Diabetes and Endocrine studies

Full title: An incident and high risk type 1 diabetes research cohort - After Diagnosis Diabetes REsearch Support System-2 (ADDRESS-2)

Summary: Characterisation of people with new-onset type 1 diabetes (<6 months duration) and their siblings who are free from diabetes. Participants consent to be contacted about other type 1 diabetes research.

Full title: Genetics of Endocrine tumours
Summary: To identify genes which are involved in the development of endocrine tumours and tumours related to the endocrine system.

Full title: Acceptability of a ready to use, low calorie, low volume, high protein liquid for patients with increased protein needs

Summary: A need for increased protein is frequently observed in disease. If not managed appropriately this may lead to reduced nutritional intake and increased risk of malnutrition. Medical nutrition support provided via enteral tube feeds or oral nutrition supplements is therefore necessary to help meet elevated protein needs. In some instances, achieving elevated protein needs can sometimes be difficult with enteral tube feeds or oral nutrition supplements alone. This is especially common in patients with normal to low energy requirements but with high protein needs, those unable to tolerate large volumes of enteral tube feeds and/or oral nutrition supplements, those with very high protein losses, with high energy requirements and exceptionally high protein needs. A low calorie, low volume, ready to use, high protein liquid modular (HPLM) feed may be beneficial for these patients to better meet protein needs but prevent caloric overfeeding.

Existing low volume, low calorie, high protein modular feeds however currently necessitate the need for decanting and/or diluting prior to use and feeding. This may increase contamination risk, instances of incorrect preparations (if dilutions are required) and inadequate provision of volume (if difficult to withdraw/decant from packaging and product spills). Consequently, a ready to use, low calorie, low volume HPLM feed has been developed in a sealed cup which may offer compositional, clinical and functional advantages.

The study is conducted for Advisory Committee on Borderline Substances (ACBS) and General Medical Services Scheme (GMS) reimbursement in the UK and Ireland, respectively, and is designed to meet their requirements for acceptability studies. As such, the aim of this study is to evaluate the acceptability (compliance, gastrointestinal tolerance and palatability) of a new HPLM feed, while also capturing information related to user experience (usability), dietary intake, risk of malnutrition, physical function, anthropometry and safety in forty eligible patients. Patients will firstly observe a 1-day baseline period, where patients continue with their existing care before receiving the new HPLM feed daily for 28 days alongside any additional routine nutritional management as required.

To assess whether blood tests, either alone or in combination with clinical features, can help us tell if a patient needs rapid insulin treatment and should be initially treated as Type 1 or Type 2 diabetes. We will combine results from this study and existing previous studies to produce a calculator, called a clinical probability model that will allow doctors and patients to combine information from clinical features and (where necessary) blood tests to accurately diagnose what type of diabetes a person has and therefore give the correct treatment.