FSE 1: Implications of vascular remodelling to the diabetic patient

Faculty: Science and Engineering

Supervisors: Dr Dan Gordon, Dr Marie Gernigon (external), and Dr Dan Robbins

Interview date: 23 March 2022

Data from Diabetes UK shows that ~185 people per week in the UK who are diabetic have leg, foot or toe amputations resulting from complications arising from diabetes. Complications such as the onset of ‘diabetic-foot’ can start to develop 5-6 years before people are diagnosed with diabetes.

Concerns have also been raised as to the efficacy of current measures used to evaluate the diabetic foot such as thermal imaging, radiography, and neuropathy sensitivity. These tests have been shown to have significant margins of error and can be invasive to the patient. Moreover, recent works have highlighted that a primary but debilitating response in the diabetic foot is the loss of vascularisation and blood flow to the limb.

A means of reducing the impact of these complications or reversing type 2 diabetes is exercise. However, for many diabetic patients, exercise is difficult to perform, due to the cited complications or poor physical health associated with uncontrolled blood sugars or associated medical factors such as cardiovascular disease or obesity.

Ischaemic pre-conditioning (IPC) promotes the development of local vascularisation and development of key metabolic components such as mitochondrial density and substrate provision. During an IPC, blood flow to a region of the body is reduced through the application of a tourniquet. This promotes a period of ischaemia in the localised area, leading to a reduced blood flow and creating a temporary hypoxic state in the cells.

It is hypothesised that through the application of repeated IPCs across a prescribed intervention period, which acts as the biological stimulus for the previously cited biological adaptations, there will be an increased level of vascularisation in the diabetic foot, leading to improved foot health and quality of life for the patient.

The successful applicant will monitor the effect of application of an IPC as part of both a diabetic foot check-up as well as a longer term stimulus for foot health. This may include monitoring the rate of reperfusion of the foot, which is a function of the local vascularisation and may enable a more sensitive and less invasive diagnosis of onset of diabetic foot. Reperfusion rates will be assessed using near infrared spectroscopy.

The supervisory team have considerable experience of research, supervising doctoral candidates and the tools to be used in this project. Both Dr Dan Gordon and Dr Marie Gernigon have access to diabetic population groups both within Cambridge and Paris.

If you would like to discuss this research project please contact dan.gordon@aru.ac.uk

Apply online by 27 February 2022.

Funding notes

This successful applicant for this project will receive a Vice Chancellor’s PhD Scholarship which covers Home tuition fees and provides a UKRI equivalent minimum annual stipend for three years. For 2022/3 this will be £15,609 per year. The award is subject to the successful candidate meeting the scholarship terms and conditions. Please note that the University asserts the right to claim any intellectual property generated by research it funds.

Download the full terms and conditions.