About

Celeste C. Thomas, MD, is an Associate Professor of Medicine in the Department of Medicine at The University of Chicago. Her clinical interests focus on diabetes in pregnancy, and she has contributed to research on the management of outpatients with diabetes at high risk of hypoglycemia, as well as broader issues related to diabetes management and health disparities. Her work includes examining the effects of racial discrimination, inflammation, sleep, and metabolic syndrome from adolescence to young adulthood, and addressing stress and human health in diabetes. Dr. Thomas has also investigated inpatient hypoglycemic events, the long-term benefits and risks of diabetes medications such as SGLT2 inhibitors and GLP-1 receptor agonists, and improving access to continuous glucose monitoring for patients with type 2 diabetes. Her research emphasizes improving clinical outcomes and health equity in diabetes care.

Research topics

• Internal medicine
• Medicine
• Endocrinology
• Biochemistry
• Pathology
• Intensive care medicine

Selected publications

• Longitudinal Metabolic Trajectories in Diabetes Prevention Program Participants Reveal Subgroups With Varying Micro- and Macrovascular Complication Risks

  Diabetes Care · 2025-08-26 · 5 citations

  articleOpen access

  OBJECTIVE: Type 2 diabetes (T2D) and its associated complications develop heterogeneously over decades, but few studies span the progression from prediabetes to clinical events. We investigated whether long-term metabolic trajectories beginning in prediabetes delineate subgroups with differential complication risk. RESEARCH DESIGN AND METHODS: Clinical data from 1,732 Diabetes Prevention Program/Outcomes Study participants (follow-up 19 years) were analyzed across 12 phenotypes. Tensor decomposition was used to capture longitudinal patterns, and Gaussian mixture modeling was used to define longitudinal clusters. Cluster-specific complications were quantified with Cox and logistic regression. RESULTS: Four clusters emerged. Clusters 1 and 2 (73% of participants) maintained stable glycemia, blood pressure, and lipids. Although 49% and 71%, respectively, developed T2D, cumulative micro- and macrovascular events remained low. Cluster 3 (12%) showed the steepest rise in insulin resistance and hyperglycemia, with 92% of the subgroup progressing to T2D and a markedly higher rate of retinopathy (odds ratio [OR] 8.8, 95% CI 3.9-20.1) and neuropathy (OR 3.4, 95% CI 2.1-5.5). Cluster 4 (15%) presented with baseline microalbuminuria often prior to the development of T2D (73%). It was distinguished by progressive estimated glomerular filtration rate decline and a doubling of cardiovascular events (hazard ratio 2.0, 95% CI 1.4-3.0), despite serum lipids comparable with other groups. CONCLUSIONS: Two-thirds of individuals with prediabetes follow metabolically resilient trajectories, whereas distinct insulin-resistant or renal-dysfunction trajectories precede micro- or macrovascular complications, respectively. The optimal window for macrovascular complication prevention in individuals with prediabetes microalbuminuria may precede progression to T2D.

  PublisherOA PDFDOI

• Impact of Parental or First-Degree Family History of Diabetes on Diabetes Incidence and Progression During Long-term Follow-up in the Diabetes Prevention Program Outcomes Study

  Diabetes Care · 2025-08-29

  articleOpen access

  OBJECTIVE: To determine the effects of first-degree family history of diabetes on diabetes incidence in Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS) participants. RESEARCH DESIGN AND METHODS: In the DPP, adults with prediabetes were randomized to an intensive lifestyle intervention, metformin, or placebo and followed for incident diabetes. On study completion 88% of eligible DPP participants reenrolled in DPPOS for long-term follow-up. The present analysis includes all 3,072 participants with family history information through DPPOS, with a median follow-up of 21 years (1,975 had parental history of diabetes [PH] [312 biparental, 947 maternal, 716 paternal], 226 had only sibling history [SH], and 871 denied any family history). The primary outcome is incident diabetes based on American Diabetes Association criteria, with adjustment for demographic and clinical variables, DPP randomization arm, and polygenic risk score (PRS). RESULTS: Adjusted hazard ratio (HR) was 1.21 (95% CI 1.06, 1.38) for any family history, 1.19 (1.04, 1.35) for PH, and 1.15 (0.91, 1.44) for SH. Biparental history conferred greater hazard (HR 1.44 [95% CI 1.22, 1.69]) than maternal (1.22 [1.08, 1.38]) or paternal (1.22 [1.08, 1.39]) diabetes history alone. PRS explained 32% of the association of any family history with diabetes risk. CONCLUSIONS: PH increased type 2 diabetes risk after DPP treatment group was controlled for. That effect was only partially explained by PRS, suggesting that rare gene variants, familial, and environmental factors may contribute to type 2 diabetes risk in people with prediabetes.

