The NIHR Diabetes Research Network

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1 The NIHR Diabetes Research Network Des Johnston, Imperial College London The Diabetes Research Network is part of the National Institute for Health Research Clinical Research Network Website:

2 Drivers for change RESEARCH FOR PATIENT BENEFIT WORKING PARTY FINAL REPORT For us, science and research constitute a front-line service, as they too, reduce distress and pain and save lives. (Dr John Reid, Secretary of State for Health, 22 March 2004)

3 Key issues that needed addressing Outstanding basic research Decline in clinical research community Decline in infrastructure for clinical research Complex regulatory environment Not yet realising the potential of a single National Health Service Need to recognise Industry R&D needs in the UK Diabetes Research Network

4 29 Nobel Prizes Since the MRC was set up in 1913, 29 scientists in our units or supported by MRC grants have won Nobel Prizes The MRC s prize winners have been spread across the Nobel categories of Physiology or Medicine and Chemistry.

5 Cooksey Review - Findings The UK has strong basic research However, there is insufficient translation of the results of basic research into applied research There is insufficient applied research to address the country s health needs There is insufficient strategic co-ordination between the Government-funded organisations that are responsible for basic research and applied research The research culture in the NHS is mixed

6 National Institute for Health Research Investigators & Senior Investigators Trainees Associates Infrastructure Clinical Research Networks Clinical Research Facilities & Centres Universities NHS Trusts Patients & Public Research Research Projects & Programmes Research Units & Schools Research Governance Systems Systems Research Information Systems

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9 National Institute for Health Research Investigators & Senior Investigators Trainees Associates Infrastructure Clinical Research Networks Clinical Research Facilities & Centres Universities NHS Trusts Patients & Public Research Research Projects & Programmes Research Units & Schools Research Governance Systems Systems Research Information Systems

10 Diabetes Research Network The NIHR DRN Initial aims of Clinical Research Networks Improve clinical research by creation of managed set of research networks, using established cancer network as a model Designed to support optimal approaches to disease prevention, diagnosis and treatment (emphasis on clinical trials) Networks in diabetes, stroke, dementia, mental health, medicines for children (primary care and comprehensive added later)

11 NIHR Topic Specific Research Networks Professors Janet Darbyshire & Peter Selby UKCRN CC and PCRN Professor Paul Wallace Deputy Director for Primary Care Professor Gary Ford Director, Stroke Research Network Professor David Cameron Director, National Cancer Research Network Professor Ros Smyth Director, Medicines for Children Research Network Professor Til Wykes Director, Mental Health Research Network Professors Martin Rossor and Ian McKeith Co-Directors, Dementias and Neurodegenerative Diseases Research Network Professor Des Johnston Director, Diabetes Research Network

12 Diabetes Research Network The NIHR DRN DRN structure 8 Diabetes Local Research Networks Good working relationships with adjacent geographical areas Close working with Primary Care Research Network and Medicines for Children Research Network Close working with devolved nations NIHR portfolio studies Strong Patient and Public Involvement

13 Local Research Networks SW Peninsula Thames Valley North West London North East London Eastern England South East Midlands North West North & East Cumbria

14 Local Research Network Resources primary and secondary care consultant and GP sessions research staff managerial, administrative support other costs (e.g. pharmacy)

15 Diabetes Research Network Types of Research Clinical treatment trials Technology assessments in real world Prevention studies Epidemiology Population genetics Pharmacogenetics Health Care Delivery Health Economics

16 Types of study Subhead Text Bullet text Diabetes Research Network

17 The NIHR DRN Diabetes Research Network

18 The NIHR DRN Diabetes Research Network

19 The NIHR DRN Diabetes Research Network

20 The NIHR DRN Recruitment , 34,000 (~2000 commercial, 32,000 non-commercial) 2013, ~40, current open studies (18 commercial) Diabetes Research Network

21 The NIHR DRN Time and target last quarter Commercial 80% Non-commercial 100% Diabetes Research Network

22 Diabetes Research Network

23 The NIHR DRN Reacting to needs regulatory issues Diabetes Mellitus: Evaluating Cardiovascular Risks in New Antidiabetic Therapies to Treat Type 2 Diabetes will increase the complexity and thus the cost of further developing diabetes drugs. In addition to the previous safety testing, the guidelines now require an in-depth safety review for all type 2 diabetes drugs with a specific focus on cardiovascular outcomes such as stroke, myocardial infarction, and cardiovascular mortality. Food and Drug Administration Center for Drug Evaluation and Research (2008) Diabetes Research Network

24 The NIHR DRN Reacting to needs medical advances Type 1 diabetes Genetic basis e.g. HLA class II genotypes Immune basis pancreatic islet specific antibodies Infective basis e.g. enteroviruses? Other environmental basis increasing incidence? Potential for aetiopathogenesis and intervention studies Diabetes Research Network

25 The NIHR DRN Reacting to needs ADDRESS The ADDRESS project is establishing a cohort of people aged 5-60y who have been newly diagnosed with Type 1 diabetes, and their siblings, who think they might be interested in taking part in diabetes research studies. ADDRESS >2000 recruits, currently 80+ incident cases per month Observational and interventional studies Diabetes Research Network

26 Recruitment Sites 126 recruiting hospitals in 122 NHS Trust and Welsh Health Boards

27 Participant Recruitment within 6 months post diagnosis (26 weeks) Number of Participants Recruited (n) Time Since Diagnosis (weeks)

28 Diabetes Research Network Who is supporting ADDRESS-2? Diabetes UK Juvenile Diabetes Research Foundation NIHR

29 The NIHR DRN Other initiatives Clinical Studies Advisory Group One Clinical Studies Advisory Group DUK/JDRF A series of time limited writing groups Mixture of open and focussed calls, e.g. Diabetes and Exercise Diabetic retinopathy Type 1 diabetes genes and treatment Diabetes and Neuroimaging Diabetes and Pregnancy Diabetes and Oral health Type 1 diabetes and eating disorders Diabetes and mental illness Diabetes Research Network

30 15 writing groups funded to date (15x 5000 = 75,000 invested) 21 successful grant applications, 5 million in funding. 4,692 recruits to date from portfolio studies resulting from writing groups Examples of cross-theme networking: Successful writing groups have created collaborations with immunology and with mental health. Current application round: link between cancer and diabetes Possible future topics: use of technology in diabetes control low calorie diets and type 2 diabetes Diabetes Research Network

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33 Medical research: What s it worth? For each pound invested in CVD and mental health research by the taxpayer or charity donor, there is a stream of benefits equivalent to earning 39 pence and 37 pence each year forever. Time lag between R&D spending and realisation of health benefits is 17 years Public and charitable funding of medical research encourages greater investment from the pharmaceutical industry

34 The NIHR Diabetes Research Network Des Johnston, Imperial College London The Diabetes Research Network is part of the National Institute for Health Research Clinical Research Network Website: