UCD – Drug can reduce risk of developing diabetes by 80 per cent, study shows

  • Drug reduces chances of developing diabetes by 80 per cent
  • Pre-diabetes also reversed in 60 per cent of those on trial

An injected drug that lowers blood sugar levels can reduce the chances of those at risk of developing type 2 diabetes by 80 per cent, according to new research led by a scientist at University College Dublin.

The drug, liraglutide, promotes weight loss by interacting with the areas of the brain that control appetite and energy intake.

The study involved a major international trial conducted over three years in which 2,254 adults with pre-diabetes participated at 191 research sites in 27 countries. The findings of the study were published in the medical journal, The Lancet.

The aim of the trial was to evaluate whether liraglutide can safely delay the onset of type 2 diabetes in participants with pre-diabetes.

The trial results show that continuous treatment with the drug over three years helped to prevent the risk of developing type 2 diabetes in participants by 80 per cent when combined with diet and exercise.

In 60 per cent of those patients, pre-diabetes was completely reversed and patients returned to healthy blood sugar levels.

Of those patients who went on to develop diabetes, those who had been taking the drug took three times longer to develop the disease than those in the placebo group.

Liraglutide also helped to sustain greater weight loss when compared to the placebo.

Pre-diabetes is a metabolic condition that is closely tied to obesity. If undiagnosed or untreated, it can develop into type 2 diabetes, which is treatable, but not reversible.

In Ireland, one in ten of the population have pre-diabetes, and pre-diabetes and obesity are risk factors for type 2 diabetes and its complications. Pre-diabetes progresses into type 2 diabetes in five to ten per cent of sufferers within ten years.

These individuals are at risk of a range of conditions that can affect their overall health, including type 2 diabetes and its complications, as well as cardiovascular disease and cancer.

Professor Carel le Roux from the UCD Diabetes Complications Research Centre, UCD School of Medicine and Fellow, UCD Conway Institute is an obesity specialist and the corresponding author on the study.

“In this study, we wanted to see if this drug in combination with a reduced-calorie diet and lifestyle intervention could delay the onset of type 2 diabetes in a high-risk population with obesity and pre-diabetes,” he said.

“On the basis of our findings, liraglutide 3.0 mg can provide us with a new therapeutic approach for patients with obesity and pre-diabetes to substantially reduce their risk of developing type 2 diabetes and its related complications.”

The study is entitled: 3 years’ of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

By: Jamie Deasy, digital journalist, UCD University Relations

Targeting Inflammation to Fight Obesity-related Diseases

Obesity is considered a risk factor for diseases including diabetes, liver cirrhosis and chronic kidney disease. Adipose (fat tissue) inflammation seems to be a common denominator among these obesity-related diseases. Inflammation is part of the body’s natural response to injury. Lipoxins are molecules that help to clear or resolve inflammation. This research study set out to investigate the impact of a lipoxin, and a synthetic version of the molecule, in a laboratory model of obesity.

The findings, published online today (June 5th 2015) in the scientific journal Cell Metabolism, could support a new therapeutic approach to treating obesity and its associated conditions. Dr Emma Börgeson, first author and postdoctoral researcher with the Godson group who is currently working in the University of California San Diego said

This work aimed to mimic what occurs in the health but becomes subverted in disease. Our findings show that lipoxins reduced the extent of liver and kidney disease caused by a high-fat diet. We found that a particular lipoxin molecule (LipoxinA4) controls various cells of the immune system with the overall impact of reducing inflammation in adipose tissue and, as a result, protecting the body from the damaging effects of systemic diseases that occur as a consequence of obesity.

While the findings support the therapeutic potential of lipoxins, the team want to find a viable synthetic alternative that could be developed as a drug given that the molecule in its natural state is unstable and expensive to make. The research team included synthetic chemists led by Professor Patrick Guiry from UCD School of Chemistry & Chemical Biology ,Centre for Synthesis & Chemical Biology & UCD Conway Institute.

The research has shown that the synthetic analogue of lipoxin [15(R)-Benzo-LXA4], is also active, easier to produce and consequently more cost effective. This opens possibilities to explore the use of similar molecules with the potential for greater efficiencies and effectiveness while still being easy to produce and economic.

Professor Catherine Godson, Director of the UCD Diabetes Complications Research Centre in UCD School of Medicine and UCD Conway Institute said

The findings of this research study demonstrate the value and potential impact of fundamental research. Drawing on collaborative expertise in synthetic chemistry, molecular biology and translational medicine, the team have produced findings with significant potential to reduce inflammation, a critical driver of the devastating consequences of obesity-related diseases.

While this research study examined the action of lipoxin in a model of obesity, we will now focus on its action in models of chronic kidney disease induced by obesity and diabetes.