  PublisherOA PDFDOI

• Nonglycemic and Glycemic Risk Factors for Painful Neuropathic Symptoms and for Distal Symmetrical Polyneuropathy (DSPN) in the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study

  Diabetes Care · 2025-06-18 · 1 citations

  articleOpen access

  OBJECTIVE: The clinical presentation, symptoms, and signs of neuropathy vary substantially. We determined whether painful neuropathic symptoms and distal symmetrical polyneuropathy (DSPN) were associated with different risk factors in a longitudinal study of Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS) participants. RESEARCH DESIGN AND METHODS: We assessed neuropathy in 1,779 DPP/DPPOS participants ∼21 years after DPP randomization. Symptoms were assessed using the Michigan Neuropathy Screening Instrument (MNSI) questionnaire and signs using pinprick, vibration, and monofilament testing. We defined four mutually exclusive neuropathy phenotypes: 1) no symptoms or signs of DSPN, 2) neuropathic pain without signs, 3) other neurologic symptoms without pain or signs, and 4) DSPN (MNSI questionnaire score ≥4 or any signs). We used multinomial logistic regression models to compare nonglycemic and glycemic risk factors among participants to better understand risk factors associated with painful neuropathic symptoms and DSPN. RESULTS: Among the participants, 501 (28%) had no symptoms or signs, 144 (8%) had painful neuropathic symptoms without signs, and 473 (27%) had DSPN. Compared with participants with neither symptoms nor signs, those with painful neuropathic symptoms were more likely to be women, to have greater weight, and lower estimated glomerular filtration rate. Painful symptoms were not associated with glycemia. In contrast, DSPN, when compared with painful symptoms, was associated with older age, White race, and glycemic exposure. CONCLUSIONS: In this cohort, risk factors for painful neuropathic symptoms and DSPN differed. Improved recognition of painful neuropathic symptoms and better consensus on diagnostic criteria may facilitate research into their causes, prevention, and treatment.

  PublisherOA PDFDOI

• Analysis of Long-term Follow-up of a Randomized Clinical Trial With Departures From Assigned Treatments: Estimation of Metformin Effects on Diabetes and Its Complications in the Diabetes Prevention Program Outcomes Study

  Diabetes Care · 2025-08-26

  articleOpen access

  The Diabetes Prevention Program (DPP) was a 3-year randomized clinical trial (RCT) with evaluation of lifestyle and metformin interventions compared with placebo for diabetes prevention in high-risk adults. Both interventions significantly reduced diabetes incidence, prompting the long-term Diabetes Prevention Program Outcomes Study (DPPOS) to assess the progression of diabetes and its complications over 22 years. During follow-up, departures from the original metformin or placebo assignment occurred primarily because of development of diabetes that, by protocol, was managed by clinicians outside the study, after participants developed diabetes with HbA1c ≥7.0%. Diabetes development led to changes in metformin treatment and addition of other glucose-lowering therapies. Using statistical methods designed to estimate intervention effects despite these deviations, we consistently found that metformin reduced diabetes incidence. However, using these methods to evaluate whether use of metformin for prediabetes confers continued benefits after diabetes diagnosis did not substantially change the conclusions from those of the simpler intention-to-treat analysis that did not account for treatment changes. All of the analytic methods used resulted in similar metformin effect estimates with 95% CIs for hazard ratios including 1.0 (no effect) for all outcomes except for diabetes incidence. Elucidating metformin's long-term role in mitigating diabetes-related complications beyond its effects on diabetes prevention is challenging.

