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1
CAT/CL10/007
Development and clinical evaluation of a new dual purpose insole used for ulcer prevention and balance-enhancement in neuropathic individuals with diabetes
Non-NIHR funding
Training
Complete
HEE/NIHR Integrated Clinical and Practitioner Academic Programme
Trainee Development
NIHR/HEE CAT Clinical Lectureship
£153 871
1 novembre 2011
31 octobre 2016
Training Award
Neuropathy (nerve damage) commonly affects the feet of people with diabetes and can lead to foot problems and falls. Insoles are commonly provided to protect diabetic feet. This project aims to improve and extend the usefulness of insoles by designing and testing a new dual purpose insole to protect feet and enhance balance. First people with diabetes who wear insoles will be asked for their views. Once designed, high-tech laboratory based equipment will be used to study balance and test the new insole. Finally an exploratory study will compare new and traditional insoles to see which is best at improving the balance of people with diabetes.The study design maximises clinical impact by transferring new knowledge directly to clinical practice. Each fall and related injury prevented could save a person from long term disability, increased dependence on others, loss of earnings, premature institutionalisation, social isolation and reduced quality of life.
Academic
University of Plymouth
PL4 8AA
50,375
-4,138
Dr Joanne Paton
0000-0002-8833-3226
Award Holder
Neurological
6. Evaluation of Treatments and Therapeutic Interventions
6.3 Medical devices
Diabetes
Award does not have an ODA Downstream Partner
2
PB-PG-1208-18232
Development, Piloting and Validation of a Questionnaire to Assess Diabetes-Specific Self-Care Behaviours
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£179 288
14 septembre 2010
31 décembre 2012
Management of type 1 diabetes has progressed from simply taking fixed, multiple daily doses of insulin to more complex, dose adjustment in response to people’s pre-meal blood glucose results and carbohydrate intake. This approach was pioneered by a team in Düsseldorf and now forms the basis of structured education programmes for type 1 diabetes. We know that for people with diabetes, carrying out certain self-care behaviours around medication, diet and exercise are a vital part of managing their care and improving their long-term health but these behaviours are often difficult to adopt. Existing questionnaire measures of diabetes self-care behaviours do not capture current approaches to diabetes management because they do not assess things like insulin dose adjustment. These questionnaires have not been revised in light of current diabetes care recommendations. We aim to develop an up-to-date measure of diabetes self-care behaviour that reflects current recommendations for type 1 and 2
BackgroundIn the 1980s, a Düsseldorf group demonstrated that teaching adults with Type 1 diabetes to eat freely and self-adjust insulin according to carbohydrate intake improved glucose control and reduced hypoglycaemia. The recent DAFNE RCT transformed Type 1 diabetes management, through improvements in glycaemic control and QoL, and showed the feasibility of this approach in the UK. Many people with diabetes find it difficult to sustain this approach. We are currently funded by NIHR to investigate barriers to self-management. Existing measures of diabetes self-care behaviour do not accurately capture diabetes self-management. Such a tool would enable a precise assessment of the contribution of patients to insulin adjustment and self-care and could be used in Type 1 and 2 diabetes.AimsTo develop, pilot and validate a questionnaire assessment tool of diabetes-specific self-care behaviours using a mixed methodological approach. This will incorporate up-to-date recommendations about diab
Government/NHS
Sheffield Teaching Hospitals NHS Foundation Trust
S10 2SB
53,378
-1,496
Dr Deborah Cooke
Not Provided
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
3
NIHR206519
Evaluation of the clinical impact and cost-utility of a comprehensive digital diabetes self-management platform (MyWay Diabetes): proposal for a mixed-methods, pragmatic, real-world evaluation
NIHR (non-ODA)
Research
Active
Invention for Innovation
Commissioned
Invention For Innovation
£1 020 521
1 juin 2024
31 octobre 2026
Aim: To provide information supporting commissioning/implementation decisions on whether the online support programme 'MyWay Diabetes (MWD) should be made available to all people with diabetes across England; including evidence supporting National Institute for Health and Care Excellence (NICE) technology appraisal/evaluation. Objectives: In people from different backgrounds, we will assess whether MWD: a) helps people control their diabetes; b) is good value for money; c) is easy for everyone to access/use; and d) how it can be improved. Background: Diabetes affects 10% of people. The NHS spends ~10% of its money treating diabetes and its complications, which are largely preventable through good care. The National Diabetes Audit showed: a) only 1 in 7 people with diabetes are monitored properly; b) only 1 in 3 have well-controlled diabetes; and c) access to structured diabetes education is poor. MWD was created to provide personalised access to NHS health records and structured ed
Research question: Is MyWay Diabetes a clinically and cost-effective diabetes self-management intervention that is also equitable, usable, and acceptable, and therefore suitable for deployment across the NHS in England? Background: The rapidly accelerating burden of diabetes is a global health emergency. Diabetes and its complications consume 10% of NHS spending, where 80% of this is spent treating largely preventable complications. However, as evidenced by the 2022-23 National Diabetes Audit, diabetes monitoring and treatment targets are seldom achieved and there are important disparities in quality of care disproportionately affecting ethnic minority and socioeconomically disadvantaged groups, leading to poorer outcomes. Lifestyle changes necessary to effectively control diabetes mean that self-management and educational support are essential. MyWay Diabetes is a comprehensive digital diabetes self-management platform aiming to reduce healthcare burden by using NHS electronic healt
Academic
The University of Manchester
M13 9PL
53,467
-2,234
Dr Deborah Wake/Professor Martin Rutter
0000-0003-4376-6973/0000-0001-6380-539X
Joint Lead Applicant/Chief Investigator
Awaiting Health Category Coding
9. Awaiting RAC Coding
9.1 Awaiting RAC Coding
Award not coded to a curated portfolio
Award does not have an ODA Downstream Partner
4
PB-PG-0610-22311
Community-based peer support in diabetes; factors associated with success and impact on volunteers providing support.
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£234 727
12 janvier 2012
31 octobre 2014
Peer support schemes, where people with a condition such as diabetes offer support and share expertise with others, are thought to help people with diabetes better manage the practical and emotional aspects of their condition.This support provides a different non-professional dimension to address the needs of those with diabetes to complement contact with NHS staff.The diabetes services based at Addenbrookes, working with researchers at the University of Cambridge have funding for a research project to investigate the benefits of peer support in local communities. In this, peer support will be set up in different ways in local areas involving either one-to-one support, support groups, a combination of these or neither. All participants will receive diabetes education at the start. The main study is looking at how helpful and effective peer support is to people with diabetes, but little is known about the people who volunteer to become peer supporters. First we want to find out whether
BackgroundPeople with diabetes face difficulties in managing their condition well. Psychological and psychosocial issues have been identified as important barriers to diabetes care, emphasizing in particular the strictness of the diabetes regimen, including diet, exercise and monitoring. Peer support, involving experience sharing, mentoring and role-modelling, has been proposed as a way of overcoming some of the barriers identified as important in impeding successful diabetes self-management. There is already research underway to assess the effectiveness of peer support for participating patients but there is a dearth of evidence on the impact on the volunteer peer supporters themselves and how they should be selected, trained and themselves supported.AimsThe purpose of this research is to generate evidence about the how the NHS should recruit, train and supervise volunteer peer supporters for people with type 2 diabetes, and also to understand the impact of providing peer support on
Government/NHS
NHS Cambridgeshire and Peterborough CCG
CB2 8FH
52,191
0,133
Dr Jonathan Graffy
Not Provided
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes/Social Care
Award does not have an ODA Downstream Partner
5
PB-PG-0808-17257
Optimum care for non-morbidly obese patients with type 2 diabetes: the perspectives of patients and clinicians on the role of bariatric surgery.
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£199 944
1 septembre 2010
31 août 2012
Weight loss surgery works by helping to reduce the number of calories in the body by either reducing the size of the stomach or by bypassing the small intestine. Studies have shown that such surgery leads to sustained weight loss over a long period of time. Surgery does however carry some mainly short term risks. In some patients with late onset (type 2) diabetes, surgery has cured their diabetes. However, surgery is normally only done on severely obese patients i.e. with a Body Mass Index greater than 40. Those with a lower BMI of less than 35 and diabetes must try other methods to reduce their weight. These methods have shown very limited effectiveness, particularly over the long term. More research is needed in order to understand the role surgery might play for those with diabetes who are not so severely obese. In order for such research to succeed it is crucial that we understand patients’ willingness to participate in such a study and identify potential barriers to taking part.
