The vast majority of those with type 2 diabetes mellitus (T2DM) are prescribed glucose lowering therapies to help manage their condition, with many taking multiple types of therapies concurrently. Increased physical activity and exercise training are also promoted as important management interventions for T2DM. However, previous research investigating the effect of exercise in T2DM has been conducted within highly selected populations, giving the findings limited generalisability. It is currently unknown whether specific types of glucose lowering therapies act to enhance or blunt responses to exercise, both in the promotion of improved physical function and improved cardiometabolic health. This is particularly relevant to newer classes of diabetes medications, such as incretin-based therapies or sodium-glucose co-transporter-2 (SGLT2) inhibitors, which like exercise, act to promote weight management and improved cardiovascular health. Understanding how medications and exercise can be used together in the management of T2DM has important implications for personalised medicine and maximizing patient benefit.
The PhD student will design a programme of research that is focused on three main questions:
Research question 1
Can exercise be used enhance the effects of sodium-glucose co-transporter-2 (SGLT2) therapies in T2DM? The student will work within a funded clinical trial to collect and analyse data investigating whether combing exercise with SGLT2 therapy can improve physical function, metabolic health and cardiac function in those with type 2 diabetes, compared to SGLT2 therapy alone or diet induced weight loss.
Research Question 2
Can exercise be used to improve cardiometabolic and functional health in T2DM in individuals taking the most commonly prescribed combinations of glucose and lipid lowering therapies? The student will systematically review the literature to derive the most commonly prescribed combinations of glucose and lipid lowering therapies in T2DM. They will then design and lead their own experimental clinical trial testing to what extent exercise can be used to enhance physical function and metabolic health in those taking the most commonly prescribed medications.
Research Question 3
Does the association of physical activity and fitness with cardiovascular disease depend on medication status in T2DM? The student will use a large national dataset to investigate whether the strength of association of physical activity and fitness with cardiovascular disease is modified by background medication status in T2DM.
The programme of research will be used to provide novel evidence for the efficacy of exercise when used in combination with newer generations of glucose lowering therapies, or when added to the most commonly prescribed background therapies. This work will used to directly inform clinical practice.
The PhD project will be embedded within a vibrant postgraduate research community within the Diabetes Research Centre, the National Institute of Health Research Leicester Biomedical Research Centre (BRU) and the East Midlands Collaboration for Leadership in Applied Health Research and Care (CLAHRC). They will work with leading experts in diabetes medicine and physical activity. The Diabetes Research Centre are ranked as one of the leading diabetes research centres internationally with a unique cluster of translational expertise and infrastructure that has been commended by the National Institute for Health Research (NIHR) and produced over 400 peer-reviewed articles published in the last seven years.
UK Bachelor Degree with at least 2:1 in a relevant subject or overseas equivalent.