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Tribute to Jay S. Skyler, MD, MACP

2021; Mary Ann Liebert, Inc.; Volume: 23; Issue: 4 Linguagem: Inglês

10.1089/dia.2021.0090

1557-8593

Diabetes Treatment and Management

Diabetes Technology & TherapeuticsVol. 23, No. 4 Free AccessTribute to Jay S. Skyler, MD, MACPPublished Online:22 Mar 2021https://doi.org/10.1089/dia.2021.0090AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Dr. Jay Skyler has retired from his role as Senior Editor of Diabetes Technology & Therapeutics after 15 years of service. The journal leadership team, the publisher, and the diabetes community are enormously grateful for his dedication and hard work. We hope that Dr. Skyler will enjoy the comments below from his colleagues, presented in alphabetical order. Knowing Jay, I am not sure he will ever retire. We will all miss him at DTT.―Satish Garg, MDEditor-in-ChiefIt is a great pleasure to say a few words about one of the major figures in diabetes of the past few decades.My earliest memories of Jay were when we were both young diabetologists. I was invited to an insulin symposium in Miami where Jay presented pharmacokinetic data on Ultralente, requiring hourly blood sampling for well over 24 hours. He had the good sense to ensure that someone else took the samples! Another memory was at a meeting on home blood glucose monitoring in Melbourne, where Professor Paul Zimmet in the end presented each of us with a pair of boxing gloves, as we had disagreed somewhat vehemently during the meeting.Jay's first major contribution, however, was as a dynamic and imaginative editor of Diabetes Care. In one of the first editions, he reproduced the excellent papers of Jean Pirart from Belgium, which showed in an uncontrolled but convincing way that glycemic control was related strongly to the development of micro- and macrovascular complications. This was a great service to English-speaking diabetes researchers.Over the intervening years I have had many fruitful and entertaining discussions with Jay.Over the decades Jay has made many contributions, particularly in the genesis and natural history of type 1 diabetes, and he shows no sign of slowing down. Congratulations, Jay.George AlbertiUniversity of Newcastle upon TyneUnited KingdomDr. Skyler will be retiring from his service as Senior Editor of Diabetes Technology & Therapeutics, and I have been asked to describe his career in “just few words”. That is an impossible task!Even though I have not had the honor to be introduced personally to Dr. Skyler, I have followed his stellar career, like a timid but dedicated “fan”, ever since I entered the world of diabetes technology some 20 years ago. Even before social media, here I was, trying to get my hands on every possible article Dr. Skyler penned or any lecture he delivered! You could call me a true ‘follower’―this term was not even coined.On the other hand, defining Dr. Skyler's impact on my career and my perception of this “Giant of Diabetes”, is easy. It boils down to two words: awe and respect.Author of hundreds of major diabetes articles, Founding Editor-in-Chief of Diabetes Care, pioneer in TrialNet research for over 20 years, with a never-ending list of accomplishments, Dr. Skyler has exemplified the ultimate diabetes researcher of the 20th century. He has made seminal contributions to the areas of diabetes at a time when the many facets of type 1 diabetes had not been fully understood, and when diabetes technology was in its infancy.When there were no books on diabetes and technology, insulin pumps or CGM, and automated insulin delivery was still a “dream”, attending Dr. Skyler's lectures during scientific meetings was “the” lecture not to be missed, where I could gather information otherwise not available.One could describe his lecturing style as a mix of energy and stamina: a force of nature. I have seen Dr. Skyler deliver lecture after lecture regardless of whether we were in the US, or in Europe, no jet leg in sight, pure exuberance, wholly entrancing the audience. Because when Dr. Skyler delivers a presentation, you do not want to miss any words; you hang onto them as you are aware of the presence of a rare combination of expertise, knowledge, and humility. As you can imagine, I would sit in the front rows, in the hope to have the opportunity to ask Dr. Skyler more questions at the end of the presentation and learn more from him. Unsurprisingly he was always surrounded, so that task was practically impossible! I did at one time, however, succeed and had the chance to ask him questions, taking furious notes once I got back to my seat! He was generous with his time, but this is also not surprising.His scientific generosity is unsurpassed: promoting new journals, including Diabetes Technology & Therapeutics, spearheading new research and clinical projects, pioneering new treatment modalities, supporting the development of new technologies―all these represent who Dr. Skyler is.Lastly, I personally