William B. Horton, MD, MSc, FACP

PRIMARY APPOINTMENT:

Assistant 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

FUNDED PROJECTS:

• AHA Career Development Award, 941481, 04/01/2022-03/31/2025
• Juvenile Diabetes Research Foundation, 3-SRA-2023-1236-M-B, 10/01/2022-09/30/2025

RESEARCH INTERESTS:

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

RESEARCH SUMMARY:

Epidemiological data indicate that people with type 1 diabetes (T1D) have 8-13 years shorter lifespans than the general population. Similarly, people with T1D have a substantial excess rate of cardiovascular events that occur more than a decade earlier than in the general population. Years of high and variable glucose levels accelerate the journey toward cardiovascular disease (CVD) in T1D. Despite this increased cardiovascular risk, the pathophysiology driving the relationship between CVD and T1D is poorly understood. While interventions that improve mean glycemic, blood pressure, and lipid control have reduced rates of vascular complications, the difference in CVD risk between persons with T1D and the general population endures unexplained by conventional risk factors. These data suggest that factors independent of hemoglobin A1c normalization drive T1D CVD outcomes. One potential explanation for this is glycemic variability. People with type 1 diabetes experience frequent and wide glycemic excursions (including both hypo- and hyperglycemic excursions) on a near-daily basis. Emerging evidence has found that glycemic variability predicts cardiovascular events and mortality in multiple patient populations. We are interested in defining the pathophysiologic mechanisms whereby glycemic variability contributes to CVD in T1D. We are also interested in determining whether therapies that reduce glycemic variability in T1D (i.e., closed-loop artificial pancreas systems) improve cardiovascular health.

My postdoctoral work was funded by an NRSA F32 award (F32 HL142304), and my early career work has been funded by the American Heart Association (#941481) and the Juvenile Diabetes Research Foundation (3-SRA-2023-1236-M-B). I also serve as a Co-Investigator on NIH/NIDDK R01 HL14225002 (2018–2022).