Happily, Harvard University appears to have jumped on the diabetes innovation bandwagon recently, with a crowdsourcing experiment called the Harvard Catalyst InnoCentive Ideation Challenge, in which Harvard president Dan Faust sent out a call to the great minds around this legendary university for creative answers to the question: "What do we not know to cure type 1 diabetes?"
However, as it turns out, the main focus was not on pursuing a cure per se, but rather submitting any new question or idea related to type 1 diabetes that was "aimed at advancing knowledge about and ultimately eradicating the disease." In other words, unlike the annual DiabetesMine Design Challenge, which calls specifically for designing new tools, the Harvard competition aimed to identify key issues and possible theories worthy of their research efforts.
"We wanted to ask the entire Harvard community—faculty, students, and administrators and staff of all levels and specialties—to share their 'out of the box' questions and proposals for this challenge, regardless of whether they had the expertise or resources to answer the question. We wanted the participants to apply their insights to a problem that may not have been in their academic or intellectual domain," said Lee Nadler, Harvard Catalyst Director and HMS Dean for Clinical and Translational Research, in a recent press release.
They received 190 submissions, from which a panel of judges selected 12 winners based on their feasibility and potential impact on patients. Each of the winners, announced in a ceremony held at Harvard Medical School on Sept. 28, received a cash prize of $2,500. Plus — and this is the real prize — their concepts will be inspected more thoroughly by the Harvard scientific community for further investigation and study.
Frankly, I was surprised by the mix of winning ideas, many of which I found surprisingly familiar. But this IS Harvard, after all. So we must assume that if anyone can make something real come of these ideas, it's these world-leading research minds.
Here are a few example winners (please let me know your thoughts):
James Mulvihill -
While you probably haven't heard of Dr. Mulvhill recently, he was a leader in the diabetes community in the mid-1990s as President of the Juvenile Diabetes Research Foundation. He also has a personal connection to diabetes: he as been the father of PWD for over 20 years. Dr. Mulvihill's proposal was for studying whether or not it's possible to develop a blood glucose sensor that works without actually having to break the skin.
"My motivation to respond to the challenge came from my knowledge of what an important advance it would be in the care of individuals of all ages with both type 1 and type 2 diabetes, if a reliable methodology to monitor blood glucose non-invasively could be developed," Mulvihill said. He wanted to push Harvard to focus on this challenge.
Ah, the non-invasive glucose-sensing dream! Certainly the idea that we need a non-invasive option is far from new. It has been tried in many forms already — through the skin, eyes, and sweat, etc. — to no avail. But if anyone can crack that nut, it should be the brains at Harvard, no?
Kevin Dolan -
One of the biggest complaints from PWDs on using CGM (continuous glucose monitoring) is the inconsistency in using blood sugar measurements to calibrate a device that reads interstitial fluid (which lags behind blood sugar in terms of readings). One of the few non-science geeks to submit a proposal, 43-year-old type 1 diabetic Kevin Dolan, assistant director of the Human Resources Department at the Harvard Medical School, wants researchers to find a way to build a new CGM device that tracks actual blood sugar, rather than interstitial fluid. By using examples of nurses placing catheters in patients for days to deliver medication, Kevin suggests that researchers focus on creating a new CGM that can do something similar.
"I don't know the first thing about biology compared to what a scientist or doctor might know in terms of coming up with a cure. But what could I contribute is from a patient care perspective, given that I've lived with disease for more than 27 years," Kevin shares.
Not all winners came with a face and a name. One winner focused his proposal on classifying diabetes in more way than just "type 1" and "type 2." This patient, with a self-described "uncommon form" of diabetes, suggests using a Diabetes Triangle that would use three criteria to classify diabetes in a more personalized way, which would help patients, and their doctors, better understand the patient's disease and the steps needed to manage it. These criteria are:
1. Ability to make insulin
2. Sensitivity to insulin
3. Comprehensive assessment of lifestyle/health, including dietary and exercise habits and a BMI benchmark
As someone frustrated with her own lack of a diabetes designation, I am interested to see how this one could turn out.
Dirk Moore -
Have you ever noticed how some families can have one child with diabetes and another child without, while there are other families in which multiple children have diabetes? Dirk Moore, a biostatician from the University of Medicine and Dentistry of New Jersey, wants to re-analyze genetic studies of diabetes to find out if we can better understand the environmental influence on the genetic predisposition toward diabetes. Dr. Moore based his proposal on a study that recruited a people with diabetes and their parents to map their genes. He theorizes that genomic imprinting, where what you inherit from your mother has a different effect than if you inherited from your father, could shed some slight on the genetic component of diabetes. Of course, there's the nationwide TrialNet study going on already. But Dr. Moore envisions something beyond the deep science of cell preservation.
"The data in this study may have information on diet and other environmental exposures that may interact with genes to affect a person's likelihood of developing type 1 diabetes," Dr. Moore explains. "In other words, it is possible that two people may have the same genetic variant pre-disposing them to type 1 diabetes, but that only one develops the disease, due entirely to differences in environment that they are raised in?"
Megan Blewett -
Currently a Harvard chemistry undergrad, Megan Blewett jumped into the competition with a different perspective. With so many of us dumping in chemicals into our body via our meds, Megan says, it would make sense to understand the chemistry of the disease itself. In her proposal, Megan posits the question: "What molecule or molecules in the islets are being targeted?" This would, of course, help scientists better understand what they're actually treating, both in the immediate future with drug manufacturing, and in the long-run with finding a cure.
"The chemistry of disease processes is arguably uncharted territory," Megan explains. "I think a major challenge for the future is understanding not only how to [influence] disease states with chemistry, but also better understanding the chemistry underlying disease. For instance, regarding type 1 diabetes, we know that lipids comprise a large fraction of the human pancreas. Some of these lipids regulate insulin secretion. One could ask: Are these lipids the elusive molecular targets of the autoimmune attack in type 1 diabetes? Questions like these are extremely important for the development of new type 1 diabetes therapeutics. The problem is that most of biology deals with matter on the scale of proteins; lipids might be hundreds of times smaller than proteins and generally fall into the chemical realm."
That's quite a mixed bag of open questions on type 1 diabetes to explore. Ironically, the one patient-winner here described this competition for himself as being like a "kid in a candy store," with so many Harvard doctors and scientists making themselves available to explore solutions.
I wonder: If you all could vote on what the experts should take on first, which of these winning ideas would stand out to you?
(And just in case you have your own idea for a new innovation, you may want to start thinking about the 2011 DiabetesMine Design Challenge :) )