Eastern Region Diabetes Local Research Network

Parents speak at paediatric diabetes research training day

Diabetes research is vital: that was the message from three mothers of children with type 1 diabetes who attended a training and education day for paediatric diabetes research teams which took place in Cambridge last month.

The parents were there to share their families’ experiences of taking part in diabetes research, and joined nearly 60 paediatric research network staff at the event. The day was organised by Jon Hassler-Hurst, Lead Paediatric Diabetes Research Nurse for the Eastern Region Diabetes Research Network, based in the Ipswich Diabetes Centre, with support from the DRN Administrator Grant Harper.

One mum, Julia, said:

‘My daughter said to me that it’s very important that research goes on. From a personal perspective, many years ago I worked with amputees [diabetes is one of the leading causes of amputation of the lower limbs] and so I know if research hadn’t gone on then, my daughter wouldn’t be benefitting now.’

Another mum, Angie, agreed:

‘I really believe that if it wasn’t for research, we’d be many years further back in how we approach diabetes.’

The training day was funded by the Diabetes Research Network. Sanofi-Aventis, BBI Healthcare, Novo Nordisk, Lifescan and A. Menarini provided educational grants.

When is the right time to talk about research?

Life with diabetes: half-full or half-empty?

30 May 2009

Is life with diabetes half-full or half-empty? That was the question asked to people in Cambridge with diabetes and their families when they attended a one-day event organised by the Wolfson Diabetes and Endocrine Clinic at Addenbrooke’s Hospital, Cambridge.

Consultants and nurses from the Addenbrooke’s clinic were on hand to talk to patients and their families about life with diabetes. The day covered a range of topics including weight management, pregnancy, and diabetic complications. Consultant Diabetologist, Dr David Simmons, also outlined what the future might hold for diabetes care and how research is developing new ways of preventing and treating the condition.

The DRN attended the event promoting the diabetes research that is taking place in the eastern region and highlighting the work of the DRN in Cambridge.

DRN at the JDRF Diabetes Research Open Meeting

18 April 2009

The Eastern DRN joined the Juvenile Diabetes Research Foundation (JDRF) and University of Cambridge scientists at a Diabetes Research Open Meeting at New Hall in Cambridge. It was an opportunity for scientists to share their latest diabetes research findings with the public on topics such as type 1 diabetes, hypoglycaemia, stem cell research, the artificial pancreas and the prevention of diabetes complications. The day was chaired by Professor John Todd and included presentations from Dr Tim Tree, Dr Roman Hovorka, Prof Mark Evans and Prof David Dunger about their current research. Prof David Dunger is a member of the Eastern DRN’s Executive Board and is Associate Clinical Lead for Paediatrics in the region.

The DRN had a stand in the main foyer of the event along with staff from the D-GAP study which was discussing its new research project with members of the public. It was an opportunity for members of the public to find out more about the diabetes research being carried out in Cambridge much of which is supported by the DRN. It also enabled the public to find out how the DRN supports diabetes research in the Eastern region and how they can get involved locally with the network.

More information about the Juvenile Diabetes Research Foundation can be found at their website www.jdrf.org.uk

UEA-IFG Study screens 1000th volunteer

14 April 2009

The UEA-IFG Study, a ground-breaking UK research study into type 2 diabetes, has recently screened its 1,000th volunteer for diabetes. Over the next two years the study aims to screen 6,000 people living in Norfolk for type 2 diabetes. The study is collaboration between the Norfolk and Norwich University Hospital and University of East Anglia and is supported by the National Health Service (NHS) and Diabetes Research Network (DRN).

Study participants undergo a simple blood test to check the level of glucose in their blood. Higher than normal glucose (known as impaired fasting glucose or IFG) could mean they are in a "pre-diabetes" phase and are more likely to develop type 2 diabetes. A group of those at risk of developing type 2 diabetes are then given help to improve diet and exercise levels in order to see if preventative changes to their lifestyle can help reduce the risk of them developing type 2 diabetes. Some of this training and support is being provided by people with type 2 diabetes called "Type 2 Trainers".

