StartRight Study
Research type
Research Study
Full title
StartRight: Getting the right classification and treatment from diagnosis in young adults with diabetes
IRAS ID
203567
Contact name
Angus Jones
Contact email
Sponsor organisation
Royal Devon & Exeter NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
The treatment of Type 1 and Type 2 diabetes is very different. People with Type 1 diabetes rapidly stop making their own insulin, so need insulin injections from diagnosis. People with Type 2 diabetes can keep making their own insulin but it may not work as well as it should, so they can be treated with diet or tablets. While they may eventually need insulin treatment it is usually not until many years after diagnosis.
It is often difficult for doctors to tell which kind of diabetes a person has, particularly in younger adults where both Type 1 and Type 2 diabetes are common. Because of this, sometimes (in about 15-20% of young adults) people are given the wrong diagnosis. This can have a huge impact as it means they could receive the wrong treatment. A person incorrectly diagnosed with Type 1 diabetes will be prescribed unnecessary insulin injections and miss out on other helpful therapies. A person incorrectly diagnosed with Type 2 diabetes may develop severely high glucose and become unwell with a condition called Diabetic Ketoacidosis if they do not receive insulin treatment.
This study aims to improve this situation by helping doctors more accurately tell the type of diabetes a person has when they are first diagnosed. We will recruit 1000 participants who have recently been diagnosed with diabetes between the ages of 18 and 50. We will record clinical features and measure blood tests that may help us determine diabetes type at diagnosis and follow participants for 3 years to see whether they stop producing their own insulin and need insulin treatment, which confirms Type 1 diabetes. We will assess whether clinical features and blood tests 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. This will be freely available to doctors and patients as a website calculator and smartphone app.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
16/SW/0130
Date of REC Opinion
16 Jun 2016
REC opinion
Further Information Favourable Opinion