Now I’m going to highlight some of Diabetes UK research successes. All of this research has helped make a significant difference to the lives of people with diabetes.
Starting at the very beginning... Diabetes UK was founded in 1934...We have been funding research from the 1930s right up to the present day, with our first ever research grant being awarded totalling £50. This grant was awarded to one of the co-discovers of insulin and revealed a key step in how the liver produces glucose from a sugar called galactose.
Skipping ahead to the 1970s:1977 – Diabetes UK purchased the UK’s first artificial pancreas to ensure that research to help stabilise blood glucose levels for people with diabetes during childbirth and surgery could continue.1978 – Researchers demonstrated for the first time that people with diabetes could measure their own blood glucose levels at home and use that information to improve their glucose control.In the same year researchers conducted the first tests of an insulin pump and showed it to be technically feasible.
1986 – Professor Roy Taylor tested the feasibility of using a retinal camera to screen people with diabetes for retinopathy. Proving it was a more reliable means of screening than using an ophthalmoscope.In the same year a development grant from Diabetes UK was awarded to set-up the first specialised Diabetic Foot Centre in the UK. Today such centres bring together the skills of chiropodists, shoe-fitters, nurses, physicians and surgeons to manage foot complications arising as a result of diabetes.
Bringing us nearly up to the present day:In early 2010: a study by Roy Taylor at the University of Newcastle revealedthat diabetic retinopathy is no longer the leading cause of blindness among Newcastle’s working age population, thanks to the pioneering retinal screening programme initiated by Diabetes UK-funded researchers in the 1980s.
I’m now going to focus on what is in the news and progressing well into becoming new treatments for the future.
First of all I’m going to talk about some research projects we have going on in relation to Type 1 diabetes.In this study, Dr Roman Horvorka at the University of Cambridge has been funded to make the first generation of ‘closed loop’ system, also known as the artificial pancreas.This consists of a glucose sensor and an insulin pump, both of which are already available. In some areas more easily than others. Key here is number (2) on this diagram which is a device that interprets how much glucose is there is in the blood and tells the pump to give insulin or to stop giving it. In April last year, Dr Hovorka published results from two studies evaluating the performance of his prototype for the artificial pancreas, which were carried out in 10 men and 14 women with Type 1 diabetes, aged 18 to 65. They revealed a 22 per cent improvement in the time participants kept their blood glucose levels in a safe range, halving the time they spent with low blood glucose levels and reducing the risk of both short term and long term complications. Diabetes UK is now funding trials that are about to start in the home setting, which is more variable and more challenging and therefore a major step forward for this type of research.
This next study also relates to Type 1 diabetes but is focused on islet transplants.As I’m sure many of you know, we are now able to transplant islets from the pancreas of a deceased donor in order to treat Type 1 diabetes. Once transplanted, these islets begin to produce insulin, leading to improvements in control over blood glucose. [CLICK] Richard Lane, the President of Diabetes UK, who has Type 1 diabetes was one of the first people in the UK to receive an islet cell transplant – and the first person in the UK with Type 1 diabetes to come off insulin altogether.However, transplanted islets are often poorly accepted by the body and become less effective over time. Only about 10-15% of people who receive islet transplants are insulin independent after 5 years and additionaltransplants can become necessary. So for example I think Richard Lane has now had three such transplants. These issues, and the widespread shortage of people willing to donate their islets when they die, mean that the effectiveness of this therapy becomes limited.
To improve this situation, researchers have used experiments in mice to demonstrate that if you transplant a specific kind of stem cell at the same time as you transplant islets the result is improved insulin secretion and improved control of blood glucose. You may have heard a lot of different things about stem cells, but the important thing is that they are cells which, given the right set of conditions, can develop into lots of different kinds of other cells. As a result they are potentially useful for repairing different tissues of the body that have degenerated as a result of diseases. The particular kind of stem cell I’m talking about here are derived from the kidney tissue of adults and can grow into the different kinds of tissues that you see here.Researchers think that these stem cells improve the survival of transplanted islets by reducing the immune response that would otherwise lead to the body rejecting an islet transplant. They can also allow blood vessels to develop which then help to keep the islets alive.
In a new study funded by Diabetes UK, Professor Peter Jones at King’s College in London is exploring the mechanisms that enable the stem cells to improve islettransplants and looking for the best locations at which stem cells could be injected.Most of their experiments will be done using islets and cells grown in the in lab, after which the researchers will test the effectiveness of the stem cells on transplantation into mice that have been specially bred to have diabetes. They will also measure the ability of the combined transplants to control the mice’s blood glucose to see how effective they are.The researchers will also try and adapt the transplant technique to one that is more suited to humans and will repeat their experiments with human islets and human stem cells in the lab to increase the relevance of their findings for treating people with diabetes.Ultimately the project could improve the design of islet transplantation methods and improve the treatment of people with Type 1 diabetes. The new transplant techniques could also reduce the number of islets needed to carry out a successful transplant, meaning that more people can be treated with the limited number of islets available from donors.
