MICA: MRC APBI STratification and Extreme Response Mechanism IN Diabetes - MASTERMIND

Lead Research Organisation: University of Exeter
Department Name: Institute of Biomed & Clinical Science

Abstract

Context of the research
Over 4% of the population have Type 2 diabetes. It is a major cause of illness and early death accounting for around 10% of the money spent in the NHS. Good control of blood glucose with appropriate life style and medication makes patients feel better and reduces the risks of the development of the complications of diabetes. The MASTERMIND study involves collaboration between academic researchers and industry to help patients with Type 2 diabetes receive the most suitable treatment. At present, the guidelines for treatment of patients with Type 2 diabetes list a large number of drugs without giving clear guidance on which patients should have which drugs. This makes it difficult for patients and their health care professionals to know which drugs are likely to suit them best. We know that patients with Type 2 diabetes vary greatly in how well they respond to different diabetes drugs, and whether they develop side effects to particular medications. Our initial pilot study has helped us to determine the best types of experiment to identify response subgroups and has let us generate preliminary results that we can now test, improve and expand upon.

Aim of the research
The aim of this project is to identify subgroups of patients that respond well or poorly to particular drugs based on particular clinical characteristics such as their weight or blood test results, to enable better targeting of treatment for a particular individual.

Outline of the research
The new project aims to build on the work done in the initial study and involves 2 strands:
1. We will carry out a trial where patients who currently have high blood glucose on metformin and sulphonylurea therapy will receive 3 different diabetes tablets in random order. We will take measurements and blood samples at the start of the study, and then measure the patients' average blood glucose control (HbA1c) at the end of 4 months on each of these drugs. We will also record any side effects and ask the patient which treatment they preferred. These 3 diabetes treatments work in different ways. We will be able to test whether this means different patients have different clinical features (e.g. whether a patient is obese, or whether they have poorer kidney function) that determine whether they respond well to the drugs.
2. We will analyse large publicly-available datasets that have data on thousands of patients with Type 2 diabetes. We will have access to anonymised data from GP practices and data from drug trials run by pharmaceutical companies. We will use statistical analysis to identify which features pick out patients who respond well to the different drugs in the short and long term and also to identify which patients have side effects.

Key outcomes of the research
The key outcomes of this work are:
1. Information on the criteria that can be used to identify which subgroups of patients respond best to which drugs. This evidence will be used to inform new guidelines for prescribing drugs for Type 2 diabetes.
2. Development of methodology for how to identify these subgroups of individuals that will help future studies in this area. These new scientific methods and data analysis techniques can then also be applied to other diseases.
3. A large bioresource of samples from patients with Type 2 diabetes and how they responded to the three different diabetes drugs will be available to both academic groups and pharmaceutical companies. This will be used in future studies where these samples can be analysed to find new blood markers that identify whether an individual is likely to respond well or poorly to a particular drug, and will help drug development by giving insights into why different patients respond differently to the different Type 2 diabetes drugs.

Technical Summary

Our vision is that a stratified medicine approach will result in more effective use of glucose-lowering therapy for patients with Type 2 diabetes (T2D). The rationale for this stratified approach is based on:
i)T2D patients showing considerable inter-individual variation in their underlying pathophysiology ii) the increasing number of classes of glucose lowering therapies that work by very different mechanisms of action iii) pilot study evidence that variation in response to therapy is, in part, robustly explained by differences in patients' underlying pathophysiology.

This extension will involve 2 strands: 1. An experimental strand that will involve a 3 way crossover study of third line oral therapy (a thiazolidinedione, DPP4 inhibitor and SGLT2 inhibitor) in patients with inadequate glycaemic control on metformin and sulphonylurea. This work will test specific hypotheses from pilot work with the primary outcome being HbA1c on therapy and secondary outcomes of side effects and patient preference. 2. A data analysis strand that will use routine clinical, academic and commercial trial data to assess how drug response is related to clinical features and routine biochemistry. We will examine short and long term glycaemic response and side effects.

The key outcomes of this work are: 1. Robust evidence to inform guidelines for the most appropriate use of glucose lowering medication for specific subgroups of patients with Type 2 diabetes. This will enable better targeting of old drugs and enable earlier more focussed use of the newer more expensive therapies in patients where old drugs are less effective. 2. Key methodology development for hypothesis generation and subsequent testing/validation of stratification in Type 2 diabetes. This will cover both data analysis and study design. 3. Establishing a large bioresource of individuals with well characterised comparative response to commonly used drugs for biomarker assessment and discovery by industry and academia.

