Rolf Luft Award 2014

Prize Lecture

  ”A New Biology for Diabetes (Type 1 and 2)”, Karolinska Institutet, May 13th, 2014.

Motivation

Unger has studied the normal and abnormal physiology of the islets of Langerhans in an effort to understand the mechanisms that predispose to diabetes.

In 1959 he developed a radioimmunoassay for glucagon and established that glucagon was a true hormone, that it originated in the pancreatic a-cells, and that it was released in coordinated fashion with insulin to maintain glycemia within the very narrow normal range.

In fact, Unger developed the first RIA for measuring a hormone and these studies were completed prior to the publication of an insulin RIA by Berson and Yalow (though Unger acknowledged their primacy in developing the method and generously held up his publication until their work could be published).

These and subsequent studies revealed that diabetes is a bihormonal disease in which insufficiency of insulin is always associated with an excess of glucagon, which accounts for the hepatic overproduction of glucose and ketones in diabetes. Moreover in the absence of glucagon signaling, either due to somatostatin treatment or a glucagon receptor knockout, a complete deficiency of insulin production no longer causes hyperglycemia or ketosis.

Recent studies have explored the effect of leptin on glucose metabolism and established that leptin can improve diabetes in both Type 1 and Type 2 diabetes. The data further suggest that leptin lowers blood glucose by inhibiting glucagon action.

Unger is a giant in endocrinology and metabolism and an extremely worthy recipient of the Luft Prize.