Chief Investigator, Professor Mike Sampson stated:

"There has been a fantastic response to our study from the people of Norfolk since we started screening in November 2008. The cost of diabetes care to the NHS is rising rapidly and if we can demonstrate that an interventional programme can help prevent people from developing the condition, the savings in terms of the human cost, and the financial cost to the NHS will be substantial. We think that mass screening and intervention programmes to prevent diabetes could well benefit from having people with type 2 diabetes provide some of the training and support, and that it will be more efficient to deliver this in group training, so people can support each other."

Diabetes is one of the biggest public health challenges facing the country and in England it is estimated 2 million people have the condition. About 80% of those with diabetes in England have type 2 diabetes. In Norfolk there are about 30,000 people with diabetes and about 2,500 are newly diagnosed each year.

Type 2 diabetes is most commonly diagnosed in adults over the age of 40, although increasingly it is appearing in young people and young adults. Glucose builds up in the blood, as in people with type 1 diabetes, but symptoms appear more gradually and the diabetes may not be diagnosed for some years.

Norfolk Diabetes Study enrols 6000th volunteer

12 January 2009

The Norfolk Diabetes Study has recently recruited its 6,000th volunteer. The study aims to identify genetic factors that are linked to type 2 diabetes and is a collaboration between the Medical Research Council Epidemiology Unit in Cambridge and the diabetes team at the Norfolk and Norwich University Hospital and University of East Anglia.

Dr. Claudia Langenberg of the MRC Epidemiology Unit in Cambridge stated:

"The fantastic response of the people in Norfolk to our study has given us a unique opportunity to investigate how genes influence the development of type 2 diabetes and its complications. We are very grateful to our study participants and the professional and motivated team here in Norfolk."

More than a million people in the UK have type 2 diabetes and the number is rising sharply. Genes play an important role in the development of diabetes, although the mechanisms are not well understood.

The Norfolk Diabetes Study has recently contributed to the discovery of a gene that is strongly linked to high blood sugar levels and an increased risk of type 2 diabetes. The gene is involved in the way the body responds to the 24 hour day-night cycle. These findings were the result of a large international collaboration including several studies in different countries that were published in the journal Nature Genetics in December.

The Norfolk Diabetes Case Control Study started in 2003 and is funded by the Medical Research Council and the Wellcome Trust. It aims to recruit a total of 10,000 people with type 2 diabetes. The study is jointly led by Professor Mike Sampson in Norwich and Professor Nick Wareham in Cambridge.

New gene associated with diabetes risk suggests link with body clock

8 December 2008

A connection between the body clock and abnormalities in metabolism and diabetes has been suggested in new research by an international team involving the MRC Epidemiology Unit in Cambridge, the University of Oxford, and the Wellcome Trust Sanger Institute. Data obtained from the Norfolk Diabetes Study, supported by the DRN, was used in this research.

The researchers have identified a gene involved in the way the body responds to the 24 hour day-night cycle that is strongly linked to high blood sugar levels and an increased risk of type 2 diabetes.

Professor Mark McCarthy, Oxford Centre for Diabetes, Endocrinology and Metabolism at the University of Oxford stated:

"We have extremely strong, incontrovertible evidence that the gene encoding melatonin receptor 1B is associated with high fasting glucose levels and increased risk of type 2 diabetes."

Melatonin is a hormone that is strongly tied to the control of our sleep-wake cycles, with concentrations in the blood peaking at night-time and dipping during the day. As a result, melatonin is implicated in conditions like jetlag and sleep disorders.

Disrupted sleep patterns are known to be associated with a range of health problems including metabolic disorders like diabetes, but it is not understood how they are connected. By identifying a link between a melatonin receptor and blood sugar levels, this study provides genetic evidence that mechanisms controlled by our body clock are connected to the machinery that keeps us metabolically healthy. The researchers suggest that the action of melatonin on the pancreas is probably being disturbed in this case.

The international research collaboration combined ten genome-wide association scans involving a total of over 36,000 individuals of European descent. A variant in the gene encoding melatonin receptor 1B (MTNR1B) showed an average rise of 0.07 mmol/l in fasting glucose level and a 9% increase in risk of type 2 diabetes for each copy of the gene variant inherited from a parent.

