The world wide pandemic of obesity and diabetes now affects adolescents and children as well as adults in developing as well as industrialized nations. These two conditions and their complications affect the structure and function of nearly all tissues in the body, resulting in morbidity, cognitive decline, accelerated aging, and premature death. Jesse Roth has actively worked in this field for fifty years at major centers in the USA. His work has been recognized with awards for highest scientific achievement from the Endocrine Society and from the American Diabetes Association (as well as other major organizations in the field). He is author of many hundreds of publications, which appear regularly in established professional journals; many have been cited because of their special impact in the field (see selected publications ).

How can we diagnose diabetes earlier – By the time a patient’s blood glucose level crosses the line to trigger the standard diagnosis of diabetes, cells all over the body (including those in the brain) have already sustained substantial damage. Some of this early damage is irreversible, even with excellent care subsequently. We have found that individual patients maintain blood glucose (and hemoglobin A1c, a surrogate for glucose) in a narrow range. We are testing the hypothesis that both of these markers break out of their tight range and start a slow but inexorable march upwards (a condition we label “dysglycemia” in the 3-5 years before diabetes is diagnosable). Likewise, basal levels of insulin (and C-peptide, a surrogate measure of insulin secretion) rise out of their own narrow ranges in the 5-10 years before diabetes is diagnosable (a condition we label “dysinsulinemia”). We suspect that diet and exercise, introduced early can slow or prevent the progression from dysinsulinemia and dysglycemia to bona fide diabetes.

The Microbiome – Starting at birth, each of us regularly hosts hundreds of trillions of microbes, roughly ten times more numerous than our own cells, referred to as the microbiome. While their existence has been known for almost five hundred years, it has been only in the last decade with new technology and insights that their importance is starting to emerge. Indeed, the NIH has singled it out as a major new focus of research. With the world wide pandemic of obesity, particular interest is being paid to the changes in the populations of microbes in the intestinal tract along with changes in microbial metabolism in obese and thin subjects and in association with changes in diets. We have recently discovered that E. coli, a representative bacterium resident in the intestine, when grown in isolation, releases a peptide that mimics melanocortin, a human hormone that plays a key role in inflammation, appetite regulation, and food intake. (Humans who lack melanocortin or one of the five types of melanocortin receptors are massively obese). These studies suggest that the microbes of the gut, in addition to contributing to the host’s metabolism and energy balance, may be providing hormone-like signals to the host’s cells. 

Lab members

Name: Sana Qureshi
Position: Research Assistant
Research: Microbiome, Melanocortin-like peptide in E. coli, cell surface receptors, IGF II
Email: squreshi@nshs.edu

Name: Ian Whitford
Position: Research Assistant
Research: Early diagnosis of diabetes, C-peptide history, IGF II, Melanocortin-like peptide in E. coli 
Email: Iwhitford@nshs.edu