Back to search

BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Type 2 DIAbetes in South Asian immigrants. Pathophysiology, Perceptions, Prevention and Treatment - The DIASA research programme

Alternative title: Type 2-DIAbetes hos SørAsiatiske innvandrere - Forskningsprogrammet DIASA Patofysiologi, Sykdomsoppfatning, Forebygging og Behandling.

Awarded: NOK 18.3 mill.

DIASA1: We are working on a variety of analyses of collected material to increase understanding of the high occurrence of prediabetes in South Asian compared to Nordic women after gestational diabetes. The analyses include questionnaire data on diet and physical activity, as well as biomarkers to map biochemical, metabolic, epigenetic, and genetic mechanisms, as well as proteomics. DIASA2 and DIASA3: We have completed clinical investigations including measurement of insulin sensitivity using glucose clamp technique and adipose tissue biopsies, and we are in the analysis phase. The intervention part of DIASA3 (a randomized study of 4 different antidiabetic drugs for South Asian women with prediabetes) had to be discontinued after including 11 participants due to recruitment difficulties. We are planning a new study with a different type of intervention and have received partial funding for this. DIASA4: We have included around 250 patients with type 2 diabetes of South Asian origin from general practice in a longitudinal observational study at Stovner and Furuset medical centers in Oslo, and have conducted an intervention aimed at the doctors following the patients. We have collected one-year data from most participants and are working on collecting additional follow-up data and seeking to link the data to the Norwegian Diabetes Register for adults.

Background: South Asians (SA) have a high prevalence of type 2 diabetes (T2D),and develop T2D approximately 10 years earlier than Norwegians (NO).T2D in SA is often poorly regulated with increased risk of complications. Primary objectives: To find effective methods to improve diabetes prevention, treatment and care in SA, herein to improve metabolic regulation and prevent diabetic complications, morbidity and mortality. Research challenges in the 5 DIASA projects: DIASA 1: To estimate the prevalence of prediabetes and T2D in SA and NO women with prior GDM 1-2 years after childbirth. To study insulin sensitivity, secretion and glucose metabolism in these women. To study the women's perceptions about health, disease risk, possibilities for and barriers against diabetes prevention. DIASA 2: To reveal possible differences between SA and NO women with prediabetes in liver and whole body insulin sensitivity, glucose and lipid metabolism and fatty infiltration in liver. DIASA 3: In SA women with pre-diabetes, to test the effect of 4 oral antidiabetic agents on insulin sensitivity, glucose/lipid metabolism and fatty liver. DIASA 4: To establish and follow a SA T2D cohort in General Practice for assessment of glucose regulation, treatment and complications. To perform an intervention in GPs to improve diabetes treatment strategies. DIASA 5: In the cohort: to evaluate adherence to diabetes treatment and study attitudes to treatment and adherence. Potential for use of the findings: Learning more about disease perceptions and adherence challenges could lead to better strategies for treatment of T2D in SA. Testing which oral antidiabetic agent is most effective in SA will give better targeted treatment. More knowledge of the pathophysiological basis of T2D in SA, and in general, through advanced studies of insulin sensitivity and glucose and lipid metabolism will help further development of targeted treatment and prevention strategies.

Funding scheme:

BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering