Transforming diabetes diagnosis, treatment and care worldwide
The University of Exeter is a world-leading research centre in the genetics of diabetes, improving diagnosis, treatment and care across the world. For more than 30 years, scientists have worked with patients and healthcare partners, making discoveries that are swiftly translated into healthcare, to improve lives worldwide. Exeter’s unique precision diabetes approach focuses on getting the right treatment for each patient, as swiftly as possible. The collaboration provided free genetic testing for diabetes for people in more than 200 countries, and has discovered 21 different genetic types of diabetes, excelled in improving diagnosis throughout the world, and optimised treatment for all diabetes types.
Andrew Hatterlsey, Professor of Molecular Medicine and Consultant Physician, said: “Diabetes affects more than 460 million people globally. Our Precision Diabetes approach to research focuses on understanding the genetics and variations of diabetes and developing and communicating the best treatment options. This is absolutely crucial to getting the right diagnosis for patients and their families first time and avoiding harmful complications."
In 2006, Professor Hattersley led the discovery that half of babies with diabetes could be treated more effectively with a simple tablet than with multiple insulin injections daily, transforming global care. The lab continues to innovate on this form of diabetes, with new genetic causes discovered recently.
The team has also changed treatment worldwide for the more common types of diabetes – type 1 and type 2. For both forms. They have created online calculators which are freely available to clinicians across the world. They can enter metrics that are widely available in clinic, alongside their genetic data. For people with type 2, the calculator suggests the best glucose-lowering drug for them, reducing side effects and complications and improving the chance that it will be effective first time. For type 1, the calculator uses a genetic risk score developed at Exeter, which can identify a person’s risk of developing the condition in the future, ensuring they can be monitored and potentially access new treatments which can delay the onset of the disease. The type 1 diabetes genetic risk score is now being used across the world, including a version specifically adapted to Chinese populations underpinning a large-scale clinical trial in China, on whether people have received the right diagnosis.
This approach of ensuring research is adapted to global populations to improve equality in healthcare is a core theme of Exeter’s research, seeking to redress the imbalance of research historically conducted in white European populations. In recent work, it has led to a new sub-type of diabetes identified in Africa, and identified that a genetic deficiency common in black and Asian men could be delaying diagnosis of type 2 diabetes. Professor Inês Barroso from the University of Exeter said: “Our findings highlight the urgent need for changes in research to tackle health inequalities. Our research is designed to fill gaps created by a legacy of research which lacks diversity, and is often tailored to specific populations around the world. Addressing this issue is not only crucial for medicine, but for health equity. Through this approach we are serving global populations more fairly and effectively, and also progressing knowledge on diabetes that benefits everyone”.