UNDERSTANDING DIABETES: School of Dental Medicine researcher receives grant to study diabetes

After 20 years in diabetes research, Dr. Shannon Wallet believes that the key to addressing Type 1 diabetes is to understand the immune system processes that lead to the disease.

Wallet, an associate professor in foundational sciences at the ECU School of Dental Medicine, will continue unraveling these mysteries, with a recent $357,382 grant from the National Institutes of Health.

“This area of research is important as it is becoming clear that Type 1 diabetes is not a singular disease, but rather a classification of diseases whose clinical outcomes are similar,” said Wallet. “Thus, the mechanisms which result in the signs and symptoms are extremely complicated and extraordinarily different.”

Millions of people around the world live with diabetes, and it’s extremely prevalent in North Carolina. The condition affects how the body uses blood sugar, or glucose, to fuel the cells. In Type 1 diabetes, the rarer form of the disease, the body fails to produce insulin—a hormone the body needs to get glucose from the bloodstream into the muscles, tissue and brain cells—because the immune system has destroyed the cells that make insulin. This results in the buildup of glucose in the bloodstream and is known as high blood sugar or hyperglycemia.

Wallet said the number of people directly and indirectly affected by the Type 1 diabetes epidemic is growing every day and although Type 1 diabetes itself may not be a deadly disease its secondary complications most definitely lead to increased pain and suffering.

Wallet also said scientists are still seeking answers to key questions about how the disease starts and progresses. For example, why don’t all people who are predisposed for the development of Type 1 diabetes actually develop the disease? Similarly, why does the disease progress more quickly in some individuals than in others?

“My thoughts are that these differences are due to differences in an individual’s response to environmental experiences,” she said. “My laboratory studies the communication of the immune system with the environment at the largest environmental interface within our body: the gastrointestinal tract.”

The specific focus of Wallet’s NIH grant is to identify pathways within the cells that line the gastrointestinal tract (epithelial cells) induced by the environment that promote and/or support the types of immune responses that are responsible for the destruction of the cells of the body that make insulin.

Wallet’s training in diabetes research started in graduate school under the direction of Dr. Roland Tisch at UNC-Chapel Hill. Wallet describes her mentor’s commitment to research and disease processes as “very contagious.”

During her 15-year independent research career, Wallet has focused on determining how and why the immune system sometimes attacks the body’s own tissues, resulting in the group of diseases referred to as autoimmune disorders.

“If we can understand the difference in the communication that occurs in the gastrointestinal tract of individuals with Type 1 diabetes and how it shapes the immune system, we can figure out the initiating events of this disease process and design better therapies and even preventive treatments to curb ongoing disease processes,” said Wallet.

Dr. David Paquette, interim associate dean for research at the School of Dental Medicine, calls Wallet’s research “innovative and cutting edge.”

“Dr. Wallet’s research on the role of gut immune responses on the pathogenesis of Type 1 diabetes has the potential to profoundly alter the way in which we prevent or manage this prevalent human disease,” he said.