Dedicated to Helping People With T1D: Dr. Gary Meininger on His Life and Career with Diabetes
This content was made possible with support from Vertex Pharmaceuticals. Beyond Type 1 maintains full editorial control of all content published on our platforms.
Gary Meininger, M.D. joined Vertex in 2019 as Senior Vice President, Global Medicines Development and Medical Affairs and is the Head of Clinical Development for Vertex Cell and Genetic Therapies (VCGT). In this role, Dr. Meininger oversees all aspects of clinical development for VCGT disease areas, including sickle cell disease, beta thalassemia, type 1 diabetes, and Duchenne muscular dystrophy. Beyond Type 1 recently interviewed Dr. Meininger on his personal connection to type 1 diabetes, his role at Vertex, and the important work being done in clinical trial research.
Beyond Type 1: Thanks for speaking with us Dr. Meininger! I understand you live with Type 1 diabetes. Can you tell me about your diagnosis?
Gary Meininger, M.D.: I was diagnosed two months before my 19th birthday when I was a junior in college. I remember feeling scared and worried about what it would mean for my life/career and practically speaking, my day-to-day routine. What would be the burden of management? Would I need to eat completely differently? I am also an identical twin, and I wondered why I had T1D and my brother did not at that time (although eventually he did almost three decades later). Knowing I had no choice but to adapt to my new diagnosis of T1D, I accepted my diagnosis and decided to do my best to ensure my health and glucose control were the best I could do.
What are some of the biggest improvements you’ve seen in diabetes care since your diagnosis?
The improvement and reduced burden in glycemic control provided by hybrid closed loop systems. These systems are very good, not perfect, and reduce the already heavy burden of disease. Glucose control with these systems is very good at night and often avoids nocturnal hypoglycemia. During the daytime, glucose control is also good, but with the added complexity/challenges of diet (and associated bolus insulin), exercise, and daily routine, the system is not as good as overnight.
How did having T1D influence your career path?
GM: I was always interested in science. At the time of my diagnosis as a junior in college, I had already made the decision that I wanted to be a physician. Exactly what type of physician I wasn’t sure (e.g., surgeon, internal medicine, pyschiatry, etc.). During my internal medicine residency, I realized that I not only enjoyed the science of endocrinology (as it covered many different diseases and organ systems), but I also had a personal connection to it via my diagnosis of T1D. That is when I decided to become an endocrinologist. The next step in my career evolution was whether I would primarily practice endocrinology or become a physician-scientist. I, of course, chose the latter, in part because I realized that if physicians and scientists didn’t work to understand diseases and discover new therapies, I wouldn’t be here today. My career has been very fufilling as it both addresses my innate scientific interest and curiousity, and also allows me to give back to the medical community by investigating and hopefully providing new transformative therapies.
When you went to medical school, did you imagine you would one day be working in cure research specifically?
On some level, I think I did. I have always been interested in the possibility of not just treating but also preventing and curing diseases. There are many examples of this in medicine, particularly in the area of infectious disease, where we have the ability to prevent disease through vaccines or cure disease through antibiotics and antivirals. I found myself wondering why the same couldn’t be true for many other diseases, including T1D. Exactly what my contribution someday would be to research was, of course, unknown to me at that time, but the journey for me from then to now has been amazing. I feel so fortunate to be able to collaborate and contribute so directly to potentially transformative therapies.
Tell me about your decision to join Vertex. What made you want to work there?
Three key things drew me to Vertex. First, the vibrant culture. Everyone was so thoughtful; I enjoyed the idea of healthy debate and bringing your best self to work really resonated with me. Second, the cutting-edge science. It’s truly amazing to see such exciting advancements in our potential gene editing therapy for hemoglobinopathies, cell-based therapy for T1D, a rational way of potentially targeting pain, and other novel interventions being studied in several other disease areas. Third, I welcomed the tremendous opportunity to work with so many talented individuals who had already successfully serially innovated in cystic fibrosis and were working to expand this success into new disease areas.
Talk to me about the work Vertex is doing in Type 1 Diabetes
Type 1 diabetes is a disease in which the underlying causal biology is well understood. Pancreatic islet beta cells are destroyed by an autoimmune attack. Our investigational approach, aimed at the underlying cause of T1D, is to use our fully differentiated islet cell therapy with the goal of replacing the insulin-producing cells that are destroyed in people with T1D. We entered the clinic earlier this year with the aim to deliver the insulin-producing cells via a transplant approach that will require immunosuppression similar to a cadaveric islet transplant or an organ transplant. A second approach that we hope to move into the clinic in the near future, focuses on protecting the transplanted cells from the immune system, thereby potentially eliminating the need for immunosuppression.
In March, the FDA granted your investigational therapy for T1D fast-track designation. What is the significance of fast-track designation?
Fast-track designation is granted by the FDA “to facilitate the development, and expedite the review of drugs to treat serious conditions and fill an unmet medical need.” Practically, it allows for more frequent interactions with the FDA to achieve these goals, and the designation itself signifies the potential of a novel therapy to address an unmet medical need.
I understand you have an identical twin brother and a daughter with T1D. What’s it like having other members of your family with T1D?
My oldest daughter was diagnosed just before her 5th birthday (she’s now 16 years old), and my twin brother, who I mentioned earlier, was more recently diagnosed with T1D many years after me (which is consistent with data from studies of T1D in identical twins). T1D never ends, it’s 24/7, but I think it’s underappreciated the work and emotional burden T1D has on family members of people with T1D, particularly parents, who all want the best for their child, sibling, parent or grandparent. As much as my own T1D has served as a motivator for me to improve the lives of patients, I think my daughter’s T1D, as well as that of my twin brother, raises that motivation to an entirely new height.
How does having T1D in the family influence your opinion on clinical trial research, if at all?
When I was diagnosed with T1D, I had already made the decision that I wanted to become a physician. Through the years, living with T1D has definitely shaped me as an individual, as I recognized the importance not only of practicing clinical medicine, but also of advancing medical research. It was very clear to me that if people didn’t work to understand diseases and investigate new products and therapeutics, I wouldn’t be here today. My diagnosis of T1D has also allowed me to empathize with patients in a way I don’t think I would have otherwise experienced. And when my daughter was diagnosed with T1D and also with me being an identical twin, our entire family entered a clinical study to help researchers better understand the genetics and immunology of T1D. The bottom line is that in order to advance medicine, we each need to do our part by contributing to scientific research in whatever way we are able and comfortable doing.
Is there anything else you would like our readers to know?
Vertex is very excited about bringing potentially transformative therapies to the Type 1 diabetes community, and we look forward to working with the whole T1D community, patients, caregivers, and study investigators towards this goal.
Editor’s Note: Vertex recently announced that the first patient dosed with VX-880 — a stem cell-derived potential therapy to treat Type 1 diabetes — has experienced a 91% decrease in their daily insulin doses. For more information on this exciting development, check out our news coverage here.