had the chance to experience that he truly cares for his patients. I had the pleasure of inheriting one of his patients who moved from Miami to Chicago; he spoke so very fondly of him and asked me that if I ever saw Dr. Skyler at a conference, I was to make sure to send him his regards. So, when I had the opportunity to say a timid “hello” during an EASD conference in Barcelona, Spain a few years ago, I told him that one of his former patients was “saying hello “. Not surprisingly, he remembered! That moment was priceless.I can say that Dr. Skyler, unbeknownst to him, has been a “virtual” mentor to me, and I can only thank him for his phenomenal accomplishments and advances in treating diabetes that have benefited not only myself, but a lot more people he will ever know. As we say in Italy, ‘Grazie!’, ‘Thank You’, for your contributions; the world of diabetes is better because of you.Grazia AleppoNorthwestern UniversityChicago, IL, USAMy favorite personal story about Jay (I wonder if he will remember this!) concerns a flight to London, on which we met – after all, where else to go to meet Jay? – unexpectedly, having attended different meetings. We were seated together and were comparing notes on our meetings when Gianfranco Bottazzo wandered down the aisle, having been at a third meeting in the same city. I cannot remember exactly the words Jay used to explain why we were traveling together, but I hope it never got back to George! Typical Jay – always humorous and quick-thinking and able to make the most of any opportunity. Although never otherwise duplicitous, of course. A polymath who never hesitates to get involved and who is thus able to speak authoritatively and with sparkle on so many topics in diabetes.Congratulations on a great job done for DTT, Jay. It is hard to imagine you retiring from anything, but I bet it is just to allow you to take up something new. Very best wishes for your next project(s)!Stephanie AmielKings College LondonUnited KingdomI first met Dr. Jay Skyler 20 years ago. Jay was the medical and clinical advisor on the Dexcom board. I was the clinical and regulatory executive at Dexcom. Over the last 20 years, Jay has been a board member, clinical advisor, and a key opinion leader in the diabetes field. I have had the privilege to work with Jay during this time. His contributions and advice have been so valuable in the development of the Dexcom CGM, but most importantly in the medical advances in treating diabetes. His clinical and medical advice to me was so helpful in designing our CGM clinical trials, as well as in recommending clinical sites for our studies.Jay is always thinking about improving patient care for people with diabetes. His passion to keep up with the latest technology and advances is second to none in my mind. You can always depend on Jay to keep folks updated on the latest news in diabetes or other medical topics relevant to improving the lives of patients with diabetes.At conferences I was very impressed with the energy that Jay had: ADA, ATTD, and many other venues. No matter what time it was, a 5:30 a.m. seminar where he is a speaker or a 6:30 p.m. debate, you would find Jay participating in the meeting either as a speaker or asking questions. He provided such inspiration through his passion to keep up with all the latest technology and to be present at the conference sessions and seminars. Of course, if I had a question about a specific point in the meeting, Jay would provide the insight to clarify the issue.There is no need to mention all of Jay's wonderful accomplishments in the field of diabetes and medicine, as there are too many to mention. He has been a key opinion leader in the field of diabetes for decades, authored and reviewed numerous publications, and he has continued to push both industry and the medical field to improve patient care. I cannot find enough words to describe the impact he has had in the field of medicine, especially in treating diabetes.It is always a pleasure to be around Jay as you always learn a little tidbit of information you never knew before.Jay, it has been an honor to know you and work with you over the past 20 years.Andy BaloDexcom, Inc.San Diego, CA, USAJay Skyler has been a pioneer in type 1 diabetes for decades. Perhaps best known for his leadership of the Diabetes Prevention Trial and TrialNet, his influence has been felt throughout all facets of diabetes. He has been a strong proponent of randomized trials and has had a leadership role in many trials over the last 40 years. It is difficult to focus on any specific contributions Jay has made as they are too numerous to cite. A key area of his research has focused on pharmacologic treatments to alter the immune process in type 1 diabetes and here his contributions have been immense.Jay has been active in the ADA, among many organizations for which he has provided service. He also has lent his expertise to many companies involved in the development of drugs and devices to help the