BackgroundObesity and type 2 diabetes are growing public health problems and a significant health care cost. Sustained weight loss can lead to improved health outcomes. Current non surgical strategies by diet, exercise and anti-obesity drugs, have limited long-term effectiveness. Bariatric surgery (BS), most commonly by laparoscopic gastric banding or bypass, leads to sustained weight loss, with a small surgical risk of mortality and morbidity. In patients with type 2 diabetes it can lead to cure of diabetes, though data are limited for patients with BMI 35 kg/m2 if there is comorbidity such as type 2 diabetes. More RCTs are needed to establish the cost effectiveness of BS in type 2 diabetes.Aimsi) To explore the attitudes and beliefs of patients with type 2 diabetes and non morbid obesity (BMI 30-40kg/m2), about the role of bariatric surgery and other weight loss interventions in their management. To ascertain whether they would consider entry to an RCT which randomised to BS.ii) To i
Government/NHS
University Hospital Southampton NHS Foundation Trust
SO16 6YD
50,933
-1,435
Professor Paul Roderick
0000-0001-9475-6850
Chief Investigator
Cancer and neoplasms/Metabolic and Endocrine/Stroke/Cardiovascular/Oral and Gastrointestinal
7. Management of Diseases and Conditions/7. Management of Diseases and Conditions
7.1 Individual care needs/7.3 Management and decision making
Diabetes/Obesity
Award does not have an ODA Downstream Partner
6
PB-PG-0909-19198
Supervised pharmacy student led medication review in primary care: A pilot study to ascertain the potential costs and effects
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£232 517
1 février 2011
31 janvier 2014
Medication reviews provide patient benefit by ensuring that medicines and monitoring are all appropriate, the patient knows how and why they are taking their medication and the medicines are being taken appropriately. Although pharmacists have good drug knowledge and are trained to help patients to take their medicines, research has shown that to regularly provide medication reviews pharmacists need to develop their communication skills and work more closely with medical practices. We believe that pharmacy student experience of undertaking real medication reviews under close supervision in a medical practice and a later related patient consultation is an innovative model which could provide significant patient benefit at relatively small cost.We plan to carry out a pilot project to identify the potential patient benefit of the idea and to describe it so that it can be easily repeated across other schools of pharmacy in the UK.To work out the best way to carry out the trial a review of
BackgroundLevel 3 clinical medication reviews (with patient and notes) are recommended by the Department of Health for specific patient groups. Pharmacy graduates acquire robust therapeutic knowledge and are trained to optimise drug therapy and patient medicine behaviour. Unlike other health care practitioners they have minimal patient contact during training and research has demonstrated a need for improvements in pharmacist consultation skills. To address this issue the current government agenda is to increase patient contact within the pharmacy undergraduate curriculum. Delivery of level 3 medication reviews by pharmacy undergraduates under close supervision has the potential for patient benefit, developing pharmacist consultation skills and providing a potential education model for the future.AimsBy replicating the process of delivering NHS services under clinical supervision, utilised by all undergraduate schools of Optometry and Dentistry within the UK the study aims to• Determi
Government/NHS
NHS Norfolk and Waveney CCG
NR7 0WG
52,629
1,372
Professor David Wright
0000-0003-3690-9593
Chief Investigator
Generic Health Relevance
8. Health and Social Care Services Research
8.1 Organisation and delivery of services
Diabetes
Award does not have an ODA Downstream Partner
7
PB-PG-1010-23040
Root causes of adverse drug events in nursing home residents with diabetes: enhancing safety in medicines management
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£205 782
1 décembre 2012
31 mai 2015
Diabetes is a common health problem in the UK affecting nearly 3 million people. Those with diabetes suffer from high blood sugar which can cause complications, both short and long term, if not treated properly. People with diabetes often receive drug therapy including tablets and injections of insulin. These need to be prescribed, dispensed, given and monitored properly without mistakes. However, we know that quite a lot of mistakes do occur and recent research has shown that older people in the care home sector are particularly at risk. Nursing homes, a type of care home, have residents that will have a number of health problems including diabetes. We will approach homes within Bedfordshire and Hertfordshire and ask them to join this study. It is anticipated that the management of these facilities will co-operate as the research will help keep residents safe and improve links to NHS services. Senior nursing home staff will be asked to identify recent incidents where drug errors have
BackgroundImprovements in patient safety are central to the Quality Innovation Productivity and Prevention (QIPP) project of the NHS. Adverse drug events (ADEs), such as drug prescribing and administration errors, dispensing problems and adverse drug reactions, are a significant and common cause of patient safety incidents in all health and social care settings. Such events carry significant human and financial costs.Diabetes mellitus is an increasingly common high impact health problem in the UK affecting an estimated 2.6 million people and up to 26% of the care home population (Sinclair & Asprey 2009).The evidence base in terms of understanding the incidence, causes and severity of ADEs is stronger in the healthcare setting with less being known about nursing home provision.AimsWith regard to nursing home residents with diabetes and NHS medicines services:- Identify, describe and analyse adverse drug events linked to NHS provision occurring in nursing homes - Conduct a critical analy
Government/NHS
Luton and Dunstable University Hospital NHS Foundation Trust
LU4 0DZ
51,894
-0,474
Mr Frank Milligan
Not Provided
Chief Investigator
Metabolic and Endocrine
8. Health and Social Care Services Research
8.1 Organisation and delivery of services
Diabetes
Award does not have an ODA Downstream Partner
8
17/63/131
NIHR Global Health Research Group on improving outcomes in sub-Saharan African diabetes through better diagnosis and treatment at the University of Exeter
NIHR (ODA)
Research
Complete
Global Health Research Units and Groups
Researcher Led
NIHR Global Health Research Group
£2 497 638
1 avril 2018
30 septembre 2022
Diabetes is a major cause of death and long-term ill health throughout sub-Saharan Africa (SSA). It is rapidly increasing and already affects over 25 million people (7% of the adult population). A recent international commission highlighted that the care of people with diabetes in SSA was greatly limited by a striking lack of knowledge as well as limited resources: we do not know the best way to either detect or treat diabetes in this population. Fundamental differences in both the diabetes and the environment in which medical care is provided mean importing care plans from the West is not appropriate. Research to develop and assess practical solutions for detection and management of diabetes in Africa are urgently needed. The University of Exeter Diabetes Research team are ideally placed to help in the efforts to improve diabetes care in SSA. The internationally renowned 60 person team leads the world in identifying and diagnosing different forms of diabetes, in pioneering n
University of Exeter Strategy and Support This work will take Exeter’s world leading expertise in diabetes research and apply this to address the challenge of diagnosing and treating diabetes in low income countries. This will be achieved through a true partnership and collaboration with leading sub-Saharan African (SSA) institutions to enable skills transfer, capacity building and world class education that will have an enduring legacy. Our research directly addresses the strategic objectives of the University of Exeter, to deliver research capable of solving global challenges, which will have international impact. The University of Exeter will support this as part of its international strategy. To facilitate the development of this group and its long term impact, the University of Exeter will provide no-cost training for SSA staff and students through our researcher development programme, fund overheads and underwrite a PhD position, and provide a dedicated research develop
Academic
University of Exeter
EX4 4QJ
50,735
-3,535
Professor Andrew Hattersley/Professor Moffat Nyirenda
0000-0001-5620-473X/0000-0003-2120-4806
Chief Investigator/Joint Lead Applicant
Metabolic and Endocrine
7. Management of Diseases and Conditions/8. Health and Social Care Services Research
7.3 Management and decision making/8.5 Resources and infrastructure (health services)
Diabetes
Uganda/United Kingdom/Cameroon
9
PB-PG-0808-17085
Enhancing the effectiveness of the Diabetes Manual: modelling a new self-management education intervention for type 2 diabetes
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£211 460
1 décembre 2010
30 juin 2013
Diabetes patient education is recommended by the Department of Health (DH) and NICE for people with diabetes. The DH currently promotes two group-based programmes for type 2 diabetes and, in a joint report with Diabetes UK in 2006, recognised the need for 1:1 programmes to meet the needs of a diverse population.The Diabetes Manual is a 1:1 education and self-management programme developed at Warwick Medical School for delivery by practice nurses in primary care. A recent trial showed that it improves patients’ confidence to self-care and to reduce their diabetes-related distress. These findings together with other research literature suggest that enhancing the practice nurse support may lead to improved diabetes-related health for patients and improve their wellbeing.We aim to undertake further pilot and development work with practice nurses and patients who have used the Diabetes Manual previously and with some GP practices new to the Diabetes Manual. Phase 1 of the study aims to expl
BackgroundDiabetes structured education provision for people living with diabetes (PLWD) was recommended by NICE in Jan 2006. For type 2 diabetes, two group-based programmes are recommended by the DOH although a joint DOH/Diabetes UK report in 2006 indicates the need for 1:1 programmes. The Diabetes Manual is a 1:1 programme which has been found to improve diabetes self-care confidence and reduce anxiety in a recent RCT. The RCT findings and the literature indicate that the clinical and psychological effects of the Diabetes Manual (DM) might be strengthened by providing additional behaviour change support to both the practice nurse who delivers the DM and the patient who follows it. In line with MRC complex intervention framework, further phase II study needs to occur to improve the intervention.AimsThe aims of this 2 phase study are to (i) Determine the nature and feasibility of enhanced-support provision from the perspective of the patient, primary care (practice nurse who is also a
Government/NHS
NHS Coventry and Warwickshire CCG
CV34 4DE
52,281
-1,591
Professor Jackie Sturt
0000-0003-1281-1401
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions/7. Management of Diseases and Conditions
7.3 Management and decision making/7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
10
NIHR300530
Proactive diabetes review in hospital: a cluster randomised feasibility study and process evaluation.
Non-NIHR funding
Training
Complete
HEE/NIHR Integrated Clinical and Practitioner Academic Programme
Trainee Development
HEE/NIHR ICA Programme Clinical Doctoral Research Fellowship
£253 926
1 juillet 2020
30 juin 2024
The number of people diagnosed with diabetes has more than doubled in the last 20 years. This is a lifelong condition leading to high blood sugar levels. With an ageing population and people with diabetes living longer more people admitted to hospital will have diabetes. A recent audit in the UK demonstrated that one in every six NHS hospital beds is occupied by someone with diabetes. Most people admitted to hospital with diabetes are not admitted because of diabetes, meaning that they are typically under the care of health care professionals who are not specialised in diabetes management. Because activity levels, food intake and general well-being are different in hospital compared to home, diabetes management is challenging and often outside of the experience of those providing inpatient care. Many hospitals have inpatient diabetes specialist nurses, despite this, good blood sugar levels are achieved for less than half of the hospital inpatient days. Furthermore, 20% have an episode
Background Nationally inpatient diabetes management is sub-optimal. Contributing factors include low levels of confidence and knowledge of diabetes management among non-specialists. Currently referrals to diabetes specialists in hospitals are usually 'reactive' after a diabetes related adverse event, such as hypoglycaemia and hyperglycaemia, both of which are associated with increased risk and increased length of hospital stay. Proactive diabetes review model (PDRM) - intervention The Proactive Diabetes Review Model is a complex intervention of multiple factors. It aims to minimise potentially modifiable diabetes related harms rather than respond to them. All eligible patients will be reviewed by a diabetes specialist nurse within one working day of admission and any clinically indicated changes made. The PDRM differs from usual care in its focus on early prevention. Research questions Is the intervention delivered as intended? Is the new model of working acceptable to patients,
Government/NHS
Cambridge University Hospitals NHS Foundation Trust
CB2 0QQ
52,174
0,139
Mrs Andrea Lake
0000-0002-2901-7020
Award Holder
Metabolic and Endocrine
7. Management of Diseases and Conditions/8. Health and Social Care Services Research
7.1 Individual care needs/8.1 Organisation and delivery of services
Diabetes
Award does not have an ODA Downstream Partner
11
DRF-2014-07-023
Diabetes and periodontitis: developing and piloting a novel oral health intervention to enable improved glycaemic control.
