Eastern Virginia Medical School
Vice Dean of Research, Harry H. Mansbach Endowed Chair in Internal Medicine
Although there were no physicians in his family, Dr. Jerry Nadler remembers always being interested in science and medicine. “Actually, my Uncle Sam influenced me,” he says. “He had what we today call Adult Onset Type 1 Diabetes. Growing up, I saw all the problems he had: heart attack, circulation problems in his leg, all of it. His mind was always sharp, but his body gradually had all of the complications of diabetes.” It made an impression.
In college, he got excited about a research project in endocrinology, an interest that became solidified when he went to medical school. His family had moved to Florida, so he chose the Miller School of Medicine at the University of Miami. Between his first and second years, he had the opportunity to work with Dr. Daniel Mintz, the founding Scientific Director and Chief Academic Officer of the Diabetes Research Institute. “He was a visionary,” Dr. Nadler remembers. “I was doing islet cell transplants in animal models to reverse diabetes. It was the first time that had been done. That’s when I decided I wanted to go into internal medicine, with a focus on diabetes.” He was hooked on research, he says, a theme that has informed his entire career.
He did his internship and residency in internal medicine at Loma Linda University Medical Center, and specialized endocrinology training in research at the University of Southern California. He did extra work at USC, funded by the National Institutes of Health and the American Heart Association. “That’s where I got my dual interest in heart disease and diabetes, and how to reverse diabetes,” he says.
Dr. Nadler stayed on at USC as tenured faculty, but when word came that the City of Hope Medical Center in nearby Duarte was looking for a director to build up its diabetes program, he enthusiastically took the position. “When I got there, there was one nurse, one full-time and one part-time doctor,” he recalls. “It was a real opportunity to focus on research.” Over the next nine years, and with the support of a local philanthropist, the program grew into a major diabetes center, and is today considered one of the most influential diabetes research programs in the world.
The next call came from the University of Virginia, asking him to head up the diabetes and endocrine division. The Nadlers were enjoying California, and said no to the offer three times. “But the offer got better and better, so we came to Charlottesville,” Dr. Nadler says. “We were there nine years, and during that time, the endocrine division was listed in the Top Ten in the country almost every year. We were No. 5 one year, ahead of Harvard and other programs.”
But the Nadlers were used to a big city, and missed the water. So when Dean Gerald Pepe called saying he needed a Chairman of Medicine and someone to head EVMS’s diabetes center, Dr. Nadler was very excited. “I’m going on my sixth year,” he says, “and I’m still excited about the work we’re doing at EVMS.”
During that time, a number of world-class physicians and endocrinologists have been recruited, including both Dr. Joseph Aloi and Dr. David Lieb. While there is a national shortage of endocrinologists, EVMS has doubled the size of its endocrine fellowship. Because there are so few endocrinologists, Dr. Nadler points out, most diabetes patients are cared for by family doctors and primary care physicians. “Here at EVMS, we see the most difficult patients, some of whom go on insulin pumps,” he says. “We’re very happy to partner with general practitioners in caring for them, because of the severity of their disease.”
Research remains his passion. The Diabetes Institute is involved in several studies he finds very exciting, particularly those dealing with reversing diabetes. “We’re working on research now to reverse Type 1,” he says. “We can do it in mice, but we can’t yet do it in people.” It would require stopping the body from destroying its insulin cells, because even if these cells could be regenerated, the body would simply try to destroy them all over again. “I am very fortunate to be collaborating with a wonderful physician scientist, Dr. Yumi Imai, who just got a grant from the state to use a combination approach, using one compound to regenerate cells and another drug to stop the immune system from destroying them,” Dr. Nadler explains. “The goal is to start doing that in the animal model, and if it works well, we can move it up to the clinic. It’s exhilarating.”
He’s working on another grant studying the causes of the tremendous increase in heart disease and heart diseases related death among diabetics. Another grant seeks to identify a virus that might be one of the triggers of Type 1 diabetes, which might ultimately lead to the development of a vaccine.
Despite the grim statistics (“we’ve already exceeded the number of diabetics estimated for the year 2025,” he notes), Dr. Nadler is hopeful that as the country moves into a new health care era, focusing on prevention and lifestyle change and being rewarded for that – and with continued vigorous research – “We might be able to stem the tide.” In the meantime, he and his colleagues offer a great opportunity for the people of Hampton Roads: “We do outreach, we do prevention, we try to reverse disease,” he says, “and we provide exceptional treatment for the diabetic patient.”
