Fascinating and frustrating: two words that Dr. Haller uses to describe researching how type 1 diabetes evolves within the human endocrine system. Type 1 diabetes stands at the top of pediatric endocrinology diseases, and Dr. Haller tells listeners about exciting developments in delaying, modifying, and preventing type 1 progression. Listen and learn What evidence in endocrinology and diabetes research shows type 1 as essentially a heterogeneous disease, What trends and differences appear in adult versus juvenile onset of type 1 diabetes, and Which endocrinology diabetes therapies are in the works, including the first ever FDA-labeled drug capable of "changing the natural history of type 1 diabetes." Michael J. Haller, MD, is a professor and Chief of Pediatric Endocrinology at the University of Florida. He specializes in type 1 diabetes mellitus research and clinical work.  What causes type 1? Well, that's part of the challenge. Triggers range from genetic to environmental to some mix of both, and Dr. Haller's research grapples with these complex pathways to disease onset. Because it has so many potential combinations of causes, using general approaches and treatments for everyone who is at risk for or has type 1 just doesn't cut it. Various treatments through immunotherapy is his current passion, and he tells listeners of its tremendous potential.  For example, he and his colleagues have been looking at drugs that are already out in the market used to treat other diseases like lupus, seeing if they can be applied to affecting the metamorphosis of type 1.  Immunotherapy offers a wide spectrum, from suppression to more immune-modulatory effects. In fact, his lab has developed the first drug to delay and prevent type 1 in high risk patients—and it's on course to be the first therapy to get an FDA label for changing the progression of type 1 diabetes. Meanwhile, research continues into how causes come into play, and he describes various approaches, from examining pancreases through a type 1 organ donation program to imaging pancreases in living patients. There's a lot to parse in this research and the work has only just begun, but so far the size of the pancreas seems to be a significant factor: they are still working on determining if that's an outcome or cause, but pancreases that come from type 1 patients tend to be about 50% smaller than average. They're also looking at the exocrine region to see if it has a role. Listen in for exciting ways researchers are making progress in treating this complex disease.  For more about these projects, see diabetes.ufl.edu. Available on Apple Podcasts: apple.co/2Os0myK