Ricerca Progetti nazionali, regionali, internazionaliPRE-MED 2

Precision Medicine for Preventing Type 2 Diabetes: a Step Forward

Over the past 10-years the prevalence of diabetes in Italy has grown from 5.1% in 2007 to 6.7% in

2017. This growth is associated with an increase of the burden to the individual as well as to the

society. Currently a person with diabetes consumes twice as much resources of the National Health

System as compared to the person without diabetes. As such prevention is highly recommendable.

However, although feasible, prevention is difficult to implement. This may be due, at least in part, to the

heterogeneity of the disease that makes response to population intervention (and treatment) only partially successful. Classification of individuals at risk into subpopulations that differ in their susceptibility to develop type 2 diabetes may foster the development of preventive interventions that will be concentrated on those who will benefit, sparing expenses and side effects for those who will not. Therefore, the main aim of this project is to establish a collaborative effort to recruit a population of subjects at risk of developing type 2 diabetes based on an opportunistic approach through engagement of the primary care system and public announcements. Selection of the population will be performed by administration of the FINDRISK questionnaire made available at the primary care sites as well as publicized through the media over the initial 30 months of the project with the objective to enroll at least 1200 subjects. All individuals with ≥20 risk of developing diabetes over 10 years will be characterized on the basis of their diet habits and physical activity (by wearable devices) as well metabolic profile. Blood samples will be collected for exosome isolation and analysis. Total RNA and miRNA will be extracted from circulating lymphocytes and plasma for profiling analysis using Nanostring Technology. A bio-bank of serum, urine and stool samples will be also collected for future omics profiling. Data will be then integrated for identification of discrete risk subtypes.

Censoring for diabetes development will be performed annually via interrogation of diabetes registry as well as via prescription of anti-diabetic drugs. For the specific purpose of the duration of this project a mHealth automated behavioral intervention via E-mail, web, and mobile phone will be developed and tested in a trial in two high-risk populations (characterized as summarized before) of obese non-diabetic subjects (n=150) and women with previous gestational diabetes (n=150). These subjects will be randomized to either mHealth support or traditional recommendations for assessment of glucose tolerance and other metabolic parameters at entry and after 12-month follow-up. The results of this project will i. provide better insights into the mechanisms underlying different responses to preventive intervention; ii. identify biomarkers for prediction of risk of disease and new targets for preventive intervention; iii. Personal guidance for prevention of type 2 diabetes.

 

Responsabile: Edoardo Mannucci

Data inizio: 23.07.20

Data conclusione: 22.01.25

CUP n. I58D20000510002 

Progetto finanziato dalla Regione Toscana nell'ambito del Bando regionale Ricerca Salute 2018

 

COSTO COMPLESSIVO	CONTRIBUTO REGIONE	BENEFICIARI	PARTNER	COSTO COMPLESSIVO PER PARTNER	CONTRIBUTO REGIONE PER PARTNER
1.000.000,00	789.000,00	Università di Pisa	capofila	600.000,00	469.000,00
		AOU PISANA	partner	200.000,00	160.000,00
		Università degli Studi di Firenze	partner	200.000,00	160.000,00