Scottish university research offers boost for people with diabetes

The number of people with diabetes is increasing dramatically and around one-quarter of those are likely to develop serious ulcers that can lead to amputations and even death.

Foot ulcers are a particular issue, and apart from causing misery and impaired mobility for patients, they are a major cost for the NHS.

“We think roughly about 25% of people with diabetes will get a diabetic ulcer within their lifetime so they are really quite common,” said Dr Catherine Wright of Glasgow Caledonian University (GCU) which has been awarded the funding from the British Skin Foundation (BSF).

“About 1% of the NHS budget is used purely to treat diabetic wounds so it is very costly both for the NHS and for those people who are unable to work because of their ulcers.

“In the UK at the moment, 7% of people have diabetes. That is predicted to continue to rise and the economic impact is only going to increase as well which is another driver for developing new treatments.”

Despite the economic implications and the suffering of patients, treatments for diabetic wounds are limited, according to Dr Wright.

“One of the problems is that treatments haven’t really moved on very much for a long time even though diabetic ulcers really do affect people’s quality of life quite badly,” she said.

It is thought the ulcers are caused by the raised glucose levels of people with diabetes affecting their blood supply, especially the small vessels on the peripheries of the body like the feet. Oxygen then struggles to get to the feet and the damage to nerves means the skin becomes dry and easily cracked, meaning bacteria can gain access more easily.

Once a wound is there, it is difficult to heal and can turn very quickly into an ulcer which in turn can lead to sepsis and amputation. It is thought diabetic wounds are hard to heal because the skin is stiffer as a result of fibrosis which commonly affects people with diabetes.

Building on previous research, the work at GCU will focus on whether blocking the stress hormone cortisol will enable skin to heal better.

“If we disrupt the mechanism using a blocker, we think that will help the wounds to heal up faster,” said Dr Wright.

Using donated skin cells from the university’s skin tissue bank, the team will create 3D and 2D models to test the theory.

“What we can do in the lab is make little skin models and see if it helps artificial wounds to heal if we put on our inhibitors,” Dr Wright said.

Because the models will use living skin cells the research is more likely to produce useful results.

“The skin is donated to the tissue bank primarily from patients in Glasgow who are being operated on for other reasons – they are really altruistic and it means we can do these sorts of studies into all kinds of dermatological issues,” said Dr Wright. “It supports our work but we can also support work of other researchers in Glasgow and beyond.”

The BSF funding will pay for a PhD studentship to carry out the research to feed into later clinical trials to develop new medicines for ulcers which it is hoped will improve quality of life, lower amputation risk and reduce NHS costs.

Lisa Bickerstaffe, head of communications at British Skin Foundation, said: “At the British Skin Foundation, we are focused on funding high-quality research into all kinds of skin problems. Dr Wright’s research has the potential to significantly improve the lives of those with diabetes in the future, both in the UK and worldwide.”