The Juvenile Diabetes Research Foundation Center for the Study of Complications in Diabetes brings together some of the world's leading authorities to find new ways to understand and treat three of the most devastating complications of this disease: diabetic peripheral neuropathy (progressive nerve damage), diabetic autonomic neuropathy (progressive autonomic nerve damage), and diabetic nephropathy (progressive kidney damage).

• Diabetic peripheral neuropathy leads to loss of feeling in the feet and hands, and is the most common cause of nontraumatic amputations not due to accidents in the United States.
• Diabetic autonomic neuropathy can also affect the autonomic nervous system, which controls cardiovascular, digestive and other vital functions.
• Diabetic nephropathy is the number one cause of renal failure requiring dialysis in our country.

This Center is the first JDRF Center to focus exclusively on the complications of diabetes.

More than 50 percent of people with diabetes suffer from some form of neuropathy, and 10-21 percent of people with diabetes have nephropathy. While research indicates that the chronic high levels of blood sugar (glucose) cause these complications, investigators are still trying to understand exactly how glucose damages the nerves and kidneys.

The researchers at the JDRF Center for the Study of Complications in Diabetes have generated a new theory about how this damage occurs. Their studies indicate that high glucose produces a series of interrelated changes in the way the body metabolizes proteins and lipids in the nerves and kidneys. These changes in metabolism generate molecules called free oxygen radicals. Free oxygen radicals are toxic to cells and produce what is called "oxidative stress." Oxidative stress robs sick nerve and kidney cells of oxygen and protein molecules called growth factors, which enable cells to grow. The result is a kind of cell suicide known as apoptosis. Unchecked, oxidative stress and apoptosis lead to neuropathy and nephropathy.

The scientists at the JDRF Center for the Study of Complications in Diabetes are uncovering the complex mechanisms through which glucose causes oxidative stress in the nerves and kidneys, and discovering how oxidative stress leads to neuropathy and nephropathy. Investigators are also developing and testing different therapies to block glucose damage to cells and thereby prevent these devastating complications of diabetes.

Most of the research at the Center uses tissue cultures (nerve and kidney cells grown in a petri dish) and animal models of diabetes. One of the Center's research projects on neuropathy, will test therapies that prove successful in tissue culture and animal models and in people with diabetes.