Diabetes is a common life-long condition which prevents the body from controlling blood sugar levels, affecting over 5 million people in the UK. It is a major cause of ill health and early death that results in over 10% of NHS expenditure. Currently there is no cure, however pioneering and life-changing research is well underway.
Professor Andrew Hattersley FMedSci FRS, is one of the leaders within this field. As a Professor of Molecular Medicine and consultant physician, his contributions to identifying genetic markers shown to cause diabetes has dramatically improved the management of this condition. His early work was on familial diabetes, an inherited form occurring in later life. Familial diabetes is caused by a mutation in a single gene, and is known as a subtype of monogenic diabetes. With his research team based in Exeter Professor Hattersley showed that different types of familial monogenic diabetes needed different types of treatment. Genetic diagnosis and targeted treatment for familial monogenic diabetes is now widely adopted in the UK and worldwide.
Over the past 10 years, Professor Hattersley’s research has focused on neonatal diabetes. This is also a subtype of monogenic diabetes which is diagnosed within the first 6 months of life. It is a rare condition which occurs in one infant for every 100,000 live births. Professor Hattersley discovered genetic changes seen in infants with neonatal diabetes, which result in the abnormal function of an insulin-secreting protein channel. Infants with this gene mutation cannot secrete any insulin and rapidly develop a dangerously high blood sugar level. Whereas in healthy infants, the secretion of insulin would be used to control blood sugar levels.
Prior to this discovery, infants with this type of neonatal diabetes could only have been treated with insulin injections. These insulin injections needed to be taken before every meal and overnight, in order to try to control blood sugar levels. Professor Hattersley’s breakthrough, in combination with scientific advances in our knowledge of the changes that can prevent normal function of insulin-secreting protein channels, has resulted in neonatal diabetes infants now being better treated with sulphonylureas tablets. These drugs restore normal insulin secretion within the body, therefore removing the need for insulin injections ever again. Professor Hattersley’s work has transformed the way in which this group of patients are treated by showing that defining the genetic cause of an individual’s diabetes can dramatically improve treatment. As a result, genetic testing for neonatal diabetes is now readily available on the NHS and has been provided by the Exeter lab to patients from 87 countries worldwide.
Professor Hattersley said “we must use science to find the cause of the different subtypes of diabetes, in order to improve clinical care”. The next challenge is to individualise therapy in all types of diabetes by matching the treatment to the cause in the same way as he has achieved in genetic diabetes. Already there is progress in identifying novel subgroups in different types of diabetes. In the future he hopes to use the same principle to influence their treatment.
We are pleased to award the Royal Society GlaxoSmithKline Medal 2016 to Professor Hattersley for his innovative contributions to medicine and for revolutionising treatment for diabetes patients. Professor Hattersley will be giving his prize lecture on ‘From base change to better care in diabetes’ at the Royal Society on 8 September. For information on attending this prize lecture please visit our website.