Hull York Medical School continues to drive innovation in diabetes research

More than 4.9 million people in the UK are currently living with type 1, type 2 or more rare forms of diabetes, and recent analysis from Diabetes UK suggests this could increase to 5.5 million people by 2030.

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 diabetes.

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, 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 Professor 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.

Professor Green said: "We have made good progress in deciphering how an inappropriate immune response towards the quality control cells leads to their demise. We have identified that a key component of the immune system’s fight against infection – Complement – acts in concert with antibodies that target the quality control cells, to change the cell’s fate. We have also discovered that inhibitors of Complement that normally protect uninfected cells from inappropriate Complement activity, are diminished in the quality control cells in type 1 diabetes." 

Diabetes and severe mental illness: improving outcomes and services

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 Professor Najma Siddiqi of Hull York Medical School at the University of York, is investigating the lived experience of people with diabetes and severe mental illness. The team is also developing and testing a new bespoke diabetes self-management intervention for this population. 

Early findings show that people with severe mental illness and diabetes struggle to manage several conditions at once and to access care that supports their physical and mental health. Physical health issues are sometimes overlooked and access to the right type of treatments can be difficult.

The DIAMONDS team has worked with service users and carers to develop a new intervention that aims to address these issues. This is currently in the early stages of being tried out in the NHS with further testing planned for next year.

Learn more about the DIAMONDS project

Tackling depression in diabetes

Depression in type 2 diabetes is rapidly increasing across the globe, particularly in South Asia. When both these conditions occur together, they signify a considerable disease burden which necessitates the need for a joint approach to care.

The four-year DiaDeM research programme, also led by Hull York Medical School’s Professor Najma Siddiqi will develop and test a culturally appropriate treatment for depression in people with diabetes in Bangladesh and Pakistan. This is based on a relatively simple psychological talking treatment called Behavioural Activation (BA), that has been shown to treat depression effectively and can be delivered by non-specialist health workers.

Researchers are currently developing and modifying the BA, involving people with experience of depression and diabetes, their caretakers, healthcare professionals and policymakers. The effectiveness of DiaDeM BA will be evaluated in comparison to the optimised usual care, and the economic influences on people with depression and diabetes will be assessed.

Learn more about the DiaDeM project 

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.

Patients participating in the group’s research have had access to newly emerging drugs and innovative treatments, including a new glucose monitoring device, which assists patients in identifying patterns in their glucose levels and spotting hypoglycaemia (‘hypos’) before they happen. The system reads glucose levels through a sensor worn on the back of the upper arm, eliminating the need for routine finger pricks.

The study found that patients showed significant improvements in glycaemic control and awareness of hypoglycaemia, and were much less likely to utilise healthcare resources as a result of improved management of their diabetes.

The research 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.

For more information on participating in a clinical trial, please email hyp-tr.clincal.research@nhs.net.