Planned Impact

Who will benefit from the MASTERMIND project and how?
a) Patients with type 2 diabetes: It is estimated that only 30-70% of patients respond positively to any given drug (Stratified Medicine in the UK- Vision and Roadmap, TSB, Oct 2011). The greatest beneficiary of the MASTERMIND study will be type 2 diabetes patients. Most second and third line glucose lowering therapies available do not have clear differences in overall effectiveness (NICE management of type 2 diabetes 2015 (draft)). There is therefore considerable uncertainty regarding treatment choice. This study will inform clinical guidelines to facilitate prescription of an agent most likely to be effective. Avoiding less effective medication will improve glycaemic control and reduce side effects.

b) Economic: MASTERMIND will contribute to the UK's shared vision for tackling Stratified Medicine (Stratified Medicine in the UK- Vision and Roadmap, TSB, Oct 2011). This research will complement the vision of supporting world-class research as a solid base for capturing value from the UK's precision medicine research (Precision Medicine Catapult Enhanced Business Case Across the UK, March 2014), with an annual revenue of £44 billion from the pharmaceutical sector and £1.1 billion annual revenue from the diagnostic sector. Healthcare models are facing increased physical and financial pressures in providing for a burgeoning ageing population. Costs are also increasing for the pharmaceutical industry with increased costs for fewer new drugs. The pharmaceutical industry will benefit from this work in the following ways:
- Identified strata with poor response to existing therapies will present an opportunity for the development or positioning of new therapies effective in these strata
- Identification of strata with poor response to older generic therapies but response to more recent therapies will present an opportunity to target therapies appropriately
- Methodology development will assist identification of strata and validation of stratification based pathways within industry and provide a pipeline for confirming strata and health economic impact of stratified interventions
- The development of a bioresource (Strand 1) with well characterised differential response to third line oral therapies and biological sample availability will present an opportunity for industry to identify new biomarkers and strata
- Understanding of pathophysiological mechanisms of altered response may assist the development of newer more effective therapies targeted to non responders

c) National Health Service: Type 2 diabetes now affects 4-5% of adults in the UK and it currently costs the NHS £9.8 billion every year to treat diabetes and related complications (The Cost of Diabetes, Diabetes UK 2014). Clinical guidelines arising from this research will improve diabetes drug prescribing and effectiveness, leading to more targeted use of therapies with greater effect (greater glucose lowering and therefore reduced long term complications) and reduced side effects. This will reduce service utilisation and complications from ineffectively treated hyperglycaemia. This research will also facilitate more effective (and cost effective) use of newer, more expensive, glucose lowering therapies.

d) The Academic Community: MASTERMIND will strengthen stratification research capability across participating centres and the wider academic community by providing the theoretical frame work on which future studies can be performed and access to major resources for further research. In addition this study will strengthen academic collaboration between centres and with industry and provide training, development and experience to increase research capacity in participating centres.

Publications

10 25 50

 
Guideline Title ISPAD Clinical Practice Consensus Guidelines 2018: The diagnosis and management of monogenic diabetes in children and adolescents
Description International guidelines for diagnosis and management of monogenic diabetes
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact The guideline means patients get the right treatment after genetic testing - for 50% of patients with a potassium channel mutation
URL https://cdn.ymaws.com/www.ispad.org/resource/resmgr/consensus_guidelines_2018_/4.the_diagnosis_and_m...
 
Description British Heart Foundation-Turing Cardiovascular Data Science Award Round 2
Amount £110,000 (GBP)
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2020 
End 06/2021
 
Description Developing a working platform for a treatment selection algorithm for glucose lowering in Type 2 diabetes
Amount £49,941 (GBP)
Funding ID NIHR129108 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 06/2019 
End 11/2019
 
Description Funding extension
Amount £3,281,749 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 07/2015 
End 11/2019
 
Description NIHR Clinican Scientist Award for Angus Jones StartRight - Getting the right classification and treatment from diagnosis in young adults with diabetes
Amount £960,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 01/2016 
End 01/2021
 
Description NIHR Funding for Clinical Research Facilities for Early Translational (Experimental Medicine) Research
Amount £5,738,298 (GBP)
Funding ID CRF-2016-10027 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2017 
End 03/2022
 
Title Type 2 Diabetes Treatment Selection Decision Aid 
Description A decision aid to support type 2 diabetes care in primary care. The decision aid identifies the likely best drug class for a particular person with type 2 diabetes based on their characteristics. 
Type Of Material Computer model/algorithm 
Year Produced 2020 
Provided To Others? No  
Impact Model will require prospective validation in a trial prior to deployment in clinical practice. 
 
