Tackling the diabetes epidemic

The Maastricht Study focusses on research into diabetes, cardiovascular diseases and other chronic diseases, as well as the relationships between them. Data from more than 7,000 of the total of 10,000 participants in the Maastricht-Heuvelland region have been collected so far. The result is an remarkable amount of data, 70 terabytes big (=70.000 gigabytes). What makes the study unique in the world is the large number of participants both with and without type 2 diabetes, the mapping of practically all of the many possible causes and effects of the disease and the use of very sophisticated research techniques.

Nine hours of sitting
Using an advanced three-dimensional pedometer researchers found out that the average person in South Limburg spends nine hours a day sitting down; actually not much longer than people elsewhere. But all that sitting turns out to be strongly correlated with worse health. “However, what’s striking about our most recent data is that it suggests that if you replace half an hour a day of sitting with walking, climbing stairs or similar activities, you can reduce the risk of diabetes by 20 percent”, says Stehouwer. Another important finding is that the number of people in the preliminary phase of diabetes – pre-diabetes, as it’s known – is much higher than initially thought. “The number of people with diabetes or pre-diabetes is now double what it was 10 or 15 years ago. We’re talking about roughly a million people in the Netherlands alone. So it seems very likely that, beyond lifestyle-related factors, there are other factors at play here. We think that stress, environmental pollution and the inhalation of toxins may play important roles in contributing to the development of diabetes. Still,” Stehouwer continues, “even if you discount all that, it still doesn’t fully explain the drastic increase in the prevalence of diabetes. So there have to be other causes too; causes that are as yet unknown to us.”

Work to do
The Professor advises to closely follow up on the large group of people with pre-diabetes. “The detrimental effect on quality of life is huge. Around half of patients develop classic symptoms like cardiovascular disease, and around three quarters of those eventually die from it. Not to mention complications that have more recently come to light, such as accelerated cognitive deterioration and depression. Although their effects are not yet clear, they’re likely to have a big impact too.” That means there’s work to be done by the Maastricht Study, that will run until 2019. The project employs 250 people, including 25 PhD candidates. But science is not the only beneficiary; the study also has value for the participants themselves and for the region. The results are communicated to both participants and their GPs, and participants can request tailored lifestyle advice. Stehouwer: “We hope the data from the Maastricht Study will help to turn the tide of the diabetes epidemic. After all, the knowledge acquired will be put to good use in the development of new methods of prevention, diagnostics and treatment of chronic diseases, in particular diabetes and cardiovascular disease.”

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