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Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, USA. Among the Harvard Medical School Affiliated institutions, Joslin is unique in its sole focus on diabetes. Joslin has the world’s largest team of board-certified physicians treating diabetes and its complications, as well as the largest staff of Certified Diabetes Educators anywhere in the world. Since its inception, Joslin has focused on aggressive, comprehensive care of the patient. Over 23,000 active patients receive specialty care for their eyes, hearts, kidneys, pregnancies and feet. Joslin supports the world’s largest diabetes research team with more than 40 faculty level investigators for a total of more than 300 researchers. Joslin has 46 clinical care affiliates in the US and two in other countries. ==History== Joslin Diabetes was founded in 1898 in Boston by diabetes specialist Elliott P. Joslin on the belief that the key to managing diabetes is with patient involvement, education and empowerment.〔Kahn CR, Rafferty JF. The Joslin DiabetesCenter. Molecular Medicine 6(2): 65-68, 2000.〕 Joslin Clinic has helped revolutionize the diagnosis, treatment and prevention of diabetes, most notably by improving the survival rate of babies born to women with diabetes, developing sight-saving laser surgery, devising treatments to reduce amputation, and uncovering ways to predict who will develop diabetes. Some notable historic milestones include: *1949: Priscilla White, M.D., a founding member of Joslin Clinic, introduces the White Classification of Diabetic Pregnancies. This pioneering concept classifies patients according to their level of risk and tailors their treatment protocol accordingly. When Dr. Priscilla White joined Joslin’s practice in 1924, only 56 percent of babies born to diabetic mothers survived; 50 years later when she retired, that rate had jumped to more than 90 percent.〔Dunn, PM. Dr Priscilla White (1900-1989) of Boston and pregnancy diabetes. Arch Dis Child Fetal Neonatal Ed. 2004 May;89(3):F276-8.〕 *1967: A laser treatment (Ruby laser photocoagulation) is developed by William Beetham, M.D., and Lloyd M. Aiello, M.D., which within the next five years revolutionizes the care of diabetic retinopathy, a potentially blinding complication of diabetes.〔Beetham WP, Aiello LM, Balodimos MC, Koncz L. Ruby-laser photocoagulation of early diabetic neovascular retinopathy: preliminary report of a long-term controlled study. Trans Am Ophthalmol Soc. 1969;67:39-67.〕 *1976: Joslin researchers perfect the A1C test, paving the way for this blood test to assess blood glucose control over a two- to three-month period. *1980s: Basic research at Joslin shows that type 1 diabetes evolves over a period of years, presenting hope that a means may be found to prevent autoimmune destruction of the pancreas’ beta cells before they stop producing insulin. *1980s: C. Ronald Kahn and his team define the molecular mechanism of insulin action and how it is altered in insulin resistant states such as type 2 diabetes and obesity. *1989: George King, M.D., and colleagues demonstrate that high blood glucose levels activate protein kinase C (PKC), part of a major signaling pathway that causes cellular changes in the eye, kidney and arteries that lead to diabetic complications.〔Lee TS, Saltsman KA, Ohashi H, King GL. Activation of protein kinase C by elevation of glucose concentration: proposal for a mechanism in the development of diabetic vascular complications. Proc Natl Acad Sci U S A. 1989 Jul;86(13):5141-5. Erratum in: Proc Natl Acad Sci U S A 1991 Nov 1;88(21):9907.〕 *1996: A molecular pathway (called NF-κB) is identified in fat and the liver that is activated by obesity (and a fatty diet) and causes the insulin resistance that can lead to type 2 diabetes (Steven E. Shoelson, M.D., Ph.D.). *1998: Joslin Vision Network—a telemedicine technology developed at Joslin—found to produce images of the retina just as accurately as standard equipment, but without having to dilate the pupil. Remote sites across the United States can now access Joslin’s expertise in diabetic eye disease diagnosis and treatment. *2002: The Diabetes Prevention Program (DPP) study shows people with elevated blood glucose levels who are at risk for developing type 2 diabetes can reduce their risk by 58 percent through sustained modest weight loss and increased moderate-intensity exercise, such as walking 30 minutes daily.〔Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403.〕 *2003: Researchers discover that early signs of kidney disease (microalbuminuria) can be reversed back to normal with proper medical screening and diabetes control.〔Perkins BA, Ficociello LH, Silva KH, Finkelstein DM, Warram JH, Krolewski AS. Regression of microalbuminuria in type 1 diabetes. N Engl J Med. 2003 Jun 5;348(23):2285-93.〕 *2006: Joslin researchers find that specific genes can determine both obesity and body-fat distribution in humans.〔Gesta S, Blüher M, Yamamoto Y, Norris AW, Berndt J, Kralisch S, Boucher J, Lewis C, Kahn CR. Evidence for a role of developmental genes in the origin of obesity and body fat distribution. Proc Natl Acad Sci U S A. 2006 Apr 25;103(17):6676-81.〕 *2009: Researchers in the lab of C. Ronald Kahn, MD discover that brown fat is present in some adults, providing a new target for the treatment of obesity.〔Cypess AM, Lehman S, Williams G, Tal I, Rodman D, Goldfine AB, Kuo FC, Palmer EL, Tseng YH, Doria A, Kolodny GM, Kahn CR. Identification and importance of brown adipose tissue in adult humans. N Engl J Med. 2009 Apr 9;360(15):1509-17.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Joslin Diabetes Center」の詳細全文を読む スポンサード リンク
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