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StartRIGHT:the Right Diabetes Diagnosis and Treatment (Pilot Study)

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Last updated:6th Nov 2014

There are three main forms of diabetes: Type 1 diabetes, Type 2 diabetes and genetic diabetes. The treatment for each is very different because they have different causes. People with Type 1 diabetes stop making their own insulin, so need insulin injections instead, whereas people with Type 2 diabetes can keep making their own insulin but it may not work as well as it should, so they need to watch what they eat, and may also need tablets or eventually insulin injections. Genetic forms of diabetes have specific treatments according to the subgroup.

It is not easy for doctors to be able to say for definite what kind of diabetes a person has, particularly in young adults, where the distinction between the types is less clear. Because of this, sometimes (in about 10% of cases) people are given the wrong diagnosis. This can have a huge impact as it means they could be on the wrong treatment from the start, so they cannot control their blood sugars properly, which can lead to increased problems with their health and poor quality of life.

We think we have a way of improving this situation. We have developed a tool called an "Optimised Diagnostic Strategy" (ODS). This combines a person's clinical features (such as their age and weight), with blood tests looking for changes in their body's immune (defence) system, and a blood test looking for specific changes in their genetic code, to help accurately diagnose what kind of diabetes that person has. We now need to test this ODS to see if it is better at getting the right diagnosis and treatment from the start compared with what we do in routine clinical practice at the moment. This kind of project is called a Randomised Controlled Trial (RCT) and would involve patients from General Practitioner (GP) surgeries all over the United Kingdom (UK). The project would be expensive as it involves a lot of work by many people to get it set up and to keep it running. Before we can do this we need to do a "pilot" to see if the bigger study would be possible and practical to do. This pilot project will be done locally in Exeter and test all the parts needed for the larger scale RCT.

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Study start date 2014-11-06

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