What is diabetes?
Diabetes develops when the body is unable to process glucose properly, so blood sugar levels increase.
Diabetes is a serious condition in itself, but having diabetes also greatly increases the risk of developing heart and circulatory diseases.
Normally, the hormone insulin works to move glucose out of the blood and into our cells for energy and storage. In type 1 diabetes, the body cannot make insulin. In type 2 diabetes - which is far more common - either the body does not produce enough insulin, or the body is resistant to the insulin produced.
Nearly 3.8 million adults in the UK have been diagnosed with diabetes, with around 900,000 more thought to be undiagnosed.
Find out more about the symptoms and causes of diabetes.
Diabetes and blood vessel health
Many of the health complications of diabetes - including heart disease, circulatory system related conditions such as Peripheral Arterial Disease, and blindness – are linked to the damage caused to the blood vessels. We’re powerless to stamp out these heartbreaking effects until we understand how diabetes causes damage to our circulatory system. BHF Professor Mark Kearney and his colleagues at the University of Leeds are working to understand how insulin resistance affects the cells lining the blood vessels and leads to the development of atherosclerosis. Professor Kearney has discovered a new pro-atherosclerosis insulin signalling pathway in the cells that line blood vessels and is using pharmacological and genetic therapy approaches to target it. Their goal is to find medicines that could restore insulin sensitivity in blood vessels, to prevent disease.
The effects of diabetes on our blood vessels are wide-ranging, including disrupting the body’s natural ability to repair damage to our circulation and grow new small blood vessels – known as angiogenesis. We fund other Leeds researchers such as Dr Richard Cubbon, to understand the impact of diabetes on angiogenesis and investigate ways to boost self-repair of circulation in people who have the condition. This area of work is vital for the prevention of some of the devastating consequences of diabetes.
Read about more of our diabetes research in Leeds, by Dr Stephen Wheatcroft.
Diabetes and heart health
The BHF has contributed £1.9m for important state-of-the-art equipment at the Centre for Translational Cardiovascular Imaging at the University of Leeds. BHF Professor Sven Plein and Head of the Biomedical Imaging Division in Leeds uses sophisticated imaging equipment to understand why people with diabetes are more likely to develop heart disease.
The drug empagliflozin was found to reduce the risk of dying from heart and circulatory diseases in people with diabetes. But it is not understood why the drug has these benefits. BHF Professor Plein is now harnessing Leeds’ powerful MRI scanning capability to study the effects of diabetes on heart muscle, and how this changes with empagliflozin. This is important, because we urgently need better treatments for people who have diabetes who are also living with heart failure.
Simple steps to protection
Professor Jane Armitage and colleagues in Oxford are completing an important clinical trial to find out if daily aspirin and fish oil can help prevent people with diabetes having a heart attack or stroke. The study – called ASCEND – is the largest trial of its kind. More than 15,000 people with diabetes from around the UK are taking part and have been taking either active or dummy aspirin tablets and active or dummy fish oil capsules for several years. The results will reveal whether these simple steps could help people with diabetes live longer, healthier, lives.
The power of data
In partnership with Diabetes UK, we’re funding new analysis of medical data for insights into diabetes. Professor Nish Chaturvedi is leading a detailed examination of medical measurements from 500,000 volunteers, taken through the UK Biobank programme. The goal is to evaluate whether blood sugar thresholds for the diagnosis of diabetes are set at the right level, and if current diabetes medications could be increasing the risk of other health problems. They also hope to reveal clues as to why some people – including women and ethnic minority groups – are more susceptible to diabetes-related diseases. This important work could change the diagnosis and care of people with diabetes.
The difference we have already made
We have funded diabetes research ranging from large clinical trials to discovery basic science.
One of our largest ever studies – the Heart Protection Study, jointly funded with the MRC – involved over 20,000 people, including nearly 6,000 people with diabetes. The study revealed that the risk of a heart attack or stroke can be reduced by lowering levels of harmful LDL cholesterol. Now, cholesterol-lowering statin medicines are often prescribed to people with diabetes, and help to prevent thousands of heart attacks every year.
We know that Type 2 diabetes is much more common in people of South Asian origin in the UK. Ongoing studies are shedding light on how ethnic differences may cause or increase the risk of complications in common diseases, such as diabetes.
Find out more about our successes in diabetes research.