PhD Study : The Diabetic Lung: Impact of Diabetes and Obesity on Lung Health (IDOL study)

Summary

Background: Type 2 Diabetes (T2D) is a complex metabolic disorder, driven by obesity and elevated blood glucose concentrations (hyperglycaemia). Secondary complications, including vascular disturbances, account for most morbidity and mortality associated with T2D. The lung is not usually considered an end target organ for damage in diabetes. However, increasing evidence suggests that diabetes is detrimental to lung health. People with T2D have reduced pulmonary function even after controlling for known risk factors such as smoking and age [1].

T2D increases the risk of developing inflammatory lung diseases such as asthma and Chronic Obstructive Pulmonary Disease (COPD), but not lung cancers [2]. Both asthma and COPD share a common aetiology with T2D in the form of obesity, which increases the risk of developing asthma and COPD by 2 and 2.3-fold respectively [3]. The T2D-lung disase association is established both clinically and epidemiologically [4]. However, the underlying mechanisms behind this association are not well understood. It has been proposed that the hyperinflammatory state associated with obesity [5] and the potential damage caused by hyperglycaemia to the respiratory vasculature have roles to play [6].

This study therefore aims to determine whether obesity and/or hylerglycaemia drives the reductions in lung function observed in those with T2D. Objectives and study design:

1. To conduct a systematic review to identify trends in lung health in those with T2D and in obese, non-diabetic populations. This objective will examine the presence of restrictive and obstructive respiratory phenotypes in these groups and will determine the known relationships between glycaemic control, obesity, and lung function.
2. To recruit participants with and without T2D to a pilot study measuring lung function (FEV1/FVC ratio) at baseline and after 1 year.

To assess the potential role of obesity and diabetes in the progression of lung decline, we will recruit people falling into the following categories (n=50 per group):

a.Lean control participants (BMI<25, no diagnosis of a lung condition or diabetes, aged 55-70).

b.Obese participants (BMI>30, no diagnosis of a lung condition or diabetes, aged 55-70)

c.Obese T2D participants (BMI>30, no diagnosis of a lung condition, confirmed diagnosis of T2D for 3 years or more, aged 55-70) The relationship between obesity (BMI), diabetes and lung function will be assessed.

One-year follow up data from this pilot study will allow us to determine if changes in weight or diabetic status play a role in lung health. At present, lung function is not routinely monitored in the T2D population. The findings of this pilot study will provide evidence on whether lung function monitoring is warranted in this population. (3)To interrogate data from the IDOL cohort and two further existing cohorts – DIASTRAT (Stratification in Diabetes) and the UK Biobank to identify prognostic biomarkers for the development of lung disease. Analysis will determine the incidence of comorbid T2D/lung diseases in these populations and compare the clinical, proteomic and genomic profiles of people with T2D alone, versus those with T2D and a lung condition.

AccessNI clearance required

Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Sound understanding of subject area as evidenced by a comprehensive research proposal
• Clearly defined research proposal detailing background, research questions, aims and methodology

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• Completion of Masters at a level equivalent to commendation or distinction at Ulster
• Experience using research methods or other approaches relevant to the subject domain
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• Work experience relevant to the proposed project
• Publications record appropriate to career stage
• Experience of presentation of research findings
• A comprehensive and articulate personal statement
• Relevant professional qualification and/or a Degree in a Health or Health related area

Funding and eligibility

The University offers the following levels of support:

Vice Chancellors Research Studentship (VCRS)

The following scholarship options are available to applicants worldwide:

• Full Award: (full-time tuition fees + £19,000 (tbc))
• Part Award: (full-time tuition fees + £9,500)
• Fees Only Award: (full-time tuition fees)

These scholarships will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance) and will provide a £900 per annum research training support grant (RTSG) to help support the PhD researcher.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Please note: you will automatically be entered into the competition for the Full Award, unless you state otherwise in your application.

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,000 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living