Description Data Science collaboration with Turing Institute 
Organisation Alan Turing Institute
Country United Kingdom 
Sector Academic/University 
PI Contribution John Dennis (Co-PI, Exeter) and Sebastian Vollmer (Co-PI, Turing) lead applicants on a BHF funded project to apply cutting edge machine learning approaches to refine the algorithm to aid selection of glucose-lowering therapy. Funding primarily covers travel costs to enable face-to-face collaboration over Jan 2020 - July 2021.
Collaborator Contribution Sebastian Vollmer (Co-PI, Turing) will lead data science approach, other collaborators (Bilal Mateen, Ashwini Venkatasubramaniam) will spend research time developing and applying data science ideas.
Impact No outputs or outcomes yet. Disciplines: Cardiovascular medicine / Diabetes; Data Science.
Start Year 2019
 
Description MASTERMIND Clinical investigation 
Organisation King's College London
Department Faculty of Life Sciences and Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Collaborator Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Impact Grant application to MRC
Start Year 2012
 
Description MASTERMIND Clinical investigation 
Organisation University of Dundee
Department School of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Collaborator Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Impact Grant application to MRC
Start Year 2012
 
Description MASTERMIND Clinical investigation 
Organisation University of Glasgow
Department School of Medicine Glasgow
Country United Kingdom 
Sector Academic/University 
PI Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Collaborator Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Impact Grant application to MRC
Start Year 2012
 
Description MASTERMIND Clinical investigation 
Organisation University of Newcastle
Department Faculty of Health and Medicine
Country Australia 
Sector Academic/University 
PI Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Collaborator Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Impact Grant application to MRC
Start Year 2012
 
Description MASTERMIND Clinical investigation 
Organisation University of Oxford
Department School of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Collaborator Contribution Design and carrying out of clinical studies to define predictors of drug response and identifying extreme responders and progressors to glucose lowering drugs in diabetes.
Impact Grant application to MRC
Start Year 2012
 
Description MASTERMIND Industrial partnership 
Organisation AstraZeneca
Country United Kingdom 
Sector Private 
PI Contribution Presentation of issues relating to stratification in Type 1 diabetes and presenting possible solutions and approaches
Collaborator Contribution Critical appraisal of research aims and research plans
Impact MRC application Strand 1 and Strand 2
Start Year 2013
 
Description MASTERMIND Industrial partnership 
Organisation Eli Lilly & Company Ltd
Country United Kingdom 
Sector Private 
PI Contribution Presentation of issues relating to stratification in Type 1 diabetes and presenting possible solutions and approaches
Collaborator Contribution Critical appraisal of research aims and research plans
Impact MRC application Strand 1 and Strand 2
Start Year 2013
 
Description MASTERMIND Industrial partnership 
Organisation GlaxoSmithKline (GSK)
Country Global 
Sector Private 
PI Contribution Presentation of issues relating to stratification in Type 1 diabetes and presenting possible solutions and approaches
Collaborator Contribution Critical appraisal of research aims and research plans
Impact MRC application Strand 1 and Strand 2
Start Year 2013
 
Description MASTERMIND Industrial partnership 
Organisation Sanofi
Department Aventis
Country France 
Sector Private 
PI Contribution Presentation of issues relating to stratification in Type 1 diabetes and presenting possible solutions and approaches
Collaborator Contribution Critical appraisal of research aims and research plans
Impact MRC application Strand 1 and Strand 2
Start Year 2013
 
Description MASTERMIND Industrial partnership 
Organisation Takeda Pharmaceutical Company
Country Japan 
Sector Private 
PI Contribution Presentation of issues relating to stratification in Type 1 diabetes and presenting possible solutions and approaches
Collaborator Contribution Critical appraisal of research aims and research plans
Impact MRC application Strand 1 and Strand 2
Start Year 2013
 
