Colleges & Campus

UCF Podcast: Finding a Cure for Type 1 Diabetes

Season three of Knights Do That, UCF’s official podcast, returns with its eighth guest, Christopher Clifford ’22, a UCF electrical engineering alum who is pursuing a Ph.D. in bioengineering at Harvard-MIT. Clifford’s research is centered around find a cure for and reducing the impact of Type 1 diabetes — a cause that’s personal to him. Before attending Harvard-MIT, he received the prestigious honor of being selected as a Gates Cambridge Scholar. However, Clifford turned it down to pursue another competitive path.

Here he shares his personal and professional insights into diabetes, finding your own version of success, and his hopes for the future of bioengineering.

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Transcript

Chris Clifford: There’s just so many things that are said are out of reach due to having diabetes. Being able to lift those barriers really, I think is a driving force and why I’m interested in pursuing diabetes research.

James Evans: Hello and welcome back to another episode of Knights Do That. We’re talking with Chris Clifford today. Chris is a UCF alum now studying in the Harvard MIT Health Sciences and Technology program. He lives with Type 1 diabetes and is researching a cure for it.

I want to let you know that this will be one of our longer episodes, but I think you’re going to find a lot of value from what Chris has to say. He has an amazing story to share. Chris is an Astronaut Scholar, the first student at UCF to be offered the Gates Cambridge Scholarship and a stellar example of excellence at UCF. His research and life’s work has the ability to change millions of lives.

Thanks for being here today, Chris. How are you?

Chris Clifford: I’m great. Thanks for having me.

James Evans: Of course. If you’re OK with it, I think we’ll just jump right into the questions.

Chris Clifford: Sure.

James Evans: Awesome. You were diagnosed with diabetes at 13. Can you explain what that experience was like in your own words? I think it’s super important to, even if they have read your story, to be able to hear it in your own voice and explain it from your point of view.

What was that like being diagnosed at that age and then now still living with diabetes and it becoming your mission to cure it?

Chris Clifford: I was like a normal kid. I was 13, like [you] said. I loved playing soccer. I was in band. I played French horn  Over the summer I went, it was actually my first trip alone.

I flew up to upstate New York. That’s where my mom’s family is from. And when I was flying up there and, you know, a couple days before I kind of noticed that I wasn’t feeling great, thought I was just feeling a little sick maybe. And then on the plane, I remember I really remember asking for like multiple drinks.

Like they come around, they offer you some Coke. I was like, Can I get more? Can I have more? And I started to think, this is a little weird. I got to my aunt’s place and I remember just having no energy. And over the next couple days I was urinating like every hour. And it just got worse and to the point where I couldn’t get up the stairs.

And that’s when my uncle, he’s a paramedic, he took me to the hospital and they tried checking my blood sugar and they couldn’t read it. It was too high. So I don’t remember what happened after that because I passed out. But from what they told me, I was in an ambulance. They took me to the hospital and I was diagnosed with Type 1 diabetes.

That is a pretty normal experience for anyone that’s gone through DKA, which is diabetic ketoacidosis. And that’s basically where your blood sugar’s so high that you start to have ketones in your blood, which [are[ acidic and it can damage your organs. And unfortunately, because we’re not very good at diagnosing diabetes, that happens to a lot of people.

So that’s a long winded way of saying that it was a shocking diagnosis for me. And definitely my parents weren’t ready for it. They got shocked because they weren’t with me. And from that point on, it really drastically changed my life because I had to change how I ate, how I thought about everything, what I had to bring with me.

I always had to have insulin with me. I started out with a insulin injection pen. So you have to have basically a syringe and every single time you eat, you have to take insulin and you have to do the math in your head. You have to calculate how much carbs you’re eating. You have to know how much carbs is in the food you’re eating. A lot of times the food doesn’t tell you how much carbs are in it especially if you’re going to a restaurant. So that’s a challenge in itself. That takes months to figure out, get an idea.

So it’s, it is really, it’s a complicated problem. And it’s crazy to me, thinking back on it, you bringing this up, that people go through this day to day and there’s really hasn’t been much change in how people deal with diabetes diagnosis.

James Evans: What do preventative measures look like? Are there — well, I know Type 1 diabetes is genetic, correct? Am I wrong on that?

Chris Clifford: There are genetic components.

James Evans: OK.

Chris Clifford: But it’s very environmental. So there it’s a mixture of both. The interesting thing about Type 1 diabetes is basically your beta cells don’t exist and your beta cells are the cells in your body that produce insulin.

So, the normal way that happens is an autoimmune attack. So your immune system attacks your insulin producing beta cells, they die, and then you have no insulin in your body, so you have to give yourself insulin. But there’s other ways that people lose their beta cells through autoimmune attack that can be caused by very rare genetic mutations or other diseases. And all of that kind of gets classified as Type 1 diabetes.

So one of the really interesting problems with Type 1 diabetes is just because you all present in, like in science, we would call it your phenotype, kind of how things observationally look. Just because your phenotype is Type 1 diabetes doesn’t mean that the way that you got Type 1 diabetes is the same for everyone.

And that’s one of the really interesting problems in Type 1 diabetes research right now is what we call the endotypes of Type 1 diabetes and how different people come to the same kind of clinical manifestation.

James Evans: So is there a better way to clinically diagnose Type 1 diabetes? Should it be broken up into subsections?

I would imagine that, I mean, whoever has Type 1 diabetes is probably aware of how they got it and, you know, their version of it to, you know, I say version and air quotes here, which also makes me really curious on prevention as well. Is there a capability for prevention? And also there’s a second question that I started off with is there a better way to diagnose it?

Chris Clifford: Yeah. So, as far as the diagnosis goes, I think one of the big improvements that’s been made is people are becoming more aware of what Type 1 diabetes is. So that kind of comes to patient advocacy as well as it becoming more prevalent in the population. So people kind of knowing what the symptoms of diabetes are.

