Jakob's big challenge: too little time for research

JaKob Appel Østergaard

Jakob Appel Østergaard faces a very considerable challenge: having completed a postdoctoral assignment, he must embark on his main educational topic: endocrinology. In his own words, he must leave one fantastic area of work to go to another, equally fantastic one. The challenge will be to have to choose, when in fact he would like to pursue both things. “I am looking forward to applying my knowledge to clinical practice, but I dread the possibility that there won’t be time enough to do research”, he says. 

Jakob is aware of his obligation to continue research, something he owes to himself, the Danish Diabetes Academy and the Novo Nordisk Foundation and other contributors, who have made the investment in him, and he wants to retain the connection with the Danish Diabetes Academy and participate in the symposia and workshops as well as the expanded network it provides. 

It has always been his dream to continue as a researcher, so the challenge consists in finding a solution that allows him to combine this with his clinical work. It will be hard, especially since he must also find time for home life with his wife Lisbeth, a nurse anaesthetist, and their daughters aged five and seven. 

Something that counts in his favour is that, unlike others who have had to give up their research, he already has his postdoctoral fellowship behind him. “The three years I spent on the postdoc in the Danish Diabetes Academy have helped me build a great network and I envisage plenty of exciting projects, so my odds have become much, much better. One the other hand, I can`t do research only in my free time for the rest of my life. This will be a tipping point”. He is, however, admirably optimistic that systems will change to prevent a lot of research from falling by the board when students finish their postdoctoral or PhD work, and that it will be possible for them to carry projects through. 

Diabetes has a massive impact on people’s lives

The subject of Jakob’s research is diabetic kidney disease. And the reason for his choice of specialism is partly that both his brothers have type 1 diabetes. “So, I have seen close up what it means to have diabetes. It is something that impacts massively on your life. I don’t think the public are sufficiently aware of this impact. But when someone close to you has diabetes, you want to make things better for them”, he says. 

What particularly interests him in diabetes is the risk of complications. How do these connect with the disease itself? What exactly is happening? 

Jakob turns to military terminology when describing his research. “In war, they speak of friendly fire when an army shoots at their own troops by mistake. What our research group has identified is that the body’s own weaponry, the immune system, seems to be mistaking its own cells for those of invading bacteria. So, when it opens fire, the body’s cells are hit; this seems to be happening in the development of diabetic kidney disease”, he concludes.

Around 30 percent OF PATIENTS WITH DIABETES ARE AFFECTED BY kidney problems

Jakob’s aim is to discover a means of deflecting or at least mitigating the attacks on the body’s own cells. This, he feels, would mean a healthier, better quality of life for a lot of diabetes sufferers. Nearly 30 percent of patients with type 1 or type 2 diabetes are affected by varying degrees of kidney problems. “The research perspectives are very promising. A number of drugs that control the immune system have already been developed. It is reasonable to speculate that they could be applied preventively in the case of diabetes patients”, Jakob says.

When asked about further goals, Jakob does not hesitate: “I hope that the road I’m on now will prove to have been the right one when I come to my retirement. My task now is to test my hypothesis and continue working on preventing damage. The ultimate dream is that these immune system ‘inhibitors’ can be used by people with diabetes. And in the short-term view, I would like to be able to describe the mechanisms involved. This is a realistic short-term aim.”