We aim to develop new ways to help people with diabetes and other long-term conditions improve their health, including understanding how treatments can be better monitored, identifying new ways of using them and exploring their use by patients and clinicians. Our work includes carrying out systematic reviews of the literature, understanding the effects of treatment using routine data collected in primary care, developing new ways of helping people take charge of and monitor their health, and evaluating both new and established treatments in clinical trials. While much of our work is carried out with either the Primary Care Clinical Trials Unit (PC-CTU) or the Oxford Centre for Monitoring and Diagnosis (MaDOx), we also have strong links to other groups in Oxford and beyond, including the Oxford Centre for Diabetes, Endocrinology and Metabolism.
…[the group] provides the best evidence to date…Clar et al (2010)
Our work has shown that current approaches to use of blood glucose self-monitoring for people with type 2 diabetes, who are not using insulin, are not supported by the evidence from a number of clinical trials, and need to be better targeted at people who might benefit, with more support for those who are using it. The group undertook a landmark trial and health economic analysis of blood glucose self monitoring and led a wider collaboration within the Department of Primary Care Health Sciences to combine data from the trial with data from five other similar studies to look at the effects of the treatment in different groups of patients. The work has provided a strong evidence base to guide clinical practice and future research.
We have also looked at urine tests for people with diabetes to identify abnormal levels of albumin that might indicate early kidney disease. Increased levels of albumin in the urine indicate an increased risk of cardiovascular disease and are a sign that kidney disease is likely to deteriorate further. Our work has provided evidence to support current recommendations for testing every year, but also suggest that treatment of people with type 2 diabetes might be worthwhile, even without the presence of albumin in the urine.
We have a productive collaboration with colleagues from the Department of Biomedical Engineering at Oxford. Our previous work has included the first evaluation of mobile-phone base telehealth systems to support patients with type 1 diabetes in managing their insulin treatment. More recent work has included using the mobile phone systems to help people with type 2 diabetes adjust their insulin and tablet treatments. We have recently developed these systems to help people with other conditions including chronic obstructive lung disease.