NIHR (non-ODA)
Training
Complete
NIHR Fellowships
Trainee Development
Doctoral Research Fellowship
£237 287
1 janvier 2015
31 décembre 2018
Gum disease (periodontitis) is a lesser known complication of diabetes. Furthermore, gum disease makes diabetes control more difficult, and it has also been shown that treating gum disease results in improved diabetes control. These facts are generally not known to most people with diabetes or by the medical teams who treat them. The aim of my research is to reduce the gap that currently exists between evidence and clinical practice by working with patients and clinicians to develop and pilot intervention(s) to increase awareness of the importance of managing periodontal health as part of overall diabetes management.
Background: Diabetes is a major risk factor for periodontitis (increasing the risk of periodontitis approximately 3-fold), and, importantly, evidence supports a 'two-way' relationship between diabetes and periodontitis with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. This bi-directional relationship between diabetes and periodontitis is now widely accepted by periodontal researchers and dental clinicians all over the world. However, the evidence linking diabetes and periodontitis has had limited impact on the organization of diabetes care, and, as my previous research in the Tyne & Wear region has shown, diabetes care providers are generally not aware of the links between the two conditions. Objectives: I will conduct a 3-phased project to develop and pilot an oral health intervention to improve awareness of patients and clinicians of the links between periodontitis and diabetes, and of the importance of managin
Academic
The University of Newcastle upon Tyne
NE1 7RU
54,980
-1,616
Dr Susan Bissett
0000-0002-1997-3027
Award Holder
Metabolic and Endocrine/Oral and Gastrointestinal
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
12
RP-PG-0606-1142
Non-pharmacological approaches to improving diabetes outcomes
NIHR (non-ODA)
Research
Complete
Programme Grants for Applied Research
Researcher Led
Programme Grants for Applied Research
£2 087 489
1 août 2007
30 septembre 2014
Nature of Research: Diabetes is becoming much more common. It is treated with lifestyle changes (diet, exercise) and drugs but increases risk of heart attack, stroke, blindness, kidney failure, foot disease. The risks are much reduced if diabetes is well controlled but living with diabetes is not easy. Our programme tackles barriers to achieving better results with conventional diabetes therapies. We will investigate a range of psychosocial factors for potential impact on diabetes control and complication risk in people with newly diagnosed Type 2 diabetes. This commonest diabetes is associated with a doubling of depression and with factors related to where and how people live. Our study will be the first to relate such factors to outcomes 2 years later. From it, we can build interventions to improve diabetes outcomes in the early years. The rest of our programme tests strategies that have either worked in related health areas (eg. obesity, heart disease) or have some but inconclusive
Aims:The overarching aim of our programme is to test the need for and efficacy of non-pharmacological interventions to improve self-care skills, and thereby outcomes, for people with diabetes, in a variety of diabetes situations important in morbidity, mortality, quality of life and health expenditure. Background: Despite proven efficacy of strategies to reduce diabetes complications, nearly half of all patients with diabetes have suboptimal diabetes control. A major contributor to this may be reduced self-care skills resulting in impaired adherence to all aspects of diabetes care. The underlying hypothesis is that psychological and social factors impact on self–care skills and diabetes outcomes and are targets for effective intervention. Research plans Four projects address different clinical settings using mixed epidemiological, randomised controlled trial (RCT), and qualitative methodologies. Project 1, a prospective cohort study of ~1700 people with recently diagnosed Type 2 diabe
Government/NHS
King's College Hospital NHS Foundation Trust
SE5 9RS
51,468
-0,094
Professor Stephanie Amiel
Not Provided
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.3 Management and decision making
Diabetes/Social Care
Award does not have an ODA Downstream Partner
13
14/213/10
A systematic review of psychological interventions to improve motivation for self-management in people with type 1 and type 2 diabetes
NIHR (non-ODA)
Research
Complete
Health Technology Assessment
Commissioned
HTA Commissioned
£174 013
1 janvier 2016
31 décembre 2017
Looking after diabetes involves taking on new roles and responsibilities, and is the key to success in achieving the best diabetes control. In type 2 diabetes, which is the most common form of diabetes and occurs in middle-age, the body cannot use the insulin very well and the pancreas is progressively producing less insulin. The patient has to make changes to their diet, do more exercise, check blood sugars, take tablets to bring the blood sugar down, and other tablets to control blood pressure and cholesterol. After about 10 years, they may have to start taking insulin injections. In type 1 diabetes, the pancreas has stopped making any insulin at all, and patients must take insulin every day to survive. For best control, they should correct the insulin dose according to the amount of carbohydrates and exercise. There are education programmes which give the necessary information and skills to manage diabetes mostly by ourselves. However even after attending these education programmes,
Self-management is the cornerstone of diabetes management yet the majority of patients struggle to achieve national targets for effective glycaemic control. Psychological factors such as depression, eating and weight concerns, diabetes specific fears and worries, acceptance of the diagnosis, coping, health beliefs, family distress and stigma, can reduce the motivation to self-manage. The last systematic reviews of randomised controlled trials (from 1966 to 2003) suggest that motivation is potentially modifiable using brief psychological interventions to address these psychological factors but the quality of most studies had limited validity. In the past decade the number of intervention studies has grown significantly. With the epidemic of type 2 diabetes and the rise in the incidence of type 1 diabetes, increasing awareness of the inequity of mental health services compared to physical health services, the rising costs of new anti-diabetes medications and medical devices, there is a n
Academic
King's College London
SE1 8WA
51,505
-0,113
Dr Kirsty Winkley
0000-0002-1725-6040
Chief Investigator
Metabolic and Endocrine
6. Evaluation of Treatments and Therapeutic Interventions
6.6 Psychological and behavioural
Diabetes
Award does not have an ODA Downstream Partner
14
CS-2015-15-018
Integrating clinical features and biomarkers to improve diabetes classification and treatment in young adults
NIHR (non-ODA)
Training
Complete
Integrated Academic Training Programme
Trainee Development
Clinician Scientist Award
£866 656
1 mars 2016
28 février 2022
The treatment of Type 1 and Type 2 diabetes is very different. People with Type 1 diabetes rapidly stop making their own insulin, so need insulin injections from diagnosis. People with Type 2 diabetes can keep making their own insulin but it may not work as well as it should, so they can be treated with diet or tablets. While they may eventually need insulin treatment it is usually not until many years after diagnosis. It is often difficult for doctors to tell which kind of diabetes a person has, particularly in younger adults where both Type 1 and Type 2 diabetes are common. Because of this, sometimes (in about 10% of cases overall, and 26% of adults treated as Type 1 diabetes) people are given the wrong diagnosis. This can have a huge impact as it means they could receive the wrong treatment. A person incorrectly diagnosed with Type 1 diabetes will be prescribed unnecessary insulin injections and miss out on other helpful therapies. A person incorrectly diagnosed with Type 2 diabetes
Background Correct classification of Type 1 and 2 diabetes is fundamental to appropriate management. Rapid beta cell failure in Type 1 diabetes means these patients require early and physiological insulin replacement. In contrast patients with Type 2 produce substantial endogenous insulin for many years after diagnosis and may therefore be treated with non-insulin therapies. As population obesity has increased classification of young adult diabetes has become increasingly difficult, with Type 2 diabetes occurring in the young and many people with Type 1 diabetes being obese. Misclassification is therefore common, occurring in 26% of adults treated as Type 1. We have systematically reviewed the utility of clinical features in classifying diabetes and found no papers assessing young adult onset diabetes, and only one assessing features in combination. While biomarkers such as islet autoantibodies may assist classification there is a lack of evidence supporting their use. Aims To syste
Academic
University of Exeter
EX4 4QJ
50,735
-3,535
Dr Angus Jones
0000-0002-0883-7599
Award Holder
Metabolic and Endocrine
4. Detection, Screening and Diagnosis
4.1 Discovery and preclinical testing of markers and technologies
Diabetes
Award does not have an ODA Downstream Partner
15
NIHR300171
INtroducing DIabetes Checks in A denTal practice Environment: INDICATE
NIHR (non-ODA)
Training
Complete
NIHR Fellowships
Trainee Development
Doctoral Fellowship
£445 158
1 février 2020
30 avril 2023
Aims To determine the feasibility and acceptability of using UK dental practices to identify patients at high risk of diabetes or with undiagnosed type 2 diabetes, by seeking the opinions of people affected by the research including patients, dental and medical teams. Background Type 2 diabetes is a growing problem, predicted to account for 17% of money spent in the NHS by 2035(10). Almost 4 million people in the UK are currently diagnosed with diabetes, but it is thought another 1 million have undiagnosed diabetes(11) and another 12 million are at high risk of developing it(12). People may remain undiagnosed for years because diabetes often has no symptoms in its early stages(13). The UK National Screening Committee (NSC) recognises benefits to earlier identification of people at high risk of developing diabetes or with undiagnosed diabetes(3) including reducing the risk of complications like heart-attacks, stroke and blindness(14, 15). It is suggested that 1-in-5 diabetes patie
Research questions Could dental teams identify and clinically refer people with non-diabetic hyperglycaemia (NDH) or Type 2 Diabetes Mellitus (T2DM)? What are the facilitators/barriers to introducing such a care pathway? Background NDH and T2DM represent significant health and economic burdens. Glycaemic control is important to dental patients due to the established bi-directional co-morbid relationship between periodontitis and T2DM(2). Dental teams see patients regularly for 'check-ups', whereas patients typically visit their GP when symptomatic(3, 4). Hence it is possible that dental teams could detect NDH or pre-symptomatic T2DM among a population not normally assessed by GPs. US-based research suggests that dental teams can be effective in identifying those with NDH or T2DM (5-8). NICE recommends healthcare professionals including dentists should assess individual risk of T2DM(9) using the Leicester Risk Assessment (LRA) tool, and to refer anybody with assessment scores ab
Academic
The University of Birmingham
B15 2TT
52,453
-1,928
Miss Zehra Yonel
0000-0002-5477-8315
Award Holder
Metabolic and Endocrine
2. Aetiology/4. Detection, Screening and Diagnosis
2.5 Research design and methodology (aetiology)/4.2 Evaluation of markers and technologies
MLTC/Diabetes
Award does not have an ODA Downstream Partner
16
16/136/102
NIHR Global Health Research Unit on Global Diabetes Outcomes Research, University of Dundee
NIHR (ODA)
Research
Complete
Global Health Research Units and Groups
Researcher Led
NIHR Global Health Research Unit
£6 884 918
1 juin 2017
30 septembre 2021
Diabetes results in a wide range of serious medical complications with significant implications both for the affected individual and their society. Globally three quarters of diabetes is now in low and middle-income countries who lack the infrastructure to manage the scale of the emerging problem. Diabetes is a major problem in India with 1 in 12 people affected amounting to 69 million individuals currently (more than the entire UK population). With increasing economic development, the numbers are rapidly increasing. The majority of studies on how diabetes develops, how patients respond to medications and the causes of medical complications that arise are from white European ancestry populations despite the fact that diabetes in Europeans is very different to diabetes in South Asians. There is an urgent need for a large in-depth study of the specific causes and consequences of diabetes in LMIC in order to identify different subtypes of diabetes that exist and understand how best to
