Diabetes and its associated complications present an enormous global challenge. In 2021, according to the International Diabetes Federation (IDF), 537 million adults are living with diabetes, with over 3 in 4 adults with diabetes living in low- and middle-income countries1.
The 14th of November marks World Diabetes Day (WDD) which was created in 1991 by the IDF and the World Health Organisation (WHO). The WDD campaign aims to “promote the importance of taking coordinated and concerted actions to confront diabetes as a critical global health issue”. The 2023 WDD campaign highlights the importance of knowing your risk of type 2 diabetes, the impact of diabetes-related complications, and the importance of access to the correct information and timely treatment. Learn more about WDD and reducing your risk of diabetes at https://worlddiabetesday.org/about/ .
Principal Investigators within the UCD School of Medicine and the UCD Diabetes Research Centre (DCRC) are working with colleagues in Northern Ireland and internationally to meet the challenges of this global health crisis. The featured diabetes research projects below demonstrate the scope of innovative research being carried out in advancing diagnosis, response to treatment and, management of diabetes.
Title: A functional genomics pipeline for genetic discovery in diabetic kidney disease.
Key Personnel: Prof. Catherine Godson (UCD), Prof. Peter Maxwell (Queen’s University Belfast) and Asst. Prof. Eoin Brennan (UCD).
Background: Diabetes is one of the leading causes of chronic kidney disease, with around 40% of people living with diabetes developing kidney disease in their lifetime3. Diabetic kidney disease (DKD) is a devastating microvascular complication of both type 1 (T1D) and type 2 diabetes (T2D).
The Genetics of Nephropathy – an International Effort (GENIE) consortium is a collaboration between UCD, Queen’s University Belfast, University of Helsinki, University of Michigan, University of Pennsylvania and the Broad Institute. DKD has been shown to have a heritable component, but prior searches for the genetic determinants of this condition have had limited success. The consortium will perform genetic screens to discover shared and distinct risk factors for DKD in T1D and T2D and will use computational tools and experimental models to derive biological insights into DKD pathogenesis.
Prof. Godson said, “This project is a wonderful opportunity to further develop our research on diabetic kidney disease in collaboration with our partners in Northern Ireland, the US and elsewhere. From our large international studies on genetic background to diabetic kidney disease we can propose various biomarkers of disease susceptibility and potentially of response to therapies. Our investigations have also led us to propose alternative therapeutic strategies that may be helpful against this devastating disease”.
Funder: Health Research Board (HRB) and Science Foundation Ireland (SFI) in Ireland; Department for the Economy (DfE) and the Health & Social Care R&D Division in Northern Ireland; National Institutes of Health (NIH) in the USA.
Title: Harnessing the glucose lowering actions of alpha-melanocyte stimulatory hormone as a new adjunctive therapy for people with Type 1 Diabetes.
Key Personnel: Prof. Carel Le Roux (UCD/Ulster University), Prof. Alex Miras (Ulster University) and Assoc. Prof. Neil Docherty (UCD)
Background: Management of blood glucose for people with Type 1 Diabetes (T1DM) can be challenging. High blood sugar in the long term can lead to organ damage and reduced quality of life. In patients with T1DM, intensive insulin therapy is used to control blood sugar however it's use can commonly cause side-effects such as low blood sugar (hypoglycaemia) and weight gain. There is an urgent need for new therapies for patients with T1DM that work alongside insulin to control blood sugar that can reduce their insulin dose and improve quality of life.
We have recently discovered a new biological pathway in humans by which the hormone alpha-melanocyte stimulatory hormone (alpha-MSH) can induce skeletal muscle glucose uptake, thus lowering blood sugar in a similar manner to insulin. We have demonstrated this mechanism is present in healthy humans. This JDRF funded collaboration between UCD, Ulster University and Prof Michael Cowley in Monash University, aims to investigate whether this novel pathway can be used to reduce blood sugar in T1DM. This project will be carried out in close collaboration between Ulster University and University College Dublin. Patients with T1DM will be recruited to undergo oral glucose tolerance tests, hyperinsulinaemic-clamps, and muscle biopsies to elucidate the exact mechanism by which alpha-MSH causes skeletal muscle glucose uptake, and assess the therapeutic potential of harnessing this pathway in T1DM. We hope that completion of this project will lead to a new class of drugs that could have a major positive impact on the lives of people living with T1DM in the form of a safe and effective treatment that would enable patients to improve their blood sugar control with less insulin.
Funder: Juvenile Diabetes Research Foundation (JDRF) International
Title: Understanding ingestive eating behaviour after bariatric surgery in patients with diabetes
Key Personnel: Prof. Carel Le Roux (UCD/Ulster University), Prof. Alex Miras (Ulster University) and Dr. Ruth Price (Ulster University)
Background: According to the IDF and WHO, obesity is responsible for approximately 43% of all type 2 diabetes, rising to 80-85% in some populations (e.g., UK and USA)4. Bariatric surgery is one of the most effective methods to aid and maintain weight loss. However, the mechanisms underlying sustained weight loss following bariatric surgery are complex and are not fully understood. This clinical study aimed to develop robust research methods to assess ingestive behaviour to clarify these mediators following bariatric surgery. It investigated changes in energy intake (caloric or energy content of food), energy density (amount of energy or calories in a particular weight of food), eating patterns, and food preferences in patients with diabetes following surgery.
Funder: National Institutes of Health (NIH) USA, Medical Research Council (MRC) UK, and Health Research Board (HRB) Ireland.