Description MASTERMIND Strand 2 data analysis 
Organisation University of Dundee
Department School of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Analysis approaches for drug response data and of results of analysis of the CPRD
Collaborator Contribution Analysis approaches for drug response data and of results of analysis of the UKPDS Analysis approaches for drug response data and of results of analysis of the DARTS MEMO study
Impact Unified approach and ability to compare outcomes in different data sets for validation
Start Year 2013
 
Description MASTERMIND Strand 2 data analysis 
Organisation University of Oxford
Department Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)
Country United Kingdom 
Sector Academic/University 
PI Contribution Analysis approaches for drug response data and of results of analysis of the CPRD
Collaborator Contribution Analysis approaches for drug response data and of results of analysis of the UKPDS Analysis approaches for drug response data and of results of analysis of the DARTS MEMO study
Impact Unified approach and ability to compare outcomes in different data sets for validation
Start Year 2013
 
Description Personalised Medicine to Treat Patients with Diabetes, Berzelius Symposium No. 96, Malmo, Sweden 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Personalised medicine to treat patients with diabetes
Berzelius Sympoisum No 96
Malmo, Sweden
Year(s) Of Engagement Activity 2018
 
Description Precision medicine in Diabetes - Present and future, at 15th Portuguese Congress of Diabetes, Algarve, Portugal 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Precision medicine in Diabetes - Present and future
15th Portuguese Congress of Diabetes
Quarteira, Algarve, Portugal
Year(s) Of Engagement Activity 2019
 
Description AMRING Neonatal Diabetes Expert Group Meeting, Paris 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Advice and recommendations on: Review of the existing data on AMGLIDIA, Place of AMGLIDIA in the therapeutic strategy, Review of the current patient journey and medical needs, interest for a dedicated European expert networking
AMRING, European Neonatal Diabetes Expert Meeting, Paris, France
Year(s) Of Engagement Activity 2018
 
Description Banting Memorial Lecture,Diagnosing diabetes subtypes improves clinical care, Diabetes UK, London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Banting Memorial Lecture
Diagnosing diabetes subtypes improves clinical care
Diabetes UK, Excel Centre, London.
Year(s) Of Engagement Activity 2018
 
Description Better diagnosis of types and subtypes of Diabetes improves clinical care: new research from Exeter, Diabetes Unit, KEM Hospital, Pune, India 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Better diagnosis of types and subtypes of Diabetes improves clinical care: new research from Exeter
Year(s) Of Engagement Activity 2018
 
Description Confessions of a very lucky clinical researcher, NIHR National Paediatric Research Event. Wellcome Trust UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Confessions of a very lucky clinical researcher
National NIHR Paediatric research
Welcome Trust, London
Year(s) Of Engagement Activity 2017
 
Description DUK patient group presentations 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Participants in your research and patient groups
Results and Impact 60 patients attended the meeting which sparked questions and discussion

Patients keen to take part in future research
Education about future advances in T1D through research
Request to speak at future meetings
Year(s) Of Engagement Activity 2012,2013,2014
URL http://www.exeterdiabetes.org.uk/Core/Exeter-Voluntary-Diabetes/Pages/Default.aspx
 
Description Defining heterogeneity in diabetes to improve clinical care, Evert van Ballegooie Lecture, Evert van Ballegooie Foundation, The Netherlands 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Evert van Ballegooie Lecture
Defining heterogeneity in diabetes to improve clinical care
Evert van Ballegooie Foundation, The Netherlands
Year(s) Of Engagement Activity 2018
 
Description Diabetes, HNF1B Support Day, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Ask the expert session
HNF1B patient day
Bristol, UK
Year(s) Of Engagement Activity 2018
 
Description Diagnosing subtypes of diabetes to improve clinical care, Oxford Novo Nordisk Fellowship Symposium, Oxford  
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Keynote speaker Diagnosing subtypes of diabetes to improve clinical care
novo Nordisk-Oxford Fellowship Programme Meeting
Oxford, UK
Year(s) Of Engagement Activity 2018
 
Description Diagnosing the different types of diabetes and why it matters, Diabetes UK 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Went to DUK offices to present research.Staff were able to hear Andrew Hattersley describe the impact his research has had on our understanding of the rarer forms of diabetes and an explanation of how Diabetes UK funding has contributed to that. This included a look forward to the possibilities around personalised medicine.
Year(s) Of Engagement Activity 2017
 
