Diabetes Research

Diabetes and Related Metabolic Conditions

Diabetes and related metabolic conditions are a leading cause of ill-health and premature mortality exerting huge financial pressures on the health services. The Diabetes Research Group is active in areas of basic, clinical, epidemiological, social care and health services research. The Groups overarching aim is to address these important health-care needs by undertaking and supporting translational research to advance development and implementation of therapeutic strategies for prevention and treatment of diabetes.

Diabetes Research at the Medical School

In Wales 7.3% of the population aged >17 years live with diabetes, the highest prevalence in the UK. Diabetes affects all socio-demographic sections of society accounting for more than 10% of NHS spend. Only 9% of patients achieve nationally agreed targets for blood glucose control and over 66% have values which expose them to risk of developing life changing diabetic complications

New Therapies and Devices

We have developed to become a leading UK centre for conducting clinical trials in the area of diabetes making more new therapies and devices available to patients through participation in research, and providing for new treatment pathways and for their incorporation into national guidelines. We work with novel therapies and devices for diabetes, collaborating with industry (pharmaceutical companies, SMEs and device companies) advising, developing and delivering new studies.

Laboratory Analysis

We have developed extensive experience in assays related to diabetes. This has included involvement in assay development, assay validation and use of these assays in a variety of clinical situations such as clinical trials, research into the relative roles of insulin secretion and insulin resistance and also for the diagnosis of hypoglycaemic states such as insulinoma and factitious hypoglycaemia. Our laboratory is accredited to Good Clinical and Laboratory Practice (GCLP) standards, which allows us to provide a high quality service for diabetes and endocrinology research.

Diabetic Retinopathy

We have established international collaborations, using image analysis to aid diabetic retinopathy screening and to determine if retinal images can be used to assess cardiovascular risk. Previous successful research, utilising the Diabetes Eye Screening Wales dataset, has assisted in the understanding and development of new Diabetes Retinopathy screening services.

Obesity and Metabolic Surgery

We work in conjunction with the Welsh Institute of Metabolic and Obesity Surgery (WIMOS) focusing on basic adipose biology and the effects of bariatric surgery on metabolic outcomes examining the genetic and biochemical characterisation of adipose tissue in obese subjects and prospective outcomes from bariatric surgery.

Public Involvement

Public involvement is key to producing research relevant to the needs and concerns of those living with diabetes or at risk of developing the disease. We have an established Reference Panel of public contributors that work closely with diabetes researchers providing lay opinion and helping to shape our programme of research and public engagement activities.

Self-Management of Diabetes

We are undertaking work to explore the tools for successful self-management of diabetes including investigating alternative methods for supporting and enabling people with diabetes to manage their condition and health themselves. We have a particular focus on self-monitoring of blood glucose and the evaluation of diabetes prevention programmes.

Research Outcomes

Our group focusses on ways of both preventing and managing the epidemic of diabetes and has contributed to national and international healthcare impact including:

Contribution to the development of diabetes therapies which have become part of standard diabetes treatment guidelines in the UK and worldwide;
Working with industry to assess devices for the monitoring of blood glucose and identifying their place in diabetes management;
Research into diabetic retinopathy

Blood Glucose Monitor and droplet of blood on finger

Effect of structured self‐monitoring of blood glucose

Self-Monitoring of Blood Glucose in non-insulin treated T2D: The SMBG Study

The value of Self-Monitoring of Blood Glucose (SMBG) in people with non-insulin treated T2D has been debated for many years with current UK guidelines limiting its use. We led a study across Wales and England to evaluate ‘Structured SMBG’ and demonstrated that it can provide clinically significant improvements in blood glucose control. We also found that it improved an individual’s quality of life. This evidence demonstrates that SMBG is a useful aide in diabetes self-management.

Incidence of diabetic retinopathy

Screening Intervals for Diabetic Retinopathy

Diabetic retinopathy (DR) is a leading cause of blindness and national guidelines recommend that screening for DR should be conducted on an annual basis. Our group showed in a large number of patients followed over a period of 4 years that in persons with type 2 diabetes with no retinopathy the screening intervals could be extended to 2 to 3 years and it may be possible to stratify screening intervals based on level of risk.

Performance evaluation of a self‐administered home oral glucose tolerance test

Performance of novel home oral glucose tolerance test kit

The oral glucose tolerance test (OGTT), is a diagnostic test for diabetes, usually carried out in a clinical setting. Laboratory and clinical researchers from the group have been involved with the development and validation of a novel device that enables an ‘at home’ OGTT. A comparison trial in 100 volunteers showed good agreement between the device and laboratory analysers, demonstrating its potential as an alternative to clinic based OGTTs, especially beneficial in higher risk groups.

Associated Research Projects

Joint Clinical Research Facility
Sail Data Bank

Associated Sub-Theme Publications

Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, Jeppesen OK, Lingvay I, Mosenzon O, Pedersen SD, Tack CJ, Thomsen M, Vilsbøll T, Warren ML, Bain SC; PIONEER 6 Investigators. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2019 Aug 29;381(9):841-851.
- doi: 10.1056/NEJMoa1901118.
Dunseath GJ, Bright D, Luzio SD. Comparative Accuracy Evaluation of a Blood Glucose Meter With Novel Hematocrit Correction Technology, With Three Currently Used Commercially Available Blood Glucose Monitoring Systems. J Diabetes Sci Technol. 2019 May;13(3):568-574.
- doi: 10.1177/1932296818821389.
Thomas RL, Dunstan F, Luzio SD, Roy Chowdhury S, Dunstan F, Hale SL, North RV, Gibbins RL, Owens DR . Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the Diabetic Retinopathy Screening Service for Wales: retrospective analysis. BMJ 2012 Feb 22;344:e874
- doi: 10.1136/bmj.e874
Prior SL, Churm R, Min T, Dunseath GJ, Barry JD, Stephens JW. Temporal Effects of Sleeve Gastrectomy on Glucose-Insulin Homeostasis and Incretin Hormone Response at 1 and 6 Months. Obes Surg. 2020 Jun;30(6):2243-2250.
- doi: 10.1007/s11695-020-04457-9.
Parsons SN, Luzio SD, Harvey JN, Bain SC, Cheung WY, Watkins A, Owens DR. Effect of structured self-monitoring of blood glucose, with and without additional TeleCare support, on overall glycaemic control in non-insulin treated Type 2 diabetes: the SMBG Study, a 12-month randomized controlled trial. Diabet Med. 2019 Jan 17.
- doi: 10.1111/dme.13899.