Type 2 diabetes is a major and rapidly increasing health problem worldwide. Keeping the blood glucose (sugar) from going too high helps prevent complications. Recently a number of new treatments (collectively called 'incretin based' treatments) to lower blood glucose have become available but response is very variable and it is difficult to predict which will work for an individual. The investigators want to see if we can identify whether the new treatments are likely to be effective for an individual patient. Identifying the right treatment would improve control and minimise the side-effects and costs from ineffective treatments. We will collect blood (for measures of blood glucose, insulin secretion and genetics information), urine (for a simple measurement of insulin secretion) and other clinical information (such as weight,age, duration of diabetes and medication) in people who are about to start these new 'incretin based' treatments and assess their response over the first 6 months of treatment. We will analyse this information to see if we can predict treatment response. Study Hypothesis: The investigators hypothesise that those who have low insulin secretion, as measured by post meal urine C-peptide Creatinine Ratio or blood C-peptide, will have poor blood glucose response to incretin based treatments.
Study Type
OBSERVATIONAL
Enrollment
957
Cornwall and Isles of Scilly NHS Primary Care Trust
Truro, Cornwall, United Kingdom
North Devon NHS Trust
Barnstaple, Devon, United Kingdom
Royal Devon and Exeter NHS Foundation Trust
Exeter, Devon, United Kingdom
Plymouth Hospitals NHS Trust
Plymouth, Devon, United Kingdom
South Devon Healthcare NHS Foundation Trust
Torbay, Devon, United Kingdom
Taunton and Somerset NHS Foundation Trust.
Taunton, Somerset, United Kingdom
Yeovil Disctrict Hospital NHS Foundation Trust
Yeovil, Somerset, United Kingdom
The Royal Bournmouth and Christchurch Hospitals NHS Trust
Bournmouth, United Kingdom
North Bristol NHS Trust
Bristol, United Kingdom
Ipswich Hospital NHS Trust
Ipswich, United Kingdom
...and 8 more locations
Glycaemic response (HbA1c change post treatment)
Change in HbA1c over 6 months treatment (as a continuous variable and/or defined as binary response/non response). Our Primary analysis will be the relationship between insulin secretion (as measured by blood C-peptide or UCPCR) and glycaemic response. Secondary analysis will include examination of relationship between baseline weight, HbA1c, age, duration of diabetes, HOMA B, HOMA IR, autoantibody (GAD, IA2) status and glycaemic response. We will also examine the relationship between glycaemic response and polymorphisms in GLP-1R, TCF7L2, WFS1 and FOX01 genes.
Time frame: 6 months
Weight change over 6 months treatment
Time frame: 6 months
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