lives of patients with diabetes. In addition to all of this, Jay has been an educator and mentor and has been responsible for training and advancing the careers of many endocrinologists. Jay has had an important role as a senior editor for Diabetes Technology & Therapeutics for many years. His wisdom and insights will be missed but we know where to reach him in a time of need.Roy BeckJaeb Center for Health ResearchTampa, FL, USAI am told Jay Skyler is leaving the position of Senior Editor of Diabetes Technology & Therapeutics, and I'm given the opportunity of greeting Jay on such an occasion.I first met Jay forty years ago, the first year of presidency of Ronald Reagan. Jay was coming to Italy as an invited speaker to a pioneer meeting in Assisi “Artificial Systems of Insulin Delivery”, organized by the University of Perugia. As a young researcher with quite limited international experience, I was attracted by the big names of people at that time in metabolism and bio-engineering research, namely Jack Gerich, George Alberti, Michael Albisser, among others. However, my curiosity was captured by the speeches, the comments and, overall, the vivid personality of young Jay Skyler about topics such as artificial pancreas, pumps for continuous subcutaneous insulin infusion, and precursors of glucose sensors. That September 1981 has remained memorable for me: not only had I watched at the television Simon & Garfunkel playing the concert in the Central Park in New York City, but I had also met Jay. Soon upon receiving an invitation to submit an original paper, I learned Jay was the first Editor of this newborn journal, Diabetes Care, quite unknown at that time. In the subsequent years, I have witnessed the rapid success of the journal under the editorship of Jay.Ever since, I have been in contact with Jay, either directly or indirectly by reading his innumerous papers, listening to the hundreds of presentations at the ADA and all sort of other meetings. What I have always admired about Jay, has been his ability to deliver lectures on a wide array of topics, moving from immunology to clinical therapeutics, from prevention to treatment of diabetes, and so on. He is not monothematic in research (as I consider myself), but universal, and able to quickly move across different fields of science, always with competence, information, authority, and delivery of long-lasting take-home messages. I consider this ability unique and extraordinary.It would be difficult for me to list all the important scientific contributions of Jay. Other colleagues and friends, I am sure, are going to do this. Today Jay retires as senior editor of DTT.We are all looking forward to Jay's future contributions, still many to come I am sure!Ciao Jay, ad majora!Geremia BolliUniversity of PerugiaPerugia, ItalyJay Skyler – The Ultimate TeammateJay Skyler and my career were loosely connected in my youth. I have the vaguest recollection of Jay on the interview circuit looking for his first faculty appointment visiting with my parents who tried to recruit him in Charleston in 1975. As a MD, PhD student at Duke, I often heard a mention of Jay's exploits as I traveled in his wake. That said, I only knew his name and his scholarship until I was in my mid-30's. Everyone has had the experience of meeting someone respected from afar for the first time and being shocked. When I first got to know him personally in the early 1990’s, it was inconceivable to me that “Dr. Skyler” was so young and willing to engage a young squirt like me. And for the last 30 years I have valued his friendship, advice, and insights.Jay's ability to combine serious scholarship, leadership, and genuine friendship with so many people has been his defining characteristic. In that way, he is the ultimate “teammate”. Whether as leader or follower, his contribution and conviviality are unparalleled. His concept of “team” variously has included collaboration with investigators from other disciplines, among multiple institutions, with companies, and most importantly the teamwork required of patients and providers working together. And with this team-based approach, Jay has innovated serially in various settings in ways that have changed the field of diabetes forever.From Jay's first “diabetes summer camp” experiences as a fellow, he reported on increased independence of campers in managing their diabetes after attending summer camp. He was one of the first to recognize that the top-down style of diabetes management in which the doctor prescribed treatment and the patient's job was to comply was inherently flawed. He was also one of the first to examine the behavioral aspects of diabetes management and to embrace the concept of diabetes self-management. As the founding editor of Diabetes Care, through the late 70's and early 80's he used it as an instrument to extend this focus through a series of important papers that established the current tenets of modern diabetes management such as patient empowerment, peer