A team in Dundee will combine health records from over 600,000 diabetes patients in Scotland and India to build personalised treatment models for the disease. Diabetes affects hundreds of millions of people worldwide, but most treatment guidelines are based on Western populations. India has one of the highest diabetes burdens globally, yet little is known about how the disease progresses differently there—in terms of subtypes, complications, and responses to therapy. The researchers will harmonise two decades of clinical data, including diagnostic codes, biochemistry, eye screening, and prescribing records, to fill this gap. If successful, the work could transform how diabetes is managed in India by moving from one-size-fits-all care to stratified, data-driven treatment. Clinicians could predict which patients are at risk of specific complications or likely to respond to particular drugs, improving outcomes and reducing healthcare costs. The partnership also trains a new generation of Indian data analysts in linking molecular and clinical datasets, building long-term analytical capacity.
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The University of Dundee is actively engaged in global health issues across a broad range of disciplines, where not only life sciences, medicine, dentistry and nursing have significant impact, but also where environmental, political, and regulatory issues are major players in the health agenda. To this end the University of Dundee has formed the Tayside Institute for Global Health, which engages with staff and students from the University and NHS Tayside to tackle global health issues. The Institute will provide further opportunities for impact for the diabetes research proposed here. The current proposal will integrate existing areas of excellence in diabetes health informatics and genetics research in Scotland with that of the largest clinical network of diabetes care in India, Dr Mohan’s Diabetes Specialities Centre. This has over 20 centres around India with 400,000 registered patients with diabetes , and hosts a WHO coordinating centre for non-communicable diseases prevention and control. The University of Dundee has a proven track record in global health (Rated 7th in UK) . The University is rated 1st in UK for Research Outputs in Life Scences and 1st in the UK for impact in Medicine). The University of Dundee is an internationally recognised centre of excellence in diabetes research, hosting over 20 research groups that include some of the world’s most cited scientists. Dundee is one of the top four institutions in the UK for Diabetes UK-funded research, receiving more than the rest of the Scottish research community combined, a measure of the level of work taking place at the University. Professor Sir Mark Walport, the current Government Chief Scientific Adviser (GCSA) and Head of the Government Office for Science has stated that “If you live in Dundee and suffer from diabetes, you have been participating in a medical revolution.” (The Times, 30.05.11) It is this revolution that we wish to progress with partners in India. Proposed programme of research. The programme will establish the partnership of the Dundee group with the Madras Diabetes Research Foundation in Chennai with the training of a new generation of big data analysts in the analysis of linked molecular and clinical data, including the deep data mining of imaging and clinical datasets. This coupled to the existing advanced clinical management systems in both centres will accelerate the adoption of the big data revolution into real life personalized care in diabetes and related morbidity. In order to deliver this vision our strategic plan comprises six workpackages. WP1: Leveraging large scale health record data. (Short term Years 1 to 2 ) In order to provide a unique insight in to both inter-individual and population variation in the causes and consequences of diabetes in India we will consolidate and harmonize the pre-existing large scale clinical datasets in Scotland and India amounting in total to over 600,000 patients with diabetes with continuous data spanning over 20 years This includes all diagnostic codes, biochemistry, blood pressure, all relevant prescribing particular for diabetes, eye screening data, and podiatry. In Dundee we have extensive experience of using such holistic and longitudinal data to develop models of disease progression, susceptibility to complications and response to therapy (1-5). Recent work performed within our European network has determined new models that differentiate Type 2 diabetes into 5 different diseases. Preliminary analysis of Dr Mohan’s DiabetomeDb (6) has determined that over 95,000 patients have had C-peptide measured and these data are available. This one data point alone suggests that the biggest study of beta-cell reserve in Type 2 diabetes in the world is possible We will use these extensive data to: • Characterise the pathophysiology of subgroups of diabetes in India. • Undertake epidemiology of the complications of diabetes in India • Investigate determinants of inter-individu
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