Prevention of Type 2 Diabetes

Coordinators:

Andreas Fritsche | Sofiya Gancheva | Andrea Icks | Matthias Schulze

Type 2 diabetes does not develop overnight, but rather develops insidiously via the preliminary stage of prediabetes. DZD researchers are working on new approaches to prevent the development of the metabolic disease.

Not every person who suffers from a preliminary stage of diabetes (elevated blood glucose levels, prediabetes) also develops the metabolic disease. Many can regain control of their blood glucose levels with more exercise and a healthy diet. However, not every person with prediabetes benefits from lifestyle intervention (non-responder). DZD researchers are working to identify the different subgroups of diabetes and prediabetes and to develop appropriate prevention strategies for each of these subgroups.

The central focus of the Academy is to break down the barriers to successful diabetes prevention.
There are two main goals:

  • Understanding the mechanisms leading to a response or non-response to diabetes prevention and to determine how to break through these non-responsive mechanisms
  • Transfer of diabetes screening and prevention to the general population / health system

In order to achieve these goals, the researchers investigate fundamental mechanisms that are essential for prevention processes, test them in clinical studies and conduct health care research in order to implement prevention in the public health system.

Prevention through lifestyle intervention
The Academy focuses on prevention through lifestyle modifications. In 2019, several studies on dietary intervention were published: a 12-week diet with a greatly reduced calorie intake, supported and accompanied by a special app, resulted in a significant reduction in body weight and liver fat, which led to an improvement in blood glucose parameters. Another study investigated whether less red meat and more dietary fiber had additional positive effects. This could not be confirmed, rather calorie reduction proved to be much more significant than other possible positive effects.

The researchers also succeeded in describing several risk phenotypes for prediabetes and defining non-responders based on data from clinical studies (TÜF, TULIP, PLIS). In a recent publication, the scientists were able to define different risk groups in prediabetes using a so-called cluster analysis. In high-risk groups of prediabetes, an increased risk of secondary diseases of diabetes can be identified even before diabetes manifestation. Also recent studies in collaboration with the DZD Academy Brain on mechanisms for non-responders showed that physical exercise could improve the brain's insulin action. Proteomics analyses, for example, have identified signatures that are potentially useful for predicting type 2 diabetes.

High need for information
In addition, care-based studies on information needs of people with diabetes and the general population showed a high need for information on both clinical and lifestyle aspects of diabetes. Health economic studies have shown that people with diabetes spend a great deal of time on self-management of their disease. A monetary evaluation of this time expenditure results in patient time costs of around 2,000 euros per patient and year, more than direct medical costs.

The national diabetes information portal diabinfo.de provides research results in the field of diabetes prevention, the diabetes risk score and information on early diabetes prevention. In addition, members of this academy are also actively engaged in information events for secondary school teachers.

Publications

Pathophysiology-based subphenotyping of individuals at elevated risk for type 2 diabetes. Nature Med (2021). DOI: 10.1038/s41591-020-1116-9

Opposing Associations of NT-proBNP With Risks of Diabetes and Diabetes-Related Complications. Diabetes Care (2020), DOI: https://doi.org/10.2337/dc20-0553

Plasma N-glycans as emerging biomarkers of cardiometabolic risk – a prospective investigation in the EPIC-Potsdam cohort study. Diabetes Care (2020), DOI: https://doi.org/10.2337/dc20-0553

Deciphering the Plasma Proteome of Type 2 Diabetes. Diabetes (2020), Online ahead of print. DOI: 10.2337/db20-0296

Protein markers and risk of type 2 diabetes and prediabetes: a targeted proteomics approach in the KORA F4/FF4 study. Eur J Epidemiol (2019), DOI: 10.1007/s10654-018-0475-8

Patient time costs due to self-management in diabetes may be as high as direct medical costs: Results from the population-based KORA survey FF4 in Germany. Diabetic Medicine (2019), DOI: 10.1111/dme.14210

Prof. Dr. Andreas Fritsche, Head DZD Academy Prevention

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Talk at the 10th anniversary celebration of the DZD on June 24, 2019 in Berlin (in English).

Members of the Academy

Andreas Birkenfeld, IDM
Matthias Blüher, Leipzig
Andreas Fritsche, IDM
Sofiya Gancheva, DDZ
Andrea Icks, DDZ
Stefan Kabisch, DIfE
Michael Laxy, HMGU
Wolfgang Rathmann, DDZ
Sabrina Schlesinger, DDZ
Matthias Schulze, DIfE
Peter Schwarz, PLID
Norbert Stefan, IDM
Michael Stumvoll, Leipzig
Julia Szendrödi, Heidelberg
Barbara Thorand, HMGU
Siegfried Ussar, HMGU
Robert Wagner, IDM
Cora Weigert, IDM