The research has been funded through a Marie Curie fellowship to Dr Börgeson and builds on previous research funded through Science Foundation Ireland and the Health Research Board.

Journal reference
Börgeson et al. Lipoxin A4 Attenuates Obesity-Induced Adipose Inflammation and Associated Liver and Kidney Disease. Publi

UCD – First Point of Care Blood Test for Heart Disease in Malawi

A team of researchers from University College Dublin and Imperial College London have carried out a blood test for detecting early signs of heart disease for the first time in Malawi, Africa as part of a new research project for the management of type 2 diabetes.

When under stress, the heart releases a protein called a natriuretic peptide (NTproBNP), which can be used as a marker of cardiovascular disease in diabetes and other cardiometabolic conditions. The use of natriuretic peptides has been shown to be an effective method of targeting care and improving outcomes in people with risk factors for cardiovascular disease and heart failure1.

In collaboration with the Faculty of Health Sciences in Mzuzu University, further research will be carried out to use this test to identify early cardiovascular disease in diabetes in Africa. The Irish researchers donated a point-of-care machine and testing strips to the university to augment training for local medical scientists and enable this initiative.

The Managing Type 2 Diabetes in Malawi, Africa (MTIMA) project is a collaborative effort between University College Dublin, Imperial College London, Mzuzu University, Ungweru (Malawi based community outreach NGO), Luke International Norway (Malawi based ICT NGO), and the Ministry of Health, Malawi.

 

Training workshop for NTproBNP (Roche Diagnostics) point of care device in Mzuzu University. Pictured (l-r): Dr. Joe Gallagher (UCD), Dr. Mike Zulu (Dean and Head of Health Science, Mzuzu University Malawi), Dr. Chris Watson (UCD)
Training workshop for NTproBNP (Roche Diagnostics) point of care device in Mzuzu University. Pictured (l-r): Dr. Joe Gallagher (UCD), Dr. Mike Zulu (Dean and Head of Health Science, Mzuzu University Malawi), Dr. Chris Watson (UCD)

 

Training workshop for NTproBNP (Roche Diagnostics) point of care device in Mzuzu University. Pictured (l-r): Dr. Joe Gallagher (UCD), Dr. Mike Zulu (Dean and Head of Health Science, Mzuzu University Malawi), Dr. Chris Watson (UCD)

During this project, Dr Chris Watson (UCD Conway Institute & School of Medicine & Medical Science) and Dr Joe Gallagher (UCD School of Medicine & Medical Science), together with Dr John O’Donoghue, Imperial College London, will establish electronic decision support systems in the community and point-of-care blood testing to enable treatment of diabetes in the primary care setting.

Educating communities, patients and healthcare workers on the prevention and treatment of type 2 diabetes will be an important goal. The project will also develop standardised medication packs to simplify the delivery of diabetes therapies in the community and widen access to effective care.

Currently, it is estimated that 347 million people worldwide suffer from diabetes with more than 80% living in low and middle-income countries. Sub-Saharan Africa will see a rise in incidence of diabetes from 12.1 million in 2010 to 23.9 million in 2030. Just like the developed world, 90% of diabetes patients in Sub-Saharan Africa have type 2 diabetes. The current prevalence of diabetes in Malawi is 5.6%.

According to Dr Chris Watson, the scale of the problem is apparent and the issue of accessing care locally leads to patients presenting late with complications and difficulties with accessing medications occur on a regular basis.

“A survey that we carried out in collaboration with the local community group, Ungweru in Mzuzu showed that although 96% of local healthcare workers had heard of diabetes and 83% knew someone with diabetes, no healthcare worker was aware of guidelines for the management of the disease.

65% of these healthcare workers had no access to a method to measure blood pressure and 26% felt that they would do nothing if they thought someone had diabetes as there were no facilities available to manage the disease. In this country of almost 16 million people, there is only one hospital that can test HbA1c, a vital marker of diabetes control.

Through the MTIMA project, we are committed to developing primary care based solutions using innovative technologies to deal with the issue. We will build on the success of the EU FP7 Supporting LIFE project led by Dr O’Donoghue and Dr Gallagher currently running in the Mzuzu area, which uses an electronic decision support system on mobile phones to improve the management of illness in young children in Malawi.”

In Tumbuka, a Bantu language spoken in Malawi, Zambia and Tanzania, Mtima is the word for ‘heart’. It is a fitting title for the project given that the vast majority of complications in type 2 diabetes relate to cardiovascular disease and Malawi is known as the ‘warm heart of Africa’.

Further information on this project can be found at www.ghealthresearch.org
1 STOP HF study led by Prof Ken McDonald and Dr Mark Ledwidge, UCD, JAMA 2013