The prevalence of diabetes mellitus has been increasing exponentially over the last decade, and the disease is rapidly becoming a global problem. Current estimates suggest that almost 25,000 people suffer from diabetes in Luxembourg (i.e. about 6% of the adult population between 20 and 79 years of age).
1 in12 adults in the worlds having diabetes
Sadly, this number is projected to further increase. Indeed, international diabetes experts predict that, in the absence of radical change, 592 million people will live with diabetes by 2035. This constitutes 10% of the global population. Diabetes represents a daily burden on the patients who have to scrupulously watch their diets, monitor their blood sugar levels and administer insulin injections. The disease can also lead to serious complications affecting the eyes, heart, kidneys and feet and is estimated to cause 11% of deaths in Europe. In addition, the increasing number of patients means that diabetes is becoming a growing burden on healthcare systems. In fact, in Germany, about 10% of all healthcare costs are spent on diabetes treatment and care.
Discovering the underlying causes
There are three different forms of diabetes:
- type I diabetes, which is due to the pancreas’s failure to produce insulin;
- type II diabetes, where the patient’s cells have stopped responding properly to insulin;
- diabetes in pregnant women, called gestational diabetes.
While it is clear that both genetic predisposition and environmental factors play important roles in the development of diabetes, many of the exact mechanisms underlying its development are still unknown. To improve the understanding of diabetes and identify new therapeutic and diagnostic approaches, we currently support several diabetes projects.
Studying the role of bacteria
In 2016 one of the first projects initiated by the Personalised Medicine Consortium achieved a major breakthrough in diabetes research. 60 donors were recruited for this study, including families with a history of type 1 diabetes, with the help of Dr de Beaufort (CHL/LCSB) and the Clinical and Epidemiological Investigation Center at the LIH. By analysing the stool samples collected and processed by the biobank, researchers from the LCSB discovered clear differences in the way bacteria function in the gut of people with and without diabetes.
A second long-term project is ongoing. By documenting the development and evolution of bacteria from birth, scientists try to figure out how the bacterial populations in babies might influence the onset of diabetes later in life. For this study, stool samples of healthy new-borns and new-borns that are at increased risk of developing diabetes as adults due to known risk factors such as low birth weight will be collected and processed by the biobank before reaching researchers’ laboratories.
Identifying new therapeutic targets
For another collaboration with the Otto von Guericke University of Magdeburg in Germany and the LCSB, we collect, process and store fat tissue and purified white blood cell samples from patients that display multiple risk factors for developing heart disease, stroke or diabetes. This study aims to determine how a lifestyle-mediated weight loss programme can affect a specific type of molecules inside cells, called microRNAs, in an effort to identify new therapeutic targets.
Our national projects
IBBL is involved in a number of national research projects on diabetes, in close collaboration with all major biomedical research and healthcare actors in Luxembourg. Below a selection of some of our latest projects.
The overall objective of INNODIA is to advance the way we predict, evaluate and prevent the onset and progression of type 1 diabetes (T1D), by creating novel tools, such as biomarkers, disease models and clinical trial paradigms. These tools will allow to distinguish and understand at the cellular and molecular level distinctive paths of ontogeny and progression in this heterogeneous disease, thus impacting on the future management of T1D patients and at risk individuals. For this goal, INNODIA will establish a comprehensive and interdisciplinary network of clinical and basic scientists, who are leading experts in the field of T1D research in Europe, with complementary expertise from the areas of immunology, beta‐cell biology and biomarker research. The consortium will interact in a coordinated fashion with all major stakeholders in the process, in particular regulatory bodies and patients with T1D and their families.
Type 2 diabetes (T2DM) can contribute to heart failure (HF) through the development of functional and structural abnormalities in the heart, causing a dysfunction named cardiomyopathy. Diabetic cardiomyopathy (DCM) is considered as a distinct form of HF that occurs in diabetic patients in the absence of other heart diseases. Its origination and development are yet to be clearly defined and no effective therapy is currently available. CARDIATEAM aims to determine how unique and distinct DCM is compared to other forms of HF, and whether T2DM represents a central factor contributing to the development and progression of DCM. The study seeks to elucidate the specific underlying mechanisms that might lead to an early and more precise diagnosis of DCM. It also aims to identify new biomarkers and find innovative therapeutic targets to enable the classification of patients with T2DM for personalised preventive and therapeutic strategies. CARDIATEAM is a 5-year public-private partnership between 22 partners – including the Luxembourg Institute of Health and IBBL – from nine European countries and the EFPIA (European Federation of Pharmaceutical Industries and Associations) and is co-funded by the European Commission under the Innovative Medicines Initiative (IMI).
Currently, our diabetes studies are not actively recruiting participants. If you wish to stay informed about the recruitment for our upcoming diabetes studies, simply sign up to our newsletter.
What about ethics ?
All of our biological samples are contributions from volunteers, both patients and healthy citizens, who have given specific consent for the collection of their sample. Every donor has the right to withdraw their consent at any time, in which case all of the unused samples will be destroyed and related data deleted.
We work with national and international authorities to ensure that the collection and use of samples and data conform to high ethical standards and safeguard the privacy of the donor. All of our donors’ identities are kept strictly confidential and our data secured. We have a rigorous process in place to remove all identifying information from samples and health records at the source, so no identifying information is known by the biobank staff or given to researchers.
Before receiving any samples, research organisations must submit an application to our sample access committee. To receive the approval of this committee, applicants must show that they have the expertise to perform their proposed research, that the proposed research has ethical clearance, and that they have sufficient funds to see the research through to completion.