The University of Dundee is actively engaged in global health issues across a broad range of disciplines, where not only life sciences, medicine, dentistry and nursing have significant impact, but also where environmental, political, and regulatory issues are major players in the health agenda. To this end the University of Dundee has formed the Tayside Institute for Global Health, which engages with staff and students from the University and NHS Tayside to tackle global health issues. The Institute will provide further opportunities for impact for the diabetes research proposed here. The current proposal will integrate existing areas of excellence in diabetes health informatics and genetics research in Scotland with that of the largest clinical network of diabetes care in India, Dr Mohan’s Diabetes Specialities Centre. This has over 20 centres around India with 400,000 registered patients with diabetes , and hosts a WHO coordinating centre for non-communicable diseases prevention a
Academic
University of Dundee
DD1 4HN
56,457
-2,978
Professor Colin Palmer
0000-0002-6415-6560
Chief Investigator
Metabolic and Endocrine
4. Detection, Screening and Diagnosis
4.5 Resources and infrastructure (detection)
Diabetes
Nigeria/India/United Kingdom/Ethiopia
17
NIHR205441
Optimising the delivery of Diabetes Distress informed care for its prevention, detection, and management in adults with type 1 diabetes: a hybrid effectiveness – implementation programme (D-Stress study)
NIHR (non-ODA)
Research
Active
Programme Grants for Applied Research
Researcher Led
Programme Grants for Applied Research
£2 881 494
1 mai 2024
30 avril 2029
Almost half of adults with type 1 diabetes (T1D) experience elevated diabetes distress. Diabetes distress is experienced when a person feels burdened or overwhelmed by living with diabetes. Diabetes distress makes it more difficult to deal with diabetes and reduces quality of life. Currently no effective treatments are available in the National Health Service (NHS). Researchers in the USA, Denmark and Australia have developed and evaluated treatments for detecting, managing, and preventing diabetes distress. Although these are proving effective, they are not used in the UK. These international treatments will combine to form the D-Stress programme within the NHS. The main aim will be to reduce diabetes distress, improve blood sugar levels, management of diabetes and quality of life of those with T1D. Research questions What is the best way to deliver diabetes distress care for the detection, prevention, and management in adults with T1D within the NHS? Design and method To answer
Background Almost half of adults with type 1 diabetes experience elevated diabetes distress. Diabetes distress is experienced when a person feels burdened or overwhelmed by living with diabetes. It contributes to poor diabetes outcomes such as hypoglycaemia and hyperglycaemia because it compromises the person s ability to execute self-care behaviours necessary for good health. Hypo and hyperglycaemia contribute to high health care costs due to hospital stays and eye, nerve, kidney and vascular disease. No effective treatments are available in the UK. Researchers in the USA, Denmark and Australia have developed and evaluated interventions for detecting, managing, and preventing diabetes distress. Although these are proving effective, they are not used in the UK. These international treatments will combine to form the D-Stress care pathway. We will evaluate D-Stress to see if it reduces diabetes distress and improves interstitial glucose in people with type 1 diabetes. Alongside we w
Government/NHS
Guy's and St Thomas' NHS Foundation Trust
SE1 9RT
51,503
-0,087
Professor Jackie Sturt
0000-0003-1281-1401
Chief Investigator
Awaiting Health Category Coding
9. Awaiting RAC Coding
9.1 Awaiting RAC Coding
Award not coded to a curated portfolio
Award does not have an ODA Downstream Partner
18
PB-PG-0317-20046
Interventions to preserve insulin-secreting beta cell function in people newly diagnosed with type 1 diabetes: a systematic review of quantitative and qualitative evidence.
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£149 955
1 septembre 2018
31 décembre 2020
BACKGROUND AND AIM Diabetes is a common illness which causes the sugar level in a person s blood to be too high. This is due to the body not producing enough of the hormone insulin, or not responding to insulin. In one form of diabetes (type 1 diabetes), the cells that make insulin, called beta-cells, are damaged and stop making insulin. However, not all of these cells are damaged when patients are first diagnosed. This means that patients can still produce a little insulin. Protecting these remaining beta-cells helps control sugar levels, and prevents the development of many diabetes problems, such as blindness and heart attacks. Many studies have been done over the past 35years to protect these beta-cells. The aim of this research is to review all of these previous studies so that we understand which approaches work best for patients with type 1 diabetes. DESIGN We will find these studies by searching through libraries of scientific research. We will look at how well the studies have
Background Type 1 diabetes (T1D) is a devastating chronic illness that reduces life-expectancy by more than 15 years. It is one of the commonest cause of blindness, foot amputation, renal failure, and cardiac disease. The annual financial cost of T1D to the NHS is £2billion. T1D results from loss of insulin-producing pancreatic beta cells. Following diagnosis, T1D is treated with lifelong insulin injection therapy. The destruction of beta cells is incomplete at the time people are diagnosed with T1D, and a small but significant proportion of them continue to function. There are clear clinical benefits to preserving these beta cells. These benefits include better glucose control, less hypoglycaemia, and fewer long-term diabetic complications. Preservation of residual beta cells has therefore been the focus of over 70 clinical trials in T1D for over 3-decades. Whilst some trials have shown promise, not one therapy alone has demonstrated sufficient benefit to be used routinely in
Government/NHS
University Hospitals Birmingham NHS Foundation Trust
B15 2GW
52,453
-1,938
Professor Parth Narendran
0000-0002-4583-8793
Chief Investigator
Metabolic and Endocrine
8. Health and Social Care Services Research
8.3 Policy, ethics and research governance
Diabetes
Award does not have an ODA Downstream Partner
19
NIHR150958
PROTECT PRegnancy Outcomes using continuous glucose monitoring TEChnology in pregnant women with Type 2 diabetes: A multicentre randomised controlled trial of the clinical and cost-effectiveness of using continuous glucose monitoring in pregnant women with type 2 diabetes
NIHR (non-ODA)
Research
Active
Health Technology Assessment
Researcher Led
HTA Clinical Trials & Evaluation
£1 580 142
1 mai 2023
30 avril 2027
Pregnancies in women with type 2 diabetes have DOUBLED in the last 15 years, particularly affecting women from poorer backgrounds and minority ethnic groups. Nearly ONE in TWO BABIES born to mothers with type 2 diabetes have serious health complications; birth defects, neonatal care unit admissions or death. These have major impacts for women, families and the NHS. We know from national pregnancy in type 2 diabetes data that having ABOVE TARGET GLUCOSE LEVELS increases the chances of serious complications and baby deaths. Women with TARGET GLUCOSE LEVELS have fewer newborn complications, neonatal care admissions and baby deaths. "How can DIABETES TECHNOLOGY be used to improve pregnancy, birth, and mother and child health outcomes?” was voted TOP PRIORITY for diabetes pregnancy research by women with diabetes and health professionals. Continuous Glucose Monitoring (CGM) technology consists of a small sensor, which sends glucose readings to a mobile phone and alerts women and healthca
RESEARCH QUESTION: What is the clinical and cost-effectiveness of using continuous glucose monitoring (CGM) compared with standard care, for improving maternal glucose and neonatal health outcomes in pregnant women with type 2 diabetes? BACKGROUND: The prevalence of EARLY-ONSET type 2 diabetes (T2D) is increasing with serious public health consequences. Pregnancies in women with T2D in the UK have DOUBLED in the last 15 years. These women face striking healthcare inequalities; 90% are overweight or obese, 70% live in poverty and 60% are from Asian, Black and mixed ethnic groups. National audits highlight the lack of medical attention paid to these women with complex physical, mental & social problems, who like many in the Ockenden report, 'feel ignored'. Almost 50% experience poor pregnancy outcomes (neonatal care admissions, birth defects, baby deaths) despite compelling evidence that improving maternal glucose improves neonatal health outcomes in T2D pregnancy. Continuous Glucose M
Academic
University of East Anglia
NR4 7TJ
52,622
1,241
Professor Helen Murphy/Professor Eleanor Scott
0000-0002-5489-0614/0000-0001-5395-8261
Chief Investigator/Joint Lead Applicant
Reproductive Health and Childbirth/Metabolic and Endocrine
6. Evaluation of Treatments and Therapeutic Interventions
6.3 Medical devices
Obesity/Diabetes
Award does not have an ODA Downstream Partner
20
15/70/26
Improving diabetes outcomes for people with severe mental illness (SMI): a longitudinal observational and qualitative study of patients in England
NIHR (non-ODA)
Research
Complete
Health and Social Care Delivery Research
Researcher Led
HSDR Researcher Led
£507 491
1 septembre 2017
31 août 2019
Background: Severe mental illness ‘SMI’ describes a group of illnesses (such as schizophrenia and bipolar disorder) in which ‘psychosis’ occurs. Psychosis describes the loss of reality a person experiences so that they stop seeing and responding appropriately to the world they live in. People with SMI have poorer physical health and a shorter life expectancy compared to the general population. We know diabetes is partly to blame; people with SMI are 2-3 times more likely to develop diabetes, and get more complications because of their diabetes (such as blindness, kidney problems, strokes, and death). We know of several reasons for this, including the individual’s mental illness, its treatment, unhealthy behaviours (e.g. lack of exercise, smoking) and poverty. However, we do not know how much each of these factors contributes to the increased risk of diabetes and its complications. There is also limited understanding about how diabetes is managed for people with SMI and at what cost,
Background: People with SMI have poorer physical health and lower life expectancy than the general population. A two to three-fold increased risk of diabetes and its associated complications contributes to this health inequality. Little is known about the relative influence of risk factors on the onset of diabetes and its outcomes in SMI; or about the diabetes care that people with SMI receive, and how this may contribute to the established health inequalities in this population. Aim: The overarching goal of our research programme is to improve diabetes outcomes for people with SMI. The present proposal contributes to that goal and aims to identify the determinants of diabetes and explore variation in diabetes outcomes for people with SMI in order to develop potential healthcare interventions that can be tested further. Our key research questions in this study are: 1) What are the socio-demographic and illness-related risk factors associated with a) developing diabetes in peo
Government/NHS
Bradford District Care NHS Foundation Trust
BD18 3LD
53,840
-1,789
Professor Najma Siddiqi
0000-0003-1794-2152
Chief Investigator
Mental Health/Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
MLTC/Diabetes
Award does not have an ODA Downstream Partner
21
NIHR158753
Evaluation of integrated diabetes and mental health services to support patients with Type 1 diabetes related disordered eating (T1DE)
NIHR (non-ODA)
Research
Active
Health and Social Care Delivery Research
Researcher Led
HSDR Researcher Led
£0
1 juin 2023
30 avril 2024
A Type 1 diabetes diagnosis means initiation of insulin therapy and modification of eating habits to optimise healthy glycaemic control. The increased focus on eating patterns and food intake required by people with Type 1 diabetes, alongside the need for daily insulin and negative experiences from their diagnosis, can impact on eating practices and related behaviours. As a consequence people with Type 1 diabetes may be at increased risk of disordered eating. NHS England is providing funding to support integrated diabetes and mental health services for people with Type 1 Diabetes-related Disordered Eating (T1DE). People with T1DE are likely to experience more hospital admissions and are at increased risk of developing diabetes related complications. The National Institute for Health Services (NIHR) has requested the Greater Manchester Rapid Service Evaluation Team (REVAL) to design and conduct a rapid evaluation of research into T1DE services to explore how integrated diabetes and m
