Community spirit generates unique resource

The University of Dundee has an ever growing reputation as one of the world's leaders in the field of diabetes research. A major contributing factor to this success has been the amazing contribution of the people of Tayside and the fantastic achievements of the research team in recruiting huge numbers of volunteers to participate in the studies.

In the past two years, more than 11,000 people in Tayside - half with diabetes and half without - have taken part in "the UK Type 2 diabetes genetics consortium case-control collection", a Wellcome Trust funded case control study. The team are well on their way to reaching their target of 15,000 by next year. This level of success in recruiting volunteers is unprecedented and there are few, if any, other research institutions that can boast of such success. In fact, so impressive is the database that researchers from all over the world are accessing the Dundee data.

Chair of diabetic medicine at the University, Professor Andrew Morris, said, "There is nothing like this in the rest of Europe and researchers from as far as New York, Sweden and France are accessing this data to advance their research."

The Diabetes Research Nurses in the Division of Medicine and Therapeutics have been a major driving force behind the recruitment process, determinedly working to not only invite people to participate in the study, but also ensuring the best service and care is provided to those that do.

The participants with type 2 diabetes have typically been recruited though the Diabetic clinics and GP practices all over Tayside., Patients attend once they are first diagnosed with the condition and for yearly reviews. At the clinic they receive education about diabetes and diet and meet with specialist diabetes nurses. Here, the research nurses also meet the patients and invite them to participate in this research. Information is gathered from willing participants such as blood pressure, weight, height, cholesterol, lifestyle and blood samples which can be used in the study

In order for the research to be meaningful it is critical for a 'control group' that corresponds to the diabetes group for age, sex and so on is also available for comparison. Identifying the genetic or lifestyle factors that then differ between the two groups helps to provide clues why some people develop diabetes while others do not.

The diabetes research nurses have successfully managed to recruit thousands of healthy controls from Tayside through General Practices and by contacting businesses directly. The nurses need to be flexible in their approach, travelling out to GP clinics to meet volunteers at a time that suits the practice. They have also visited some local businesses, including DC Thompson where a number of people took part in the study.

"While we benefit enormously from the information we gather, the GP, individual companies and the control subjects themselves also benefit because the tests we do provide a sort of MOT for the body," said Bridget Shepherd, the lead diabetes research nurse.

"If we find any other conditions, such as high blood pressure or high cholesterol, the volunteer will be informed about this and advised to get it checked by their GP."

As well as testing blood pressure, height, weight and determining lifestyle factors, such as levels of exercise and whether or not the person smokes, the nurses also take blood samples from the volunteers. Some of this blood is sent to the laboratory for clinical testing, where cholesterol levels, for example, can be determined.

The remaining blood is taken to the Diabetes Research Centre where the DNA is extracted for genetic testing. Already these studies have led to the discovery of five new genes linked to diabetes and one linked to obesity. The findings were published in Science earlier this year.

The diabetes clinic and research centre at Ninewells recently moved to a purpose-built facility in the hospital, which will further enhance the level of care and research possible at the centre.