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Data driven innovation for gestational diabetes

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  • Full or part time
    Prof R Reynolds
    Dr F Denison
  • Application Deadline
    No more applications being accepted
  • Competition Funded PhD Project (Students Worldwide)
    Competition Funded PhD Project (Students Worldwide)

Project Description

The newly established four-year Medical Sciences & Translational Research PhD with integrated studies in Engagement for Impact Programme will combine medical science and translational research projects with integrated and credited teaching in science communication, public engagement, patient involvement, data design and informatics, via established MSc courses and/or new Engagement for Impact courses. Our vision is to teach a generation of researchers equipped to address and solve real-world problems through excellent science and who have the engagement and impact skills we believe will give them an edge in their future careers.
https://www.ed.ac.uk/inflammation-research/postgraduate-training/phd-programme

This potential PhD project, selectable by successful applicants to this Programme, is supervised by Prof. Rebecca Reynolds (www.cvs.ed.ac.uk) at the Centre for Cardiovascular Science, with co-supervisor Prof. Fiona Denison.

Project Summary:
Gestational diabetes (GDM) is one of the commonest pregnancy complications. GDM poses significant risks to the immediate and long-term health of both the mother and child. For mothers, GDM is associated with a 7-fold increased risk of type 2 diabetes in later life. For the fetus, uncontrolled GDM leads to accelerated fetal growth, increasing the risk of macrosomic, large-for-gestational age neonates and diabetes in later life (1). Hence it is essential to implement effective clinical interventions to maintain glucose control in pregnancy. The tablet metformin is widely used to control glucose levels in women with GDM but its use is controversial with preliminary data indicating the potential for adverse effects on fetal growth. In this project we plan to utilise data from our established database of women with gestational diabetes (2) and linked Edinburgh Reproductive Tissue Biobank of blood samples through pregnancy and placental samples at delivery, including from our randomised controlled trial of metformin in pregnancy (3). The rich data includes deep clinical phenotyping such as demographics, pregnancy complications, fetal ultrasound data, laboratory data, birth outcomes and bioresource. We will determine the impact of metformin on fetal growth trajectories and explore the underlying mechanisms. We will also compare the outcomes of metformin compared with other treatments including diet and insulin. Such work has potential to change clinical practice with respect to management of GDM.

Engagement for Impact:
We will engage with pregnant women and their children to inform them about diabetes in pregnancy. Using this network, we plan to identify at least one woman to buddy with the PhD student throughout the studentship. This will enable to student to have real-world exposure to the challenges of having GDM. Furthermore, it will enable the student to co-produce and develop appropriate public engagement strategies in partnership with women with GDM.
The supervisors work closely with the Tommy’s the Baby Charity which is active at promoting information to pregnant women through its website. At the Edinburgh Tommy’s Centre, we frequently host visitors e.g. lay public, fundraisers, potential donors to the Tommy’s Centre, have a public facing facebook page for disseminating information about studies and a quarterly newsletter distributed to community midwives and the staff of Simpson’s Centre for Reproductive Health reporting on research activities. In 2020, we are embarking on a broader impact and engagement strategy across Scotland to demonstrate the power of data-driven and technology enabled research to drive forward innovation for maternal and offspring health. The PhD student will be supported to lead outreach on data-driven approaches to improve pregnancy outcomes in partnership with the supervisors and out charity partners.
Both supervisors recently conducted a public engagement activity with the MRC festival focused on obesity in pregnancy and attracted > 100 participants and GDM would be make an excellent topic for a future event. The topic could also be presented at the University of Edinburgh Public Lecture series (which both supervisors have presented at) attracting local school children and teachers. Reynolds also works closely with Diabetes UK which has a Lay and Health Care Professional forum of > 2000 members to which the work could be disseminated. Denison works closely with the maternal medicine and intrapartum clinical studies group of the Royal College of Obstetrics and Gynaecology, both of which engage actively with women to inform research and impact.


Funding Notes

This is one of the potential projects in the University of Edinburgh College of Medicine and Veterinary Medicine’s new 4 year Medical Sciences & Translational Research PhD with integrated studies in Engagement for Impact Programme. Successful applicants will select their preferred PhD projects from the available options in discussion with proposed supervisors. Three studentships are available in the programme, providing full tuition fees (EU/UK rate only), stipend of at least £15,000 per year, £450 annual travel and conference allowance, dedicated engagement support grant of £1,500, and £5,000 annually towards research consumable costs.
Apply before 26th January 2020 at https://www.ed.ac.uk/inflammation-research/postgraduate-training/phd-programme

References

References:
1. Johns EC, Denison FC, Norman JE, Reynolds RM. Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends Endocrinol Metab. 2018 Nov;29(11):743-754.
2. Ryan DK, Haddow L, Ramaesh A, Kelly R, Johns EC, Denison FC, Dover AR, Reynolds RM. Early screening and treatment of gestational diabetes in high-risk women improves maternal and neonatal outcomes: A retrospective clinical audit. Diabetes Res Clin Pract. 2018 Oct;144:294-301
3. Chiswick C, Reynolds RM, Denison F, Drake AJ, Forbes S, Newby DE, Walker BR, Quenby S, Wray S, Weeks A, Lashen H, Rodriguez A, Murray G, Whyte S, Norman JE. Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2015 Oct;3(10):778-86.



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