It’s actually a pretty easy disease to pick up on if you kind of know the signs to look for. Some of the really common symptoms, like I was describing in my case is, [are] you’ll start to feel really lethargic, you’ll start urinating a lot, sometimes your temperament will change and you’ll get aggravated really easily.

And there’s all of these different symptoms that if people are aware of what Type 1 diabetes onset looks like and what high blood glucose does to people, then it can be diagnosed earlier before people go into DK like I did. If you are concerned about having Type 1 diabetes, and usually this is because you have like a primary relative that has Type 1 diabetes there is a test it’s called trial net, where basically you can get a blood test and they’ll look for auto antibodies, which are basically your immune cells secreting antibodies, which would respond to your insulin secreting cells.

So scientists have discovered certain antibodies that are risk factors for diabetes. So if you get this test and you have a certain number of these antibodies, then they can predict with a certain confidence level that you’re going to develop Type 1 diabetes. So that has been a huge improvement because if you

take the test and figure out that you have a high chance of developing Type 1 diabetes. There are some kind of interventions that can be done to either delay the onset of Type 1 diabetes or you could be enrolled in clinical trials and maybe help progress the science.

James Evans: That’s really interesting.

Then, I, and the reason why I’m asking you all these questions is I don’t know a lot about Type 1 diabetes and I think it’s important for our listeners to also get this kind of precursor in this context as to what Type 1 diabetes actually is. Because again, awareness is so important, right? Is there an average age? Is it typically 13-year-olds, teenagers being diagnosed? Or could you develop it later on, (that) was another thing that you had talked about.

So, is it possible that somebody could, you know, develop Type 1 diabetes in their 60s, 70s, 80s? What does that look like across somebody’s life? Is there ever a prime time when you’re most likely to get it, versus you could still get it 30, 40 years down the road?

Chris Clifford: Yeah, really good question. So it used to actually be called juvenile diabetes. Before it was called Type 1 Diabetes. And that’s because we thought that it primarily happened in younger people. So if you kind of look at the population distribution of Type 1 diabetes, it would be what we would call like a bimodal peak.

So there’s a peak around 13 years old, 13 or 14 years old. So that’s where you’d see a lot of the younger diagnoses. But you can get it, you know, very young. You can get it less than a year old. So, the distribution isn’t like, “Oh, people get it at 13 years old and they get it at 40 years old, there is a peak early on in life around 13 years old.”

And then people also get it in their late 30s and early 40s. Very common. People get it, I’d say about half or a little more than half of what we consider Type 1 diabetes happens around 13 years of age, and then the other half happens later in life.

James Evans: That’s really interesting. OK.

So I had always heard it, and I guess I’m very wrong on this, which is, it’s good to correct me now. And I think it’s good for the audience cuz possibly they’ve heard this too.

I had always heard the Type 1 was the more genetic based or you can’t really control it type of diabetes. Whereas Type 2 was completely environmental and more so based on your actions and you can prevent that as a person by eating healthy and, you know, exercising better and X, Y and Z.

Is that the case or — obviously the genetic piece for Type 1 is wrong, but some people may know or have heard Type 2 better or more. What’s the difference there? And can you kind of give us the lay of the land on that?

Chris Clifford: Yeah, for sure. And I think you’re partially right and I think that it’s totally understandable, too, to not understand because there’s just so many different factors that are involved in developing diabetes and then there’s also so much misinformation about diabetes. It’s very hard for someone that’s not studying diabetes to kind of have a good grasp of what causes it.

And part of the reason for that is we don’t know. If we did know then we would be a step ahead of where we are now, but there is definitely a genetic component in both Type 1 and Type 2 diabetes. And how strong that genetic component is maybe not completely understood. And I don’t know how it relates between Type 1 and Type 2 diabetes, but I can say for sure that it’s not like one gene gets mutated and you get Type 1 diabetes or one gene gets mutated and you get Type 2 diabetes.

There’s also environmental factors that are very important to developing diabetes, primarily obesity. Obesity is a huge contributor to developing Type 2 diabetes, but does that mean that someone you know of a certain body weight has the same likelihood as someone else with a certain body weight of developing Type 2 diabetes? No.

Which is, one of the reasons why it’s such an interesting disease and really hard to prevent from onsetting because there’s so many different factors, environmental and genetic that play into the development of diabetes. One of the, I guess, most important distinctions between Type 2 diabetes and Type 1 diabetes is Type 1diabetes is the self-destruction of your own insulin producing cells.

For me, I have antibodies circulating in my blood to where if I even got insulin secreting cells from outside my body and put them into my body, they would die again because I have those antibodies. Someone with Type 2 diabetes has dysfunctional insulin, or their cells don’t respond to insulin the way that they should.

So insulin basically allows the blood glucose or the sugar that’s in your blood to get absorbed into your cells, and then it lowers your systemic glucose level, and that’s how much sugar is just free in your blood, which is important because if you have high sugar in your blood, it can cause organ damage and a whole bunch of complications.

So with Type 2 diabetes, You have dysregulation of insulin. Your insulin doesn’t work, but your beta cells, the insulin secreting cells are still making insulin. So there’s a bunch of oral medications you can take for Type 2 diabetes. Some people with Type 2 diabetes take insulin like a Type 1 diabetic would if they have a more severe form of Type 2 diabetes.

Some people can completely reverse their Type 2 diabetes by just changing lifestyle and increasing their exercise. That’s not the case with Type 1 diabetes. You can’t change lifestyle alone and reverse Type 1 diabetes because you have no insulin producing cells. So there’s a clear difference between the two, but you can see how it’s so multifactorial that it becomes very hard to delineate the two.

