A groundbreaking study published at the UK Specialist Conference of Diabetes 2025 and published in the Lancet showed that millions of people with type 2 diabetes have received better treatment.
Researchers at the University of Exeter have been funded by the Medical Research Council, Welcome and the NIHR Exeter Biomedical Research Centre, supported in the Diabetes UK and have developed innovative methods to identify the most effective glucose-lowering drugs for people with type 2 diabetes. By predicting which drugs will lead to the greatest reduction in blood glucose levels, an easy-to-use tool can open the way for millions of health conditions at the press of a button.
Careful management of blood glucose levels is essential to reducing the risk of serious diabetic complications. However, maintaining blood sugar levels within a safe range can be difficult, with only about a third of people meeting the target of type 2 diabetes. New approaches to improve glycemic control are urgently needed by diabetic complications destroying catastrophic lives and spending £6.2 billion on the UK health system each year.
In the UK alone, more than 3 million people with type 2 diabetes use glucose-lowering drugs to manage their condition. Metformin is the most common and first treatment, but five other major types of glucose-lowering drugs are available. However, their effectiveness varies widely from person to person, and up until now, it has not been possible to determine the optimal glucose-lowering treatment for each patient.
A new tool was created to tackle the challenges of drugs to select after metformin. It was developed and tested using data from a million people with type 2 diabetes in the UK, linking GPs with hospital records and verifying their accuracy with clinical trial data.
The study revealed that only 18% of people with type 2 diabetes in the UK are being treated with the most effective glucose-lowering drugs.
Modeling has been shown to start people with recommended drugs by new tools, which can lead to a significant decrease in blood glucose levels (HBA1C) in a year of about 5 mmol/mol on average. Importantly, these improvements in blood sugar levels can be about twice as long before people need to start taking additional diabetes medications. The use of this tool was also predicted to reduce the risk of developing serious long-term diabetes complications such as heart attacks, strokes and kidney disease.
Using routinely collected clinical information, this tool offers a low-cost, practical, ready-to-use solution that can convert treatments for type 2 diabetes. For millions of people with type 2 diabetes, its use ensures that they receive optimal treatment to maintain blood glucose levels in their target range and minimize the risk of developing life-limiting complications.
Dave Pomfrey, 67, from Hampshire, was diagnosed with type 2 diabetes 27 years ago. Dave was told he needed medication to manage his blood sugar levels and reduce the risk of complications.
“The prospect of taking medication with the threat of complications potentially for life was a concern. However, I saw the impact of the health complications my relatives faced with type 2 diabetes, so I tried anything.
“We have experienced many changes in drug therapy to keep our blood sugar levels within range over the years. By getting the most appropriate treatment as soon as possible and trying different medications less can have that effect on a person's well-being.”
The tool's performance in clinical practice is currently being evaluated in 22,500 patients with type 2 diabetes across Scotland and is deployed in the UK and around the world, enabling personalized treatment for a new era of type 2 diabetes patients.
John Dennis, an associate professor at the University of Exeter who led the study, said, “We have developed an entirely new, personalized approach to diabetes treatment, which could benefit everyone with type 2 diabetes in the UK and around the world. For the first time, our model will allow type 2 diabetes patients to quickly identify the best treatments and reduce the risk of promoting a diabetic approach to medicine.”
Critical, our model can be implemented immediately in clinical care without additional costs. This is because we use simple measurements such as gender, weight and standard blood tests. We hope to quickly deploy the model to help people with type 2 diabetes in the UK and around the world. ”
Professor Andrew Hattersley at the University of Exeter
Dr. Elizabeth Robertson, UK Diabetes Research and Clinical Director, said: “This innovation using routine clinical data will help countless people with blood sugar levels reach a safe range. Significant advances in treatment of type 2 diabetes will improve health outcomes for millions of people over a decade.”
Dr. Adam Babs, head of translation at the Medical Research Council, which funds the research, said: Provides the efficiency of your healthcare system. ”
This research paper is entitled Type 2 diabetes: a five-drug class model using routinely available clinical features to optimize prescriptions in predictive models development and validation studies. This tool can be found at https://www.diabetesgenes.org/t2-treatment/.
Earlier this month, the UK of Diabetes revealed new data stating the size of the UK's diabetes crisis. Currently, there are 4.6 million people diagnosed with diabetes in the UK, a record high of 4.4 million since last year. Approximately 90% have type 2 diabetes.
An estimated 6.3 million people suffer from non-diabetic hyperglycemia, commonly known as prediabetics, and an additional 1.3 million people live with undiagnosed type 2 diabetes.
This means that over 12 million people in the UK (1 in 5 UK adults have diabetes or prediabetics).
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Journal Reference:
Dennis, J. M., et al. (2025). Five-drug class models using routinely available clinical features to optimize prescriptions in type 2 diabetes: development and validation studies of predictive models. Lancet. doi.org/10.1016/S0140-6736(24)02617-5.