"High fasting glucose levels are early markers of diabetes and this observation provides important clues about the possible mechanisms linking genes to diabetes risk."

Professor Nick Wareham, Director of the MRC Epidemiology Unit in Cambridge

Other genes have previously been shown to be associated with high blood sugar levels, but have not shown an increase in diabetes risk. The melatonin receptor found in this genome-wide study is the first gene to be linked to both high blood sugar and increased risk of diabetes.

"Although levels of glucose in the blood are used to diagnose diabetes, most of the genes previously associated with high glucose levels do not increase risk of diabetes. We have found a variant – a G in the genome in place of a C – in MTNR1B. This single-letter change influences both sugar levels and diabetes. This remarkable result should allow us to gain new insight into this problem."

Dr Inês Barroso, Wellcome Trust Sanger Institute

The findings described in this article are taken from the following publication:

Prokopenko I, Langenberg C, Florez JC, Saxena R, Soranzo N, Thorleifsson G, Boehnke M, Barroso I, van Duijn C, Dupuis J, Watanabe RM, Stefánsson K, McCarthy MI, Wareham NJ, Meigs JB, Abecasis GR for the MAGIC investigators. Variants in the melatonin receptor 1B gene (MTNR1B) influence fasting glucose levels. Nature Genetics 2008. Published online in advance of print.

Hertfordshire Physical Activity Trial public meeting

19 November 2008

The MRC Epidemiology Unit in Cambridge hosted a public meeting on the 19th November 2008 to present results from the Hertfordshire Physical Activity Trial. The event was attended by nearly 200 members of the public including most of the 100 volunteers that took part in the study.

The afternoon consisted of presentations by staff from the MRC Epidemiology Unit and the MRC Epidemiology Resource Centre in Southampton. There was also an opportunity for the volunteers to pick the brains of the study team in a question and answer session. The main talk of the afternoon by Dr Francis Finucane (pictured above) presented the early findings from analysis of the study data. There were also talks from Professor Nick Wareham and Dr Simon Griffin from the MRC Epidemiology Unit.

The Hertfordshire Physical Activity Trial is investigating whether birth weight affects how an individual responds to exercise in later life. Previous studies have shown that people that had a low birth weight have a greater risk of developing diabetes and cardiovascular disease in adulthood. In contrast, exercise has been shown to have beneficial effects on the body and its sensitivity to insulin.

The study consisted of a group of volunteers born in the 1930s who had an accurate weight measurement taken when they were born. During this study they had very detailed measurements taken including scans to measure body and tissue fat content, a glucose tolerance test and a muscle biopsy to examine the effects of exercise on muscle cells. Half of these volunteers were randomly assigned to a fully supervised 12-week aerobic exercise programme involving three one-hour sessions per week. The other half continued with their usual level of weekly physical activity. All of the study measurements were then repeated after the 12 week period.

UEA-IFG study launched

14 November 2008

A new research programme, known as the UEA-IFG (University of East Anglia—Impaired Fasting Glucose) programme, has started at the Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) and University of East Anglia (UEA). The pilot programme is funded by the NIHR over two years.

About 6,000 members of the public that are at risk for diabetes will be screened. Those with ‘pre-diabetes’ will enter a novel diet and exercise group education programme. This will be delivered in part by trained patients who already have developed type 2 diabetes themselves. These people will act as lifestyle trainers and there will be group activities to advise about diet and exercise.

Study chief investigator Professor Mike Sampson said:

"We think that intervention programmes to prevent diabetes could well benefit from having people with type 2 diabetes provide some of the training and support, and that it will be more efficient to deliver this in group training, so people can support each other. Diabetes is one of the big public health challenges of our time for hospital and primary care; and if we can demonstrate that this prevention programme works, the savings in human and financial cost will be substantial."

There have already been a number of events in Norfolk to mark the launch of this study. These have included a GP launch event and T2Trainer open event.

If you want to know more about the study look at the website www.uea-ifg.nhs.uk or contact the research team on 01603 597300.