Hull York Medical School drives innovation in diabetes research

Around 4.7 million people in the UK are currently living with diabetes. The number of people diagnosed with Type 1, Type 2 or more rare forms of diabetes has more than doubled between 1998 and 2018, and the NHS spends at least £10 billion per year on the condition. Almost 80% of this expenditure is dedicated to treating diabetes-related complications, including heart attacks, strokes, vision loss, kidney disease, amputations and mental health problems including depression, all of which are more likely to occur in those living with the condition.

Hull York Medical School, in partnership with both the University of Hull and the University of York, is at the cutting edge of diabetes research, pioneering a range of projects dedicated to better understanding and combating the condition, as well as supporting those living with it.

Getting to the root of Type 1 diabetes

Type 1 diabetes is believed to contribute to 10% of all diabetes cases. In the UK, this equates to approximately 400,000 people, predominantly affecting children and young adults. Type 1 diabetes occurs when the immune system mistakes insulin secreting cells as a threat to the body, and kills them.

Research has shown that the numbers of immune cells that kill insulin producing cells are higher in people living with Type 1 diabetes, than people who do not have the condition.

A three-year research project funded by Diabetes UK and led by Dr Allison Green of Hull York Medical School at the University of York has shown that a potential reason for this increased prevalence of immune cells is the immune system first attacking specialised ‘quality control cells’ whose job it is to detect and destroy insulin responsive immune cells before they can cause Type 1 diabetes.

Dr Green said:

We have long speculated that loss of quality control cells pushes the Type 1 diabetic response, but failed to understand how this happens. Our research showing that particular cells of the immune system are killing these quality control cells well before Type 1 diabetes occurs paves the way to determine just how the immune cells target the quality control cells for death. If we decipher this response, we have the potential to design therapies that stop the immune system attacking the quality control cells, thereby preventing the progression to Type 1 diabetes.

Diabetes and mental illness: improving outcomes

Diabetes is more than twice as common in people living with severe mental illness, and has poorer outcomes than diabetes in the general population.

Hull York Medical School research carried out as part of the DIAMONDS project led by Dr Najma Siddiqi at the University of York has quantified the health inequalities associated with living with both conditions, and measured differences in how the conditions are experienced and managed. The project has found that people with a severe mental illness experience significantly greater levels of diabetes related distress, report receiving less person-centered care, and perform self-care activities less frequently than other people with diabetes.

The DIAMONDS project explores how living with a severe mental illness can impact people's ability to manage their diabetes, and has highlighted the need to create accessible services and support to improve outcomes for this group. The findings from the research are now being used to create a new evidence-based diabetes support programme for people with severe mental illness, designed in partnership with patients themselves, with the ultimate goal of improving diabetes outcomes and reducing inequalities.

Ground-breaking treatments and interventions

 Clinical research led by Professor Thozhukat Sathyapalan within Hull York Medical School’s Diabetes, Endocrinology and Metabolism Research Group at the University of Hull is resulting in newer treatments and interventions in the fight against diabetes and the often life-limiting complications and co-morbidities it can lead to.

Over the past year, patients participating in the group’s research have had access to newly emerging drugs and innovative treatments, including new continuous glucose monitoring devices not yet widely available, which assist the patient in identifying patterns in their glucose levels and spotting hypoglycaemia (‘hypos’) before they happen.

The group is also involved in obesity research aimed at preventing the progression of Type 2 diabetes and reducing cardiovascular risk, as well as seeking to improve and evaluate service provision and patient experience, for example working with young adults with Type 1 diabetes to assess their experiences of transitioning from child to adult services.

Professor Sathyapalan said: ‘These opportunities mean there has never been a better time to participate in research. Without new treatments and innovations, we will never avoid the often dangerous complications associated with diabetes. Our participants with obesity, Type 1 or Type 2 diabetes are working with researchers to move treatments forward.’

For more information on participating in a clinical trial, please call (01482) 675387 or email clin.research@hey.nhs.uk