Skeletal Muscle Health and Blood Sugar Control In Type 1 Diabetes
Pinar Gumus Balikcioglu, M.D.
Duke University Medical Center
Type 1 diabetes (T1D) causes breakdown of skeletal muscle and impairs muscle function. Given the critical importance of skeletal muscle in glucose metabolism and insulin action, the loss of skeletal muscle leads to high blood glucose, high lipid levels, and insulin resistance. These in turn promote development and progression of long-term complications such as blindness, kidney failure, and cardiovascular disease. Thus, keeping skeletal muscle healthy is essential for management of T1D and preventing future complications. However, assessing muscle health in children is difficult and often impractical. Current methods, such as muscle biopsy, are invasive and risky. To that end we need new reliable and non-invasive methods/markers that associate with, or predict, muscle health in children with T1D.
My colleagues and I will measure muscle mass and function in children with Type 1 diabetes using a novel, noninvasive D3-creatine dilution method. We will correlate the measures of muscle mass and function with variations in blood sugar as assessed using continuous glucose monitors and with the levels of blood metabolites of fat, protein, and carbohydrate. This will allow us to identify novel biomarkers that associate with muscle wasting and poor glycemic control in children with type 1 diabetes.
This project has the potential to: 1) characterize a novel, noninvasive technique for measurement of muscle health in children with T1D; 2) identify novel biomarkers of skeletal muscle health in T1D; and 3) identify targets for T1D treatment focused on improving skeletal muscle health. These will address our goals of delaying/preventing the development of future diabetic complications and premature death.