At the present time, 75 percent of the funding for PNDRI comes from National Institutes of Health (NIH). The residual comes from other non-profits, such as the Juvenile Diabetes Association. It is part of Robertson’s daily chore to find and secure funding for PNDRI, his lab and his scientists.
There is much to do.
Robertson says he has a big bandwidth. “I can multi-task well,” he smiles.
Despite his added duties with the ADA and the daily administration of the PNDRI, it is the work of the laboratory that is his focus and his joy.
“It is the middle of the action — I stay current,” he said without irony.
Indeed when Robertson steps into the lab on the sixth floor of the building on Broadway Avenue in Seattle, directly across the street from the front door of Swedish Medical Center, his step quickens. He is proud to introduce his team of young scientists from around the world, who are either M.D.s or Ph.Ds or a combination of both. All but one of his lab people are women. They laugh and chat easily, defying the intense nature of their work.
But he knows that the research cannot be an end in itself. The data and results must be shared and critiqued with other researchers and physicians throughout the world.
Robertson also edits the medical journal Diabetes and sets up world conferences and oversees the results of work published on the large “posters” at conferences that summarize the research results. Filled with dense font, charts and numbers, the posters are set up on easels, like products offered by a vendor, for researchers to review and discuss.
It is all part of what scientists at NIH term “Translational Research.”
To improve human health, scientific discoveries must be translated into practical applications. Such discoveries typically begin in the lab with basic research — in which scientists study disease at a molecular or cellular level — then progress to the clinical level, or the patient’s “bedside.”
The work conducted at PNDRI is “wonderful translational work,” Robertson said.
Robertson was born in 1939 in North
Dakota. His mother was a nurse and his father was a physician who made house calls in a Model T. After completing a medical residency and fellowship at the UW, the doctor and his wife Peggy lived on Mercer Island between 1968 and 1983. They left for several years when he took a position in the Midwest then returned in 1997. They have three grown children and five grandchildren.
Robertson makes time to sing with a local music group, Promusica. On the rare occasions that he has time for himself, he listens to classical music and thinks of ways he can be more creative in his work.
A sense of urgency comes with any disease spreading across the population. Diabetes is no exception. The Centers of Disease Control in Atlanta states that if the diabetes epidemic continues at it current pace, one out of three children born in 2000 will develop diabetes in their lifetime.
And there is frustration.
Along with the rapid advance of diabetes, Robertson said he is disturbed that patients being diagnosed are younger and younger. He is concerned about the misunderstandings about who develops it and how dangerous it is.
“What is distressing is that the public does not recognize the seriousness of Type 2 diabetes.
And it is not just obesity that causes diabetes,” he explained. Diabetes is caused by a gene or combination of genes. Some 17 separate genes are involved in the onset of type 2 diabetes.
Just one in five people with the disease are obese, he notes. Obesity remains however a major a factor in the onset of diabetes.
Robertson knows exactly what is needed to keep the hope alive for the treatment of diabetes.
“What we need most are private sources of revenue to take up the slack in diminishing support from NIH that all walks of scientists have experienced over the past eight years.
The single most important factor in our research is attracting young, new talent who are excited about discovery and enamored with preventing and curing diabetes,” he said.
“I am a discovery-oriented person,” he said. “That is where the hope is.”
The Benaroya Research Institute at Virginia Mason focuses on immune diseases in general, including type 1 diabetes. PNDRI focuses on all types of diabetes, including type 2 which constitutes 95 percent of all diabetes and especially affects underserved populations.
For more information on PNDRI, go to www.PNRI.org.Contact Mercer Island Reporter Editor Mary L. Grady at firstname.lastname@example.org or (206) 232-1215 ext. 1050.