Background: A Type 1 diabetes diagnosis means initiation of insulin therapy and modification of eating habits to optimise healthy glycaemic control. The increased focus on eating patterns and food intake required by people with Type 1 diabetes, alongside the need for daily insulin and negative experiences from their diagnosis, can impact on eating practices and related behaviours. As a consequence people with Type 1 diabetes may be at increased risk of disordered eating. In response to growing recognition of unmet need, NHS England commissioned a pilot of two, exploratory, Type 1 diabetes-related disordered eating services. The pilot implementation and evaluation were conducted during the COVID-19 pandemic, and this, combined with the relatively small amount of participant data available, limited conclusions that could be drawn. NHS England is now providing two years of national funding to support Type 1 diabetes-related disordered eating services in an additional five sites. The a
Academic
The University of Manchester
M13 9PL
53,467
-2,234
Professor Peter Bower
0000-0001-9558-3349
Chief Investigator
Awaiting Health Category Coding
9. Awaiting RAC Coding
9.1 Awaiting RAC Coding
Award not coded to a curated portfolio
Award does not have an ODA Downstream Partner
22
NIHR303033
Improving diagnosis and holistic management of patients with diabetes secondary to chronic pancreatitis: a mixed methods study
NIHR (non-ODA)
Training
Active
NIHR Fellowships
Trainee Development
Doctoral Fellowship
£644 956
1 juin 2023
31 mai 2026
Background: Chronic pancreatitis (CP) is a long-term condition. It develops when the pancreas, an organ in the abdomen, becomes inflamed. The pancreas makes digestive juices and hormones such as insulin (which is responsible for helping the body use sugar for energy). CP causes pain and problems with digestion and production of insulin. Reduced insulin, due to pancreas damage, results in sugar levels becoming too high, leading to diabetes (known as Type 3c diabetes). Around 100,000 people in the UK are living with CP, and around 1/3 develop Type 3c diabetes.[CM1] This type of diabetes is poorly researched so we know little about the experiences of people living with CP related diabetes or the best treatment options for them. Aims The aim of this project is to improve the diagnosis and management of diabetes in people living with CP, reducing complications from diabetes and improve quality of life (QoL). Project design: Study 1: Understanding how diabetes is managed in people with C
Background Diabetes secondary to chronic pancreatitis(PPDM-C) is a frequent complication of chronic pancreatitis(CP) and is the most common form of Type 3c diabetes (diabetes secondary to pancreatic disease. Although frequently misclassified, a study of more than 2 million primary care records in the UK showed Type3c diabetes was more common than type 1 diabetes. In a further population study diabetes secondary to CP was associated with increased risks of severe hypoglycaemia and all-cause mortality compared to type 2 diabetes. There is currently no consensus relating to diagnosis and treatment practice in PPDM-C, including absence of specific guidelines, structured education and clinical trials determining the most effective management strategies. There is also an absence of qualitative research exploring the journey and experience of patients with PPDM-C. Aims To improve diagnosis and management of diabetes in people living with CP through detailed characterisation of individuals w
Academic
The University of Newcastle upon Tyne
NE1 7RU
54,980
-1,616
Dr Ayat Bashir
0000-0002-2814-3877
Award Holder
Metabolic and Endocrine
6. Evaluation of Treatments and Therapeutic Interventions/7. Management of Diseases and Conditions/2. Aetiology
6.3 Medical devices/7.1 Individual care needs/2.1 Biological and endogenous factors
Diabetes
Award does not have an ODA Downstream Partner
23
NIHR201179
Improving self and clinical management of comorbid diabetes during cancer treatments: a qualitative interview study with patients and clinicians to identify theory-based intervention targets, strategies and implementation options
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£149 784
1 janvier 2021
31 décembre 2022
Background Almost half of people living with diabetes will also develop cancer in their lifetime. Cancer and its treatment can negatively affect diabetes-management in many ways. For example, some anti-cancer drugs cause high blood glucose levels and some treatment side-effects like sore mouth and sickness impact diet and eating. Research, our clinical experience, and our PPI work, shows that patients and health care professionals (HCPs) struggle to manage diabetes during cancer treatments. Cancer patients who also have diabetes, especially if this is poorly-controlled, are more likely to have an adverse reaction, develop an infection, and be hospitalised during cancer treatment. They also have a lower survival rate and greater risk of cancer reoccurring. Very little research has examined the experiences and support needs of patients or HCPs who are managing diabetes during cancer treatment. No research has developed ways to help cancer patients to better self-manage diabetes, or
Background Many people living with diabetes will also develop cancer in their lifetime. The research evidence and our clinical and PPI consultations indicate that patients and health care professionals (HCPs) struggle to manage diabetes during anti-cancer therapies, and that cancer patients with pre-existing diabetes have poorer morbidity and mortality outcomes. No research has developed interventions specifically aimed at addressing the challenges to effective self or clinical management of diabetes during cancer treatments. Our proposed research aims to begin addressing this gap. Improved diabetes management has potential to reduce the risk of adverse events and complications like infections, and thus treatment dose reduction or stoppage, and ultimately to positively impact cancer outcomes and survival. Effective management of diabetes during periods of cancer treatment will also mitigate risk of diabetic complications (e.g. retinopathy) during cancer survivorship. Improved morbid
Government/NHS
Leeds Teaching Hospitals NHS Trust
LS9 7TF
53,807
-1,520
Professor Laura Ashley
0000-0002-9439-3778
Chief Investigator
Cancer and neoplasms/Metabolic and Endocrine
7. Management of Diseases and Conditions/7. Management of Diseases and Conditions
7.1 Individual care needs/7.3 Management and decision making
MLTC/Diabetes
Award does not have an ODA Downstream Partner
24
NIHR202263
A Feasibilty Study and Process Evaluation of an Integrated Support Programme for Adults Following a Diagnosis of Type 1 Diabetes- the Living with and ADapting to DiabetEs PRogramme (LADDER)
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£255 219
1 mars 2022
28 février 2024
Over half of the people who develop Type 1 diabetes (T1D), do so as adults. Getting a T1D diagnosis in adulthood is life changing. It interrupts usual life-patterns and introduces new diabetes self-care responsibilities such as taking insulin and blood sugar tests multiple times each day. Through our previous research, we found that if adults are not supported following their diagnosis, they can develop psychological and social problems such as anxiety, depression, and distress. This may make them less involved with their diabetes self-care, increasing their risk of future costly and burdensome diabetes complications such as eye, heart, or kidney disease. We have also found that adults do not feel health professionals support them adequately following their diagnosis, particularly regarding the emotional and social impact of the diagnosis. Therefore, we have co-designed a new care programme with patients and health professionals. The programme aims to offer the emotional and technical
Background: Around half of all new diagnoses of Type 1 diabetes (T1D) are in adults. Being diagnosed with T1D in adulthood can significantly disrupt a person s life-plans and self-identity. Without appropriate support newly diagnosed adults can rapidly develop distress, negative adaptive behaviours and psychological problems (fear of complications and hypoglycaemia). The diagnosis also disrupts social factors such as relationships and employment. In consequence, newly diagnosed adults may disengage from and avoid their diabetes leading to suboptimal self-management performance potentially increasing the risk of future complications. We have worked with newly diagnosed adults and health-care professionals (HCPs) to co-design a programme of interventions that aim to enable a more positive adaptation to a life with diabetes, called: the Living with and ADapting to DiabetEs Programme(LADDER). The LADDER programme involves two psychologically modelled intervention components: one-to-one ses
Government/NHS
Guy's and St Thomas' NHS Foundation Trust
SE1 9RT
51,503
-0,087
Professor Angus Forbes
0000-0003-3331-755X
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
25
RP-PG-1209-10057
Development of a structured screening and lifestyle intervention for prevention of Type 2 Diabetes Mellitus in a population with Learning Disabilities
NIHR (non-ODA)
Research
Complete
Programme Grants for Applied Research
Researcher Led
Programme Grants for Applied Research
£1 089 331
1 janvier 2012
30 novembre 2015
Diabetes is a condition where the body either does not produce enough insulin or the insulin it produces does not work as well as it should. Long term complications of diabetes include damage to your eyes, heart, kidneys, nerves and feet. Impaired glucose regulation occurs when sugar levels in the blood are higher than normal but not high enough to be diagnosed with diabetes. People with impaired glucose regulation are more likely to develop diabetes and heart disease but they can make changes to their lifestyle to prevent this.People with learning disabilities have more health problems than the rest of the population and are less likely to access help. People with learning disabilities are more likely to be overweight, not get enough exercise and be prescribed drugs that cause diabetes. This may mean that they may be more likely to have diabetes and develop serious health problems. There are 5 main parts to this research1) Screening programme: we will find out the best way to find peo
LD Learning DisabilitiesIGR Impaired Glucose RegulationT2DM Type 2 Diabetes Mellitus Aims and objectives The overall aims of the programme are to:• Establish a programme of research conducted in a population with LD that significantly enhances the knowledge and understanding of IGR and T2DM in people with LD• Test strategies for early identification of IGR and T2DM in people with LD • Develop a diabetes prevention programme through the application of a structured lifestyle education programme and undertake a cost-effectiveness analysisBackground T2DM is a serious chronic condition that is associated with an increased risk of cardiovascular disease. IGR is a condition affecting around 12% of the UK adult population where blood glucose concentrations are elevated above the normal range but do not satisfy the criteria for T2DM. IGR represents an important public health problem due to an associated increased risk of developing T2DM and cardiovascular disease. The maj
Government/NHS
*NHS Leicester City CCG
LE1 6NB
52,632
-1,127
Professor Kamlesh Khunti
0000-0003-2343-7099
Chief Investigator
Mental Health/Metabolic and Endocrine
3. Prevention of Disease and Conditions, and Promotion of Well-Being/4. Detection, Screening and Diagnosis
3.1 Primary prevention interventions to modify behaviours or promote well-being/4.4 Population screening
Diabetes/MLTC/Obesity
Award does not have an ODA Downstream Partner
26
DRF-2012-05-155
Quantitative cardiac magnetic resonance for the evaluation of sub-clinical fibrosis and microvascular dysfunction in diabetic cardiomyopathy
NIHR (non-ODA)
Training
Complete
NIHR Fellowships
Trainee Development
Doctoral Research Fellowship
£141 853
1 octobre 2012
30 septembre 2015
People with diabetes mellitus have a heightened risk of developing heart disease. In part this is due to diabetes and heart disease sharing risk factors. However, diabetes also causes heart wall fibrosis, contributing to the development of heart failure. This project aims to develop and test quantitative magnetic resonance imaging methods for measuring the degree of heart muscle fibrosis. The methods will be tested in healthy volunteers and patients with type 2 diabetes. They are expected to improve assessment of heart wall damage in its early, potentially reversible phase, allowing more timely treatment to help prevent or delay heart failure.
