Insulin injection

9 February 2017

The government’s announcement today of more than $5.7 million in funding for research into diabetes has the potential to radically transform delivery of health care to hundreds of thousands of New Zealanders with diabetes or prediabetes, says Health Research Council of New Zealand Chief Executive, Professor Kath McPherson.

Three projects, all relating to the prevention and management of diabetes, have been awarded funding through a partnership initiative between the Health Research Council of New Zealand (HRC), Ministry of Health, and the Healthier Lives National Science Challenge.

The successful recipients are the University of Otago, Wellington, for two projects – a study into preventing type 2 diabetes by including probiotics and prebiotics in the diet – and a digital health initiative aimed at helping people prevent and manage diabetes using online tools.

The National Hauora Coalition has also received funding to support a targeted programme aimed at improving outcomes for Māori living with diabetes.

“Chronic, long-term conditions like diabetes can have a significant, debilitating impact on people’s lives and the lives of their families. We have a serious health problem in New Zealand, with diabetes affecting about six per cent of our population,” says Professor McPherson.

“This funding partnership is a great example of a cross-government group working together to develop an evidence-base that will support innovative, effective approaches to tackling diabetes right across the health system. It also signals a major push to reduce health inequities in New Zealand, as our Māori and Pacific populations have a diabetes rate about three times higher than other New Zealanders.”

The successful projects are:

Preventing type 2 diabetes with probiotics and prebiotics (PDP2)
Associate Professor Jeremy Krebs – University of Otago, Wellington
$1,800,000
Duration: 36 months
Summary:
A quarter of New Zealanders have pre-diabetes, which is a condition that can progress to type 2 diabetes and cause significant long-term health problems. There is now research demonstrating that the microbes in our gut affect our health in many ways, including how our bodies process foods and sugars. We can modify our gut microbes by taking probiotic supplements (which contain live bacteria that give health benefits) and prebiotics (substances from foods which support gut microbes).

This study is a blinded randomised placebo-controlled trial to see if taking a probiotic supplement with either a standard cereal or a cereal enriched with a specific prebiotic called beta glucan for six months can improve glucose and fat levels in the blood of adults with pre-diabetes. In addition, this work will evaluate the cost effectiveness of the interventions and how to translate the study findings into clinical practice.

Innovative management of diabetes with a comprehensive digital health programme
Professor Diana Sarfati – University of Otago, Wellington
$1,600,000
Duration: 36 months
Summary:
Six per cent of New Zealand adults have diabetes mellitus and one in four have pre-diabetes. Rates of both are rapidly increasing, and are higher among Māori and Pacific people. We have developed an innovative digital health programme which supports prevention and self-management of pre-diabetes and diabetes. The programme is delivered via web and mobile-based platforms. It integrates with primary care providers and uses peer support, health coaches, health tracking, and tools with engaging content to drive changes in behaviour. Initial pilot results showed that more than 70 per cent of pre-diabetics had normal blood glucose levels after four months on the programme.

We propose a group of studies, including a randomised controlled trial, to assess the clinical and cost effectiveness of this intervention in reversing pre-diabetes and improving self-management of diabetes, compared with usual care. We will explicitly assess the impact among Māori and Pacific people, and focus on translating findings into clinical practice.

Mana Tū: a whānau ora approach to long-term conditions
Dr Matire Harwood – National Hauora Coalition
$2,300,000
Duration: 36 months
Summary:
Diabetes is a long-term condition in which there are significant ethnic and social disparities in prevalence and outcomes. There is huge scope to reduce diabetes inequalities. The complex nature of the condition means a comprehensive and sustained approach that tackles the wider determinants for causes, management and complications is required.

We propose to test Mana Tū – a programme co-designed with whānau, clinicians, health service planners and whānau ora providers to improve the impact of clinical and lifestyle interventions for whānau living with pre-diabetes and people with poorly controlled diabetes. Mana Tū deploys skilled and supported Kaimanaaki-whānau (KMs) in practices. The KMs use a mana whānau approach and work with general practice teams while being operationally supported by a central hub. The hub will co-ordinate broader community and social service support systems for whānau and provide training, programme design, and support within a rich data environment.

Read the Health Minister Jonathan Coleman and Science and Innovation Minister Paul Goldsmith’s announcement

*About the partnership

The HRC, Ministry of Health and Healthier Lives National Science Challenge formed Long-Term Conditions Research Partnership to fund research which will improve our understanding of long-term conditions and support rapid transformational change in the delivery of care. The funding partners have an interest in supporting the development of an evidence-base that will support the identification and development of innovative, effective approaches that could be implemented across and beyond the health system.

The partnership presents a unique opportunity to explore new approaches to delivering health care in ways that meet the complex needs of people with long-term conditions. It is anticipated that this will include re-thinking health care delivery systems to coordinate activities and interventions across the continuum of care. For the purpose of this initiative long-term conditions is broadly defined as people with chronic conditions, therefore, people at risk of or having any ongoing, long-term or recurring condition that can have a significant impact on their lives.