Description Diagnostic diabetes: a paradigm shift, Sir Henry Dale Medal Lecture (BES), Harrogate, UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Diagnostic diabetes: a paradigm shift
Sir Henry Dale Medal Lecture
Harrogate, UK
Year(s) Of Engagement Activity 2017
 
Description Diagnostic diabetes; a paradigm shift, Dutch Endocrine Society Meeting, NH Conference Centre, Noordwijkerhout, The Netherlands;  
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Diagnostic diabetes; a paradigm shift
Dutch Endocrine Meeting
NH Conference Centre, Noordwijkerhout, the Netherlands
Year(s) Of Engagement Activity 2019
 
Description Focus Group Sessions 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact 1) Exeter Diabetes PPI group (10.10.2019)
2) Focus group for GPs and practice nurses (16.10.2019)

At both sessions we discussed how to make the decision aid the most useful for primary care, and what information the decision aid should include. We covered the following topics:
a) Acceptability of the decision aid for health professionals
b) When to trigger the decision aid (in the clinic, or before clinic as an audit tool)
c) The display - e.g. how best to display information on the differences in HbA1c by drug
d) What other information to include, for example:
• Personalised frailty related HbA1c target
• Risk of side effects & treatment discontinuation
• Cardiovascular and renal outcomes
• Cost
Year(s) Of Engagement Activity 2019
 
Description From Base Change to Better Care in Diabetes, Heather Dean Lecture, DREAM symposium, Winnipeg, Canada 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Heather Dean Lecture
From Base Change to Better Care in Diabetes
DREAM symposium, Winnipeg, Canada
Year(s) Of Engagement Activity 2017
 
Description From base change to better diabetes care, Jaap de Graap Lecture, Leiden University Medical School, Netherlands 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Jaap de Graap Lecture
From base change to better diabetes care
Leiden University Medical School, Netherlands
Year(s) Of Engagement Activity 2018
 
Description Genetic insights into the human beta-cell and the treatment of diabetes, Peter Baker Lecture, Kings College, London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Peter Baker Lecture
Genetic insights into the human beta-cell and the treatment of diabetes
Kings College, London
Year(s) Of Engagement Activity 2018
 
Description Genetics in the diabetes clinic: the sequencer will see you now, Innovation in Medicine 2018 RCP Annual Conference, ExCel Centre, London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Genetics in the diabetes clinic: the sequencer will see you now
Innovation in Medicine 2018
RCP, London, UK
Year(s) Of Engagement Activity 2018
 
Description Lessons from Monogenic Diabetes,- lessons for Precision Medicine in Type 2 diabetes, Precision Medicine in Diabetes conference, University of Dundee, Scotland 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Learning from monogenic diabetes - lessons for Precision Medicine in Type 2 diabetes
Precision Medicine in Diabetes - GoDARTS
Pitlochry, Scotland
Year(s) Of Engagement Activity 2018
 
Description Lessons from monogenic diabetes, nPOD Annual Symposium, Miami, Florida, USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Lessons from monogenic diabetes
nPOD annual symposium
Miami, Florida, USA
Year(s) Of Engagement Activity 2018
 
Description MASTERMIND Patient Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact Presented interim data to the current MASTERMIND participants

.
Year(s) Of Engagement Activity 2014
 
Description Minkowski Award Lecture, EASD 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Award lecture - best diabetes research in those under the age of 45 at application.
Year(s) Of Engagement Activity 2017
 
Description Monogenic Diabetes Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organised and also gave 3 talks at our Monogenic Diabetes Sympoisum, Exeter
Year(s) Of Engagement Activity 2018
 
Description Monogenic Diabetes Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This two day symposium on Monogenic Diabetes is aimed at consultants, SpRs and experienced DSNs, and is designed to help busy clinicians recognise and treat patients with MODY and other forms of monogenic diabetes. It will focus on the current practices and new developments in the management of monogenic diabetes.

