Our groundbreaking diabetes research 

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Studies you can take part in...

The treatment of diabetes has come a long way since the Ancient Greeks considered the condition ‘incurable’ – although it’s hard to believe that insulin was only introduced less than a century ago.

Today, global research initiatives are delivering remarkable benefits with important new breakthroughs being announced in quick succession.

We play a significant role in that international effort with our team of experts involved in leading-edge research programmes.

Our proactive research programme includes beta cell studies, clinical research studies and large scale motivational behaviour trials. During 2012, for instance, our studies ranged from an artificial pancreas project to new urine measures of kidney function, diabetes care in different communities and a structured intensive psycho-educational programme.

Talk to the diabetes team
If you are interested in taking part in our research please talk to your medical consultant about this at your next appointment. They will know about research studies that are happening with UCLH and also research studies that are happening locally that you might be able to participate in.

Here is more information about Type 1 Diabetes Research

 

Current research projects at UCL and UCLH

Good quality research improves the way we can provide care for children and young persons with diabetes.  It informs us on aspects of diabetes management, keeps us up-to-date and allows us to offer you the best advice. It also means that UCLH is an exciting place to work and, in the long-term, this will attract the best health care professionals to want to work with us. The team are involved in a large variety of projects and some of these are listed below.  This list will be constantly updated as and when future projects “go live” and old ones finish.  If you would like to take part or are simply interested in what happened during a study then please ask during clinic or email one of us. 

Artificial Pancreas

We continue to be involved with the Artificial Pancreas Project in Cambridge with Roman Havorka. The “at home” study has been completed and was published in the New England Journal of Medicine.  We are looking to start in 2016 an extension of this study along with a possible closed loop at diagnosis study.

TRIALNET - Can we stop people developing diabetes?

Relatives of people with diabetes have a 10 to 15 times greater risk for getting diabetes than people with no family history.  Because of this, TRIALNET will screen close blood relatives of people with type 1 diabetes.  This includes brothers, sisters, parents, children, cousins, aunts, uncles and grandchildren of people with type 1 diabetes.We will take up to 1 tablespoon of blood to test for diabetes related autoantibodies.  A member of the TrialNet research team will contact you if you have one or more autoantibodies present in the blood (you are positive) and this will give you an estimate for if and when you might develop diabetes.  Importantly TRIALNET may then follow this up by offering a new treatment as part of a study that attempts to delay or prevent the onset of diabetes.

UCLID - Why do diabetes complications occur?

People with diabetes have a greater risk of developing other medical problems, particularly involving the eyes, kidney, nerves and heart.  This process starts from diagnosis of diabetes and quickens up during adolescence, but we don’t know why.  In the next 12 months, we hope to be starting the UCLID Study,which is a very ambitious study, where we aim to collect a bit of extra blood and urine during your annual review and also DNA.  We will store this in a special repository called the UCL BioResource.  We will also be asking if other family members would provide a blood and urine sample, as much of how our body behaves is inherited.  In the years (decades!!) to come this “Resource”, together with the routine information we gather during clinic, will provide a very powerful way to determine why diabetes complications occur.  We will also be making the Resource available to other researchers, providing their study proposals are good enough!

Measuring Oxidative Stress - Does inflammation in people with diabetes matter?

In conjunction with Dr Kevin Mills at Institute of Child Health, Professor Hindmarsh has been looking at the development of markers of oxidative stress in urine.  Diabetes is associated with high glucose values in the blood and these lead to damage to blood vessels through a process known as oxidative stress.  Currently we try to keep blood glucose normal to reduce these problems but we know that problems still occur.  As a result we are looking at ways of measuring oxidative stress as this may be another factor, like HbA1c, that we should control.  So far we have identified a marker in urine which is a by-product of the body’s metabolism of Vitamin E which is generally higher in those with diabetes.  Our research centres on how this might relate to other markers of blood vessel health.  This is now moving into field studies with linking these changes with other markers of blood vessel health.
We are also looking into the use of two new urine measures of kidney function which initial studies suggest might be of value.

Urine Vitamin E Metabolites - A new test to measure inflammation in people with diabetes

We will also be investigating whether oxidative stress, measured by theby-product of the body’s metabolism of Vitamin E, is able to give a very early warning of heart problems in adults with type 1 diabetes.

Diabetes care in different communities

Delivering care equitably is a hallmark of a Quality Service.  We have started to look at this in our clinic population.  What we have found is that the background of the person, particularly their ethnicity, is important in how well they do with their diabetes.  We showed that deprivation played a small role in this. From this, we have started to look at how we might better address the needs of different ethnicities. More specifically, Jennifer Pincherri is leading on a project to assess attitudes to health in the African population that comes to our service.

Paediatric HOMA - A new test to measure how well insulin works

How well insulin works in the body is called insulin sensitivity. In children and young persons with type 2 diabetes, insulin works less well and this is present before the onset of their diabetes. Insulin sensitivity is therefore an important measurement to know about.  The test most commonly used by doctors to measure insulin sensitivity is called the Homeostatic Model Assessment (HOMA) but was derived from adults.  Children's bodies are very different.  Therefore we are attempting to re-calculate HOMA using information from well children and hopefully this may be a more accurate way to measure insulin sensitivity.

A cardiovascular disease prediction tool for type 1 diabetes

GPs use specially created formulas (called algorithms) to estimate a person’s future risk of heart problems in non-diabetic people and, as a result, they get people started on treatment earlier to prevent or delay the onset of problems. However these formulas are inaccurate when applied to an individual with T1D.We aim to develop a new formula  specifically for T1D and we will develop a free online resource to allow use of the formulaby members of the public and in clinic.

Diabetes as a second chronic condition - how does a second medical problem affect people with diabetes

Many of the children at GOSH have diabetes as a complication of another underlying condition, such as cystic fibrosis or after an organ transplant. We are using questionnaires to examine the psychological impact of the diagnosis of diabetes as a second long term condition. Our aim is to ensure that we can provide appropriate support and resources to these CYP in the future.

Cystic fibrosis related diabetes

Many children and young persons with cystic fibrosis will develop diabetes as teenagers. For this reason, annual screening for diabetes is undertaken using oral glucose tolerance tests. We are looking at the use of continuous glucose monitoring as part of this screening process.

Beta Cell Loss

In conjunction with Johnnie Ludwigson and Tim Cole we have a study modelling beta cell loss which is led by Rachel Besser.  The idea is to determine factors that influence the rate of beta cell loss after diagnosis.
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