The Weston Centre for Childhood and Adolescent Diabetes and Endocrinology

Embedded within the IMS and adjacent to the Wolfson Diabetes and Endocrine Clinic, the Weston Centre is a dedicated outpatient clinic for children and adolescents with diabetes, endocrine and growth related disorders. It provides local services for the surrounding Cambridge area and acts as a tertiary referral centre for the East of England region (www.addenbrookes.org.uk).

Research at the Weston Centre

The Weston Centre also supports several thriving programmes of research. David Dunger is a paediatric clinical scientist with experience in several key research areas. For the last twenty years his group has established a number of prospective cohorts involving over 12,000 young people with Type 1 diabetes (T1D) to explore the genetics of diabetes and its complications. These studies have contributed to the identification of diabetes susceptibility genes and studies defining the natural history of microalbuminuria have led to the first randomised controlled trial of statins and ACE inhibitors in young people with T1D.

His group have a longstanding interest in the perinatal origins of risk for obesity and type 2 diabetes (T2D). Collaborations with the Avon Longitudinal Study of Pregnancy and Childhood and the Cambridge Baby Growth Study have delineated the metabolic consequences of low birth weight and rapid postnatal rapid ‘catch-up’ weight gain in the development of risk for T2D. Recently the group have been working with collaborators in the MRC Unit in Gambia and the Birth to Twenty Cohort in Soweto, South Africa to explore early programming and potential transgenerational risk for T2D.

The group also has a well established interest in the growth hormone/insulin like growth factor 1 axis (GH/IGF-1) and its effects on metabolism. In subjects with T1D links between low circulating levels of IGF-1 and poor glycaemic control have led to studies of the use of recombinant human IGF-1 as a potential therapy. The effects of insulin and IGF-1 deficiency in preterm infants short and longer term outcomes have led to trials of neonatal insulin replacement. The group’s increasing expertise in the physiology of insulin stimulated glucose regulation has led to the first studies of closed-loop insulin delivery in subjects with T1D and are being extended to the study of the preterm newborn.

Publications

Hovorka R, Allen JM, Elleri D, Chassin LJ, Harris J, Xing D, Kollman C, Hovorka T, Larsen AM, Nodale M, De Palma A, Wilinska ME, Acerini CL, Dunger DB. Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial. Lancet 2010;375:743-51.

Regan FM, Williams RM, McDonald A, Umpleby AM, Acerini CL, O’Rahilly S, Hovorka R, Semple RK, Dunger DB. Treatment with Recombinant Human Insulin-like Growth Factor (rhIGF)-1/rhIGF Binding Protein-3 Complex Improves Metabolic Control in Subjects with Severe Insulin Resistance. J Clin Endocrinol Metab 2010;95:2113-22.

Marcovecchio ML, Dalton R.N., Schwarze P, Prevost AT, Neil A, Widmer B, Dunger DB. Ambulatory blood pressure measurements are related to albumin excretion and more predictive than ‘nocturnal non-dipping’ of risk for microalbuminuria. Diabetologia 2009;52:1173-81.

Ong KK, Emmett P, Northstone K, Golding J, Rogers I, Ness AR, Wells JC, Dunger DB. Infancy weight gain predicts childhood body fat and age at menarche in girls. J Clin Endocrinol Metab 2009;94:1527-32.

Marcovecchio ML. Dalton RN, Prevost AT, Acerini CL, Barrett TG, Cooper JD, Edge J, Neil A, Shield J, Widmer B, Todd JA, Dunger DB. Prevalence of Abnormal Lipid Profiles and the Relationship with the Development of Microalbuminuria in Adolescents with Type 1 Diabetes. Diabetes Care 2009;32:658-63.

Salgin B, Marcovecchio ML, Humphreys SM, Hill N, Chassin LJ, Lunn DJ, Hovorka R, Dunger DB. The effects of prolonged fasting and sustained lipolysis on insulin secretion and insulin sensitivity in normal subjects. Am J Physiol Endocrinol Metab 2009;296:E454-61.

Salgin B, Marcovecchio ML, Williams RM, Jackson SJ, Bluck LJ, Humphreys SM, Acerini CL, Dunger DB. Effects of growth hormone and free fatty acids on insulin sensitivity in patients with type 1 diabetes. J Clin Endocrinol Metab 2009;94:3297-305.

Beardsall K, Vanhaesebrouck S, Ogilvy-Stuart AL, Vanhole C, Palmer CR, van Weissenbruch M, Midgley P, Thompson M, Thio M, Cornette L, Ossuetta I, Theyskens C, de Jong M, Ahluwalia JS, de Zegher F, Dunger DB. Early insulin therapy in very-low-birth-weight-infants. N Engl J Med 2008;359:1873-84.

Amin R, Widmer B, Prevost AT, Schwarze P, Cooper J, Edge J, Marcovecchio L, Neil A, Dalton RN, Dunger DB. Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 2008;29;336(7646):697-70.

Saukkonen T, Shojaee-Moradie F, Williams RM, Amin R, Yuen KC, Watts A, Acerini CL, Umpleby AM, Dunger DB. Effects of recombinant human IGF-1/IGF-binding protein-3 complex on glucose and glycerol metabolism in type 1 diabetes. Diabetes 2006;55:2365-70.

Weston Centre Image

Working together to translate research into better health