Clinical Behavioral and Outcomes ResearchClinical Behavioral and Outcomes Research

​Section Heads: Allison Goldfine M.D., Lori Laffel M.D., MPH

Other Members: Florence Brown M.D., Enrique Caballero M.D., John A. D'Elia M.D., Robert Gabbay M.D., Ph.D., Om P. Ganda M.D., Osama Hamdy M.D., M.B., B.C.H., Edward S. Horton M.D., William Hsu M.D., Elvira Isganaitis M.D., MPH, Michelle Katz M.D., MPH, Sarah Lessard M.Sc., Ph.D., Sanjeev Mehta M.D., MPH, Medha N. Munshi M.D., Gail Musen Ph.D., Marilyn Ritholz, Ph.D., Sylvia Rosas M.D., Katie Weinger Ed.D., Mark E. Williams M.D., John Zrebiec M.S.W.

The Section on Clinical, Behavioral and Outcomes Research aims to elucidate the underlying genetic and environmental determinants of types 1 and 2 diabetes and its complications, and develop new treatments to prevent or delay the development of diabetes its complications in high-risk individuals. The section has an active clinical research environment to train future investigators. The scope of ongoing investigations ranges from small physiologic projects to NIH-funded multi-center trials. There are over 300 unique, active IRB-approved human protocols at the Joslin, of which about 175 involve active patient participation. These studies include a wide range of investigations that can be described as observational (55%) or interventional (45%); single site (60%) or multicenter (40%); and involve participants who are adult (80%), pediatric (7.5%), or both (10%). Studies are led by more than 47 PIs (many of whom are in other Joslin sections). Investigators in the section collaborate extensively with members of basic research sections at the Joslin and with investigators in the surrounding Harvard-affiliated teaching hospitals and at other academic institutions.

Recent "highpoints":

  • Gaglia demonstrated the ability to generate noninvasive, 3D, high-resolution maps of pancreatic inflammation in autoimmune diabetes of patients with recent-onset T1D using magnetic nanoparticle enhanced magnetic resonance imaging.  Proc Natl Acad Sci U S A. 2015;112:2139-44.
  • Laffel and colleagues identified psychosocial distress in association with use of continuous glucose monitors (CGM) in youth with type 1 diabetes, leading to the identification of approaches to increase durability of CGM in this vulnerable population. Diabetes Technol Ther. 2012; 14:523-6; Diabetes Technol Ther. 2015; 17:373-8.
  • King and collaborators have evaluated factors protective against development of diabetic complications in a cohort of 1000 type 1 diabetic patients with chronic duration of disease of more than 50 years. Recent work shows PKCδ participates in wound healing and may lead to new therapeutic strategies. JCI 2016; 126:837-853
  • Goldfine and Shoelson tested the inflammatory hypothesis of diabetes running multi-center trials to target inflammation with salsalate, and demonstrating effects to lower glycemia in patients with type 2 diabetes. Ann Intern Med 2013; 159:1-12.
  • Doria and collaborators identified a novel susceptibility locus for coronary heart disease (CHD) specific to patients with diabetes supporting a role for glutamic acid metabolism in the etiology of CHD in diabetes which points to potential targets for developing new drugs that can prevent or treat CHD specifically among diabetic patients. JAMA.2013; 310:821-8.
  • Musen was among the first to demonstrate that patients with T2D have impaired connectivity in the default mode network of the brain which is implicated in Alzheimer's disease. The level of impairment was correlates with degree of insulin resistance and therefore may be modifiable. Diabetes 2012; 61:2375-2379.