Type 2 research standouts from the EASD – by Anna Morris
We’ve already brought you the big Type 1 research stories from an action packed few days at the European Association for the Study of Diabetes (EASD) in Berlin. This time we’re talking Type 2. Anna Morris, our Assistant Director of Research Strategy and Partnership, wraps-up the research developments that caught her eye.
Do some people adapt to excess weight?
Dr Jessica Tyrrell from the University of Exeter filled us in on her work to find out whether your risk of Type 2 diabetes as an adult is affected by how much your BMI changes between the age of 10 and adulthood. Dr Tyrrell used information on over 370,000 people in the UK Biobank – one of the largest health studies in the world that’s we co-fund here at Diabetes UK. They were categorised as either ‘thin’, ‘average’, or ‘plump’ at the age of 10 and either overweight or obese (based on their BMI) as adults.
Dr Tyrrell calculated each person’s risk of Type 2 diabetes. She found that those who had been thin as a child, but had a higher BMI as an adult, were more likely to develop the condition than people whose BMI didn’t significantly increase from childhood to adulthood.
This opens up the question of whether people who have a consistently higher BMI throughout their life may somehow adapt to the excess weight. And whether the increase in BMI between childhood and adulthood might be considered as potential a new risk factor for Type 2 diabetes.
Celebrating 40 years of the UK Prospective Diabetes Study (UKPDS)
There was a packed room for the session opened by Professor Rury Holman from the University of Oxford celebrating 40 years of the UKPDS. UKPDS was a landmark trial (part funded by us) led by Professors Holman and Robert Turner which ran for 20 years. It showed, for the first time, that the complications of Type 2 diabetes, which had previously been thought to be inevitable, could be reduced with improved blood glucose and blood pressure control.
You could hear a pin drop as Professor Holman recalled the 1998 EASD meeting in Barcelona when the results were first announced. He told us that expectations had been low because the trial had been going on for so long. But the results blew everyone away and had an immediate and global impact.
Professor David Matthews closed the session by shining a spotlight on this life-changing impact. He explained that the UKPDS has transformed treatment for Type 2 diabetes, the thinking of healthcare professionals and education for people with the condition all over the world. As a result it’s played a significant role in reducing the harm diabetes does and improving the health of people with Type 2.
I left the session feeling inspired and proud of the difference that our research funding has made, and continues to make on the lives of people with diabetes.
A new way of thinking about Type 2?
You may remember news earlier this year reporting on research from Sweden suggesting Type 2 diabetes could be broken down into different subtypes or clusters. Subtypes of diabetes is a hot topic so I was keen to see John Dennis from the University of Exeter present his work taking this idea forward.
John wanted to see whether the same clusters from the Swedish study could be found using information from people who’d taken part in clinical trials. He then wanted to know whether the clusters could predict blood glucose control and the success of different medications.
John did find the same clusters, backing up the idea that there could be differences within Type 2 diabetes. He also discovered that the clusters could help predict who was more likely to progress to higher blood glucose levels. And that people in the different clusters responded differently to treatments. But interestingly, looking at simple characteristics – like age of diagnosis, sex and BMI – was even better at predicting how a person’s blood glucose control will progress and their response to treatments.
While there’s still lots to figure out potential subtypes and how to best identify them, research like this helps us think about moving towards a more personalised approach to improve care for people with Type 2 diabetes.
Coming to a consensus on hyperglycemia in Type 2
On the final day, a group of researchers came together to present new recommendations for managing high blood glucose in Type 2 diabetes. The team advised that lifestyle change should be key for treating the condition. And highlighted the emerging evidence from the Diabetes UK funded DiRECT trial showing that weight management can help some people put their Type 2 diabetes into remission.
They also noted that managing high blood glucose is a complex area, with so many medications now available. The group hope that their report will make it easier for healthcare professionals and people with Type 2 diabetes to make decisions on the right treatments for them.
Find out more advice on managing your blood glucose levels.