Training Award
Government/NHS
Leeds Teaching Hospitals NHS Trust
LS9 7TF
53,807
-1,520
Mr David Broadbent
0000-0002-5892-4762
Award Holder
Metabolic and Endocrine/Cardiovascular
4. Detection, Screening and Diagnosis
4.2 Evaluation of markers and technologies
Diabetes
Award does not have an ODA Downstream Partner
27
NIHR156184
Improving outcomes for people with type 2 diabetes in Sub-Saharan Africa
NIHR (ODA)
Research
Active
Global Health Research Units and Groups
Researcher Led
Global Health Research Groups
£3 019 211
1 juillet 2024
30 juin 2028
Over 20 million people live with type 2 diabetes in sub-Saharan Africa (SSA), and this number is increasing faster than anywhere else in the world. Treating this condition in countries with limited healthcare resources is a huge challenge, and people living with type 2 diabetes in SSA have some of the highest levels of diabetes complications and early death. An international commission on diabetes in Africa in 2017 identified important challenges, including lack of studies in Africa to inform prevention and treatment of diabetes in this region. It warned that it would be dangerous to assume that interventions derived in high-income Western countries will have the same effectiveness in SSA. This is what, at least in part, stimulated our 2018 “NIHR Global Health Research Group on improving outcomes in sub-Saharan African diabetes through better diagnosis and treatment”. With a focus in Uganda and Cameroon, we established one of the best diabetes laboratories in Africa and began to bui
Research question How can we improve management of type 2 diabetes (T2D), particularly in lean individuals, in SubSaharan Africa? Background Over 20 million people live with T2D in sub-Saharan Africa (SSA). This number will increase 134% by 2045, the largest expected increase of all regions in the world. A key challenge for managing T2D in SSA, highlighted by a recent Lancet Commission, is lack of local data to inform appropriate management. Increasing evidence, including from our recent NIHR funded studies, shows that diabetes presents differently in SSA compared to high-income countries. One important difference is that those diagnosed with T2D in SSA are often young and lean, in stark contrast to its classical presentation in the old and obese in high income countries. These observations raise important questions, such as: 1) what is making lean individuals susceptible to diabetes, do lifestyle factors play a role?; 2) What is the best way to identify people at risk of T2D in SSA,
Academic
University of Exeter
EX4 4QJ
50,735
-3,535
Dr Angus Jones/Professor Moffat Nyirenda
0000-0002-0883-7599/0000-0003-2120-4806
Chief Investigator/Joint Lead Applicant
Metabolic and Endocrine
2. Aetiology/6. Evaluation of Treatments and Therapeutic Interventions/3. Prevention of Disease and Conditions, and Promotion of Well-Being
2.3 Psychological social and economic factors/6.1 Pharmaceuticals/3.1 Primary prevention interventions to modify behaviours or promote well-being
Diabetes
Award does not have an ODA Downstream Partner
28
PB-PG-0906-10182
Improving Concordance in Older PEople with Type-2 Diabetes (ICOPE-D)
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£141 441
7 janvier 2008
6 décembre 2009
The purpose of this research is to help patients to control their diabetes more effectively, by allowing them to develop a greater understanding of their condition and increase their confidence to keep to necessary behaviour changes such as appropriate diet and regular exercise. The method used here is based on an ‘adherence therapy’ manual originally developed to help older people comply with their antidepressant medication. We think that this approach can be adapted to improve the extent to which people with diabetes stick to their treatment plans. We have selected this group of patients because diabetes presents a significant challenge, both to the patient and healthcare system. Diabetes is also increasingly common in the ageing population and can increase the risk of other serious conditions such as heart disease and stroke. If people can control their diabetes effectively, the risk of complications and further health problems can be reduced. In this study we compare patients’ abil
BackgroundDiabetes affects around 4% of the UK population, although the rate is closer to 10% among people aged 65 and over. Type 2 diabetes accounts for the majority of diagnoses (DOH, 2004). Although failure to comply with treatment regimes can increase the risk of outcomes such as blindness, renal failure, loss of limbs, heart disease and stroke (DOH, 2001; ONS, 2003), many patients fail to achieve adequate glycaemic control (Warren and Hixenbaugh 1998; Lee et al. 2006). This has been attributed to psychological variables including depression (Anderson et al. 2001; Lustman and Clouse, 2005), illness perceptions (particularly perceptions of control over diabetes) and self-efficacy (Griva et al. 2000; Haggar and Orbell 2003). Psychosocial interventions may help patients to self-manage the disease mAimsWe aim to test a psychosocial intervention for people aged 65 or over with a diagnosis of type 2 diabetes. ‘Adherence therapy’ targets the psychological variables described above (illnes
Government/NHS
East Kent Hospitals University NHS Foundation Trust
CT1 3NG
51,267
1,087
Professor Cornelius Katona
Not Provided
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Award not coded to a curated portfolio
Award does not have an ODA Downstream Partner
29
DHCS/07/07/008
Translating Genetic and Molecular Phenotyping in Diabetes into Clinical Care
NIHR (non-ODA)
Training
Complete
Integrated Academic Training Programme
Trainee Development
Clinician Scientist Award
£678 329
1 février 2008
31 août 2013
Training Award
Increased knowledge about genetic aetiology in diabetes means that monogenic forms of diabetes can be formally diagnosed. Although first-line treatment is directed by aetiology, systematic assessment at diagnosis is rarely preformed. Obstacles include cost, deficiencies in the evidence-base and lack of structures to perform this. In multifactorial diabetes, new susceptability genes in novel pathways have been identified from Genome-wide association studies and opportunity to exploit potential future clinical application. Objectives - To explore ways of translating genetic and molecular data on aetiology on monogenic and multifactorial diabetes into advances in clinical care. In monogenic diabetes the aims are to: i) Enhance the evidence base with improved estimates of prevalence ii) Explore development of additional diagnostic tools using biomarker discovery iii) Refine, test and publish clinical diagnostic protocols iv) Produce a model for NHS delivery. This will be done by establishi
Academic
University of Oxford
OX1 2JD
51,758
-1,262
Dr Katharine Owen
Not Provided
Award Holder
Metabolic and Endocrine
4. Detection, Screening and Diagnosis/2. Aetiology
4.2 Evaluation of markers and technologies/2.1 Biological and endogenous factors
Diabetes
Award does not have an ODA Downstream Partner
30
10/66/01
Development of a cost-effectiveness model for optimization of the screening interval in diabetic retinopathy screening.
NIHR (non-ODA)
Research
Complete
Health Technology Assessment
Commissioned
HTA Commissioned
£435 430
1 mai 2012
31 octobre 2014
Diabetes affects 2.5 million people in England and the treatment and complications of diabetes cost the NHS about 10% of its budget. Diabetic retinopathy (DR) is a complication of diabetes resulting from damage to the small blood vessels generally occurring 10 years after diabetes onset. DR is also the leading cause of blindness in the working age population. It is possible to treat sight threatening DR successfully and at an affordable cost if detected early. In 2003 a National Screening Programme was introduced in England as recommended by the National Institute for Health and Clinical Excellence. However, with a continuing rise in the number of people with diabetes, and the government’s commitment to offer DR screening to all diabetic patients, there is likely to be an increasing strain on delivery and resources. The 2010 Scottish guidelines addressed this issue by recommending that patients with diabetes but no detected DR could be screened every two years, with all others being s
Our aims and objectives are to: • Use demographic and routinely collected clinical information from 15000 patients in 85 Gloucestershire GP practices to develop a risk score for each patient and to identify patient groups whose risk of retinopathy progression is low and whose screening interval can be safely extended; • Model what the influence of the grading classification error is on over referrals and under referrals and how that influence changes over time, taking into account sequential grading results and hospital outcome results, comparing screening intervals that vary according to risk score against current standard practice (annual screening intervals for all patients) and other fixed-interval approaches. • Extend our results to multi-ethnic populations • Determine if assigning diabetic patients to differing diabetic retinopathy screening intervals using a risk estimation model is cost-effective when compared to current practice, which is annual screening of all eli
Government/NHS
Gloucestershire Hospitals NHS Foundation Trust
GL53 7AG
51,891
-2,071
Professor Peter Scanlon
0000-0001-8513-710X
Chief Investigator
Eye/Metabolic and Endocrine
4. Detection, Screening and Diagnosis
4.4 Population screening
Diabetes
Award does not have an ODA Downstream Partner
31
ICA-SCL-2015-01-002
A mixed methods study to support insulin self-management for people with type 2 diabetes.
