Implications of vascular remodelling to the diabetic patient

Data from Diabetes UK shows that ~185 people per week in the UK who are diabetic have leg, foot or toe amputations resulting from complications arising from diabetes. Complications such as the onset of ‘diabetic-foot’ can start to develop 5-6 years before people are diagnosed with diabetes. Concerns have also been raised as to the efficacy of current measures used to evaluate the diabetic foot such as thermal imaging, radiography, and neuropathy sensitivity.. These tests have been shown to have significant margins of error and can be invasive to the patient. Moreover, recent works have highlighted that a primary but debilitating response in the diabetic foot is the loss of vascularisation and blood flow to the limb.  

A means of reducing the impact of these complications or reversing type-2 diabetes is exercise, however, for many diabetic patients exercise is difficult to perform, due to the cited complications or poor physical health associated with uncontrolled blood sugars or associated medical factors such as cardiovascular disease or obesity.

Ischaemic pre-conditioning (IPC) promotes the development of local vascularisation and development of key metabolic components such as mitochondrial density and substrate provision. During an IPC, blood flow to a region of the body is reduced through the application of a torniquet. This promotes a period of ischaemia in the localised area, leading to a reduced blood flow and creating a temporary hypoxic state in the cells. 

It is hypothesised that through the application of repeated IPC’s across a prescribed intervention period which acts as the biological stimulus for the previously cited biological adaptations there will be an increased level of vascularisation in the diabetic foot, leading to an improved foot-health and quality of life for the patient. The successful applicant will monitor the effect of application of an IPC as part of both a diabetic foot check-up as well as a longer term stimulus for foot health. This may include monitoring the rate of reperfusion of the foot, which is a function of the local vascularisation and may enable a more sensitive and less invasive diagnosis of onset of diabetic neuropathy of the foot ‘diabetic foot’. Reperfusion rates will be assessed using near infrared spectroscopy.

The supervisory team have considerable experience of research, supervising doctoral candidates and the tools to be used in this project. Both Gernigon and Gordon have access to diabetic population groups both within Cambridge and Paris.  

If you would like to discuss this research project please contact Dr Dan Gordon (dan.gordon(@)aru.ac.uk) 

Candidate requirements

Applications are invited from UK fee status only. Applicants should have (or expect to achieve) a minimum upper second-class undergraduate degree (or equivalent) in a cognate discipline. A Masters’ degree in a relevant subject is desirable.

Applicants must be prepared to study on a full-time basis, attending at our Cambridge campus. The Vice Chancellor’s PhD scholarship awards are open to Home fee status applicants only.

Application Procedures

Applications for a Vice Chancellor’s PhD Scholarship are made through the application portal on our website: https://aru.ac.uk/research/postgraduate-research/phd-studentships

We will review all applications after the submission deadline of 27^th February. We will contact shortlisted applicants in the week commencing 14^th March. Interviews will be held between 21^st March – 1^st April. The interview date for this project can be found on our website.

If you have any queries relating to the application process or the terms and conditions of the scholarships, please email vcphdscholarships(@)aru.ac.uk.

Documentation required

You will need the following documents available electronically to upload them to the application portal (we can accept files in pdf, jpeg or Word format):

1. Certificates and transcripts from your Bachelor and Masters degrees, (if applicable)
2. Your personal statement explaining your suitability for the project
3. Passport and visa (if applicable)
4. Curriculum Vitae