  PublisherOA PDFDOI

• THU-133-YI Risk of hypoglycemia in people with cirrhosis without diabetes

  Journal of Hepatology · 2025-05-01

  article
  PublisherDOI

• The Diabetes Prevention Program and Its Outcomes Study: NIDDK’s Journey Into the Prevention of Type 2 Diabetes and Its Public Health Impact

  Diabetes Care · 2025-04-24 · 20 citations

  reviewOpen access

  The current-day epidemic of type 2 diabetes, largely driven by increased adiposity and reduced physical activity in the setting of genetic susceptibility, is a major public health challenge. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) presciently proposed the Diabetes Prevention Program (DPP), a multicenter randomized clinical trial, designed by investigators in conjunction with NIDDK staff and initiated in 1996. The primary goal of DPP was to determine whether an intensive lifestyle intervention (ILS) or metformin in comparison with placebo would reduce the development of diabetes in a high-risk population with prediabetes. After mean 2.8 years, ILS reduced diabetes risk by 58% and metformin by 31%, leading to study termination ahead of schedule due to demonstrated efficacy of both interventions. In 2002, an extension of the DPP study, the Diabetes Prevention Program Outcomes Study (DPPOS), was initiated for examination of the longer-term course and consequences of diabetes prevention. Over 21 years of median total follow-up, in comparison with the placebo group, cumulative diabetes incidence was reduced by 24% and 17% in the original ILS and metformin groups, respectively, with median increases in diabetes-free survival of 3.5 and 2.5 years/person. During long-term follow-up, there were no significant effects of the original DPP interventions on microvascular or cardiovascular outcomes. However, compared with prevalence of microvascular outcomes among participants who progressed to diabetes, prevalence among those who did not progress was significantly lower. Longer-term follow-up of the cohort continues with examination of relationships between diabetes and prediabetes and an expanded array of diabetes- and aging-related morbidities.

  PublisherOA PDFDOI

• Project ECHO for Diabetes Improves Primary Care Providers’ Comfort With and Use of Diabetes Medications and Technology

  Diabetes Spectrum · 2024-01-26

  articleOpen access

  Care Innovations| January 26 2024 Project ECHO for Diabetes Improves Primary Care Providers' Comfort With and Use of Diabetes Medications and Technology Nicole Ehrhardt 0000-0003-1813-0789 ; Nicole Ehrhardt 1University of Washington Diabetes Institute, Division of Endocrinology, Diabetes and Metabolism, Seattle, WA Corresponding author: Nicole Ehrhardt, nehrhard@uw.edu Search for other works by this author on: This Site PubMed Google Scholar Celeste C. Thomas; Celeste C. Thomas 2Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, IL Search for other works by this author on: This Site PubMed Google Scholar Tracy Zou; Tracy Zou 1University of Washington Diabetes Institute, Division of Endocrinology, Diabetes and Metabolism, Seattle, WA Search for other works by this author on: This Site PubMed Google Scholar Ana Gabriela Vasconcelos; Ana Gabriela Vasconcelos 3Department of Biostatistics, University of Washington, Seattle, WA Search for other works by this author on: This Site PubMed Google Scholar Matt Bouchonville 0000-0003-2852-0510 Matt Bouchonville 4Division of Endocrinology, Diabetes, and Metabolism, University of New Mexico School of Medicine, Albuquerque, NM Search for other works by this author on: This Site PubMed Google Scholar Corresponding author: Nicole Ehrhardt, nehrhard@uw.edu Diabetes Spectr ds230050 https://doi.org/10.2337/ds23-0050 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Citation Nicole Ehrhardt, Celeste C. Thomas, Tracy Zou, Ana Gabriela Vasconcelos, Matt Bouchonville; Project ECHO for Diabetes Improves Primary Care Providers' Comfort With and Use of Diabetes Medications and Technology. Diabetes Spectr 2024; ds230050. https://doi.org/10.2337/ds23-0050 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsDiabetes Spectrum Search Advanced Search This article contains supplementary material online at https://doi.org/10.2337/figshare.24945009. This content is only available via PDF. ©2024 by the American Diabetes Association2024Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/journals/pages/license. Article PDF first page preview Close Modal You do not currently have access to this content.

