DRWF Events: Reviewing study proposals for vital research into diabetes

DRWF interviews from United Through Diabetes: Professor Ketan Dhatariya Consultant in diabetes, endocrinology and general medicine at the Norfolk and Norwich University, Honorary Professor of Medicine at the University of East Anglia Chair of the Association of British Clinical Diabetologists and member of the DRWF Research Advisory Board.

Professor Dhatariya presented at United Through Diabetes in a Panel Discussion on Research hopes for the future (for all types of diabetes).

The DRWF Research Advisory Board comprises experts in a wide variety of research disciplines to ensure that all applications are assessed knowledgably and fairly.

On his role as a member of the DRWF Research Advisory Board, Professor Dhatariya said: “I am part of the team that looks at the applications that come in for research funding, that grades them and looks at them. We have conversations about all of them as a group together and then decide who is lucky enough to get the funding.

“There are lots of things that all of which are pieces of the jigsaw, all of which are really important.”

Discussing developments in research to produce new treatments Professor Dhatariya said: “All medications that we use have to start somewhere. It starts with a basic scientist thinking about the molecules, thinking about what they do, doing all of the laboratory work and seeing if they have an effect on the cells. It does take a long time, but it does translate. Some of the newer molecules that we are using these days with such amazing success started in that way 12, 15, 20 years ago, because there was no other way of doing it.”

The “two big new kids on the block”

Professor Dhatariya discussed the impact of new treatments including sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of prescription medicines for use with diet and exercise to lower blood glucose levels in adults with type 2 diabetes: “The two big new kids on the block? Well, they're not even really that new. They have been around for the last 10 years. One is a group of drugs called the SGLT2 inhibitors. The treatment helps people urinate sugar, which reduces blood glucose levels. In addition, they have been shown to help reduce the complications of diabetes, including reduce premature cardiovascular risks.

“The treatment has also been used for people without diabetes, with heart failure and chronic kidney disease, because the strength of the information is so amazing.”

“The other treatment that many people would have heard of, is semaglutide and dulaglutide.”

The latter treatments are glucagon-like peptide-1 (GLP-1) receptor agonists used to treat type 2 diabetes, with semaglutide used as the active ingredient in medications like Wegovy and Ozempic.

Professor Dhatariya added: “These treatments are new and very popular around the world. They started, as I mentioned, with the basic science many years ago, and now into clinical practice, which we prescribe all the time.”

On treatment, Professor Dhatariya said: “The vast majority of type 2 diabetes is looked after in primary care, type 1 diabetes should be treated by a specialist. The earlier diabetes is under control, as soon as they're diagnosed, then the less likely they are to develop complications.

“There are people with type 2 diabetes who are loathe to go on to medications and want to manage the condition through diet and exercise. They are quite proud of the fact that they are not taking any medications. I think there is an argument that their diabetes might be better controlled.

“This is where I think there is a great deal of education that needs to come through to people with type 2 diabetes, because whilst people do want to control their diabetes with diet and exercise, for the vast majority of people it does not work.

“Therefore, while people may think that, yes, having no medication is brilliant, it is probably the wrong thing to do.

“You need to be treated really aggressively to get the diabetes under as good a control as possible using these newer treatments, which have been shown to prevent premature death. That is what is going to keep you alive.”

Professor Dhatariya also discussed the impact of continuous glucose monitors (CGM) in the treatment of type 1 diabetes: “Insulin has been around now just over 100 years, and we have all known that insulin is a medication which has what is called a very narrow therapeutic index. That is a technical term, that means it is easy to give too little, and it is very easy to give too much. So to give the right dose, it is really, really hard when you have to use the pens and needles and dose it up yourself and try to judge how much carbohydrate you have, how much exercise you have got, what time of the month it is. For example, for many menstruating women, all of these things really make a big difference and make it very tricky.

“With newer CGMs, new closed loop systems, newer devices that we have, a lot of that thinking has been taken away. There are new algorithms which are being developed within the machines that allow the sensors to ‘talk’ to the machines, the pumps, and allow people to have a constant infusion of insulin at the moment.

“The present CGM and the pumps are called the hybrid closed loop system. I am sure in the very near future we will have a fully closed loop where the ‘thinking’ is taken out, and hopefully there will be less room for mistakes and errors and people could live a complication-free life right from the very get go. That is the ultimate goal for people with type 1 diabetes using the technology. Of course, there are other things that we have been doing in the development of restoring beta cell function and so on, but that is for the future.”

Of the United Through Diabetes event Professor Dhatariya said: “I think this is a fantastic resource. I really hope that listeners will support the cause, to allow DRWF to continue the fantastic research that is absolutely necessary to improve the lives of people living with diabetes.”

Thank you for listening to this Living With Diabetes special podcast report from United Through Diabetes 2024, presented by Claire Levy and brought to you by DRWF.

Visit the DRWF United Through Diabetes Digital Hub for more information and resources from the day

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