Non-NIHR funding
Training
Complete
HEE/NIHR Integrated Clinical and Practitioner Academic Programme
Trainee Development
HEE/NIHR ICA Programme Senior Clinical Lectureship
£298 652
1 avril 2016
31 mars 2021
Health systems are having to cope with increasing numbers of people with type 2 diabetes (T2DM) and obesity. This means that changes need to be made in terms of where and how diabetes services are provided, to introduce treatments that support patients with how they manage their diabetes to prevent problems with their heart and blood vessels, eye problems, kidney problems and nerve damage and to involve patients in the design of health services to ensure they are what people want and need. There are around 3 million people in the UK with diabetes, 90% have T2DM and of these approximately 300,000 people use insulin to treat their diabetes and keep their blood glucose levels in the non-diabetic range. However, more people than this need insulin and there can be a delay of up to 5 years putting them at further risk of diabetes problems. Often the delay is caused by a combination of factors. Many people who need insulin do not want to take it because they are worried about weight gain, low
Background Many people with type 2 diabetes (T2DM) will require insulin as their diabetes progresses and beta cells fail. Insulin is the most effective treatment for glycaemia and is supported by long-term safety data and non-analogue intermediate-acting insulin is relatively inexpensive. However, it is well known that patients have barriers towards insulin and it is often delayed by up to 5 years to the detriment of glycaemic control and future morbidity. Psychological factors such as depressive symptoms, diabetes distress and negative beliefs regarding insulin are more prevalent in insulin naïve samples. However, the role of specific psychological factors with regard to the delay in insulin initiation is understudied as there are few prospective studies which have examined these constructs. Likewise, although psychological therapies, such as motivational interviewing (MI), are known to be effective in T2DM for improving glycaemic control and weight loss these have yet to be appl
Academic
King's College London
SE1 8WA
51,505
-0,113
Dr Kirsty Winkley
0000-0002-1725-6040
Award Holder
Metabolic and Endocrine
5. Development of Treatments and Therapeutic Interventions/7. Management of Diseases and Conditions
5.6 Psychological and behavioural/7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
32
PB-PG-0706-10488
Self Assessment of Waist Circumference for Screening for Type 2 Diabetes & Pre-diabetes
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£160 860
1 novembre 2007
31 août 2010
Diabetes is a common long-term condition which can lead to serious complications and death. If diagnosed early and treated appropriately, these complications can be avoided or delayed. However, many people with diabetes are unaware that they have the disease and by the time they are diagnosed many already have complications such as damage to the eyes, kidneys, feet and heart. We also know that some ethnic groups such as South Asians have an even higher risk of diabetes. There is a need to focus efforts to prevent this devastating disease. One in seven adults may have a condition called 'prediabetes' and 50% of people with this condition are likley to develop diabetes over the next 5-10 years. We also know that we can reduce the number who will go on to develop diabetes, for example by encouraging changes in diet and exercise. However, there is currently no clearly agreed method by which we can easily identify people who have diabetes or prediabetes without doing invasive and costly blo
BackgroundType 2 diabetes is a common condition often leading to serious complications and involving high NHS costs. It is often diagnosed at a late stage and is preceded by prediabetes. If detected early, strategies such as lifestyle modification and pharmaceutical intervention are available which could reduce or delay progression from prediabetes to diabetes and prevent complications in those who already have diabetes. However, there is a lack of evidence relating to simple strategies for screening for diabetes and prediabetes through primary care. Waist circumference measurement has been indicated as good precictor of those at risk. AimsThe aims of the study are to develop and test the effectiveness of a screening strategy for identifying people with diabetes and prediabetes in an ethnically diverse population. This strategy will include self-assessment of waist circumference by patients. We will also aim to assess feasibility, uptake and acceptability of the proposed screening str
Government/NHS
Leicestershire Partnership NHS Trust
LE4 8PQ
52,677
-1,103
Professor Kamlesh Khunti
0000-0003-2343-7099
Chief Investigator
Metabolic and Endocrine
4. Detection, Screening and Diagnosis
4.2 Evaluation of markers and technologies
Award not coded to a curated portfolio
Award does not have an ODA Downstream Partner
33
PB-PG-0317-20012
Developing an Intervention to Support Positive Adaptive Strategies for Adults Recently Diagnosed with Type 1 Diabetes: Patients and Health Professionals as Co-designers
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£126 415
1 août 2018
31 juillet 2019
Over half of the people who develop Type 1 diabetes do so as adults. The issues confronted by adults developing Type 1 diabetes are distinct, as many aspects of their lives are already established (employment, relationships and lifestyle). In talking to adults newly diagnosed with diabetes, we have found that it has a big impact on their current and future life-plans, creating emotional upset and frustration. Consequently, many adults struggle to come to terms with their condition. They can also quickly become fearful of low blood sugar levels (hypoglycaemia) and of diabetes complications (feet, eye, kidney and heart problems). Therefore, in this early period of Type 1 diabetes people can develop psychological problems (fear of complications and hypoglycaemia), and low motivation to look after their diabetes (testing their sugar level and injecting insulin regularly). We have identified that while these patients get practical help with diabetes following diagnosis, they get very little
Background: Type 1 diabetes(T1D) is generally associated with childhood, however, around half of cases occur in adulthood. There have been few studies examining the experiences and needs of the adult diagnosed population. We recently completed a longitudinal qualitative interview study with 30 adults aged 20 to 67 years diagnosed within the last 3 years. The findings suggest that a diabetes diagnosis in adulthood causes significant physical, psychological and social disruption, contributing to the development of maladaptive behavioural responses and diabetes related distress. Current strategies for the newly diagnosed adults do not attend to these issues, increasing the risk of patient disengagement, psychological morbidity and future diabetes complications. Hence, early intervention to support adults in developing positive adaptive strategies following diagnosis may attenuate these problems. Study aim: To co-design with patients, family members and health-professionals a psychoedu
Government/NHS
King's College Hospital NHS Foundation Trust
SE5 9RS
51,468
-0,094
Professor Angus Forbes
0000-0003-3331-755X
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes
Award does not have an ODA Downstream Partner
34
PB-PG-0711-25111
Deriving evidence-based clinical criteria to aid classification of diabetes
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£168 547
1 septembre 2012
31 août 2014
Diabetes is a major health problem affecting 4% of the UK population and accounting for approximately 10% of NHS healthcare costs. There are two main subtypes of diabetes: Type 1 (approximately 15% of diabetes) and Type 2 (approximately 83%), along with other rare genetic subtypes. The labelling of a patient as having Type 1 or Type 2 diabetes when they are diagnosed is important as the treatment for the two types is completely different. Differences include the treatment used, dietary advice, and monitoring required by patients and their healthcare team. This difference in clinical care is because Type 1 patients stop making insulin, while in Type 2 diabetes, insulin production continues, but is less effective. Surprisingly, at the moment there are no clear clinical criteria to help doctors know what type of diabetes their patient is likely to have. This leaves the decision to classify a patient as having Type 1 or Type 2 mainly down to the individual doctor and often they will
There are two main subtypes of diabetes: Type 1 diabetes (~15%) and Type 2 diabetes (~83%)[1], in addition to rare monogenic or secondary forms of diabetes. The type of diabetes a patient has is determined by their clinician at diagnosis. Clinical management of the two types is very different in terms of the treatment for the diabetes, the education provided, and monitoring required, so a correct classification is vital for appropriate patient care. These differences are due to the presence (Type 2) or absence (Type 1) of endogenous insulin secretion. However, measures of insulin secretion are seldom carried out in practice, and there are no clear clinical criteria to aid classification decisions. Recent studies in general practice suggest 13-16% of patients with diabetes are misclassified, so there is a clear need for evidence-based clinical guidelines to aid classification. We aim to derive a set of clinical diagnostic criteria that reflect a patient s underlying endogenous ins
Government/NHS
Royal Devon University Healthcare NHS Foundation Trust
EX2 5DW
50,717
-3,507
Dr Beverley Shields
0000-0003-3785-327X
Chief Investigator
Metabolic and Endocrine
7. Management of Diseases and Conditions
7.3 Management and decision making
Diabetes
Award does not have an ODA Downstream Partner
35
10/133/01
The cost-effectiveness of testing strategies for type 2 diabetes
NIHR (non-ODA)
Research
Complete
Health Technology Assessment
Commissioned
HTA Commissioned
£85 621
1 juillet 2012
30 septembre 2013
We know that it is possible to identify people at risk of diabetes, and those having diabetes, many years before they develop symptoms. The current NHS Health Check Programme, which is inviting all adults aged between 40 and 75 for a health assessment, provides an opportunity to test people who might be at risk for diabetes. However we are still unsure about the best way and the most cost-effective way to identify people who have diabetes. This is largely because there are a number of different blood tests we can use which have different advantages, disadvantages and costs. Some tests can be done at any time (a random blood sugar measurement or a test of how much glucose is attached to red blood cells HbA1c) and some tests can only be done after someone has not eaten for eight hours. In addition we can use paper based or computer based risk scores to identify which patients require a blood test. We therefore need to determine the approach which is both best value for money and m
The overall aim is to compare the cost effectiveness of fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in testing for diabetes in people as part of the NHS Health Check Programme. This will include evaluation of the impact of using risk stratification tools and random blood glucose (RBG) measurement to determine which individuals should have further tests. A secondary aim will be to assess the relative values of these tests in detecting individuals at high risk of developing both diabetes and vascular disease in the future. We will review the evidence on the sensitivity, specificity and FPG, HbA1c and RPG for detecting undiagnosed diabetes based on published literature and analysis of data from screened populations cohorts. We will then model the outcomes of screening using alternative tests, taking account of uptake rates. Uptake is an important consideration because some HbA1c tests can be done at any time whereas FPG tests can only be done after someone has not ea
Academic
The University of Sheffield
S10 2TN
53,381
-1,489
Mr Michael Gillett
Not Provided
Chief Investigator
Metabolic and Endocrine
