Large-scale study to better understand why people develop diabetes

by | June 15, 2016

The team hopes to identify biomarkers of progression and change the course of the disease.


Type 2 diabetesA new project, ‘Assessing the Progression to Type-2 Diabetes’ (APT-2D), aims to collect and analyse comprehensive information from 2,300 volunteers, so as to study in greater detail the factors which contribute to the progression of Type-2 Diabetes (T2D), one of the world’s most common conditions.

By doing so, the study hopes to identify ways to change the natural course of the disease, through the development of more targeted and effective interventions that will help to improve the outcomes for every patient with, or at risk of, T2D.

T2D is a condition in which a person has high blood sugar levels, either because the pancreas does not make enough insulin to absorb sugar from the bloodstream (i.e. defect in insulin secretion) or the body does not respond to insulin effectively (i.e. insulin resistance). The contribution of each type of defect in developing diabetes, and the reasons why some individuals progress to T2D and its related complications (e.g. heart, kidney and eye disease) more than others, are incompletely understood.

APT-2D is a landmark collaboration between the National University Hospital (NUH) and Janssen Pharmaceuticals and facilitated by Johnson & Johnson Innovation, marking the first time that researchers will be collecting and studying an extensive array of detailed biological, clinical, environmental and lifestyle information in individuals with normal or pre-diabetic blood sugar levels, in the largest-ever study of this kind in this region. The participants in this study will be followed up for three years to see if they develop T2D, including assessing how well their bodies can secrete and respond to insulin. The results of this five-year study will help to better characterise the specific risk factors and identify the biomarkers, which increase individuals’ susceptibility to developing T2D, as well as to predict potential response to treatment or progression to T2D-related complications. Besides hoping to deliver more targeted treatment and interventions, the study will also help other researchers to develop drugs, which could more effectively treat diabetes.

The study’s principal investigator, Dr Sue-Anne Toh, senior consultant with the Division of Endocrinology in NUH and a clinician-scientist at the National University Health System, said, “Globally, much of our efforts are put into treating the disease rather than prevention. As people live longer, they are likely to spend more years in declining or poor health due to chronic diseases such as diabetes. There is an urgent need, both at the individual and population level, to prevent illnesses associated with ageing or lifestyle. To stop and reverse this trend, improved approaches to prevent, pre-empt and treat diseases are needed.”


Expansion of local diabetes study

APT-2D is an expansion of a current local diabetes study called BRITE-SPOT which is also spearheaded by Dr Toh. Started in October 2015, BRITE-SPOT seeks to build a large bio-bank of biological samples and a registry that captures lifestyle and environmental information, medical history and physical measurements of 3,000 persons with T2D and their first-degree relatives (parents, siblings and children) who are not diabetic but are at high risk of developing the disease. BRITE-SPOT will serve as a major resource to support a diverse range of research intended to improve the prevention, diagnosis and treatment of T2D. Half of the participants under BRITE-SPOT (those who are pre-diabetic or have normal blood sugars) will also be eligible to participate in APT-2D. It is estimated that there will be 3,800 participants recruited for both BRITE-SPOT and APT-2D in total.

The APT-2D study is supported through fundings from Janssen Pharmaceuticals and the Singapore Ministry of Health’s National Medical Research Council under the Ministry of Health Industry Alignment Fund.


Volunteers still needed

Individuals who are interested to be part of the APT-2D study and fit the following criteria may contact the research team at e-mail – or mobile 9135 4495/9131 4490 (during office hours).

  • 30 to 65 years of age.
  • Generally healthy with no known history of diabetes or other chronic diseases requiring long-term medication.
  • Normal blood sugar level or pre-diabetic (borderline high blood sugars approaching diabetic range).





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