James Evans: Yeah, it’s super complex and I can understand why there’s so much research investment going into it right now because it sounds like we don’t know as much as we would like to know. Of course. And also it’s already so difficult and with the American epidemic of obesity. I know Type 2 has been way more in the news and way more heard about and discussed than Type 1 for sure.

I didn’t even know Type 1 existed until well after I had heard about Type 2. Obviously I’ve been aware of it, but that education on it has not been the same.

How did you begin doing research with Type 1 diabetes? Because it’s my understanding that you had an electrical engineering degree, then got into the lab, realized that this was something you really wanted to get into and something you really wanted to do research on and make a difference in. So you went from electrical, added on minor in bio at bioengineering specifically, and worked in a whole bunch of labs all over the place.

Give me the rundown. That’s a lot.

Chris Clifford: Yeah. It definitely was a huge shift in what I knew and what I was learning. I think i just kind of happened. It wasn’t like something that I planned on doing, obviously, because my major was electrical engineering, which doesn’t have too much to do with the research that I was doing, but I can’t say that it wasn’t helpful.

You learn a lot of really valuable skills in engineering that you can apply to pretty much any kind of problem. So, I guess when I started undergrad, I didn’t even consider doing research. It wasn’t even on my radar I decided to do engineering because I knew that I loved it.

My mom and my dad are engineers. My sister went to UCF and graduated two years before me, and she’s an engineer, so I’m the fourth engineer in my family. So they definitely had some effect on me, whether I realized it or not.

I remember one day as a freshman during the first semester at UCF, I saw a flyer for an undergraduate research event that UCF was hosting. I went and checked it out and I thought it was kind of interesting. I didn’t really know what research was because I didn’t have any experience and know anyone that was in research. So I looked for a lab, thought I might try it out, see what it’s like.

And I ended up joining Dr. Song’s lab at UCF. And he basically works in bio-robotics, so mechanical electrical engineering. And he was working on problems like how can we cut out cartilage and patient’s knee with a robot? And I thought that was really interesting. I liked the idea that I could use engineering and apply it to biological and medical problems.

So I tried it out. I loved research and that’s kind of where I found out that I liked research. After finding that out I knew that I wanted to work on a problem that I cared about, so I kind of just thought, what is a problem that I care about? And I didn’t really take that long thinking, you know, diabetes is a problem I deal with every day.

So if I’m going to work in research and I’m highly motivated to work in diabetes, let’s do that. As you said, I was doing electrical engineering and I thought that the way that I could do that, how I could kind of use EE to work on diabetes, would be to work on insulin pumps. So if you’re not aware what insulin pumps are I swapped to an insulin pump from doing syringe injections of insulin five years after I was diagnosed.

Insulin pumps are amazing. They’re basically little, they almost look like cell phones. They have insulin cartridges in them, and you just tell it how many carbs you ate, and it doses the insulin into you through a tube. So the tube is just attached. It’s like, it kind of clips into your, like wherever you have your site at.

So mine’s usually on my leg or on my stomach. So I wanted to work on these pump devices. I thought that would be a really cool way that I could use EE. And the pumps are super cool because they can work with these devices called constant glucose monitors, which measure your blood glucose all the time.

Every five minutes, which before CGMs, constant glucose monitors, people used to prick their fingers. Some people still do prick their finger to get blood drops, and then they measure the blood drops and find out what their blood sugar is. But people typically, when they do that, maybe six, eight times a day, it’s much, much less than a CGM.

So these pumps can use the data from CGMs. They can do some of the hard controlling of your blood sugar by themselves, and that makes managing your diabetes a lot easier. I wanted to try working on that and I applied to countless internships at pump companies hoping that I could get an internship there, and I heard back from zero.

So, I thought that I wasn’t good enough. And I figured I probably wouldn’t be doing anything away from UCF for the summer. I ended up getting contacted by Mayo Clinic during the first summer at UCF my freshman year by a researcher Quinn Peterson. And he ended up kind of changing my life and my course of you know, research interests.

So, Quinn is a developmental biologist biochemist. He works in Minnesota at Mayo Clinic and his lab takes stem cells, which are the cells that can turn into any cell type of your body. So these cells are usually derived from either originally embryos because, you know, if you think about an embryo, it starts out as one cell and then it ends up becoming an entire human.

So we call that blurry potency. It has the potential to turn into every cell type of the body, which has amazing scientific implications. If you think about it, you have the ability to make any kind of cell, any kind of organ. Theoretically. It’s not easy to do in practical senses, but theoretically you can make anything. If you think in the case of Type 1 diabetes, we could make the insulin to creating cells that are lost in Type 1 diabetes, transplant those cells into a Type 1 diabetic patient and they would restore the normal insulin that you would have in your body and you wouldn’t have to give yourself outside insulin. I thought that was amazing. And the more amazing thing is that I hadn’t heard of it. It blew my mind. I didn’t know what a stem cell was.

I had never worked in a biology lab never used a pipette. I was the furthest thing away from anyone that should be working in a biology lab. I don’t know why he trusted me to work in his lab, but I look back on it now and I think it’s really funny and I really appreciate that he gave me that chance.

So I went to Mayo my first summer. And I would say the first summer I didn’t do too much. I basically learned how to work in a biology lab. I ended up actually making a library of chemicals that we use to screen our — it’s called a differentiation. So a differentiation is the process of how you take that cell, that stem cell that can turn into any cell in the body and you figure out which chemicals do I need to throw on that cell so that I can turn it into an insulin secreting cell.

So that’s what I did my first summer there. And I came back again and again. I ended up spending three summers there. It would’ve been four if COVID didn’t happen. And ended up finding some really cool results while I was there. But most of all, I kind of fell in love with developmental biology and how we can use regenerative medicine to treat diabetes.

