A summary of results of IMI diabetes research illuminates the sheer breadth of achievements, and recommends a path forward for making the most of them
IMI spent 13 years, launched 13 projects, and spent nearly €450 million on diabetes research. A zoomed-out results roundup by a trio of scientists from the University of Lisbon has illuminated just how big the impact has been when taken all together.
Biomedical black spots
IMI’s strategy set its sights on diabetes, as well as antimicrobial resistance, brain disorders like Alzheimer’s disease and autism, and cancer, because these are the kind of intractable problems that not only sap public health purses, but for whom new treatments are few and far between. IMI’s goal all along has been to bring together the best brains and latest technology to remove the stubborn roadblocks that are preventing doctors from prescribing ‘the right medicine at the right time for the right patient’. In short, personalised medicine. So how did we do when it comes to diabetes research?
‘’Scientific Advances in Diabetes: The impact of the Innovative Medicines Initiative’’, published in the journal Frontiers, is a deep dive into IMI diabetes-related research projects that examines how the results fit with IMI and Europe’s strategic research goals, namely new targets and biomarkers, better clinical trials, new and better medicines, and patient-tailored adherence programmes.
For example, we now definitively know that despite causing common symptoms, under the surface, type 2 diabetes looks very different for different people. It has been definitively shown that there are distinct subgroups of the disease. Tell-tale biological signs of looming blood sugar problems have been discovered, and we now have tests that can make predictions about who will likely end up developing the disease and how they will fare once they do. Other tools can predict how well a person will respond to certain drugs, others still can help spot who is at high risk of heart and eye problems. In terms of genetics, we now know of markers for people at risk, at risk of getting worse, and even verified the influence of genes on reactions to medicine.
In other developments, the first ever human pancreatic beta-cell line that can be studied in the lab is now being used by the scientific community. Another team built the infrastructure for clinical trials of diabetes drugs, including more efficient 'adaptive' trials. We have confirmed the influence of gut composition, age of diagnosis, year of diagnosis, and BMI factors on the onset of diabetes, and even the association with other factors like ethnicity.
Bringing it all together
Taking into account the wealth of scientific knowledge produced by IMI projects, the authors suggest a strategy divided into two tracks that should be deployed in parallel - a scientific track and a medical track. The scientific path involves objectives like acquiring more biological samples and data, doing more research on beta cells, validating even more biomarkers, fine-tuning stratification, weeding out molecular pathways, and, of course, developing new treatments
The medical track leans heavily on the projects’ outcomes in order to get better at treating people. This means making use of markers to identify people at higher risk, thus promoting the possibility of early lifestyle interventions. The medical path is focussed on prevention, but also diagnosis and treatment of recent-onset patients, figuring out who belongs to which sub-type, selecting the best pharmacological treatment and better follow-up.
“Only in this way, it will be possible to decrease the incidence and mortality rate of diabetes, provide an increase in the patient's quality of life, ensure sustainable people-centred health systems, and minimise direct and indirect diabetes-related costs in health systems,” the authors conclude.
IMI projects continue to deliver large numbers of high-quality scientific papers. Read the most recent IMI bibliometrics report here.