  PublisherOA PDFDOI

• Management of Outpatients With Diabetes at High Risk of Hypoglycemia

  JAMA · 2024-03-14 · 4 citations

  article1st authorCorresponding

  This JAMA Clinical Guidelines Synopsis summarizes the Endocrine Society’s 2023 recommendations on management of outpatients with diabetes and high risk of hypoglycemia.

  PublisherDOI

• Racial Discrimination, Inflammation, Sleep, and Metabolic Syndrome From Adolescence to Young Adulthood

  JAMA Network Open · 2024-04-18 · 2 citations

  letterOpen accessSenior authorCorresponding

  Although the term crisis may often be overused when describing the burden of disease processes, it is not an overstatement when describing the impact of metabolic syndrome (MetS) on the lives of US residents.One in 3 US residents is affected by MetS, "a cluster of metabolic dysregulations that includes insulin resistance, atherogenic dyslipidemia, central obesity and hypertension." 1 As such, it has been associated with a 2-fold increase in cardiovascular outcomes and 1.6-fold increase in all-cause mortality, 2 not to mention its outsized economic impact. 3And while MetS affects people of all demographics, it is a constellation of metabolic factors that disproportionately affects individuals from racial and ethnic minority groups.Furthermore, while the effects of MetS may be most profound in adulthood, incidence of MetS in young adults is on the rise. 4ven the outsized impact of MetS on individuals who belong to minoritized racial and ethnic groups and the rise in incidence of MetS in younger adults, the authors of this study 5 set out to explore the association between racial discrimination in one's youth and MetS in early adulthood.By utilizing the Strong African American Families Healthy Adults (SHAPE) Project, a longitudinal cohort of Black adolescents, Heard-Garris et al 5 were able to track the progression of MetS in a cohort of Black adolescents in the rural US South as they advanced into adulthood.They noted that more incidents of self-reported racial discrimination were associated with increased levels of systemic inflammation (measured by soluble urokinase plasminogen activator receptor [suPAR]) and poorer sleep (self-reported through a validated sleep scale), both of which were associated with a higher prevalence MetS.By associating discrimination with systemic inflammation and poor sleep during adolescence, and subsequently with MetS in early adulthood, the authors 5 further explored the profound pathophysiological effects that racism and racial discrimination can have, especially early on in life.Racial discrimination has long been one of several environmental factors associated with adverse health outcomes, particularly cardiometabolic syndromes, in racial and ethnic minority populations. 6Specifically, experiences with racism and racial discrimination

  PublisherOA PDFDOI

• <b>Project ECHO for Diabetes Improves Primary Care Providers’ Comfort With and Use of Diabetes Medications and Technology</b>

  2024-01-26

  preprintOpen access

  <p dir="ltr">Cardiovascular disease (CVD) and diabetes are leading causes of death in the United States; yet, less than one-third of American adults living with diabetes reach glycemic, blood pressure, and cholesterol targets for preventing or delaying diabetes complications. The need for improved patient care is urgent because people with diabetes are two to four times more likely to die as a result of CVD compared to those without diabetes. A recent study found that only 26% of American adults reached the combined goals for preventing or delaying diabetes complications, which include the management of A1C, blood pressure, and cholesterol levels and smoking cessation (1). Despite the progress made in reducing death rates from heart disease and stroke, the impact of cardiometabolic disease is significant. According to the Centers for Disease Control and Prevention, “Every 29 seconds, someone will suffer a coronary event in the United States, every 60 seconds someone will die from such an event, and every 45 seconds, someone will suffer a new or recurrent stroke” (2). Heart disease affects all racial and ethnic groups,</p>

  PublisherDOI

Frequent coauthors

• Piotr J. Bachul

  University of Chicago

  17 shared

• Martin Tibudan

  University of Chicago

  15 shared

• Lindsay Basto

  15 shared

• Justyna Gołębiewska

  Gdańsk Medical University

  15 shared

• Louis H. Philipson

  University of Chicago

  14 shared

• Piotr Witkowski

  Maria Curie-Skłodowska University

  14 shared

• Karolina Gołąb

  Riverside Transplantation Institute

  14 shared

• David L. Nyenhuis

  12 shared

Labs

• Celeste Thomas LabPI