James Evans: So can you give me further insight into that experience of beginning that research, moving away from specifically engineering based and wanting to work on pumps and the hardware of the problem, but working more towards the actual bio of the problem, the actual, here’s this regenerative opportunity that we have?

That’s obviously not your background and not something you were super skilled with. Again, taking that first summer to just kind of learn what does that come with? What kind of imposter syndrome exists there When you’re in the lab and you’re like, I don’t know what I’m doing. What’s a pipette, What’s going on?

I know I want to be here and I know what I want to learn, and I know that I have a completely different skill set that is not entirely related to this, but could eventually be useful if I understand how to marry these two things together.

Chris Clifford: Yeah, I, you know, I think that imposter syndrome definitely is a huge influence in being a student, being a researcher.

I think just everyday life when you’re in situations where you might not be the smartest person in the room. But it really didn’t bother me that much. I think part of it was that there wasn’t much expected of me. Like people didn’t expect me to be good at biology because I hadn’t taken biology classes. That would be kind of weird if they thought that I was good at biology and I hadn’t done anything in biology.

So I think I benefited in that sense, but, also there’s no really sugarcoating it, it was a lot of work to be able to make that jump. I think that if you want something bad enough, then that’s fine, but you have to be willing to do what it takes to become proficient in what you’re doing.

It didn’t feel painful to me because I was so interested in the research. But it was a huge leap and I definitely still knew less than some lab members when I left, but I developed a specialization in a couple things in the lab where I could say I started from knowing nothing. And by the time that I ended my time at Mayo, there were people coming to me asking me how to do certain things, which to me was amazing.

And then to get scholarships based off the research I did at Mayo and making that change in my educational focus, that kind of validated the hard work that I put in three or four years ago And I think a factor that really benefited me was that I started early.

It is really helpful to, explore things as soon as you can because I think it’s always easier to kind of change your trajectory earlier than later, in my experience.

James Evans: The earlier you get started and exploring and finding different things, the earlier you can change out or move into something that’s more suitable for you. You’re 100% right on that.

I couldn’t agree more. You mentioned scholarships and I’m glad that you open that door because I’ve got a lot of questions. You’ve earned several, but the first one I want to talk about is the Astronaut Scholarship. Can you explain what that is for our listeners? What was the experience like earning that scholarship and what did it mean for you as you continued on in your research?

Chris Clifford: Yeah. The Astronaut Scholarship is a really unique scholarship. I don’t think I  completely understood the implications of the Astronaut Scholarship when I applied for it. So basically it’s a STEM scholarship and you can apply for it if you are a sophomore or junior, I believe.

And like the name implies, if you get the scholarship, you end up building these relationships with, not only experts in STEM and those areas, but you also get to meet astronauts and people that are involved in the space industry, which is amazing icing on the cake. Even though I wasn’t planning on working anywhere in like aerospace engineering or anything like that, just the people that become astronauts are such driven individuals with such lofty goals and just like a wealth of experiences.

Just getting to interact with them kind of inspires you in a way. But it’s also an amazing scholarship because they give you funding to support your research and you get to present your research. I got to present my research in Washington, D.C. That was a really cool experience, and you build this lifelong network of relationships.

I actually have an amazing story. When I started my program here at MIT, one of the MD Ph.D/s that are in my program was also an Astronaut Scholar. So we were talking and somehow we were talking about astronauts and I actually got this scholarship where I got to meet some astronauts. It was so cool. And she’s like, “Oh my God, did you get ASF?” And I was like, “Yeah.” So that was an amazing way to make a friend in my program, and we’re actually still super close friends. So I think opportunities like that where you get to build these really tight networks it, it can’t hurt.

James Evans: I think it’s so important early on to get access to people who are that motivated, who have already experienced much more than you, and can speak to the importance of staying motivated let alone the actual scholarship itself and what that means for your ability to continue to get your education and continue to do research and all those important things.

The network and the access and all those other opportunities that come with something like ASF. Super, Super important. And that gets me into your second scholarship. You’re the first person at UCF to have been offered the Gates Cambridge Scholarship.

So please, by all means, tell us what that experience was like. What did that mean for you? What was that decision like as you were kind of deciding whether to take it or not?

Chris Clifford: Yeah, that was it was just a real experience for sure. I think it’s probably the decision that I’ve made in my life, or one of them.

It was a really interesting experience. I ended up applying to Gates Cambridge because Cambridge has amazing research in stem cell biology. And the mission of Gates Cambridge is they want to fund people who have a vision to have a betterment for society, however they’re going to do that.

And a lot of Gates Cambridge Scholars are working in health, but not necessarily for me, my application was centered around reducing Type 1 diabetes and diabetes in general because it is an epidemic. Being able to do basic research and stem cell biology, figure out how we can improve how we make these cells from pluripotent stem cells, how we can get around the ethical issues of using embryonic stem cells and instead use other pluripotent cell sources.

There are so many challenges that need to be tackled in, the diabetes and regenerative medicine space and cellular therapy space. That was kind of what my Gates Cambridge application was centered around. But the scholarship is an amazing opportunity because it funds you for an entire Ph.D. at Cambridge, which would not be cheap otherwise.

And you also are in a cohort of all of these extremely motivated and wonderful students that are working, to have some kind of tremendously beneficial impact on society. So, being the first UCF scholar for Gates Cambridge was really yeah, it was surreal.

James Evans: You eventually had to make the decision whether to go to Cambridge or not, and you actually ended up deciding to go to Harvard-MIT. So obviously both paths are amazing and both paths lead you to the ability of being able to do tremendous work for the world and possibly curing or helping cure Type 1 diabetes.

What was that decision like, and then how did you end up making the decision to go one way or the other?