support, glucose monitoring, insulin dose self-adjustment, insulin pump therapy, glycemic targets.He performed some of the earliest comparative research studies examining how various techniques and products performed relative to each other in clinical practice. This early portion of his career is remarkable as the seminal Diabetes Control and Complications Trial would not be completed for more than a decade later. In the 1980's and beyond, Jay continued his clinical studies on optimal treatments in diabetes focusing on pregnancy; diabetic neuropathy, foot ulcers and cardiac autonomic neuropathy as well as diabetic kidney disease describing and debunking various clinical techniques in diabetes care and establishing much of the current management of the complications and comorbidities of diabetes. For me, as an MD, PhD student and later house officer and fellow focused on diabetes, his publications had a huge impact on my thinking as his words rang so true with my experience.Most people have forgotten Jay's role as the premier clinical care thought leader of a generation ago and do not realize how his engagement of the broad diabetes community and writing was formative of our current standards of care.Jay is most widely recognized for his work on the immunology of type 1 diabetes as a means to prevention. After leading or participating in a series of studies aimed at prevention or cure of type 1 diabetes since the mid-1980’s, in 2001 he was successful in establishing a national consortium funded by NIDDK. TrialNet has been hugely successful, recruiting hundreds of thousands of participants over two decades. His vision and leadership were critical elements in establishing this explicit collaboration of patients, families, mechanistic scientists, trialists, clinicians, companies, foundations, and government agencies. In 2021, we may have the first FDA-approved treatment to prevent or delay type 1 diabetes based on his effort.But my strongest impression of Jay is as a great friend. Whether on business travel, a long weekend get-together, or a vacation, Jay, Mercy, and their extended family are outstanding hosts and companions. We get a few hundred holiday cards every December, but Jay's is consistently the loveliest photograph presented with pride in his and Mercy's large and growing family. So to close, Jay, cheers to you as you give up another task! Just because you are stepping down, you must know that you cannot step away. Love you, be well and keep the holiday cards coming.John BuseUniversity of North Carolina School of MedicineChapel Hill, NC, USADiabetes Technology & Therapeutics, the only peer-reviewed journal addressing all aspects of diagnosing and managing diabetes with cutting-edge devices, drugs, drug delivery systems, and software, has just bid farewell to their outstanding Senior Editor, Dr. Jay Skyler. This is relevant because Diabetes Technology & Therapeutics has become an increasingly important journal in the current and expanding world of diabetes science and medicine! Dr. Skyler is a well-documented pillar of knowledge in diabetes science, drug and device development research, and clinical care.Having worked closely with him for nearly 15 years as a co-chair for the Cardiometabolic Health Congress, I've been privileged to witness his breadth of diabetes knowledge and its implementation to people of all ages living with diabetes. Moreover, his track record speaks for itself. Jay is currently a Professor of Medicine, Pediatrics, & Psychology, in the Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, University of Miami Miller School of Medicine where he served as Director of that Division from 2000 to 2004. Until very recently he was Chairman of the NIH (NIDDK)-sponsored Type 1 Diabetes TrialNet, an international network conducting clinical trials to prevent type 1 diabetes or modify the natural history of the type 1 diabetes disease process. His research interests have been broad-based and relate not only to the metabolic aspects of the disease but the psychosocial and behavioral support so often lacking in many clinical settings wherein we all work.Jay is a past President of the American Diabetes Association, the International Diabetes Immunotherapy Group, and the Southern Society for Clinical Investigation, and was a Vice President of the International Diabetes Federation. He served as a member of the Endocrinology, Diabetes, and Metabolism Subspecialty Examining Board of the American Board of Internal Medicine, as Chairman of the Council of Subspecialty Societies of the American College of Physicians (ACP) and a member of the ACP Board of Regents. Looking back, it remains hard for me to imagine the academic legacy of Diabetes Care, a journal he founded as Editor-in-Chief in 1978. I remember this so well as I was entering my third year of fellowship training in endocrinology and metabolism at the University of Washington in Seattle at that time.Hey Jay, you've done a spectacular job at Diabetes