The programme will include plenary lectures on major topics delivered by Prof. Andrew Hattersley and his team of international experts. Separate small group casebased discussions w
Year(s) Of Engagement Activity 2017
URL http://www.youngdiabetologists.org.uk/events/242-mody-course
 
Description Neonatal Diabetes Family Day 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact A international gathering of Neonatal Diabetes patients and families with various rare forms of genetic diabetes with workshops for families on dealing with outcomes, treatments and advice from the neonatal diabetes team at the University of Exeter, as well as ongoing research participation.
Year(s) Of Engagement Activity 2016
URL http://www.exeter.ac.uk/research/newsandevents/news/title_369479_en.html
 
Description Neonatal Diabetes Family Day - Kir6.2 and SUR1 Mutations 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact .Neonatal Diabetes Family Day

.
Year(s) Of Engagement Activity 2014
 
Description Neonatal Diabetes Family Day - Neonatal Diabetes 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Participants in your research and patient groups
Results and Impact .
Year(s) Of Engagement Activity 2014
 
Description Novel Approaches to Precision Diabetes Think-Tank EGID 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Gave a talk
Novel Approaches to Precision Diabetes
Think-Tank EGID, Faculté de Médecine Henri Warembourg
Lille, France
Year(s) Of Engagement Activity 2019
 
Description Novel use of genetic information in the diabetes clinic, EASD-SGGD, Leiden, Germany 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Novel use of genetic information in the diabetes clinic
EASD-SGGD
Leiden, Germany
Year(s) Of Engagement Activity 2017
 
Description Personalized medicine to treat patients with diabetes mellitus Sigrid Jusélius Symposium, 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Gave a talk
Personalized medicine to treat patients with diabetes mellitus
Sigrid Jusélius Symposium, Pancreas in Focus: Common Pancreatic Diseases with Heavy
Burden to Patients and Health Care
Hanaholmen, Helsinki, Finland
Year(s) Of Engagement Activity 2019
 
Description Precision Diagnosis in Diabetes ADA and EASD Task force on Precision Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Gave a talk
Precision Diagnosis in Diabetes
ADA and EASD Task force on Precsion Medicine
Madrid, Spain
Year(s) Of Engagement Activity 2019
 
Description Precision diabetes: right diagnosis leads to the right treatment, ADS Annual Meeting, Perth, Australia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Precision diabetes: right diagnosis leads to the right treatment
ADS Plenary Lecture Perth, Australia
Year(s) Of Engagement Activity 2017
 
Description Precision treatment in Type 2 diabetes Royal College of Physicians Symposium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Gave a talk
Precision treatment in Type 2 diabetes
Royal College of Physicians Symposium
Edinburgh, Scotland
Year(s) Of Engagement Activity 2019
 
Description Role of clinical phenotyping and biomarkers in precision medicine,Diabetes UK, Liverpool,UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Speaker: Role of clinical phenotyping and biomarkers in precision medicine;
(standing in for Timothy McDonald) - Time to measure C peptide in all insulin treated patients
Diabetes UK, ACC Liverpool
Year(s) Of Engagement Activity 2019
 
Description Special Considerations for MODY and neonatal diabetes - pregnancy, CV and complications risk, World Diabetes Congress on Prevention of Diabetes and it's Complications, Edinburgh, Scotland on Neonatal Diabetes 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Special considerations for MODY and neonatal diabetes - pregnancy, CV and complications risk
World diabetes congress 2018
Edinburgh, Scotland
Year(s) Of Engagement Activity 2018
 
Description Talk: Precision diabetes: A new approach to a common disease, for the Torbay Medical Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation "Precision diabetes: A new approach to a common disease" for the Torbay Medical Society, 45 minutes with questions following.
Year(s) Of Engagement Activity 2017
 
Description The Diagnosis of MODY, Dutch MODY Symposium, Leiden 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Diagnosis of MODY
Dutch MODY symposium Leiden
Year(s) Of Engagement Activity 2018
 
Description The current and future roles of pharmacogenetics in Diabetes 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Diabetes UK professional conference
Year(s) Of Engagement Activity 2019
 
Description Time to Measure C Peptide in All Insulin Treated Patients, Diabetes UK, ACC Liverpool 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact (stood in for Timothy McDonald)
Year(s) Of Engagement Activity 2018
 
Description Unexpected insights into T1D:Confessions of a Monogenic Diabetologist! Rachmiel Levine Lecture, Orlando, USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Unexpected insights into T1D:Confessions of a Monogenic Diabetologist!
2017 Rachmiel Levine Lecture
Orlando, USA
Year(s) Of Engagement Activity 2008,2017