Birmingham research into Type 1 Diabetes could change treatment for newly diagnosed patients

Birmingham based consultants and researchers in diabetes are conducting ground breaking research into how best to treat people in the very first weeks after diagnosis, and how this can affect the long term outcome for patients.

Dr Parth Narendran, who is based at University Hospitals Birmingham (UHB) NHS Foundation Trust and the University of Birmingham, described their study on exercise and its effect on the ‘honeymoon’ period for patients.

Dr Narendran explained: “It is believed that around 60% of adults newly diagnosed with Type 1 diabetes experience a ‘honeymoon’ period. This means the beta cells in their pancreas are still working and their body is still sensitive to insulin, which means they do not need much insulin. We found that that those who exercised had a ‘honeymoon’ that lasted on average four times longer (28.1 months) than those who did not exercise (7.5 months).

“This suggests that physical activity around the time people are diagnosed with Type 1 diabetes could have long-term health benefits.”

This work, carried out in conjunction with Birmingham Children’s Hospital and the University of Exeter, was praised by national research charity, Diabetes UK, who stated: “This is the first time scientists have examined the effect of exercise on people recently diagnosed with Type 1 diabetes. The results are very exciting and suggest exercise could play an important role in delaying the progression of the condition, which in turn could help to protect against devastating long-term complications.”

Research teams across both UHB and the University of Birmingham, also worked on another similar study, published in Diabetologia, the journal of the European Association for the Study of Diabetes. Here Dr Narendran, together with other colleagues, examined how the initial treatment of patients in the first months and years after diagnosis of Type 1 diabetes could change the way their disease progresses. Their research indicates that early “focussed and active” treatment can set a precedent for good diabetes control, and this could have long-term consequences influencing how well controlled a person’s diabetes remains for the rest of their lives.

Dr Narendran explained: “The research involved around 4,500 people newly diagnosed with Type1 diabetes. We wanted to find out how glucose control, (measured by HbA1c, also called glycosylated haemoglobin), behaves in the years after people are diagnosed with Type 1 diabetes.

“We found that the HbA1c generally tends to stabilise and plateau after five years of Type 1 diabetes, and be more difficult to change. However the age of diagnosis and whether the person is male of female seems to influence the behaviour of the HbA1c over the10 years that we followed up these patients.

“Therefore if Type 1 diabetes is controlled very carefully over the first five years, the diabetes HbA1c control may stabilise at a good level over the longer term.”

This is the first comprehensive study of its kind and supports the need to optimise diabetes control early after diagnosis of Type 1 diabetes. Dr Narendran added: “Studies are now needed to explore how best to optimise HbA1c in newly diagnosed people with Type 1 diabetes. Other than careful use of insulin and glucose testing, we may also need to consider lifestyle measures. Early exercise, as suggested by our first study, may be such an example.”