- 2014Pump Priming
Reducing fear of hypoglycaemia in families and Improving metabolic control in Children and young people with diabetes (RICHes): A feasibility pilot studyRecipient:Dr Deborah ChristieInstitution:University College LondonCity:LondonAmount:£20,000Description: Fears about hypoglycaemia and associated seizures can result in blood glucose (BG) concentration being run higher than recommended. This fear is underpinned by a) anxiety about frequent monitoring; b) the relentless nature of daily management and c) lack of confidence that others are able or willing to provide appropriate care. The resulting higher HbA1c significantly increases the risk of long-term complications. This study will evaluate an intervention to reduce anxiety and increase confidence in self-management that will result in improved diabetes control for children and young people, and improved quality of life for the whole family.
- 2014Pump Priming
The prevalence and risk factors for non-alcoholic fatty liver disease in patients with type 2 diabetes mellitusRecipient:Dr William AlazawiInstitution:Queen Mary University of London and Barts Health NHS TrustCity:LondonAmount:£11,000Description: Deaths from liver disease are rising more rapidly than any other cause of death in the UK. The most common cause of chronic liver injury in the developed world is non-alcoholic fatty liver disease (NAFLD), which is found in up to 75% of patients with diabetes. NAFLD is a spectrum of disease that includes simple fat deposition to the more aggressive form involving inflammation and scarring in the liver (non-alcoholic steatohepatitis (NASH) that can progress to cirrhosis, liver failure and liver cancer. The factors that determine whether an individual patient will develop the more aggressive NASH are not fully understood although a combination of genetic, environmental and lifestyle factors are likely to play a role. There has been recent interest in the effect of ethnicity in the progression of NAFLD and our group has recently reported that NAFLD is three times more common among patients of Bangladeshi origin compared to other ethnic groups – including other South Asian groups. Our aim is to study the degree to which NAFLD and NASH affect patients with diabetes from different ethnicities and to develop guidelines to help doctors manage patients with NAFLD in an ethnically diverse population, such as ours.
- 2014The Professor David Matthews Non-Clinical Fellowship
To use Mendelian randomisation to understanding the causal relationship between circulating biomarkers and Type 2 Diabetes in the UK Biobank.Recipient:Dr Jessica TyrrellInstitution:University of Exeter Medical SchoolCity:ExeterAmount:£172,389Description: Type 2 diabetes represents a huge health burden worldwide (in the UK, it costs the NHS £296 per second), and research is underway to determine how this burden can be reduced. It is a complex disease, with many factors contributing to disease development. Epidemiological studies have demonstrated that type 2 diabetes is associated with a myriad of biomarkers, often as a consequence, rather than cause of the disease process. Understanding which biomarkers play a causal role in type 2 diabetes is of critical importance for understanding disease aetiology, improving diagnosis, and successfully developing treatments. This study will use one of the largest UK population-based studies, the UK Biobank and apply genetic and statistical techniques to investigate the causal relationship between more than 40 biomarkers and type 2 diabetes. The size of UK Biobank will provide a powerful resource for these studies and enable us to draw robust conclusions about which biomarkers are causally linked to diabetes. This project will investigate causality using a Mendelian randomisation approach; a technique that has already helped further our understanding of type 2 diabetes aetiology. This project will be organised in three sequential stages. In Stage 1, we will investigate the association between biomarkers and incident (~3,500 January 2014) and prevalent type 2 diabetes cases (n=14,486) using regression models. In stage 2, we will identify genetic variants associated with our selected biomarkers using regression models. Finally in stage 3, we will utilise instrumental variable analysis to assess the causal relationship between circulating biomarkers and type 2 diabetes. This project will be of critical importance. Identifying the likely small number of biomarkers that truly influence disease aetiology will be incredibly important – it will highlight the pathways and systems that researchers and pharmaceutical companies should focus on if they want to prevent disease or improve treatments.
- 2014Pump Priming
Young people with type 1 diabetes (16 – 25 years old) with good and poor glycaemic control: adopting a resilience approach to enhance understanding of differences in this transitional group with generally poor clinical performance.Recipient:Professor Jorg HuberInstitution:University of NorthamptonCity:NorthamptonAmount:£19,821Description: Young people with type 1 diabetes find it difficult to adjust to and deal effectively with their illness as evidenced by poor blood sugar control, serious complications and high mortality. The problem is particularly pronounced in England in the 16 – 25 age group. Our understanding of this national failure is very limited, particularly as scant recent research is available for the UK. Instead of focusing on the negative aspects of diabetes, we want to find out how young people successfully adjust to and integrate the condition into their day-to-day life. They are living through an important transitional period where crucial developments are taking place, which impact on partner, career and other life-style choices. We adopt a novel approach focusing on resilience, which others and ourselves have successfully researched in groups without diabetes. Resilience is the ability to deal effectively with adversity and bounce back from poor wellbeing/mental health and this will be explored in our study. We will use questionnaire data to assess resilience and associated factors such as attachment, social support, self-esteem and recent life events. We will use in-depth interviews and personal diaries exploring issues of self-care, the challenges of the condition and the way individuals deal with these challenges with the aim to develop a deeper understanding of the role of resilience in dealing with a complex and demanding illness. A key element will be the comparison of individuals with good glycaemic control with those with poor control; in line with the resilience approach a key aim will be to provide an initial resilience profile of the young adult with type 1 diabetes with good blood glucose control. This initial study will provide the basis for further applications carrying out a longitudinal study, possibly incorporating neurobiological assessments, and contributing to the development of targeted interventions.
- 2013Pump Priming
Can VEGFC rescue albuminuria in a experimental model of diabetic nephropathy?Recipient:Dr Rebecca FosterInstitution:University of BristolCity:BristolAmount:£12,460.00Description: Damage to the endothelial cells that form the blood vessels is a key step in many of diabetes-related pathologies. This damage is associated with removal of a protective layer (glycocalyx) that lines the inside of blood vessels. The kidney glomerulus is a convoluted ball of small blood vessels which is also susceptible to loss of the glycocalyx in diabetes, leading to endothelial dysfunction and diabetic kidney disease. Glomerular endothelial damage can be measured by small amounts of protein escaping into the urine and reflects generalised endothelial damage. We have identified a growth factor that is produced naturally within the body, which maintains the glycocalyx on glomerular endothelial cells and stops passage of protein in culture conditions. We aim to assess the therapeutic potential of this growth factor on rescuing damaged glomerular endothelial cells in an experimental mouse model of diabetic kidney disease.