Chris Clifford: Yeah, I’m not sure I entirely did on my own. I got, I guess, fortunate and unfortunate, depending on how you look at it. I tend to say that I was fortunate. But my mentor, so Ph.D.s in the U.K. you have to apply to work with the person that you’re going to do your Ph.D. under. So that person that I anticipated doing my Ph.D. under ended up moving their lab to Germany. So that made Gates less appealing for me because I would basically have to work with someone who I didn’t really anticipate working with. And the research I’d be doing would maybe not directly have anything to do with Type 1 diabetes, and that’s kind of a situation I really wanted to avoid.

Even though Gates Cambridge is an amazing program and such an amazing opportunity, I know my values are centered around working in Type 1 diabetes and I think that my Ph.D. experience would not be very fulfilling if I had to work in something that was outside of that realm. So, I ended up deciding on Harvard-MIT, which is an equally amazing opportunity. And I never thought that I would get the gates Cambridge because it’s such a competitive scholarship.

That was always my top pick because you know, Boston, where Harvard and MIT are at, is just a huge biotech hub. And there’s so many innovators in the Type 1 diabetes, pharmaceutical and cellular therapy space in Boston that it’s kind of exactly where I wanted to be. And then, you know, life happened so like a couple days after accepting the Harvard-MIT program the person that I wanted to work with at MIT ended up going into industry.

I think that you have to roll with the punches. It’s not like everything’s smooth sailing. After that happened I had to identify some other labs that I was really interested in working with, and I had a list, obviously, but now that my top pick was in industry, I really had to start thinking, what do I want to do with my Ph.D. and my academic career?

From my experience at Mayo, and just how the science and diabetes is moving, we actually have a pretty good grasp on how we can make insulin secreting cells. We don’t have it down to a science at all, but we can make enough cells to treat someone with diabetes. So in my mind, you know, my engineering mind, and I think a lot of people, this is not just me, a lot of people in the field agree with this sentiment, if we can make enough cells, what’s the point of making it so that we perfected the protocol, we have the cells, let’s try and put them in people?

So the next challenge that really pops up is like I was talking about earlier even though we have these cells, if we transplant them into people with diabetes, they will get killed again because your autoimmune response persists. So now we have to find ways that we can change how these cells look to the immune system so that we can put them in someone and the immune system doesn’t see them as dangerous and try killing them. So that’s what I am trying to focus my Ph.D. on now, is how we can modulate the immune expression of ours.

Pancreatic beta cells that we’re generating from stem cells so that people can eventually get these cellular transplants without having immunosuppressive drugs, which have very severe side effects.

James Evans: Yeah, absolutely. So, to make sure I understand it correctly the problem initially was creating the insulin creating cells just to begin with, having enough of them being able to actually get them into somebody’s body so they can be used. But then that, of course, doesn’t solve Type 1 diabetes because Type 1 diabetes is where your autoimmune system attacks those cells That’s why there’s none of them now and so by putting them in there, you’re not doing anything because at the end of the day, they’re still going to be attacked and destroyed.

So now the important piece in what you’ve had to do over time is pivot into this, is focus on those cells once injected into the body or as you’re getting them into somebody’s body that they’re looking or disguised to our immune system so that they aren’t attacked so that they are OK and usable. And viable over at least some period of time, if not somebody’s lifetime.

Chris Clifford: Exactly. And it, you can think about it, just like you said, it’s like an invisibility cloak. How can we cloak the cells from our immune system? And you know, that comes with a lot of challenges because if you think about what an invisibility cloaked cell from your immune system is, that’s cancer.

James Evans: Yeah.

Chris Clifford: So you have to be. Careful that what you’re designing is safe for patients. Because if you put something into someone that their immune system can’t see and then that becomes cancerous, then you know, that’s a huge problem. And fortunately, we haven’t seen that pop up as a huge problem in the data that it has come out so far.

But it’s a good thing that people are being really careful.

James Evans: That’s actually a really good area to get into. Obviously I wouldn’t be aware of it, but I’m super curious are you pulling research from other areas that have tried to do almost this exact thing? Because there are other diseases, of course, that you know, have similar kind of issues where the immune system attacks some cell in the body that’s important to function and then suddenly not having that function is a really big problem.

So are you pulling research from other areas? Is something like this research quickly applicable or practical in a different area that kind of like crosspollination that can happen between these different sections of science and these different problems being solved concurrently, essentially?

Is there that ability to kind of use it in other areas or other applications?

Chris Clifford: Yeah, that’s a great point. There  definitely is that cross pollination from different fields. I would say cancer biology, cancer immunology has had a huge influence on Type 1 diabetes research, but immunology in general as well as developmental biology. Even biomaterials (is) one of the approaches that people have tried using and are trying to use. Researchers are trying to basically put these cells in like an algenate bubble. So it’s like a biocompatible material that encloses the cell but still lets oxygen and nutrients get through, but stops the immune molecules and cells from interacting directly with the insulin greeting cells. So it’s kind of like a little house. That lets what you want in, but not what you don’t want, which would be the immune cells. Which theoretically sounds great, but in practice it’s very hard to design. Because you have to have really precise manufacturing. But there’s all kinds of different ways people are going about trying to solve this problem, which makes it, in my opinion, a really interesting field to do research in.

So I think I’m fortunate that not only am I really motivated to work in this field, but that the field is so interesting.

James Evans: I think it’s really fascinating as somebody who’s standing from the outside, being able to ask you questions. And very curious about what’s going on here and being able to understand it. It’s so important to have this information out there, have this awareness, by the general population as to what’s going on and for other people to understand in the essentially layman’s terms what’s happening with the research.

That gives us a better sense in confidence that it can be solved, it can be fought, which is super important for a whole bunch of reasons as far as people’s hopes around the subject and the ability and the future to be able to cure it and all these amazing things.

