Type 2 diabetes is a condition marked by a continuous decline in the function of pancreatic beta-cells. These beta-cells are where insulin is made and subsequently released into the body to control our blood glucose levels. If beta-cells are damaged and not working optimally, insulin delivery from the pancreas to its target organs can no longer occur, leading to high blood glucose levels.

What if it was possible to stop type 2 diabetes in its tracks? To slow down or even prevent its progression if caught in its early stages? Dr. Ravi Retnakaran is working to do just that. His research investigates ways to reverse beta-cell dysfunction and cause early remission of type 2 diabetes.

Dr. Retnakaran is a professor in the Division of Endocrinology and Metabolism at the University of Toronto, and a clinician-scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital. In between caring for patients as an endocrinologist, Dr. Retnakaran leads innovative clinical studies to test new therapies and treatment strategies to preserve beta-cell dysfunction in the early stages of type 2 diabetes. Two of his most recognized recent studies are (1) the RESET IT trial and (2) the PREVAIL trial, and both are showing some promising results.

In his RESET IT study, Dr. Retnakaran discovered that providing temporary and short-term (2-4 weeks) intensive insulin treatment to people with early type 2 diabetes restored their body's capacity to make and use insulin. Not only that, it successfully sent them into remission that lasted for up to a year, where they lived symptom-free. Dr. Retnakaran emphasizes the importance of introducing this insulin treatment early (within a few years of the initial type 2 diabetes diagnosis) for optimal results.

The PREVAIL study, a follow-up to the RESET IT trial, is currently underway to examine the impact of combining this insulin therapy with a new medication called Exenatide. Exenatide mimics the actions of a gut hormone known to trigger insulin release from the pancreas and can help keep diabetes under control. Study completion is estimated for December 2021, with initial data showing that this combination may lead to better control of glucose levels.

Dr. Retnakaran’s interests also extend to other important topics. He is working on uncovering why women with gestational (i.e., temporary pregnancy-related) diabetes are at a higher risk of developing heart disease or type 2 diabetes later in life and which factors put them at this higher risk. He is collaborating with researchers in Toronto and China on a population-based study with the hopes of finding ways to understand and minimize these risk factors.

Dr. Retnakaran's hard work and devotion to improving the quality of life for those living with type 2 diabetes has earned him the Dr. Charles Hollenberg Young Investigator Award by the Canadian Society of Endocrinology and Metabolism and the Joe Doupe Award from the Canadian Society of Clinical Investigation. With the prevalence of type 2 diabetes increasing, Dr. Retnakaran’s clinical breakthroughs could help change the landscape of current diabetes treatment forever.

— Written by Ayaat Hassan