Technology & Therapeutics, and the international cadre of diabetes scientists, clinicians, and people living with diabetes and their families and friends appreciate your contributions. Your esteemed career continues and I wish you the very best to follow!Robert H. Eckel, MDUniversity of Colorado Anschutz Medical CampusAurora, CO, USAJay Skyler… Where do I begin after staring at my empty word document for half an hour? Jay has been at the forefront of diabetes for as long as I can remember and has made such a significant impact on the field in so many ways. He also positively affected scores of medical students, residents, fellows, faculty and individuals in the device and pharmaceutical industry.My first interaction with Jay was when I was a junior faculty member at UCSD and was asked to give a lecture in Miami in 1993. Jay picked me up from the airport in his small economy car and on the way to drop me off at the hotel, we made a stop at one of his patient's house to pick up a urine collection to drop off at the lab. The patient was worried about her kidney function and had no transportation. This story sums up the personal nature of Jay, very warm, caring and the type of person who would do anything to help anyone in need.I cannot remember any national meeting where Dr. Skyler was not chairing and or speaking in a major symposium. Jay knew how to moderate better than anyone to keep the focus on the topic and stay on schedule, a unique talent! When I think of type 1 diabetes, I think of Jay Skyler. When I think of type 2 diabetes, I think of Jay Skyler. Amazing that Jay could go both ways and be a true key opinion leader in almost any aspect of diabetes clinical and basic research as well as clinical care.Generosity is also one of Jay's most impressive virtues. Jay and Mercy have opened up their home, on too many occasions to count, and always made their guests feel so comfortable. Their hospitality is second to none. Incredible food, open bar, great cigars and, most important, engaging and unimpeded conversation. I cannot think of a single individual inside or outside of the diabetes world who is as impressive an individual as Jay Skyler. There is no way he can retire. His mind is just too active. Jay is a thinker and always will be. I am privileged to call Jay my friend and colleague. Lastly, he is damn lucky to have Mercy as his better half as well!Steve EdelmanUniversity of California, San DiegoSan Diego, CAI have known Jay Skyler professionally for over twenty-five years. The first time I met him was at an investigator's meeting in Scottsdale, Arizona held by Eli Lilly on insulin lispro. Since then, we have interacted many times at various academic and research forums. He has also been a mentor to many of us and many of our colleagues.He is the founding Editor-in-Chief of Diabetes Care. The journal's growth and circulation status are both a testament to Jay's incredible passion and drive in the field of diabetes. Diabetes Care is still one of the highest circulated journals in the field of diabetes and metabolism.Fifteen years ago, I took over as Editor-in-Chief of Diabetes Technology & Therapeutics (DTT) and invited Jay and Irl Hirsch as Senior Editors. Jay acted as Editor-in-Chief for all of my manuscript submissions to DTT. When I asked him to write a commentary on any topic, he would form a well-researched and thought-provoking opinion. I still remember so vividly how the three of us (Jay, Irl, and myself) wrote an editorial regarding glargine and cancer. The three of us worked on a holiday weekend around July 4th and it was uploaded to the DTT website in three days.Since 2012, I have relied on Jay's help and enthusiasm while creating the agenda for the Barbara Davis Center for Diabetes' and University of Colorado Denver's “Practical Ways to Achieve Targets in Diabetes Care” (ATDC) conference held in Keystone annually for the past 30+ years. This CME-accredited conference attracts over 600 attendees who work in the field of diabetes or care for patients living with both Type 1 and Type 2 diabetes. I know I can assign him any topic and he will rise to the challenge, even though his primary interest is in immunology and diabetes. He has given several lectures on diabetic retinopathy, other microvascular complications, and cardiovascular disease and Type 2 diabetes. He is an amazing orator and engages the audience very well. He routinely receives top scores from the majority of the ATDC participants.As many of you know, Jay has truly become a model of a family man. He enjoys hosting his extended family, including grandchildren, both in Miami as well as in Basalt, CO. It's always fun when Ralph DeFronzo and he spend time together just before the ATDC conference. They have great stories to share after every meeting. The only thing missing that I can think of in Jay is that he doesn't golf. Maybe he'll take up the hobby now with all the extra time from giving up the Senior Editor position at DTT. To the best of my