From designing insulin-producing cells to trialling a potentially life-saving screening programme for children, the University of Birmingham is becoming an important hub for diabetes research. More than 20,000 young people have been recruited for screening – and one of them has also taken part in a UK-first: a trial of a new diabetes delaying drug.
The ELSA Study
Fourteen-year-old Sam, from Kings Norton in Birmingham, is the first person in the UK to be treated with Teplizumab, a trial drug that could delay the onset of Type 1 diabetes for up to three years.
Sam was identified via the ELSA study, set up by the University of Birmingham to investigate the efficacy of early screening programmes for diabetes. Teplizumab is licensed in America and has been hailed as one of the biggest treatment advances of the last 100 years. It has yet to be approved for use in the UK, however, and ELSA is playing an important part in identifying young people and adolescents – like Sam – at risk of developing the condition who could benefit from new treatments.
ELSA (EarLy Surveillance for Autoimmune diabetes) was launched in 2022 and is one of the UK’s biggest paediatric studies. It is recruiting across all four nations and has already overshot (by 8,000) its target of recruiting 20,000 young people to undergo a simple blood test that can detect the very earliest signs of the condition. Funded by Diabetes UK and Breakthrough T1D (formerly JRDF), study participants contribute to the research and at the same time get valuable updates about their health, with early support for people found to be at risk of developing diabetes. ELSA’s success has also enabled the team to secure EU funding to extend the programme across Europe.
Type 1 diabetes affects insulin-producing cells in the pancreas and, while the only treatment currently available is insulin, early diagnosis could help avoid complications and could also identify children who could benefit from new treatments.
Study lead Professor Parth Narendran commented: ‘We hope that the ELSA study will enable us to establish an early detection programme for children across the UK, which means many more children could benefit from potential treatments to delay the onset of Type 1 diabetes.’
Being able to delay insulin-dependent diabetes will have a huge impact on a child's life. It means we are letting children have a normal childhood for much longer.
Dr Renuka Dias, a researcher from University of Birmingham’s Department of Applied Health Sciences and Lead Paediatrician for ELSA, helped to deliver Sam’s care.
She emphasised the importance of the treatment: ‘There is huge momentum in Birmingham in Type 1 Diabetes research to improve outcomes for all young people. Being able to delay insulin-dependent diabetes will have a huge impact on a child's life. It means we are letting children have a normal childhood for much longer.’
Tackling health inequalities
Effective management of diabetes is essential, but there can be huge differences in approaches to this. A new study looking at health inequalities across the treatment and management of diabetes has recently been awarded National Institute for Health Research funding.
Led by Tim Barrett, Leonard Parsons Professor of Paediatrics and Child Health at Birmingham, the research focuses on children and young people from poorer and/or ethnic minority backgrounds to find out how language issues, income, living conditions and food availability affect how they manage their condition.
Professor Barrett says: ‘The NHS wants people to take greater control over their own health, but for that to be successful in this area, we need to be involving the young people, families and health care workers to develop action plans that will work for them.’
Investigating future treatments
While diabetes management is a research strength at the University of Birmingham, so too is laboratory-based research into the condition, with programmes such as that led by Dr Ildem Akerman to improve the way insulin-producing beta cells can be grown in the lab. Also funded by Diabetes UK, this important study could pave the way for a future in which beta cells can be transplanted into people with diabetes to replace cells that have stopped working.
Dr Akerman explains: ‘Cell replacement therapy has the potential to transform how we treat diabetes. By helping people make enough of their own insulin again, it could bring an end to insulin injections and pumps and reduce the need for constant blood sugar monitoring.’
Professor Narendran added: ‘We have the whole pathway from bench to bedside here in Birmingham. It’s a broad spectrum of research and it’s exciting to work alongside colleagues and patents who contribute to every aspect of it.’