Complications of Diabetes


Stephan Herzig | Annette Peters | Julia Szendrödi | Robert Wagner

Diabetes can lead to a number of serious complications, such as diabetic foot syndrome, eye diseases, kidney dysfunction and occasionally also cancer. In order to prevent or delay such consequences in the future, it is important to recognize which patients are at high risk of complications. The aim of the Academy is to bundle the expertise in the DZD in order to find new ways to prevent, improve treatment or even cure secondary diseases of type 1 and type 2 diabetes.

The DZD researchers suspect that frequent long-term diabetic complications are based on a dysfunctional metabolism of glucose and lipids in the early stages of disease manifestation, leading to the formation of toxic metabolites and oxidative stress. This, in turn, can damage the DNA and, in the long term, impair organ function.

The research focus on diabetes complications aims to:

  • Identify early risk factor profiles and associations between subphenotypes and the development of diabetes-related complications and to define new pharmacotherapeutic modalities for this purpose
  • Identify new, non-classical diabetes-related complications through clinical phenotyping and to define their mechanistic basis, especially fibrosis in lung and liver as well as neuropathies
  • Establish fasting therapies and mechanistic principles for the treatment of diabetes-related complications

Diabetes subgroups
With the discovery of the diabetes subgroups, which show a different susceptibility to various diabetes-related complications, the basis for personalized prevention strategies was created. To facilitate the diagnosis of cardio-metabolic complications, the DZD identified new relevant imaging parameters.

DZD researchers are also investigating new pharmacological options: preclinical studies have confirmed the improvement in metabolic performance and / or cardiovascular parameters for two new substances. In addition, another therapeutic approach was successfully validated to improve at least one diabetic complication.

Therapeutic fasting
The DZD also regards effective fasting therapies as an interesting alternative. Researchers are comparing different fasting protocols and are creating an organ-specific fasting proteome, i.e. an overview of the spectrum of the proteins present in order to provide new insights into the molecular mechanisms of fasting.


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Liver fibrosis-activated transcriptional networks govern hepatocyte reprogramming and intra-hepatic communication. Cell Metabolism (2021), DOI: 10.1016/j.cmet.2021.06.005

Repositioning of the global epicenter of non-optimal cholesterol. Nature (2020), DOI: 10.1038/s41586-020-2338-1

Epigenetic Link Between Statin Therapy and T2D. Diabetes Care (2020), DOI: 10.2337/dc19-1828

Targeted pharmacological therapy restores β-cell function for diabetes remission. Nat Metab (2020), DOI: 10.1038/s42255-020-0171-3

The haemochromatosis gene Hfe and Kupffer cells control LDL cholesterol homeostasis and impact on atherosclerosis development. European Heart Journal (2020), DOI: 10.1093/eurheartj/ehaa140

Prof. Dr. Stephan Herzig, Head DZD Academy Complications

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Talk at the 10th anniversary celebration of the DZD on June 24, 2019 in Berlin (in English).

Members of the Academy

Ferruh Artunc, IDM
Alexander Bartelt, LMU
Mauricio Berriel Diaz, HMGU
Matthias Blüher, Leipzig
Gidon Bönhof, DDZ
Bilgen Ekim Üstünel, Heidelberg
Anastasia Georgiadi, HMGU
Martina Guthoff, IDM
Christian Herder, DDZ
Stephan Herzig, HMGU
Susanna Hofmann, HMGU
Andrea Icks, DDZ
Natalie Krahmer, HMGU
Haifa Maalmi, DDZ
Timo Müller, HMGU
Annette Peters, HMGU
Maria Rohm, HMGU
Sabrina Schlesinger, DDZ
Matthias Schulze, DIfE
Annette Schürmann, DIfE
Norbert Stefan, IDM
Alexander Strom, DDZ
Alba Sulaj, Heidelberg
Julia Szendrödi, Heidelberg
Barbara Thorand, HMGU
MatthiasTschöp, HMGU
Robert Wagner, DDZ
Rui Wang-Sattler, HMGU
Eleftheria Zeggini, HMGU