- 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.
- 2013Sutherland-Earl Clinical Fellowship
Development of a robust clinically-relevant approach to antibody-medicated diabetes and hypoglycaemiaRecipient:Dr David ChurchInstitution:Cambridge University Hospital NHS Foundation TrustCity:CambridgeAmount:£180,000Description: Two rare and severe disorders of insulin action – namely type B insulin resistance (TB-IR) and insulin autoimmune syndrome (IAS) - are caused by pathogenic antibodies against the insulin receptor (anti-INSR Abs) or insulin (anti-Ins Abs) respectively. TB-IR causes fulminant, acquired insulin resistance, while IAS causes postprandial hyperglycaemia and fasting hypoglycaemia. Each condition may arise in isolation, or may complicate pre-existing diabetes, and may be treated with multimodal immunosuppression. Milder forms of the conditions are often suspected in patients with insulin-treated diabetes and labile glycaemic control, for many of whom subcutaneous insulin infusion therapy is adopted. In this context, a major limitation of current diagnostics is the lack of a clinically accredited diagnostic test for TB-IR in the UK (or the USA), and the qualitative nature of existing anti-Ins Ab testing for IAS, which does not yield useful information about the likelihood that the antibody detected is altering insulin pharmacokinetics, compounded by the inability of most insulin immunoassays to detect analogue insulins. This project thus sets out to develop rapid, robust and quantitative biochemical assays for anti-Ins and anti-INSR Abs that yield clinically useful information, and to incorporate these into integrated clinical/laboratory diagnostic algorithms for brittle diabetes, IAS, severe IR and suspected interference in insulin immunoassay. These investigations will be directly translated into improved patient care, being made available nationally in the NHS via the laboratory supra-regional assay service (SAS) and the National Severe Insulin Resistance service.
- 2013Pump Priming
Evaluating the role of the pancreatic beta-cell in the development of Cystic Fibrosis related diabetesRecipient:Dr Catriona KellyInstitution:Keele UniversityCity:KeeleAmount:£14,600.00Description: People with cystic fibrosis (CF) inherit a genetic defect that significantly shortens life-span. At present, approximately 9,000 people in the UK suffer from CF, and on average, do not live beyond their mid-30s. The genetic defect causes a build-up of thick and sticky secretions (for example, mucus in the lung), which affects the lungs and digestive tracts in particular. In the digestive tract, this causes high blood sugar levels and CF patients often develop diabetes (50% of patients over the age of 30 have diabetes). We do not know the cause, but the development of diabetes accelerates lung disease, which is the primary cause of death among CF patients. This study aims to find out what causes CF-related diabetes (CFRD) by examining the cells which regulate blood sugar levels. The study will not use animal or human tissue, but will create the first artificial CFRD cell model which will be used to study how the genetic defect increases blood sugar levels. This will be the first step in understanding how CFRD develops. By building on this initial investigation, we hope to identify how best to treat these patients to prevent the development of diabetes and increase life-expectancy.
- 2013Pump Priming
Evaluation of a novel glucagon-incretin hybrid peptide for diabetes and obesity therapyRecipient:Dr Victor GaultInstitution:University of UlsterCity:UlsterAmount:£19,975.00Description: The worldwide increase in incidence of T2DM demands development of new drugs which are safe and more effective. Such drugs would also limit the risk of costly long-term complications, which ultimately will have a burden on the NHS. We have recently bioengineered a new drug molecule which acts to stimulate insulin secretion. Our preliminary data also indicate that this drug acts on three key hormones which are important therapeutic targets for treatment of diabetes. We now wish to establish long-term antidiabetic actions of this drug in animal models of T2DM in an attempt to bring forward a new class of agents that offers a safe and exciting therapeutic approach to diabetes-obesity.