Diabetes is a growing epidemic in Wisconsin. Its rise has been linked to limited access to healthy food and health care in some communities, lower levels of physical activity, and a rise in obesity, among other factors.
Approximately 573,000 adults in Wisconsin have diagnosed or undiagnosed diabetes, and it is the state’s eighth leading cause of death. The chronic disease can cause serious complications, including heart disease, stroke, blindness and death. Another concerning trend is a steady increase in the number of children diagnosed with type 2 diabetes — a disease that primarily affects adults.
Wisconsin’s problem is a national one: in 2021, the CDC estimated that more than 38 million people of all ages have diabetes and more than 8 million adults 18 years or older, who met the criteria for the disease, were not aware or did not report having it. In addition to shortening lives, diabetes more than doubles a person’s medical expenses, according to the American Diabetes Association.
Researchers at the University of Wisconsin School of Medicine and Public Health are working on new and improved treatments for diabetes and its complications, and they are also searching for what does not yet exist: a cure. The UW Comprehensive Diabetes Center connects experts in stem cell engineering, gene editing, cellular metabolism and other state-of-the-art fields with clinical and translational researchers involved in the effort to transform research discoveries into improved care for people living with diabetes.
Diabetes affects how the body uses glucose for energy. Type 1 diabetes occurs when the pancreas has no functioning beta cells to produce the sugar-regulating hormone insulin, which helps glucose enter cells. Dr. Jon Odorico, a professor in the Department of Surgery, is searching for ways to engineer human pluripotent stem cells that will produce insulin while managing to remain unrecognizable to the immune system once they’re transplanted. If Odorico and his research colleagues and collaborators are successful, this cell therapy could cure diabetes and eliminate the need for immunosuppressive drugs, which have serious and sometimes devastating complications. In collaboration with the Departments of Radiology and Medicine, Odorico enrolled participants in a successful, multinational clinical trial in 2024, which evaluated the effectiveness of stem cell-derived islets transplanted into the liver of immunosuppressed patients with type 1 diabetes. While this hypo-immune or immune-evasive strategy is still in preclinical development, preliminary results from the trial were positive.
David Harris, MD, an assistant professor of surgery and the director of the Wisconsin Surgical Laboratory in Metabolism (WiSLiM), studies the impact of metabolic interventions (such as bariatric surgery) on the body. His work spans a variety of human diseases, including obesity, diabetes, cancer and Alzheimer’s disease. One project investigates ways to maintain internal glucose regulation. Dr. Harris and his team are interested in a receptor in the human gut called TGR5. This receptor attracts chemicals in the body that help improve the body’s ability to remain sensitive to insulin, which helps regulate glucose levels. Working with fellow researchers in biochemistry and pharmacology, Harris aims to discover how the chemicals can be altered to improve insulin sensitivity and whether these alterations limit side effects to other systems in the body. Ultimately, his work could help identify a potential new target for the treatment of type 2 diabetes.
In Wisconsin, more than 70 percent of people are overweight and 30 percent are diabetic or prediabetic. Dudley Lamming, PhD, associate professor of medicine, is working with research partner Jacob Brunkard, PhD, assistant professor of genetics in the College of Agricultural and Life Sciences, to create corn and soybeans with reduced levels of two branched chain amino acids (BCAAs) — isoleucine and histidine — that have been shown to lead to higher body masses. Lamming’s research suggests that reducing these two amino acids in the diet could lead to a 5 to 10 percent weight loss and better glucose tolerance. While powdered medical diets exist that eliminate certain amino acids for people with metabolic syndromes — a group of conditions that can increase the risk of developing diabetes, heart disease and stroke — they often taste bitter, making it hard for people to stick with them. Lamming and Brunkard aim to create real food, only made with crops low in BCAAs.
Brown fat cells, also known as brown adipose tissue, burn calories to produce heat, helping the body maintain body temperature. Through this process, brown fat cells contribute to weight loss and reduce the risk of obesity. Brown fat gets its dark color from mitochondria rich in a molecule called heme. Andrea Galmozzi, PhD, who studies ways to create new and safer interventions to treat obesity and diabetes, investigates the role of heme as a central regulator in fat function. Scientists don’t fully understand how heme levels are regulated, but they do know that when brown fat cells can’t make heme properly, the body’s metabolism can go awry. Galmozzi’s team is working to establish the impact of heme biosynthesis on whole-body physiology and they intend to explore an intervention that would modulate the body’s own heme-making process to treat obesity and type 2 diabetes, which is linked to obesity.
A study led by Feyza Engin, PhD, a UW–Madison professor of biomolecular chemistry, found that deleting a stress response gene from insulin-producing pancreatic beta cells elicits a helpful response from the immune system in mice that are predisposed to type 1 diabetes, conferring protection from the disease. Removing the ATF6 gene from the beta cells causes them to enter premature senescence, a state that signals the immune system to clear detrimental and faulty cells that contribute to disease development. Even more exciting, according to Engin, is how closely the new study’s results in mice appear to be reflected in human cells. Individuals who are at high risk of developing type 1 diabetes can be identified through a blood test a month in advance of the beta cell death that characterizes the disease. The finding may point to a potential new treatment that could be administered very early in the development of diabetes.
Diabetes is the leading cause of blindness among Wisconsin working-age adults, but early diagnosis and treatment of diabetic retinopathy decrease the risk of vision loss by 95 percent. Dr. Yao Liu, an associate professor of ophthalmology, started a screening program at the Mile Bluff Medical Center in Mauston, Wisconsin, helping primary care clinics learn to use a retinal camera to take photos of patients’ eyes during routine diabetes checkups. The clinics then send the images to specialists at UW Health, who review and recommend follow-up care for patients who show signs of diabetic retinopathy. Screening rates, below the national average when the program started, have increased substantially to the top quartile nationally. Ultimately, Liu would like to see Wisconsin leading the nation with the highest screening rates for diabetic eye disease, and the lowest rates of diabetes-related blindness.
Help support diabetes research
Research at the University of Wisconsin–Madison drives innovation, saves lives, creates jobs, supports small businesses, and fuels the industries that keep America competitive and secure. It makes the U.S. — and Wisconsin — stronger. Federal funding for research is a high-return investment that’s worth fighting for. Learn more about the impact of UW–Madison’s federally funded research and how you can help.
