Diabetes researchers in the UK have welcomed a new resolution from the United Nations as an important recognition of the disease’s global impact, as well as a vindication of the proactive stance taken by the UK government through initiatives such as the Diabetes Research Network.

The resolution on World Diabetes Day, adopted by the UN General Assembly on 20 December, recognises diabetes as a chronic, debilitating and costly disease, associated with severe complications, that poses both “severe risks for families, [UN] Member States and the entire world” and “serious challenges to the achievement of internationally agreed development goals." The World Health Organisation has warned that, without remedial action, death rates from diabetes will increase by more than 50% over the next 10 years.

As well as designating the current World Diabetes Day (14 November) observed by the International Diabetes Federation as a United Nations Day, and calling for related efforts to raise public awareness of the disease, the resolution encourages UN member states to “develop national policies for the prevention, treatment and care of diabetes in line with the sustainable development of their healthcare systems." The UK government has already taken several steps in this direction through the launch of a national Diabetes Research Network in July 2005.

New UK intrastructure for diabetes research

The UK Diabetes Research Network (UKDRN) is one strand of the UK Clinical Research Network (UKCRN), established in February 2005 to spur the development of a nationwide infrastructure for clinical research in the National Health Service. The UKDRN offers a network of primary and secondary care centres for diabetes research in both the commercial and academic sectors, co-ordinated by a consortium between Imperial College London and the Oxford Centre for Diabetes, Endocrinology and Metabolism.

The new infrastructure for diabetes research was consolidated last May when the UKCRN and the Department of Health appointed eight Local Research Networks across the UK to support the delivery and conduct of clinical research on diabetes. These networks, which are designed to work collaboratively and build on existing links with clinical and research support in their local areas, now have full management teams in place and are starting to recruit patients for clinical trials.

On a global scale, the UN resolution on diabetes is viewed as a breakthrough in the recognition of chronic disease, whereas previously attention has tended to focus on acute and more ‘visible’ conditions such as AIDS and malaria. At the UK level, diabetes is already acknowledged as a fast-growing public health threat that now affects around 4.7% of the population in England alone.

More than 5% could have diabetes by 2010

According to the PBS Diabetes Prevalence Model commissioned by the DH from Yorkshire & Humber Public Health Observatory, 5.05% of England’s population could have diabetes by 2010, representing a 15% increase in prevalence since 2001. Of the total rise in prevalence, 6% would be due to an aging population and 9% to increasing obesity. In cost terms, diabetes is estimated to absorb 5% of all NHS expenditure in the UK and 9% of hospital costs.

These are good reasons to maintain the current momentum of efforts to consolidate, integrate and streamline the clinical research infrastructure for diabetes in the UK. What distinguishes these efforts in particular, and the wider environment for research in the NHS, is the government’s emphasis on applied research as a complement to academic innovations.

The OCDEM, which was set up in 1999 as a working partnership between the government, academia and the pharmaceutical industry, exemplifies this translational approach: the three founding partners included the National Health Service, Oxford University and Novo Nordisk. And as Professor David Matthews, chairman of the OCDEM and associate director of the UKDRN, notes: “Academic innovation by itself is sterile without the trials that prove it works”. By Peter Mansell