Now I’m going to move on and talk a bit about Diabetes UK research projects in relation to Type 2 diabetes.In this study Professor Roy Taylor at the University of Newcastle has been testing very low calories diets in people with Type 2.This is not a quick fix for Type 2 because such a limited diet of just 600 calories a day for 8 weeks is not easy to maintain and is unsuitable for some people.However, it has been tested as an effective alternative to surgery such as gastric banding and gastric bypass and the results are very interesting.
In June last year published results from an early stage clinical trial showed that after just one week, blood glucose levels when fasting had returned to normal. However, when participants returned to normal eating – all of them put on weight Three months after the end of the trial, ten people were re-tested and seven were still free from diabetes Overall the study suggests that reversal of Type 2 diabetes is possible and appears to be a result of decreasing excess fat around liver and pancreasProfessor Taylor is now looking at how to sustain such diets over a long period of time and deliver them through a primary care setting like a GPs surgery.
The next Type 2 project I want to talk about is being run at the University of Exeter and the researchers want to determine if consuming nitrate in the form of beetroot juice can enhance blood supply to the muscles, which might make it easier for people with Type 2 diabetes to exercise for longer.So, what’s the background to this?Well, this is nitrate (a central nitrogen atom surrounded by three oxygen atoms), which is often found in green leafy vegetables as well as beetroot. Scientists think that when we eats lots of this, it gets converted to Nitric Oxide (a nitrogen atom bound to an oxygen atom), which is important for lots of biological processes including the blood flow that supplies oxygen to the muscles.They also think that the production of Nitric Oxide is reduced in people with high blood glucose levels, which in turn reduces blood flow to the muscles. So this helps to explain why some people with Type 2 diabetes find that physical activity and exercise can be uncomfortable.[CLICK]Initial research conducted by this team in Exeter with 6 people with Type 2 diabetes found that those who were given a small amount of standard beetroot juice once a day over four days (black bars) needed to use less oxygen to cycle on an exercise bike at a particular rate than those who were given the same amount of juice with the nitrates removed (white bars).
The study we’re currently funding, which began in July and is led by Daryl Wilkerson, who you can see here, will expand on this initial work. 40 people with Type 2 diabetes aged between 35 and 75 will take part in a walking test and a cycling test to simulate different levels of daily activity and exercise. Again, for four days before the tests, half the participants will drink beetroot juice, while the other half will drink beetroot juice with the nitrates taken out. During the exercise tests researchers will use specialised equipment to measure the amount of oxygen that the different groups are using, and how much oxygen is being delivered to their muscles.If the research proves that nitrates are really effective at helping get oxygen to the muscles they could perhaps be earmarked as a simple treatment that could allow people with Type 2 diabetes to perform daily tasks and to exercise more comfortably, which could help to improve their control of blood glucose and their overall quality of life.
And finally to give you one example of how research can take new and unexpected turns, here is a quote from Sir Alec Jeffreys, the inventor of revolurionary DNA fingerprinting, who said:“Our discovery of DNA fingerprinting was of course totally accidental … but at least we had the sense to realise what we had stumbled upon."
I also wanted to emphasise that diabetes research needs your support, because without people like you it would be much, much harder for Diabetes UK to keep going with all the fantastic projects that we fund.
Diabetes UK receives no government funding, which means we entirely rely on subscriptions and donations to continue the work we do.We use a variety of revenue streams to generate income, with fundraising playing a huge part. In terms of fundraising we promote membership, payroll giving, collections, legacies, corporate donations, make applications to Trusts and Foundation, encourage individuals to fundraise and put on a huge number of events each year.Most of you will be aware of the work we do, but here are a few highlights from 2012 and information as to how you can help us or get involved...
There are also a number of ways in which you can support fundraising as a volunteer:Participate in eventsWe have a number of walks, runs, cycle rides, bungee jumps and much much more planned for 2013Volunteer at eventsWe welcome any help, be it holding a collecting can for a couple of hours to marshalling or helping at a registration deskHelp promote our eventsHelp us spread the word by postering in your locality, let local companies, clubs and groups know about our events. Local knowledge is key, so to have support on the ground is great.For further information on any of our events or volunteering opportunities just speak to a member of the fundraising team.
Here are just a few ideas to whet your appetite, but there are so many fun and varied events that can be arranged.We can offer you support, guidance, hints and tips alongside promotional materials such as balloons, banners, collecting cans and much much more.
That’s us. We have some information at our stand and please feel free to come and talk to us at any point throughout the day. Should anyone have any questions they would like to ask at this point, please do so, if not, many thanks for your time.
NORTHUMBRIA UNIVERSITY RESEARCH UPDATELinda Wood, Regional ManagerJulie Nattrass, Regional Fundraising Manager
Today’s talk Research at Diabetes UK Past research successes Research in progress How you can get involved
Research Strategy Context Diabetes UK-funded research in a wider context Limited in scope but not without ambition Priority is to meet unmet needs of people living with diabetes and at high risk of diabetes Must underpin the three key priorities set by our Board of Trustees Research considers the diversity of people living with diabetes
Funding research In 2012 Diabetes UK will spend around £6 million on research. The research portfolio is currently valued at just over £20 million We do not receive any statutory government funding for research All funds for research comes from donations to Diabetes UK (including Adopt-A-Project, Regular Giving and Legacies)
1934: Diabetic Association founded its 1935: Diabetes UK awards (but our name was changed to the to first research grant, of £50, British Diabetic AssociationUniversity of Dr Hans Kosterlitz, in 1967 and to Diabetes UK in 2000) Aberdeen.1934 1935
1978: Measurement 1978: Tests of blood glucose 1977: Diabetes UK purchased demonstrate safetythe UKsat home shown and feasibility of levels first artificial pancreas to enable key researchinsulin pumps for the to improve glucose to control continue. first time 1977 1978
1986: Retinal camera 1986: First specialised revealed as reliable Diabetic Foot Centremethod of screening established with for retinopathy Diabetes UK funds 1986
2010: Retinopathy no longer the leadingcause of blindness in Newcastle thanks to screening 2010
Artificial pancreas Dr Roman Horvorka of the University of Cambridge)has been funded to make the first generation of ‘closed loop’ system – artificial pancreas
Vaccine trials for Type 1 diabetes Type 1 diabetes results when the immune system attacks healthy insulin producing cells in islets of pancreas Professor Mark Peakman and Dr Tim Tree at King’s College London are investigating precise mechanisms and targets involved in this attack Discovered components of the immune system that forms a natural defence against attack on islets
Vaccine trials for Type 1 diabetes Defences seem to be overwhelmed in people with Type 1 diabetes, but fully intact in people without Type 1 Professor Peakman has now developed a therapy than can bolster these natural defences Now beginning clinical trials …very early days
Stem cells + islet transplants Experiments in the lab and in mice with diabetes will allow the researchers to test the effectiveness of kidney stem cells at improving islet transplants Project could help improve the design of islet transplantation methods and improve the treatment of people with Type 1
Intensive dieting Professor Roy Taylor of Newcastle University looking at reproducing the effects of surgery by intensive dieting 11 people who had diabetes for less than 4 years, with BMI of around 33. Diet of 600 calories per day for 8 weeks
Intensive dieting – results so far... After just one week, fasting blood glucose levels had returned to normal However, when participants returned to normal eating – all put on weight 3 months after the end of the trial, ten people were re-tested and 7 were still free from diabetes Reversal of Type 2 diabetes appears to be a result of decreasing excess fat around liver and pancreas
Nitrate and exercise for Type 2 40 people with Type 2 diabetes Will drink beetroot juice either with or without nitrates Short walking and cycling tests to measure oxygen consumption Could identify readily-available treatment to make exercise easier for people with Type 2
The search for a cure Important to realise that a cure for diabetes might not come directly from diabetes research Developments and discoveries take place in other areas of science and medicine It is the application of these developments to diabetes that might yield dividends It is impossible to predict how or when a cure may be found
Important to bear in mind...“Our discovery of DNA fingerprinting was ofcourse totally accidental … but at least wehad the sense to realise what we hadstumbled upon."Sir Alec Jeffreys (1950 - )GeneticistInventor of DNA fingerprintingwhich has revolutionisedforensic science & thecriminal justice system
Why we fundraise• Diabetes UK receives no government funding• We rely entirely on subscriptions and donations to fund the work we do• In 2011 Diabetes UK raised £29.53 million
Support fundraising events• Participate in events We have a number of walks, runs, cycle rides, bungee jumps and much, much more planned for 2013• Volunteer at events We welcome any help, be it holding a collecting can for a couple of hours to marshalling or helping at a registration desk• Help promote our events Help us spread the word by putting up posters in your locality, let local companies, clubs and groups know about our events
Get involvedHold your own fundraising event• Organise a local walk or pub crawl• Carry out a street collection• Hold a party on World Diabetes Day There are lots of fun and creative things you can do to raise money for Diabetes UK, and we will support you every step of the way.
Current Opportunities• Volunteer at our Street Collection in Newcastle – Thursday 29 November• Volunteer as an Events Volunteer – helping at Healthy Lifestyle Roadshow events across the North East or at fundraising walks and runs
Thank you!If you have any questions pleasecontact us at:email@example.comOr call 01325 488606