Published: 10 May 2021
The NIHR has joined forces with Diabetes UK to fund a new £2.1 million project to prevent cardiovascular disease in people with type 2 diabetes who have had a diabetic foot ulcer.
The team at the University of Leicester led by Professor Kamlesh Khunti will develop and trial a new healthcare package that could benefit tens of thousands of people with type 2 diabetes across the UK.
Diabetic foot ulcers affect over 50,000 people with type 2 diabetes in the UK. These people are at much higher risk of cardiovascular diseases, like heart attacks and strokes, and early death than those people with type 2 who have never had a foot ulcer.
Despite this, there has been little research into how to prevent cardiovascular disease and early death in people who have had a diabetic foot ulcer. There’s also been very little research to understand how people’s age, ethnicity and where they live affects the link between diabetic foot ulcers and cardiovascular disease. And currently, there is no specialised care to support these people to reduce their cardiovascular disease risk.
With the funding from NIHR Programme Grants for Applied Research and Diabetes UK, Professor Khunti and his team will use health records to find out how many people with type 2 diabetes with a diabetic foot ulcer go on to experience heart disease or stroke. The team will also explore whether factors such as age, ethnicity, socioeconomic status or geographical location might put people at higher risk.
Using this information, along with input from people living with type 2 diabetes, the researchers will develop and trial a new healthcare package called MiFoot, to test its effectiveness in preventing heart disease and early death in people with type 2 diabetes who have had a foot ulcer. The package will likely include one-to-one, group and online sessions with healthcare professionals, and support for seated exercise, medicine management and mental wellbeing.
This package will be tested in a clinical trial, with people with type 2 diabetes who have a diabetic foot ulcer, to compare its effectiveness in preventing cardiovascular disease with standard care.
Professor Khunti, Professor of Primary Care Diabetes & Vascular Medicine at the University of Leicester, said: “We are delighted that this Programme Grant has been awarded as the risk of heart attack, stroke, and early death are substantial in people with type 2 diabetes and foot ulcers. We will be able to investigate not only the epidemiology but also develop and test an intervention to reduce the risks of these poor outcomes in a multi-ethnic population with type 2 diabetes and foot ulcers.”
Professor Elaine Hay, Programme Director of PGfAR, said: "We're pleased to be co-funding this new research with Diabetes UK, with their community of patients and carers providing valuable insight into what matters most to people with type 2 diabetes. Collaborations such as this between NIHR and Diabetes UK bring together diverse expertise and join up the health and care research ecosystem, helping us to fund research that provides the maximum benefit for patients and the public."
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “People with diabetes, healthcare professionals and researchers told us we need to do more to prevent diabetes complications in those at highest risk and we’re delighted to have partnered with the NIHR to make a significant investment in this area.
“We hope Professor Khunti’s research will result in a new healthcare programme for the thousands of people in the UK living with type 2 diabetes and with a history of diabetes foot ulcers who we know are at higher risk of heart attacks and stroke. If successful, this research will help people live longer and better lives with their type 2 diabetes."