NIHR Global Health Research Group on improving outcomes in sub-Saharan African diabetes through better diagnosis and treatment at the University of Exeter

University of Exeter Strategy and Support This work will take Exeter’s world leading expertise in diabetes research and apply this to address the challenge of diagnosing and treating diabetes in low income countries. This will be achieved through a true partnership and collaboration with leading sub-Saharan African (SSA) institutions to enable skills transfer, capacity building and world class education that will have an enduring legacy. Our research directly addresses the strategic objectives of the University of Exeter, to deliver research capable of solving global challenges, which will have international impact. The University of Exeter will support this as part of its international strategy. To facilitate the development of this group and its long term impact, the University of Exeter will provide no-cost training for SSA staff and students through our researcher development programme, fund overheads and underwrite a PhD position, and provide a dedicated research development manager to assist further funding. Using leading expertise in diabetes characterisation, diagnostics and treatment to improve patient care in SSA Professor Hattersley leads the premier international group on characterising diabetes which has been recognised with every top award in the field of diabetes, received over £60m funding and, most importantly, has improved the lives of patients with diabetes worldwide. The group works in very close collaboration with the NIHR Exeter Clinical Research Facility (CRF) (Director Hattersley) and leads current national multicentre studies at over 50 sites. There is also close collaboration with Exeter Clinical Laboratory International (McDonald) which has an international reputation for excellence in moving research results into clinical practice. The group has combined cutting edge science with creating the clinical evidence and tools so that their research has had global impact on clinical practice. An example is their research on single gene diabetes; Exeter not only discovered many of the responsible genes but also identified gene-specific treatments supported by clinical trials, developed the diagnostic tests, pathways and guidelines needed for clinicians to identify patients, and established national and international education programmes to assist implementation. The end result has been >50,000 patients worldwide being able to switch from insulin to specific tablet therapy with markedly improved glucose levels and quality of life. Our strategy is to combine our expertise in Exeter with the expertise of researchers, clinicians and patients in Uganda and Cameroon to build lasting relationships, research capacity, and other resources (such as patient cohorts) that will address key problems of diabetes in the developing world and create lasting benefit for SSA patients, healthcare systems and institutions. We will use the best science to answer simple clinical questions needed to effectively and cost effectively detect and manage diabetes in the resource-poor setting of SSA. Building a network with the skills and capacity to perform the highest quality patient focussed research in sub-Saharan Africa Our collaboration will build on existing relationships and strengthen research capacity in SSA, with the majority of the proposed funding spent in Africa and on training of African researchers. Key initial academic partners include Professor Nyirenda, lead for Chronic diseases at the MRC/UVRI Uganda research unit and Prof. Eugene Sobngwi, University of Yaoundé, both of whom have extensive expertise in sub-Saharan African diabetes and conducting research in this environment. They will play a key role in the development of ongoing research studies alongside leading sub-Saharan African and international collaborators. To ensure the most effective use of resources and time our strategy is to initially focus our activities in Uganda, leveraging the expertise, infrastructure and