I really want to kind of explore this topic of how you’ve developed an academic slash professional research community around yourself and built that network to be able to feel that sense of support, that sense of capability, that we can fight this, we can solve it, we can make the world better. Because there’s a lot of different ways that you’ve done that over time. Coming to UCF, the Type 1 Diabetes Club that we have here, and building that sense of social community. That there are other people that are dealing with this. There are other people that do understand what you’re going through and you can find encouragement through that.

I really want to take a step back and look at that what has your experience been like as you developed these very clear communities around yourself, professionally, academically, socially. There [are] all these different support systems coming into play. I’m really curious where that comes from, what your thoughts are how one can build community around themselves and what that can mean for doing amazing things, getting great scholarships, going above and beyond.

Chris Clifford: I was very lucky, very fortunate to go to a school that had a Type 1 Diabetes Club. That’s not like a normal thing. Most schools don’t have a Type 1 Diabetes Club. So that was kind of fortuitous. And, you know, the Type 1 Diabetes Club, by the way, if you have Type 1 diabetes or are interested in Type 1 diabetes, I would highly recommend checking out. It’s actually started by the staff at UCF.

It’s run by Mary Schmidt Owens, who’s the head of the health department here. It’s such an amazing opportunity because not only does it kind of build a community at UCF, which is such a huge university. There’s no way that I would’ve built these relationships and found all these people that had diabetes and all of these diverse majors and at different points in their undergraduate careers.

I would’ve never made these connections. So the Type 1 Club for me was an amazing way to meet people, especially when I was a freshman transitioning from high school into college life where I couldn’t depend on my parents. I had to adapt to living with roommates which I was very fortunate to have good roommates.

There’s all of these huge life challenges and you’re becoming a more independent adult when you’re transitioning into college. So having the Type 1 Club was just this amazing support, infrastructure that you could not only learn from other people who’ve had diabetes maybe longer than you or in college, and they know the ins and outs of living with diabetes and being a college student, which is very different from being a high school student.

You also get access to all kinds of health resources they provided. The Type 1 Club provides free A1C testing, which basically is like a three month average of what your blood sugar is. That’s a routine way that people with diabetes evaluate what their blood glucose levels are.

And they normally do those at diabetes doctor’s appointments when they go to see their endocrinologist. So having access to free A1C every single month was an amazing opportunity. All the different discussions and learning about the new technologies, which was a huge component of the Type 1 Club having pump manufacturers come and talk to us and learning about how we can improve our health and how we can live better with Type 1 diabetes is an amazing resource.

And I understand that not everyone has access to that. So I’m really fortunate for that. And luckily college organizations where students with diabetes organizations are becoming more popular. So I’m really happy about that. And I was so passionate that I ended up taking a leadership position while I was an undergraduate here in the club because I just felt so strongly that it was a really important way for people to grow living with diabetes as a college student.

And from that experience, I really grew a passion for equity in diabetes care. I’m very fortunate, like I said I come from an upper middle-class family. my mom and my dad are engineers. So I was relatively well off and had decent health insurance, which is so critical for people living with Type 1 diabetes because the health insurance companies don’t seem to care that maybe one pump has better health outcomes than someone not on a pump or a different brand of insulin pump, or a different brand of insulin CGM. There’s really no standard for different health insurers. So if you happen to be on one plan, maybe you can’t get the pump that you want, or maybe you can’t get a pump at all. So these kinds of problems I think should never exist. Tons of amazing data showing the benefits of being on a pump or a CGM versus being on insulin injections using a syringe or using blood pricks to measure your blood glucose.

I became aware of these, you know, systemic issues facing people with diabetes. And I think that really motivates me even now to think about when we’re developing new therapies for diabetes. Because some people are surprised to hear that insulin has been around for over a hundred years and it really hasn’t changed much the way that we manufacture. It changed, the drug hasn’t changed much. That’s how we still treat diabetes. So the drug hasn’t changed for over a hundred years, and for some reason the United States has the most expensive insulin out of any country in the world, and people are rationing insulin in a first world country because they can’t afford their insulin.

And you know, if some of the listeners are keen on the current political climates, they may have heard about the Inflation Reduction Act, where they have capped the cost of insulin to $35 a month, but that only affects people that are retiring or 65 or older. So, sounds great. It’s some progress. But for people like me or people that were in the Type 1 Club. doesn’t really mean much. So when we’re developing these new therapies for any kind of disease, we really need to be cognizant of how can we ensure that what we’re making actually can get into the hands of people that need the treatment? Because if that effort isn’t done at a basic science level, at a pharmaceutical company level, then you know you can’t rely on the policy makers to make these treatments available to patients.

James Evans: No, you’re absolutely right. You could not be more correct on all of those statements. It is so important when you’re developing alleviation or therapeutic remedies to a disease or a cure to a disease, that it is readily accessible and the key word there is accessible to all of those affected by it.

We’re going to have to be able to implement, and hopefully very quickly, the solutions to these issues because that will affect millions of Americans, and that makes a huge difference. So it’s really important to recognize that you’re doing great work with this.

So I want to thank you for that. Some other things I’m very curious about because not only are you a researcher in bioengineering having the background in electrical engineering, you’re also working or have acquired, I don’t know, your pilot’s license. I read the (UCF) Today article and you were working on it at the time. This was the summer before you had gone to MIT when the UCF Today article was written. So I have questions around that. Did you get your pilot’s license, first of all? Second, there’s a robot that’s mentioned in that article. Did you finish the robot and did you donate it? And, you know, what was that like?

I’m really curious about all these things. I’ve got follow up, I need closure from that article.

Chris Clifford: Yeah, I did get my pilot’s license. Hooray! That’s been like a lifelong goal for me. And actually part of that was funded by the Astronaut Scholarship.

James Evans: That’s great.

