Developing and validating a set of risk scores for identifying those at high risk of Type 2 Diabetes and Cardiovascular Disease in a multi-ethnic UK population
Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder, preceded by a pre-diabetic state of impaired glucose regulation (IGR), from which the progression to diabetes is likely. T2DM/IGR are associated with increased morbidity and mortality. These conditions are often asymptomatic, with many cases remaining undiagnosed and untreated. Population screening studies have revealed that 20% of participants have undiagnosed IGR/T2DM, with much higher rates in black and minority ethnic populations. Screening for diabetes in certain groups has been recommended.
The Leicester Self Assessment Score (LSAS) was the first questionnaire based score specifically developed and validated in a UK multiethnic population (1). The score is hosted on the Diabetes UK website, over 140,000 people have completed the score (http://www.diabetes.org.uk/riskscore). This score has received global attention winning a QiC 2011 award for best early detection/screening initiative (http://www.qualityincare.org/awards/diabetes/qic_diabetes_results). We have also developed an automated score which can be used within GP practices to select high risk patients for invitation to screening (2). Both scores have been recommended for identifying those at risk in the NICE draft guidance on preventing T2DM: risk identification and interventions for individuals at high risk. Whether these scores increases the uptake the screening programs is currently being assessed in two NIHR funded studies.
The proposed project would extend this work in a number of ways:
(1) Review of current existing risk scores for IGR/T2DM for use in multiethnic populations
(2) Update and validate the paper based LSAS to take into account the new diagnostic criteria for T2DM
(3) Extend and validate the LSAS for completion via the internet
(4) Validate the scores (LSAS and automated score) on a prospective data set
(5) Develop and validate a new score for use in a multiethnic UK population for detecting both IGR/T2DM and cardiovascular disease (CVD) risk
This project will be supervised by Dr Laura Gray who has led the statistical development of the risk tools, Professor Kamlesh Khunti and Professor Melanie Davies will provide clinical input, all are part of the Diabetes Research group - http://www2.le.ac.uk/departments/health-sciences/research/primary/cvsd
Funding available
Studentships will last for 3 years and cover:
(i) University full-time PhD Registration Fees at H/EU rates
(ii) Student Stipend starting at the RCUK rate of £13,590pa
(iii)£1000pa Research Support Grant and £300pa Travel/Conference allowance
Home and EU students are eligible for these awards, as are International students who have graduated from one of the Department Masters programmes at Merit or Distinction level.
However, if an international student is appointed the difference between H/EU and International registration fees MUST be paid by either the student, supervisor, or from another source. The difference will NOT be covered by the studentship.
Applicants should send a statement of interest (no more than 1 page) and a CV with details of two referees to: Dr Laura Gray ([log in to unmask]) by 9th March 2012. Informal enquiries prior to this date are welcome.
For more information please contact Dr Laura Gray by email [log in to unmask]
References
(1) Gray L.J, Taub NA, Khunti K, Gardiner E, Hiles S, Webb DR, Srinivasan BT, Davies MJ (2010) The Leicester Risk Assessment score for detecting undiagnosed Type 2 diabetes and impaired glucose regulation for use in a multiethnic UK setting. Diabetic Medicine. 27(8) 887-895.
(2) Gray L.J, Davies MJ, Hiles S, Taub N, Webb DR, Srinivasan BT, Khunti K (2011) Detection of Impaired Glucose Regulation and/or Type 2 Diabetes Mellitus, using primary care electronic data, in a multiethnic UK community setting. In Press Diabetologia.
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