Q&A: ADA award winner calls perseverance, collaboration critical to science
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SAN DIEGO — The keys to scientific achievement are perseverance and collaboration, according to Raghavendra G. Mirmira, MD, PhD, who said those qualities combined to make the moon landing “perhaps the greatest” human accomplishment.
Mirmira said if he had 5 minutes with Neil Armstrong, who “comes to mind immediately” as someone he admires, he would “ask him — in his opinion — what he felt motivated everyone to work toward this one goal”: the landing of Apollo 11 on July 20, 1969.
Mirmira, professor of medicine at the University of Chicago and practicing clinician treating people with diabetes, is honored with this year’s American Diabetes Association’s Albert Renold Award, which recognizes mentorship of diabetes research scientists.
One of Mirmira’s trainees, Carmella Evans-Molina, MD, PhD, received ADA’s Outstanding Scientific Achievement Award at the same ceremony. Mirmira, who has trained 13 PhD or MD-PhD students and 30 postdoctoral fellows, said their successes have been highlights of his career.
In an interview with Healio, Mirmira discussed the future of diabetes, the medical advances he has seen over his career, and what makes him tick outside the field of endocrinology.
Healio: What was the defining moment that led you to your field? Why do you do what you do?
Mirmira: The defining moment was when I met my PhD mentor, the late Howard Tager, PhD. Howard was studying rare insulin mutations that led to diabetes, and my project was to determine how these mutations affect the binding of insulin to its receptor. In the course of my work, I identified regions of the insulin molecule that could be altered and lead to “monomeric” insulins. Today, monomeric insulins have been a mainstay of therapy for diabetes.
I do what I do because my work showed me how basic science discoveries can lead to therapies that impact how we live with and manage disease, particularly diabetes. In addition to my PhD, I also earned an MD degree, and today I do research in diabetes and see patients with diabetes in the clinic.
Healio: What area of research in endocrinology most interests you right now and why?
Mirmira: Ever since my experience as a PhD student studying the basic science of insulin and diabetes, I have been committed to studying the pathogenesis and treatment of diabetes, both type 1 diabetes and type 2. More importantly, we are now beginning to recognize that diabetes cannot easily be categorized and likely represents a spectrum of disease with different causes in different individuals. The disease’s heterogeneity has motivated me over the years to dig deeper into the basic biology to identify potential new therapies that could be applied to different forms of the disease.
Healio: Have you ever been fortunate enough to witness or to have been part of health care history in the making? If so, please explain.
Mirmira: Yes. I would say that my PhD experience allowed me to witness how studying something as fundamental as insulin structure impacted an entirely new generation of insulin analogs that we use today to treat the disease.
During my early training in medicine, the insulins that we used were fairly crude forms that did not have the more precise pharmacokinetics that we are accustomed to today. To see now how insulin analogs have evolved to enhance treatment precision and improve not only blood sugars in individuals, but also reduce diabetes complications, has been extraordinary. Many of these new insulins are being combined with state-of-the-art technologies, such as “smart insulin pumps” and glucose sensors, to reduce the complexity of diabetes management and allow for improvements in the way people live with diabetes.
Healio: What do you think will have the greatest influence on your field in the next 10 years?
Mirmira: In my lifetime, I have seen how improvements in insulin engineering and pump and sensor technologies have advanced precision in diabetes care. The next big achievement will come from biologics — namely, the development of cell-based technologies that allow engineering of cells from the same individual to produce and secrete insulin. I am hoping that we will see a future where such engineered cells can take the place of insulin administration, sensor and delivery technologies.
To be honest, I don’t think that this will become a reality in 10 years’ time — perhaps a bit longer than that. But we are making big strides. Within 10 years, I do anticipate that technologies will continue to improve — for example, delivery of insulin without the use of needles, or the measurement of glucose levels without the need for invasive, embedded sensors.
Healio: If you weren’t a physician and/or researcher, what would you be doing?
Mirmira: This is a hard question to answer. It’s difficult for me to imagine doing anything else than what I’m doing now. But, if I weren’t a physician-scientist, I imagine that I would still be an academician, since education and teaching are things that I have a passion for. I still imagine being a professor at a university, publishing papers and/or books, teaching and trying to grow knowledge.
Healio: Who are you outside of your job? What interests you outside of endocrinology?
Mirmira: Outside of my job, I value time with my family — these days, mostly with my wife, since my kids are grown up. I enjoy traveling and discovering different cultures and customs. I enjoy backroad adventures, hiking and biking. Most of all, I enjoy spending time with my wife and discovering ourselves and the world and people around us.
Reference:
- Extraordinary leaders in diabetes research, prevention, and treatment to be recognized at the ADA’s 83rd Scientific Sessions. https://diabetes.org/newsroom/press-releases/2023/extraordinary-leaders-diabetes-research-prevention-treatment-recognized-at-ada-83-scientific-sessions. Published March 14, 2023. Accessed June 5, 2023.
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