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Preventing type 2 diabetes complications: DUKPC research highlights 

diabetes professional conference DUKPC 22

We need to find ways to reduce the risk of developing diabetes complications. On day 2 of our professional conference (DUKPC), we heard from scientists who are working tirelessly to find new treatments and knowledge to stop the harm diabetes can cause.  

Type 2 diabetes and lung disorders  

Our researchers at DUKPC have found, for the first time, that type 2 diabetes can directly cause lung complications.  

Previous studies have shown that lung conditions, including fibrosis and pneumonia, are more common in people with type 2 diabetes. But we hadn’t known if type 2 directly causes damage to the lungs or if other factors, common to both conditions, are responsible.   

With co-funding from Diabetes UK, Professor Inga Prokopenko led a team, on behalf of the MAGIC consortium, to run the largest ever genetic study exploring how genes affect blood sugar levels and health outcomes.  

They analysed data from 17 major studies and nearly 500,000 people. They used a statistical technique to understand whether high blood sugar levels were linked to impaired lung function, and whether one was causing the other. Lung function was measured using two common spirometry tests, which are used to diagnose lung conditions.  

The results revealed that high blood sugar levels in people with type 2 diabetes directly reduced lung function. For example, they showed that increase in average blood sugar levels from 4 mmol/L to 12 mmol/L, could result in a 20% drop in lung capacity and function.  

Professor Inga Prokopenko, at the University of Surrey, said: 

“We hope our discovery that impaired lung function is a complication of type 2 diabetes is the first step towards increased awareness among healthcare professionals, leading to earlier diagnosis and treatment of lung conditions.” 

Diagnosing and treating lung disorders early could potentially save the lives of thousands of people with type 2 diabetes. And these findings are a vital step towards this.  

Dr Elizabeth Robertson, our Director of Research, said:  

"This important research answers a long-standing question, revealing for the first time, that lung disorders can be a direct complication of type 2 diabetes.   

“These results are a reminder of the seriousness of type 2 diabetes, and the importance of supporting people with the condition to manage their blood sugar levels so that they can live well with the condition and avoid future complications.  

“It is crucial that healthcare professionals are aware of the impact of high blood sugar levels on lung health. Research must now investigate how best to prevent, monitor and treat lung disorders in people with type 2 diabetes.” 

Getting MiFoot through the door  

People living with type 2 diabetes can have a higher risk of developing foot ulcers.

We know that those who’ve had a foot ulcer can also be more at risk of cardiovascular problems, like heart attacks and strokes, compared to people who’ve never had an ulcer. But there has been little research into how to reduce their risk and prevent cardiovascular problems.  

With major funding of £2.2 million from the NIHR and Diabetes UK, Professor Kamlesh Khunti and his team at the University Hospitals of Leicester have been developing a new healthcare package, called MiFoot, to start addressing this. They presented their latest ideas at DUKPC. 

They’ve been carrying out a detailed review of current treatments and care already used for people with foot ulcers. This has helped them to understand what works well and what doesn’t. This information, along with input from people living with type 2 diabetes, has been used to shape MiFoot.   

MiFoot will consist of three components:  

  1. A 1:1 session with a healthcare professional specialising in diabetes  
  2. Education sessions, with practical support for physical activity  
  3. A tailored digital self-management programme, including bespoke chair-based exercise tutorials  

The next steps are to test the MiFoot package in a clinical trial with people with type 2 diabetes who have a foot ulcer, to find out how effective it is in reducing their risk of cardiovascular problems.

If it’s effective, it could be rolled out on the NHS, preventing heart attacks and strokes for people with type 2 diabetes most at risk, and saving lives.  

Fertility fix 

Living with obesity and type 2 diabetes can affect fertility in women. For some having weight loss surgery can help to improve their fertility, but this treatment doesn’t work for everyone.  

Weight loss surgery has been shown to change levels of gut hormones in the body, including hormones that appear to play a role in fertility. With our funding, Dr Charlotte Moffett has been exploring if treatments that mimic these hormonal changes, without the need for surgery, could hold promise to treat fertility problems. At DUKPC she shared her latest findings.  

Dr Moffet and her team at the University of Ulster homed in on a hormone called gastric inhibitory polypeptide (GIP). They wanted to understand more about the role GIP might play in fertility in type 2 and obesity and then test the effects of a medication that changes levels of GIP.   

In the lab, they treated one group of mice with type 2 and obesity with the GIP medication and another group received a dummy (or placebo) treatment. They found that compared to placebo, the treatment reduced the mice's body weight and appetite, and improved their fertility. 

This is early-stage research in the lab, but the findings indicate GIP does play a role in fertility in type 2 diabetes. And that targeting this hormone could be a potential new way to help improve fertility in women living with type 2 diabetes and obesity in the future, without the need for invasive weight loss surgery.   

Preventing or delaying complications 

The complications of diabetes are not inevitable. Keeping blood sugar, blood pressure and blood fats under control will hugely help to reduce your risk of developing complications.  

We’ve got more information about the steps you can take to prevent complications, while our scientists strive for new treatments. If you’d like to talk through any worries or concerns, you can call Diabetes UK’s helpline for specialist information and advice. 


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