knowledge, I've never seen him golf.I know that Jay will never really retire, and when DTT needs help, we will reach out for his knowledge, thoughtful commentary, and guidance in the ever-changing field of diabetes technology and therapeutics. We will all miss him from the editorial board of DTT and wish him the best in life.Satish K. Garg, MDUniversity of Colorado DenverAurora, CO, USAIt has been a true honor and privilege working with Dr. Jay Skyler for 36 years. Jay was one of my first (and most important) mentors after my graduation from medical school. I remember those first years after medical school in Miami very well. Jay was the foremost expert in the new world of “intensive insulin therapy” and his compelling arguments that improved glucose control would slow or prevent the occurrence of diabetes complications were prophetic. Young physicians today will find it difficult to believe that the controversies of the mid-1980s were not conspiracy theories about light beams causing California wild-fires, but rather if near-normal HbA1c levels with higher risks of hypoglycemia would result in longer lives and as importantly, better quality of life.In many ways, we (and our patients) owe much of the success of diabetes to Jay. Jay's multidisciplinary clinic giving non-physicians the primary role of the diabetes clinician paved the way for the Diabetes Control and Complications Trial (DCCT). In fact, his book “Intensive Insulin Therapy” written with another mentor, Julio Santiago, in addition to Robert Rizza and David Schade, was a specific roadmap for the DCCT1. I believe I have the only copy signed by all four authors.Of course, the DCCT was a dramatically positive study, and how to translate a clinical trial into daily practice was Jay's next challenge. First, teaching how to best use insulin analogues, then pumps, and eventually continuous glucose monitoring systems, Jay was able to lead the medical community to new levels of clinical excellence. I am not convinced we would have automated insulin delivery today if not for Jay's international leadership. Through all of this, his parallel research interest moved to the immunology of type 1 diabetes with the goal to modulate the immune system to slow the beta-cell attack.We are all grateful for all of Jay's contributions to diabetes and his role as senior editor of Diabetes Technology & Therapeutics. What I am personally grateful for is the multidisciplinary team he led in the early 1980s. He hired a nurse who decided to leave Miami with me in 1987. Thank you, Jay, for all of your work in diabetes and allowing me to take Ruth with me from Miami!Reference1. Schade DS, Santiago JV, Skyler JS, Rizza RA: Intensive Insulin Therapy. Excerpta Medica, Princeton, 1983.Irl HirschUniversity of WashingtonSeattle, WA, USAI want to congratulate Jay on his many years of service to Diabetes Technology & Therapeutics and extend my personal thanks to him for his many remarkable contributions to the journal and to the diabetes community.Jay has been a remarkable friend and mentor – and as one who still considers myself “new” to this field (even after 40 years), am incredibly grateful for his guidance, his leadership and his untiring commitment to improving the lives of those affected by diabetes.Even as a young trainee, Jay made me feel welcome in this great community of clinicians and scholars. He has been a remarkable mentor, teacher, and leader. His myriad contributions to care and education, as well as the dissemination of novel clinical findings, is testament to his commitment to innovation and scientific exchange. Beyond that, I have been fortunate to be a “student” of Jay and he has warmly and willingly shared with me and countless others his knowledge, his opinions (of which he has many!) and his warmth. The great world of diabetes care, research, and education is so much the better for all of Jay's work. Thank you, Jay, for a job superbly done.David Kendall, MDZealand PharmaWestlake Village, CA‘L'union fait la force’ (Stronger through being united) is the motto of Belgium but it could have been the motto of Jay Skyler. All through his clinical and scientific career Jay has tried to move the field of diabetes forward through clinical and scientific collaborations. His advice and vision in many undertakings has shaped how our world of diabetes care and research looks today. He recognized the importance of evidence-based medicine and the need to demonstrate in a scientific manner what clinicians ‘felt’ or ‘observed’ in their daily life. In this vision, he has conducted many trials targeting prevention of complications in people with diabetes especially in trials attempting to arrest type 1 diabetes.In the vision of a need for scientific evidence to guide diabetes care, he was the founding father of the journal Diabetes Care, recognizing a need for a forum for discussing data with direct relevance for diabetes care. The same happened when he recognized the importance of diabetes techn