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Investigator: Rachael Allen
Phone: (404) 321-6111 ext. 7570
Primary Research Interest: Other
Description of Research: Diabetic retinopathy (DR) is clinically characterized by macular edema, retinal ischemia, and abnormal neovascularization. Previous research by our group has identified retinal function deficits that precede this vascular damage in both a rodent model of Type I diabetes and in human diabetic patients. Early DR has been associated with other diabetic complications such as cognitive and motor deficits and structural changes in the brain, suggesting that early DR could be used as a marker or predictor for other diabetic pathology. Starting interventions at the earliest signs of diabetes-induced changes in the retina could prevent development of cognitive and motor deficits and worsening of retinal deficits. Our group has identified dopamine deficiency as a mechanism underlying early visual dysfunction with DR in Type I diabetes, and demonstrated that treatments that increase retinal dopamine reduce these deficits. Furthermore, we have shown that exercise is neuroprotective to retinal degeneration, and have preliminary data showing exercise protects the retina from early diabetic dysfunction. We propose to identify the temporal relationship between DR and cognitive and motor deficits in a Type 2 diabetes model and determine whether dopamine deficiency is a common mechanism for cerebral and retinal deficits. We aim to treat at the earliest sign of DR with therapies that target dopamine either exogenously (L-DOPA) or endogenously (exercise).
Relevance to VA: Currently, over 25 million U.S. citizens (8.3% of the population) have diabetes, and an estimated 79 million have prediabetes. Diabetes was the 7th leading cause of death in 2007, and estimated treatment costs in the U.S. were $174 billion. Diabetes is of great importance to the VA patient population specifically as nearly 20% of veterans in the VA system have diabetes. With the worldwide prevalence of diabetes predicted to rise 35% by 2025, diabetic complications impose an ever-increasing burden on healthcare systems. One of the most common complications, diabetic retinopathy, is the leading cause of blindness in adults 20 to 74 years of age. Vision loss from DR negatively affects family relationships, social independence, work potential, and financial stability. In addition, DR is likely intimately related to other diabetic complications, for example, cognitive decline and microvascular changes in the brain. The continued rise in the number of diabetic patients and the complexity of their care underscores the urgent need to identify the earliest possible window for treatment. We seek to identify this window and develop clinically translatable treatments to target complications prior to obvious signs and symptoms.

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