On November 14, 2013, Robert S. Sherwin, MD will be giving a lecture titled: “The Brain-Diabetes Connection: Claude Bernard Revisited” at the Diabetes Day Symposium from 3:00 – 4:00 p.m in Moore Auditorium. Dr. Sherwin is the C.N.H. Long Professor of Medicine, Director of the CTSA-funded Yale Center for Clinical Investigation, and Chief of the Section Endocrinology at Yale University School of Medicine.
Dr. Sherwin has served as President of the American Diabetes Association and as Chairman of the JDRF Medical Science Advisory Board and is internationally recognized for his research at the interface between diabetes and neuroscience, both in the laboratory and at the bedside. Dr. Sherwin’s research program has received continuous NIH support for more than 35 years, including two MERIT Awards, and for this work he has received the Banting Award for Lifetime Scientific Achievement in Diabetes from the American Diabetes Association.
Dr. Sherwin’s first research project had an enormous impact on diabetes. While serving as a research fellow at the National Institutes of Health (NIH) he helped develop and published the first paper employing the euglycemic hyperinsulinemic clamp, now the most widely accepted method for quantifying insulin sensitivity. Dr. Sherwin’s early studies at Yale on the metabolic actions of counterregulatory hormones also had a significant impact. His glucagon studies helped place the relative importance of insulin and glucagon in human diabetes in proper perspective, his demonstration that counterregulatory hormones interacted synergistically helped explain why stress provokes hyperglycemia, and his growth hormone (GH) studies established GH as an important mediator of hyperglycemia in type1 diabetes.
Dr. Sherwin’s most important direct contribution to patient care was his role in the development of insulin pump therapy and the Diabetes Control and Complications Trial (DCCT). Based on his work showing the beneficial effects of continuous basal insulin delivery, Dr. Sherwin realized that continuous subcutaneous insulin infusion (CSII) via a portable pump would provide a more effective insulin delivery method. His group uncovered such a pump, allowing them to rapidly translate the concept into the clinical arena. A series of studies followed, showing that most of the metabolic abnormalities of diabetes were reversed by CSII, initiating the intensive insulin therapy era. This prompted Dr. Sherwin and Dr. Harry Keen from the UK to organize and co-direct the Kroc multicenter trial that established the feasibility of conducting a long-term study on the role of glucose in diabetic complications. The DCCT was, to a large extent, based on the Kroc study protocol. Noting that many insulin pump treated patients reported loss of hypoglycemic symptoms, Dr. Sherwin determined that this was due to suppression of counter-regulatory responses to hypoglycemia, a hypothesis his laboratory subsequently confirmed. He recognized that reversal of this defect required a better understanding of where and how the brain sensed glucose, an area of importance not only for hypoglycemia but also for the regulation of feeding.