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Francesco Vendrame, MD, Ph.D., is an Associate Professor of Clinical Medicine in the Division of Endocrinology, Diabetes, and Metabolism at the University of Miami School of Medicine and an adult endocrinologist at the University of Miami Health System in Miami, Florida.
Dr. Vendrame, who serves as the site PI for the T1DX-QI at the University of Miami, was a recipient of the 2022 T1DX-QI Outstanding Adult PI Award, as a widely respected and influential Type 1 diabetes (T1D) researcher dedicated to improving the quality of life for those living with T1D.
Interview with Francesco Vendrame, MD, PhD
In this interview, Dr. Vendrame discusses his involvement with the T1D Exchange Quality Improvement Collaborative (T1DX-QI), as an endocrinologist and well-published researcher who is dedicated to the prevention, diagnosis, and treatment of T1D.
The T1DX-QI was established in 2016— with the support of The Leona M. and Harry B. Helmsley Charitable Trust — to refine best practices and improve the quality of care and outcomes for individuals living with T1D. Growth has been tremendous, with 60 endocrine clinics from across the U.S. participating in the Collaborative.
Fueled by top leaders in diabetes care, the T1DX-QI has become an engine of innovation and inspiration. By engaging with the shared, data-driven, and systematic methods of the T1DX-QI, clinics have seen unprecedented success in their approach to diabetes management.
With members working closely to identify gaps in care, discover and refine best practices, and share research — the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be” by applying shared, evidence-based methods for improving care.
Vendrame’s path to medicine
When asked about his path into medicine, Vendrame laughed and replied, “It’s a very complicated story, but I’ll try to make it simple.”
“From an early age, I was always interested in science and research — and had a handful of different microscopes as a child,” explained Vendrame. “My interests led to medical school, where I began thinking broadly about endocrinology, as I developed a fascination with feedback mechanisms involved in hormone regulation.”
“While I was very interested in endocrinology in medical school, I was also drawn to immunology. During this time, I began working in T1D, which I found to be an appealing mix of both fields,” said Vendrame, who graduated with two doctoral degrees, a Medical Degree from the University of Rome “La Sapienza” in Italy and a Ph.D. in Biomedical Technologies in Clinical Medicine from the same institution.
After completing his endocrinology residency and fellowship in Italy, Vendrame relocated to the U.S., completing two more fellowships — one at the University of Colorado Barbara Davis Center, and the other, at the University of Miami.
Vendrame, who played a pivotal role in groundbreaking research in his fellowship programs, recollected, “It was a very exciting and fulfilling time for me.”
While dedicating the majority of his time to academic T1D research, Vendrame continues to spend 40 percent of his time clinically as an adult endocrinologist. Vendrame explained, “Between seeing patients in the clinic, and dividing my time between basic and clinical research, I have a 360-degree approach to T1D — which I find very interesting.”
The University of Miami and the T1DX-QI
“The University of Miami has been involved with the Exchange since 2016 — joining T1DX-QI in 2020,” explained Vendrame, who serves as the site PI at the University of Miami, along with a “fluid team” of clinicians.
“While we have a ‘core group’ of providers consisting of a diabetes educator, nurse practitioner, two registered nurses, and myself — we have additional clinicians who are kept abreast of our initiatives and join as their time permits,” said Vendrame.
“Being a member of the T1DX-QI is wonderful as it offers a unique opportunity to exchange information with colleagues and collaborate on QI-based research to quicken the pace that improvements reach patients,” explained Vendrame.
“Type 1 diabetes affects the entire life of those living with it, so finding new ways to improve quality of life and outcomes is important work.”
“Within the Collaborative, we learn so much from one another, and it’s interesting to see the commonalities in the challenges we face. Clinics thousands of miles away are having similar issues, so it’s extremely helpful in terms of consulting and information sharing,” said Vendrame.
What are your current research projects?
“I’m involved in two concurrent technology-related projects with T1DX-QI. The first is on reducing inequities in the distribution of diabetes technology in minority populations, and the second is examining outcomes in technology use with adaptations in the delivery of diabetes education,” said Vendrame.
“We need to understand and measure what technology issues exist, especially within certain populations, so we can engineer solutions to fix them.”
“As part of the use of technology in type 1 diabetes, another interest area of mine is in the use of telemedicine. I lead a quality improvement (QI) project in my clinic aimed at improving remote data sharing for people with type 1 diabetes on insulin pump therapy: Connecting From Afar: Implementation of Remote Data-Sharing for Patients With Type 1 Diabetes on Insulin Pump Therapy. In addition, with a team of collaborators from the T1DX-QI and I authored a publication in 2021 on a study examining telehealth visits during the pandemic and a follow-up study is also in press. ”
“In addition, a team of collaborators from the T1DX-QI and I authored a publication in 2021 on a study examining telehealth visits during the pandemic: Adoption of Telemedicine for Type 1 Diabetes Care During the COVID-19 Pandemic; a follow-up study is also in press.”
“Outside of my T1DX-QI work, I’m part of a research group extensively studying the recurrence of T1D in patients who were recipients of pancreas-kidney transplants. In other words, someone who had T1D, received a transplant with a functioning pancreas, and then developed T1D again,” said Vendrame.
“What happens is that the immune system is attacking the new, transplanted pancreas despite the immunosuppression. And, it’s happening in our cohort at about the same percentage rate that patients experience organ rejection,” explained Vendrame.
“As we were researching possible strategies to target autoimmunity, we came across an older medication — Dimethyl Fumarate, which is typically used to treat multiple sclerosis. We noticed that the mechanism of action of this drug, and the benefits observed in people with multiple sclerosis, made it suitable to target islet autoimmunity. This led to a number of experiments in mice,” said Vendrame.
“We’ve been working on this project for a few years and started to generate several preclinical studies,” said Vendrame. “We’ve gotten funding from multiple agencies including JDRF and NIH. While Dimethyl Fumarate is already approved for MS, we’re planning to launch a clinical trial for its role in islet immunity.
“The data has been presented in several meetings, and we’re working on a publication that suggests this medication may not only prevent but also reverse diabetes in an animal model,” said Vendrame.
What research are you most proud of?
“As far as publications are concerned, I have a nice memory of the studies I’ve done at the beginning of my career at Barbara Davis Center with the role of T-regulatory cells in T1D,” said Vendrame. “As a young scientist, it was very exciting to pioneer this new field and offer our research contributions.”
“In terms of my other work, I’m also pleased with my research on the recurrence of autoimmunity, and now, with my research on Dimethyl Fumarate,” said Vendrame, “Those are the three things I’m most proud of.”
What do you like to do outside of work?
Outside of work, Dr. Vendrame enjoys spending family time with his wife and four boys (16, 14, and 11-year-old twins). He’s likely traveling to his kids’ basketball and soccer games across southern Florida, biking, fishing, or enjoying a home-cooked family meal in Italian tradition.
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