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The Big Interview questions – Professor Kamlesh Khunti

By Editor
8th July 2020
Uncategorized

Professor Kamlesh Khunti is a pioneer in type 2 diabetes research and is ranked third among the top 10 of the world’s leading experts into the condition. 

A co-founder of the Leicester Diabetes Centre and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, he also tops the UK list of diabetes experts.

He is also Director of the National Institute for Health Research (NIHR) in Applied Research Collaborations (ARC) East Midlands and is a Trustee of the South Asian Health Foundation (SAHF).

How do you think the national approach to preventing and treating type 2 diabetes has been going in the last couple of years, prior to the pandemic?

That National Diabetes approach programme seems to have done really well. The number of people attending is greater than that was modelled in the initial programme.

Do you think the general public have become more aware of type 2 diabetes and what a serious condition it can become? If so, why?

Overall the general public is more aware of type 2 diabetes but I am not sure if they are aware it is a serious condition with long term consequences. I think there is still a lot of work to be done to raise public awareness especially in socio-economically deprived groups and black minority population

The sugar tax was introduced last year in a bid to reduce childhood obesity, do you think it has helped?

Professor Kamlesh Khunti

We do not have data on sugar tax and childhood obesity in the UK. However, there have been a number of global studies such as from Mexico which have shown that sugar sweetened beverages have been reduced as a result of sugar tax. It will take much longer to see any benefits at population level including childhood obesity.

How else do you think we should be targeting young people in a bid to help drive down type 2 diabetes figures?

I think the way we approach young people in the management of type 2 diabetes needs to be very different. They are less engaging in their care and  the model of care for this population needs to be different including virtual clinics and use of technologies for self management education.

 You were involved in the development of a major European-wide consensus statement on the safe glucose-lowering in older adults with type 2 diabetes. What impact has the consensus had?

We are not aware of the impact this consensus document has had – its early days. However, we have certainly had excellent feedback from healthcare professionals commenting that this was a timely consensus document to help them manage type 2 diabetes in this population.

Last year you were awarded with the South Asian Health Foundation’s Lifetime Achievement Award, tell us about the work you have done within this field.

I was delighted and honoured to get the award. I think this was the result of our groups work over the last 20 years in improving the care of south Asian people with type 2 diabetes with cardiometabolic diseases. This includes  the areas of screening, prevention and management of complications.

Since the DiRECT study has been published there has been a definite shift in accepting type 2 diabetes can be put into remission, why do you think this is?

I think the results of the DiRECT trial were quite dramatic with the number of people who went into remission. However, we do now have 2-year data where remission rates have attenuated. The main reason for high impact of the DiRECT trial is that for the first time we have seen remission with lifestyle intervention compared with what we had previously seen with mainly bariatric surgery.

You have been involved in helping to develop a new training programme developed to specifically help primary care healthcare professionals better understand the very latest (glucagon-like peptide 1 receptor agonists (GLP-1 RA) treatments, tell us more about this.

The Leicester Diabetes Centre  has vast experience in the training of healthcare professionals and the recent programme for GLP1RA has been designed with the view to appropriately manage people with type 2 diabetes who are at high risk of cardiovascular disease such as those with atherosclerotic cardiovascular disease.

As we know the EASD ADA consensus report recommends GLP-1 receptor agonists for people with established atherosclerosis disease or at high risk.

However, this is not translating into clinical practice. We hope that this training programme will equip primary healthcare professionals to initiate these therapies earlier on in these appropriate groups.

Education is continuing to dominate type 2 diabetes treatment, what are you currently working on, which could potentially change the future of how we approach the condition?

Our group will continuously work on education programmes in the management of people at risk or with cardiometabolic diseases. The current programme of work is similar to the ones we have done over the years but we have new additions such as the management of people with cardiometabolic and renal diseases and in particular multimorbidity. The evidence base in type 2 diabetes is also changing at a more rapid pace than many other conditions and we obviously need to make sure that our healthcare professionals are kept up to date.

What else can be done to continue to help tackle the burden of type 2 diabetes?

We need patient level interventions both to screen and prevent diabetes but also manage people with T2 diabetes more aggressively in early disease so as to reduce long term complications. There is now compelling data of aggressive early management  and we need to start putting this into practice. A lot more can also be done at population level such as the sugar tax that was mentioned previously and other interventions such as food labelling.

We last interviewed you in 2016 when you cited the Leicester Diabetes Centre as being one of your biggest achievements, has anything superseded this.

The work that is ongoing at the Leicester Diabetes Centre with our amazing team is still one of my greatest achievement. We are now one of the largest education and research centres in Europe and we would obviously like to continue to bring education programmes, innovation and published research up to the highest quality that is going to change clinical practice. 

 

 

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