GW4 BioMed MRC DTP Studentship: Dietary patterns and the progression of type 2 diabetes

Co-supervisors: Dr Clare England (University of Bristol); Dr Rob Andrews (University of Exeter Medical School) and Dr Angus Jones (University of Exeter)

Start date: 18 Sept 2017

This project is a unique opportunity for a student with strong quantitative skills to investigate the role dietary patterns in modifying the progression of type 2 diabetes, responsiveness to diabetes medication and development of diabetes complications. Findings will inform the development of individualised approaches to treatment of Type 2 diabetes.

Currently 3.3 million people in the UK have Type 2 diabetes (T2DM) with this figure expected to rise to 4.6 million by 2030. T2DM can result in loss of vision, kidney failure, and cardiovascular disease and uses 10% of the NHS budget.

In patients with T2DM, randomised trials targeting different nutrients for weight loss and prevention of cardiovascular complications have shown no single approach to dietary change is superior [1]. Dietary patterns, derived through data-driven techniques such as reduced rank regression can identify food combinations that explain maximal variation in multiple nutrient mechanisms simultaneously [2]. Dietary patterns, offer a more precise method for tracking changes in diet and may better predict the progression of T2DM. To date there have been no longitudinal studies of whether such dietary patterns are associated with progression of T2DM (worsening of HbA1c), the development of diabetes complications or responsiveness to diabetes medication.

This project brings together Bristol epidemiologist (Johnson) and dietician (England) with expertise in T2DM and multivariate dietary pattern analysis together with an Exeter clinical scientists (Andrews and Jones), who have conducted a large (593 patients) trial in newly-diagnosed patients with T2DM (Early ACTID [3]) and have access to a large cohort (1000 patients) of newly-diagnosed patients tracked for their progression of T2DM and to identify predictive factors (DIRECT [4]). ACTID and DIRECT have extensively characterised patients, including detailed dietary data (5 food diaries in ACTID and 24 hour recalls in DIRECT), blood samples and medical history at follow ups over 6 and 3 years in ACTID and DIRECT respectively.

The student will develop practical skills in coding dietary data; processing raw data to generate variables on food groups, nutrients, dietary patterns and eating habits e.g. meal size, timing and frequency. Starting with the ACTID dataset the project will investigate:
1. Within-person variation in dietary patterns and eating habits over a 6 year period
2. Associations of changes in dietary patterns with progression of diabetes, time to development of complications or responsiveness to medication.
3. Prediction of progression of diabetes, time to the development of complications and responsiveness to medication from dietary pattern variation over time.

Initial work in ACTID can be extended to the DIRECT cohort to replicate findings across Europe and in a more diverse ethnic group. The project will reveal the role that dietary patterns play in the progression of T2DM and could inform guidelines for first-line diabetes medication among patients with different dietary patterns.

For more information on how to apply and eligibility criteria, please see http://www.gw4biomed.ac.uk/available-projects/national-productivity-investment-fund-studentships/.

The Research Theme Panels of the DTP will complete the shortlisting for interviews and will inform applicants by 9 June 2017. The first round of interviews with supervisors will take place between 9-16th June. Interviews with the funders will take place in Cardiff on 26th June 2017.