Individualized Prevention and Treatment of Diabetes: How Can New Study Results Help?


Diabetes and its secondary diseases adversely affect patients’ quality of life and pose challenges to both physicians and the healthcare system alike. In a symposium on November 16th in Berlin at the 2012 Autumn Meeting of the German Diabetes Society, researchers of the German Center for Diabetes Research (DZD) presented forward-looking studies on individualized preventive and treatment measures.

The factors that cause diabetes in the individual case or make specific patients prone to certain consequential damage are not fully known. For this reason, three multicenter clinical studies of the German Center for Diabetes Research (DZD) are focusing on the development of individualized prevention and treatment strategies. “With the aid of the DZD, we are now able to carry out large clinical studies to assess the effectiveness of various preventive measures, depending on biomarkers and other individual factors,” said Prof. Dr. Dr. h.c Haring, Institute of Diabetes Research and Metabolic Diseases of Helmholtz Zentrum München at the University of Tübingen (IDM) and board member of the DZD, at the opening of the DZD Symposium at this year’s diabetes Autumn Meeting.

Individualized Diabetes Prevention
As is well known, lifestyle intervention is the most effective method for preventing type 2 diabetes. Nonetheless, not every patient benefits from it. In the Pre-diabetes Lifestyle Intervention Study (PLIS), researchers are seeking to define which subtypes will respond to which interventions.
Under the auspices of the IDM in Tübingen, all DZD sites have enrolled persons with increased risk for type 2 diabetes in the study. Following extensive phenotyping, the study participants shall take part in various lifestyle programs lasting several years. They receive nutrition counseling, their physical activity is measured with acceleration measuring devices, and the body fat compartments are assessed using whole-body MRI. “The results of this study, which is planned to have more than 1000 participants, shall lead to the development of individualized prevention measures for diabetes mellitus,” said Prof. Dr. Andreas Fritsche of the IDM.

Gestational Diabetes: Risk Factors and Prevention
Certainly a timely treatment of gestational diabetes can successfully prevent complications both for the mother and for the fetus and/or the baby during the pregnancy and birth. Dr. Andreas Lechner of the Clinical Cooperation Group of Helmholtz Zentrum München stressed the importance of comprehensive screening in this context: “Of key importance is the screening test for gestational diabetes in the 24th to 28th week of pregnancy. It has been included in the maternity guidelines and is covered by Germany’s statutory health insurance for all expectant mothers who are insured.” Affected mothers and children have a much higher risk of developing type 2 diabetes later on in life. The question of risk factors and appropriate preventive measures will be elucidated in a new DZD study, which will be carried out by the partner sites in Tübingen, Munich and Düsseldorf. Both expectant mothers and women who had gestational diabetes as far back as a maximum of ten years ago can participate in this study.

Preventing Secondary Diseases of Diabetes
Scientists of the German Diabetes Study (DDS), which the German Diabetes Center in Düsseldorf initiated and which is being conducted at further DDZ study centers, expect new insights into the prevention of serious secondary diseases due to poorly treated diabetes. “Our aim is to better understand the causes for the heterogeneity of type 1 and type 2 diabetes, in order to provide targeted treatment for the individual patient,” said Dr. Bettina Nowotny, director of the study at the DDZ. In this study, patients with newly manifested diabetes will be monitored as to the course of the disease, in order to determine individual risk profiles. The main focus is on the influence of individual risk factors such as lifestyle, other concomitant diseases or genetic and metabolic parameters in the development of secondary damage.
In collaboration with scientists from the fields of health care research and health economics, the health-related quality of life will be investigated in all three studies, because this is of key importance for the patients. Prof. Dr. Rolf Holle of Helmholtz Zentrum München explained the methodology in detail: “We determine and analyze important parameters with regard to the use of medical services, such as hospital stays or physician visits and also the participants’ medications, in order to be able to assess new prevention and treatment strategies, also from an economic perspective.” Beyond that, the quality of care for people with type 2 diabetes is the focus of studies in the DZD, for instance with respect to trends during various periods and regional differences as well as the effect of the disease management programs.

Symposium :
Individualized Diabetes Prevention and Therapy,
November 16, 2012, 11:15 AM - 12:45 PM; ICC Lounge, Berlin
6th Autumn Meeting of the German Diabetes Society