4. Detection, Screening and Diagnosis
4.4 Population screening
Diabetes
Award does not have an ODA Downstream Partner
36
13/138/03
Managing diabetes in people with dementia: a realist synthesis (DIaMonD)
NIHR (non-ODA)
Research
Complete
Health Technology Assessment
Commissioned
HTA Commissioned
£236 987
1 juin 2015
31 janvier 2017
Worldwide diabetes and dementia are both increasing in number, particularly in older people. It has been estimated that about 16% of people with diabetes may have some form of dementia and in settings such as care homes this may be higher. Having both conditions can lead to significant health problems and diabetes management and diabetic self-care may be adversely affected by the presence of dementia. Currently the main approaches to the management of diabetes revolve around self-management. Whilst this may be appropriate in the earlier stages of dementia this becomes more difficult as the dementia progresses. Knowing what interventions work best to manage diabetes in people with dementia is difficult because management is complicated by many factors including the type and severity of the dementia, the type of diabetes and the sort of medication needed to control it, the level of family support, and whether someone is living at home or in a residential or nursing home. To optimise
Design The overall aim is to identify the most effective way of managing diabetes in people with dementia. There are a range of contextual factors, such as the type of diabetes, severity of dementia, the presence of additional comorbidities and the setting, that are likely to impact on diabetes management in people with dementia. Given these complexities a realist approach focusing on key programme theories and testing them in different contextual conditions is considered most appropriate. Realist synthesis will be used to identify the theories and the mechanisms, by which the authors of studies explicitly or implicitly assume that interventions to manage diabetes in people with dementia work. Research Plan We propose to use an iterative stakeholder driven four stage approach that optimises the knowledge and networks of the research team; it will be conducted over 18 months. Phase 1: Define scope and develop theories of how diabetes management interventions work. A consul
Academic
University of Hertfordshire
AL10 9AB
51,753
-0,242
Professor Frances Bunn
0000-0002-5885-918X
Chief Investigator
Neurological/Metabolic and Endocrine
7. Management of Diseases and Conditions
7.1 Individual care needs
Diabetes/Dementia/MLTC
Award does not have an ODA Downstream Partner
37
NIHR132317
Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) cluster randomised trial
NIHR (non-ODA)
Research
Active
Health Technology Assessment
Researcher Led
HTA Clinical Trials & Evaluation
£1 472 446
1 septembre 2021
30 septembre 2025
Aim To show whether a low energy low carbohydrate food-based diet and support from practice nurses can help people with recently diagnosed type 2 diabetes achieve remission, meaning no need for diabetes medicines. Background The DiRECT trial showed that nearly half of people with type 2 diabetes diagnosed in the last six years had remission of diabetes following an intensive weight loss programme in which participants stopped eating their normal food and ate specially formulated “total diet replacements”. However, total diet replacements do not appeal to all. We developed the DIAMOND programme using “real food”, supporting patient self-management to reduce the demand on practitioner time so it is realistic for the NHS. We tested this in a “feasibility trial”, which showed we could recruit people who followed the programme with nurses delivering the programme as intended. Our initial results showed 10kg weight loss and two thirds had blood glucose in the non-diabetic range at th
Research question Does a practice-nurse delivered behavioural support programme designed to motivate and enable people with type 2 diabetes (T2D) and overweight to follow a low energy low carbohydrate diet lead to greater remission from diabetes than usual care? Background Substantial weight loss achieved through a total diet replacement programme can induce remission of type 2 diabetes, but such programmes may not appeal to all. Our feasibility trial showed that a food-based programme with similar energy content (800-1000kcal/day), based on a low carbohydrate diet passed all feasibility criteria. Participants with type 2 diabetes lost 9.5kg and reduced HbA1c by 16mmol/mol at three months, with substantial reductions in blood pressure. Aims and objectives The aim is to assess whether a low energy low carbohydrate diet and behavioural support from practice nurses is more likely to lead to remission compared with usual care in people with T2D diagnosed in the last six years. Th
Academic
University of Oxford
OX1 2JD
51,758
-1,262
Professor Paul Aveyard/Professor Susan Jebb
0000-0002-1802-4217/0000-0001-9190-2920
Chief Investigator/Joint Lead Applicant
Metabolic and Endocrine
6. Evaluation of Treatments and Therapeutic Interventions/6. Evaluation of Treatments and Therapeutic Interventions
6.6 Psychological and behavioural/6.7 Physical
Diabetes
Award does not have an ODA Downstream Partner
38
DRF-2017-10-024
Understanding pre-diabetes from the patient’s perspective: A mixed-methods study aimed at improving the success of diabetes prevention programmes.
NIHR (non-ODA)
Training
Complete
NIHR Fellowships
Trainee Development
Doctoral Research Fellowship
£401 608
1 janvier 2018
31 juillet 2024
Background Because of significant health impact and economic costs, preventing type 2 diabetes is a major national priority (1). The NHS Diabetes Prevention Programme was introduced in April 2016 (2) based on evidence that lifestyle programmes can reduce an individual's risk of developing diabetes (3). Diabetes rates are highest in deprived and minority ethnic groups; for example, South Asians are four times more likely to develop diabetes than those from white backgrounds (4). Interventions have not been very successful in reducing diabetes incidence in these groups (5, 6) partly but not wholly because of low uptake of prevention programmes. The reasons behind this lack of success are poorly understood. Few published studies have considered how pre-diabetes diagnosis is communicated to people, how people react to the diagnosis, or how their efforts to implement lifestyle change is influenced by socio-cultural context (7,8). Yet understanding this context and how people make choices
Background In people with pre-diabetes, lifestyle programmes can reduce risk of progression to type 2 diabetes in those able and willing to engage in interventions. The evidence base on how people are informed of their pre-diabetes diagnosis and how they react to such information (especially behaviourally) is sparse and theoretically superficial. Socio-cultural and material barriers to lifestyle change may mean that even those willing to change behaviour are unable to. Aims To inform prevention programmes for type 2 diabetes with a richer understanding of how the diagnosis of pre-diabetes affects people's feelings, attitudes and behaviour in different socio-cultural contexts. Objectives Explore clinicians' experiences of conveying the pre-diabetes diagnosis to patients. Explore the meaning of pre-diabetes to people who have been given such a diagnosis, including the impact on their lives and lifestyles. Identify policymakers' priorities for local diabetes prevention programmes,
Academic
University of Oxford
OX1 2JD
51,758
-1,262
Dr Eleanor Barry
0000-0003-1655-6516
Award Holder
Metabolic and Endocrine
8. Health and Social Care Services Research/3. Prevention of Disease and Conditions, and Promotion of Well-Being/7. Management of Diseases and Conditions
8.3 Policy, ethics and research governance/3.1 Primary prevention interventions to modify behaviours or promote well-being/7.3 Management and decision making
Diabetes
Award does not have an ODA Downstream Partner
39
PB-PG-0808-17303
The East Cambs and Fenland Diabetes Integrated Care Initiative
NIHR (non-ODA)
Research
Complete
Research for Patient Benefit
Researcher Led
Research for Patient Benefit
£249 997
1 mars 2010
31 décembre 2013
Diabetes care is underachieving in terms of its potential to prevent complications and associated loss of capacity and quality of life. NHS Cambridgeshire is introducing a new, integrated approach for diabetes services management in one area. The approach includes education and support for general practitioners and practice nurses for their diabetes care, improved communication and closer working together between general practice, community and specialist services, and ways to identify and address things that prevent patients from looking after their own diabetes. These include other conditions and living in trying circumstances. The research will compare the impact of these new services on hospitalisation, quality of care, barriers to diabetes care, risk factors for diabetes complications (e.g. blood glucose control, blood pressure), service integration and health service use beyond hospitalisation. Comparisons will be before and 12 and 24 months after the beginning of the interv
BackgroundDiabetes underlies a burgeoning toll in premature morbidity, reduced quality of life and financial and social costs. While the evidence supports intensive management of diabetes, particularly from diagnosis, the means to achieve this are unclear. Questions remain around how to deliver services more effectively to assist and support patients in maintaining their routines of metabolic control, and effective self-mangement. East Cambs and Fenland includes some of the most deprived areas in Cambridgeshire and is served by a range of separate diabetes services. Cambridgeshire PCT are funding new services which allow integration of primary, secondary and community services and a focus on those at high risk of hospitalisation, including those with co-morbid chronic conditions.AimsOur aims are to describe the transition to, and impact of, a new whole system approach to diabetes care. In the transition phase we will use an action research framework to document the extent of diffu
Government/NHS
Cambridge University Hospitals NHS Foundation Trust
CB2 0QQ
52,174
0,139
Professor David Simmons
Not Provided
Chief Investigator
Metabolic and Endocrine
8. Health and Social Care Services Research/8. Health and Social Care Services Research
8.1 Organisation and delivery of services/8.2 Health and welfare economics
MLTC/Diabetes
Award does not have an ODA Downstream Partner
40
NIHR202506
Development of Micro Organ Matrix (MOM) to support the viability and function of insulin secreting beta cells - Regulatory support
NIHR (non-ODA)
Research
Complete
Invention for Innovation
Researcher Led
Invention For Innovation
£148 442
1 avril 2021
31 décembre 2021
Diabetes is a chronic disease which is a major problem worldwide. Currently, there are over 4.7million patients with diabetes in the UK. The National Health Service (NHS) spends over £10 billion/year on diabetes care; with significant costs towards treating related complications. Diabetes can lead to serious health complications and even death, yet, no cure is readily available. Patients with diabetes constantly monitor their blood glucose levels, count carbohydrates in their diet to inject insulin accordingly. Thus, for millions of people living with diabetes, a cure would mean the ability to restore natural insulin production and normalise blood sugar levels without imposing other health risks. A popular emerging area of research is the use of viable cells for therapy, otherwise known as cell therapy, to restore the natural intended function using human tissue. Currently normoglycemia can be restored via the transplantation of human islets containing insulin producing beta cel
Development of Micro Organ Matrix (MOM) to support the viability and function of insulin secreting beta cells - Regulatory support
For-Profit Company
Betalin UK
LS2 3AA
53,805
-1,550
Mr David Nitsan
Not Provided
Chief Investigator
Metabolic and Endocrine
5. Development of Treatments and Therapeutic Interventions
5.3 Medical devices
Diabetes
Award does not have an ODA Downstream Partner
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