A MAJOR new diabetes project launching in Edinburgh today[mon] will analyse the genetics and lifestyle of thousands of patients in a bid to unlock why some go on to develop complications while others do not.
Scientists behind the project will also unpick population data from across Scotland to try to shed light on what is driving a mysterious rise in type 1 diabetes.
Around 350 million people worldwide are affected by diabetes with rates of both type 1 and type 2 increasing. The number of known diabetics in Scotland is at an all-time high with around one in every 20 people living with the condition.
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NHS Scotland spends £1 billion a year on diabetes - nearly 10 per cent of the health budget - with more than three quarters spent on treating complications triggered by the disease including heart disease, kidney disease and blindness.
However, researchers believe that clues to tackling the condition could also lie in Scotland.
Professor Helen Colhoun, an expert in medical informatics and epidemiology at Edinburgh University, is spearheading a €1.5 million (£1.3m) study to pinpoint patterns among patients which predict their risk of developing diabetes-related complications.
The project, bankrolled by the AXA Research Fund, will mine information from sources including diabetic blood samples and Scotland's electronic health records, which are among the most comprehensive in the world.
The hope is that this would improve outcomes for patients and cut costs for the health service.
Prof Colhoun said: "The idea is to develop tools that allow you to differentiate among people with diabetes who's on a path to a worse outcome so that we can identify them earlier, have greater intensification of treatments at a more appropriate, earlier stage and therefore slow the rate of complications, while avoiding over-treatment of people who don't need it."
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While obesity is responsible for around 80 per cent of type 2 diabetes cases and can increase the risk of complications, Prof Colhoun added that it "doesn't completely explain" different outcomes between patients.
Genetics also appear to play a part.
"There's quite good evidence that there's a substantial component of kidney disease in diabetes patients that is inheritable," said Prof Colhoun. "But so far finding the genetic variant that underpins that has proven very challenging."
One of the biggest puzzles facing scientists is the global rise of type 1 diabetes. Since 2007, the rate of children under-10 diagnosed with the condition in Scotland has increased 45 per cent, from 22 per 100,000 to 32 per 100,000 by 2015, but around half of cases are diagnosed in adulthood. It is caused when the insulin-producing cells in the body are destroyed, but has nothing to do with weight or lifestyle.
Prof Colhoun hopes that the large-scale genetic analysis underway in Edinburgh will help unpick the mystery as well as shedding light on the "understudied" genetics behind childhood versus adult onset.
She said: "Over the last three decades, type 1 diabetes has increased in incidence. We don't know why, but we are seeing the same pattern of increase in many northern countries - Finland has experienced it as well, for example. In fact, most countries have experienced it.
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"The main theory is that there are viruses which, because of someone's genetic make-up, may trigger an auto-immune reaction. What those viruses are is not known.
"One possibility is that those viruses have just become more common, but there are also theories that some aspect of our lifestyle may be making us more susceptible to getting the virus or responding the way we do."
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