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Advice for people with diabetes and their families

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DUKPC research highlights: Day 1

We’ve just kicked off our annual professional conference (DUKPC). It sees hundreds of healthcare professional and scientists come together virtually to hear about what’s new in diabetes care and research.  

Over the next two weeks, we’ll be bringing you the latest news direct from the world-leading experts who will be sharing their research at DUKPC. Day one got us off to an action-packed start. Here are some of the highlights.  

Research highlights 

A tale of the pancreas under siege 

Professor Sarah Richardson took us on a journey through what we’ve learnt about type 1 diabetes. 

Type 1 diabetes happens when the immune system attacks the cells in your pancreas that make insulin. But when it comes to how and why insulin-producing cells are destroyed or what triggers this, it gets complicated. Professor Richardson is studying a rare collection of pancreas samples to help piece together the puzzle.  

You can watch Professor Richardson’s talk, where she explains what we’ve uncovered so far and how this new understanding could lead us to ways of preventing or curing type 1 diabetes in the future. 

You can also find out more about her research that showed for the first time that children who are diagnosed with type 1 diabetes at a younger age appear to have a different form of the condition to those diagnosed in their teens. 

A century of insulin 

It’s been exactly 100 years since Banting, Best, MacLeod and Collip began their pioneering experiments and discovered insulin. At DUKPC, Professor Russell-Jones looked back at how they got there and the century of research progress that insulin ignited.  

But we know insulin isn’t perfect. It can be a frustrating and exhausting way to try to keep blood sugars in target range. Dr Alison McNeilly presented on one of its biggest downsides – hypos – and research that’s helping to tackle them.  

Her work has focused on understanding why some people with diabetes stop noticing when their blood sugars go too low, called hypo unawareness. Dr McNeilly thinks it could be down to habituation. This is when cells in the brain ‘get used’ to hypos and then don’t respond in the same way, because they’ve learnt to adapt to low blood sugar levels.  

Dr McNeilly started thinking about whether introducing a ‘shock’ to the system, known as a dishabituating stimulus, could reset the brain’s response to hypos so you’re able to notice the symptoms of lows again. 

We’re now funding research led by Dr Catriona Farrell to see if high intensity exercise could be an effective type of ‘shock’. You can read about her latest findings and how this could offer us a new, simple way to help people with type 1 diabetes get their hypo awareness back.  

Research reveals homeless people facing diabetes crisis 

New research announced at DUKPC revealed the scale of the diabetes crisis among the global homeless population. Researchers carried out a review of international research on diabetes and homelessness, combining findings from 18 studies from over the last 30 years.   

They found that up to 22% of homeless people have diabetes in the US. In England, prevalence was estimated at 4%, however the researchers suggest the actual figure is likely to be higher, as people living with undiagnosed diabetes would not have been counted.  

Homeless people living with diabetes were found to have higher blood sugar levels compared to the housed population, with two studies reporting that over 40% of those with diabetes had an HbA1c (average blood sugar level) of 64mmol/mol – significantly higher than the 48mmol/mol target for people with diabetes.  

Homelessness was also associated with higher rates of diabetic ketoacidosis (DKA), a life-threatening complication of diabetes that requires urgent hospital treatment, and higher rates of lower limb amputation – a result of diabetes-related foot complications.  

Being able to self-manage diabetes well requires access to, and regular support from, a diabetes healthcare team. It also relies on a person being able to monitor their blood sugars and manage their diet and medications, and this can be incredibly difficult for people who are homeless and often have limited access to food and medical care.  

We urgently need more research in the UK to understand how best to support homeless people to live with serious long-term health conditions and address the stark health inequalities they face. 

Spotting gestational diabetes sooner 

Gestational diabetes can increase the risk of serious complications during pregnancy. It’s usually diagnosed from a blood test 24 to 28 weeks into pregnancy, which are offered to women who have risk factors for the condition.  

Dr Robert D’Arcy, from the Royal Victoria Hospital in Belfast, presented new research showing that a quick ultrasound could help to better spot women most at risk earlier on in pregnancy. 

The researchers gave 123 women, who had at least one risk factor for gestational diabetes, an ultrasound that measured the amount of a type of fatty tissue that lines our organs. They found that women with higher levels of the tissue were more likely to develop gestational diabetes later in their pregnancy.  

In the future, this technique could help more women who are at risk of gestational diabetes get the support they need to ensure that both mum and baby remain healthy throughout pregnancy and beyond. 

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