Chris Clifford: Shout out to the Astronaut Scholarship. We love you. Yeah, so I ended up getting my private pilot’s license back in June of this year. And afterwards to celebrate I flew up to see my sister and my six nephews in Alabama. And that was an amazing experience. And then since I’ve been here at MIT, I actually just last week flew for the first time in Massachusetts, which was awesome. There’s an airport up here in Salem where they have the witch trials. So, I am so glad that I managed to get my pilot’s license. My dad is a pilot so he always made me have that goal. Like I wanted to get my pilot’s license.

And one of the challenges, one of the many challenges of having diabetes. is that most things you want to do you have to have extra considerations. Before I decided on going to college, one of the careers that I really wanted to pursue was being a fighter pilot, but you couldn’t join the military if you have diabetes. That stuck with me, kind of the limitations that are imposed on people that live with diabetes. And I think that’s another driving force and like why I’m interested in researching diabetes is there’s just so many things that are said are out of reach due to having diabetes. Being able to lift those barriers, really, I think is a driving force and why I’m interested in pursuing diabetes research.

So yeah, got my pilot’s license. That was great. The robot. Yeah, I had some amazing undergraduates on my senior design team that helped me build that. I think no one knew what they were getting into. That was on my senior design projects when I proposed that idea. But they knew that I had a clear goal and I think they kind of liked that that I had some vision for what I wanted to do and that it had real application and could make a difference in the world.

So we ended up going with my project idea which was basically a robot that would automate what I was doing at Mayo Clinic, or at least part of what I was doing. So the robot basically uses a tool that has a bunch of metal pins that dips into a plate with a bunch of chemicals. And those are the chemicals that we use to force our cells to become the cells that we want them to be. So, the robot will do that whole process, which I was doing manually for many months. So we ended up successfully making the robot, which was amazing.

It was a huge monetary investment, so that’s where scholarships really came in clutch and gave me like the intellectual freedom to kind of pursue what I want to. I mean just the metal part of the robot that goes into the chemicals like that was $4,000. So like the project was very expensive and very stressful. And also one of the huge challenges of it was that it was during like the peak of like the COVID pandemic. So, anyone that was working in engineering or computer engineering during that time knows that it was very hard to get your hands on like any kind of semiconductor chips.

So, trying to make the motherboard for the robot or like source the microprocessor chip, that was very hard. We basically just had to buy like a preexisting board and then desolder the chip off of it and then transplants it into our project because we couldn’t get our hands on one by itself.

So, that was an interesting problem to go through. And because of that we never got to completely finish the prototype. So I have the robot and it works and everything’s great. The main problem that you have to deal with working in a stem cell lab is stem cells are really delicate, so everything that you use in proximity of stem cells has to be very easily sanitizable. So basically anything touches or gets near stem cells, gets doused in ethanol. So, right now the prototype that we made was made out of material that cannot get doused in ethanol. So we need to CNC the robot out of aluminum. So we couldn’t do that during the pandemic. We couldn’t get the CNC work done or manufacture the motherboard with surface mounted ICs.

So that is what needs to be done in order to give it to Mayo. Otherwise, my team really enabled me to complete the projects in the way that I wanted to, which not only was a great end result that is actually useful, but it was a really cool experience and I have some really terrifying and amazing memories from never sleeping for days straight during that final stretch of our senior design project where we were all on crunch time and we took one hour naps in the car. We were on nap shifts. So, it was a good experience.

James Evans: That sounds like it.

And honestly, you’re working so much and you have such a purpose and a drive, and it means so much to so many other people. And it can make such a difference. That’s how life goes when you, you’re just that purpose driven. I totally get that. You’ve obviously had to pivot a lot in your life. You’ve obviously had to deal with changes and things happening, whether that’s in research, whether that’s in, making major life decisions, whether that’s in having things happen to you, such as being diagnosed, right?

How do you handle pivoting? How do you handle dealing with frustration, making huge decisions or having things happen and needing to adjust?

Chris Clifford: Yeah, that’s a good question. I think in a way I don’t actively consider how I deal with situations like that. I think I always try and put myself in a situation where I’m just taking the best opportunity presented to me. And just kind of being in a mental state where you are doing everything that time, energy is allowing you to do.

And I think a huge part of this is understanding your core values and what you’re trying to, what you’re trying to do long term. For example, for me, I didn’t really worry about going outside of electrical engineering and starting my internship in developmental biology because I knew that my end goal was that I wanted to be in a research setting where I was contributing in a team environment to curing Type 1 diabetes.

And I saw this as a better avenue than working on insulin pumps because insulin pumps are never going to cure Type 1 diabetes. They’re always going to be tied to some kind of device in my mind. So I thought it was an amazing opportunity and I pursued it. I think that. That mindset can apply to a lot of things. Not necessarily just career, but just being open to what comes your way and not kind of limiting options because you think that you either don’t have the skills necessary or that it wouldn’t be a good fit. I think just kind of being open cautiously permissive of like the options that are presented to you and just exploring.

I think also realizing that like in my case, if I ended up doing the stem cell biology research and I couldn’t do it, or I wasn’t interested in it at all, then worst case, I would’ve just not had an internship if I didn’t take that opportunity. Having the capacity to invest time in something that you don’t know too much about but seems interesting and just putting yourself out there, I think can sometimes be really rewarding.

James Evans: For our final questions. What advice would you give to someone who wants to do what you do? And I’m going to actually tailor this a little bit, what advice would you give to somebody who wants to do research in your field, or somebody who wants to get a scholarship, like the Astronaut Scholarship or Gates Cambridge?

If you could answer those both, that’d be great. But if you just want to pick one or the other, that’s up to you.

