Menu Search Icon

Search

Division of Endocrinology & Metabolism

William B. Horton, MD, MSc, FACP

Pub Med

William Horton MD

PRIMARY APPOINTMENT:

Associate Professor of Medicine, Endocrinology, and Metabolism

CONTACT:

Email: WBH2N@virginia.edu

TRAINING:

  • Undergraduate: B.S. (Biology Medical Sciences), Mississippi College; Clinton, MS
  • Doctoral: M.D., University of Mississippi School of Medicine; Jackson, MS
  • Graduate: M.Sc. (Clinical Research), University of Virginia; Charlottesville, VA
  • Residency: Internal Medicine, University of Mississippi Medical Center; Jackson, MS
  • Fellowship: Endocrinology, Diabetes, and Metabolism, University of Virginia; Charlottesville, VA
  • Fellowship: Endocrinology, Diabetes, and Metabolism, University of Virginia; Charlottesville, VA
Pub Med

FUNDED PROJECTS:

  • Breakthrough T1D (3-SRA-2023-1236-M-B)
  • Breakthrough T1D (3-SRA-2025-1773-M-B)

RESEARCH INTERESTS:

Type 1 diabetes; Diabetes technology; Cardiovascular diabetology; Inpatient glycemic control

RESEARCH SUMMARY:

William Horton Research UVA

Figure 1. The impact of vascular insulin resistance on cardiovascular health in people with diabetes.

The DCCT/EDIC Study showed that appropriate glycemic control (defined as maintaining an HbA1c value <7%) reduced the risk of cardiovascular disease (CVD) by 42% and severe cardiovascular events (nonfatal myocardial infarction, stroke, or death from CVD) by 57% over 17 years in people with type 1 diabetes (T1D) (1). Unfortunately, only ~20% of American adults with T1D are achieving this HbA1c target (2) despite the availability of modern insulin analogs (3), the improving accuracy of glucose monitoring (4; 5), and the expanding use of closed-loop automated insulin delivery (AID) systems (6). While these new technologies have proven benefits in reducing diabetes-related complications (7), excess mortality rates remain higher in people with T1D compared to the general population (8), and cardiovascular mortality rates have remained relatively static over the last 20 years (9). Indeed, epidemiological data indicate that people with T1D have lifespans ~11-13 years shorter (10) and experience CVD events on average more than a decade earlier than the general population (11). Numerous studies have identified CVD as the leading cause of death in T1D (12-15) and worrisomely found that T1D confers substantial CVD risk even when conventional HbA1c treatment targets are achieved (16; 17).

William Horton Research UVA

Figure 2. Development of a “ketone-aware” AID algorithm to eliminate ketoacidosis risk and allow for safe administration of SGLTi medications in people with type 1 diabetes.

Our research aims to test therapies that can be combined with closed-loop AID to optimize glycemic control and provide pleiotropic effects that will further improve cardiovascular health and reduce incident cardiovascular disease in this population. With this, we have two active and one upcoming project(s). First, we are evaluating the cardiovascular impact of improving glycemic control (via closed-loop AID) in people with type 1 diabetes. This project is funded by Breakthrough T1D (SRA-2023-1236-M-B). An upcoming study (also funded by Breakthrough T1D; SRA-2025-1773-M-B) will test whether a novel insulin-sensitizing drug (CIR-0602k) that targets the mitochondrial pyruvate carrier can improve glycemic control and reduce total daily insulin dose when combined with closed-loop AID in people with type 1 diabetes (see Figure 1). Finally, we are collaborating with the UVA Center for Diabetes Technology to develop a “ketone-aware” closed-loop AID system that receives input from a combined continuous glucose and continuous ketone sensor (see Figure 2). The ultimate goal of this project is to develop a ketone-aware AID system that will allow for safe administration of sodium-glucose cotransporter inhibitor (SGLTi) medications in people with type 1 diabetes.

Photo of UVA Horton Research Group

Left back row: Kevin Aylor, Eugene Barrett, William ‘Ben’ Horton, Front row: Jia Liu, Zhenqi Liu, Linda Jahn, Lee Hartline

In This Section down-arrow
Menu
DEPARTMENT OF MEDICINE