Chris Clifford: Yeah, I think advice can widely apply. I know that it works in my life. I don’t know how it applies to other people, but I have met people at MIT that share a similar philosophy which might be indicative of something that it has a good idea. But kind of what I was saying, that you just have to be open and willing to take the best opportunities presented to you. And also I would say, like my motto that I kind of live by is always strive to be the dumbest person in the room. I think that is an amazing way to grow. A lot of people are scared of being in an environment like that, but I pursue environments like that. If you’re the dumbest person in the room, there’s only one trajectory really. you’re going to be forced to learn a lot faster than you would otherwise. And I think that’s one of the reasons why I love the program I’m in right now, because I am in a minority.

The Ph.D. students are vastly outnumbered by the MDs and MD PhDs. So a lot of the classes that we have, we’re talking about these really complex diseases or working with patients and learning about their conditions. And obviously me with an electrical engineering background, and it was a lot less than some of the Harvard Medical School students. So being in an environment where you’re forced to learn from people that are so much more well studied on whatever that topic may be really forces you to grow as a person and like intellectually.

And I think that doesn’t just apply to someone that wants to do a Ph.D. at Harvard or MIT. I think that applies to a lot of aspects of life. If you want to learn something or if you want to pursue a goal, then just do it kind of blind to like what people might impose on you. If you’re really interested in something, just go for it. And I think a lot of times people are surprised to find that people aren’t trying to gate keep you from learning stuff.

They actually love the opportunity to either share knowledge or know that they played like an integral role in you developing.

James Evans: I think you’re entirely right. I could talk forever about having the mindset of seeking out uncomfortable situations, seeking out spaces where you’re not the smartest, where you’re not the best, where you’re not the most whatever because that’s super important for growing, right?

It’s so important at the end of the day to have the right mindset around being uncomfortable. You’re going to be in spaces where you’re not going to know the answer. And it’s so important to be able to take that with a grain of salt, not have the chip on your shoulder because that’s where you’re really going to be able to grow to get to the next level.

And then once you’re there, are you bringing somebody else with you? Are you mentoring? Are you training? Are you leading somebody else down that path that’s super important to continuing to make the world better? So I think you’re entirely right on that. My last question is, what’s one thing you’re still hoping to do, obviously besides curing diabetes or finding some permanent alleviation or therapeutic remedy for it, what’s one thing you’re still hoping to do?

Chris Clifford: I think in the diabetes sphere, I am really interested in pursuing different forms of public policy to kind of work on some of the issues that we touched on about how there is not equity in how healthcare is delivered, especially in the United States.

But on a more personal level I would love to join a singing club here in Boston. Do something kind of fun. There’s a lot of really cool clubs here in Boston and I think one of the things that I’ve struggled with throughout my education is trying to make like ample amount of time to do things (that) maybe don’t have direct relationship to the interests that I have academically or  things that I’m comfortable with. So, I’m actually going out tonight with a bunch of friends and we’re doing karaoke, so that’s going to be fun. I think, just kind of taking some time to slow down.

I think grad school is a very, very different beast from undergrad and you finally get a little bit of time to maybe start to live your life.

James Evans: Did I miss that earlier? I know that you’re a horn player. You had said that. Did you do choir or anything?

Chris Clifford: No, I didn’t.

James Evans: So you don’t have any singing experience or background?

Chris Clifford: No. No. And I’m awful at singing.

James Evans: I love this because I am the same way I sparingly use the word hate, but I hate people who can just naturally sing well or don’t have a lot of training and are just like, I can belt and this and that and I can transition from my head voice to my chest voice with like no gear shift and you can’t even tell. And I’m like, no, it’s not fair. It’s not fair because you just naturally have this power over everybody else and what do you do with it? You just pull it out whenever and you have your own little party trick. I don’t like it because I want it and I can’t do that.

So I love that you’re a looking to get into that and singing, because I think that’s such a cool skill that people have and it can be used in so many different ways and for so many different things.

So I love that. And also, again, just finding and doing something (that) is interesting to you, but not what you’re good at. Again, getting into those uncomfortable situations of, I’m going to eventually have a voice crack in the middle of singing, and that’s not going to be fun, but it’s going to be hilarious. And all those different things. I absolutely love that.

Chris Clifford: Yeah. Thank you. Yeah. I’ll keep you posted on how that’s coming along. Might have a different goal the next time you talk to me.

James Evans: Totally fair. Like, that’s the next thing. Doesn’t work out. All right. What are we pivoting to next?

So yeah, absolutely. You have been such a pleasure to have on the show. Seriously, thank you. We had such a long meandering conversation that covered so much important stuff and really got into the nitty gritty of Type 1 diabetes having a good, successful mindset.

What that. And what we can do to cure Type 1 diabetes. So I really appreciate you being on the show today, Chris. It means a lot both for me, for our listeners and for UCF. You are representing us well all over the place and doing amazing work, so thank you.

Chris Clifford: Well, thank you. It was a pleasure to talk to you and you know, I really appreciate the opportunity to maybe shed some more light on diabetes.

James Evans: Thank you again, Chris, for being on the show today. I have learned so much about Type 1 and diabetes in general there were just so many good nuggets of advice and hope throughout this conversation.

On our next episode, we’ll be interviewing with Dr. Greg Buckingham. Dr. Buckingham is a member of the College of Community Innovation and Education, teaching public Administration.

Before joining UCF’s faculty, Dr. Buckingham spent 28 years working for NASA, mostly at the Kennedy Space Center. As always, if you’re doing something cool, whether that’s at UCF or somewhere you took UCF that we should know about, send us an email@socialmediaucf.edu and maybe we’ll see. On an episode in the future. Go Knights, Charge On.

Gregg Buckingham: Whatever level you’re working at, local, state or federal, you will know that you contributed to the community and to the larger country or state and that is a very rewarding feeling. That’s why I went into public service.

 

Nicole Dudenhoefer ’17 | Podcast by UCF Social
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