Impact

PRIME is dedicated to the improvement of knowledge on insulin multimorbidity and to understand the full extent of insulin multimorbidity. We do this by extending research beyond somatic diseases to include brain-based diseases. We use large-scale epidemiological studies using the world-wide largest existing registries and population cohorts as well as the largest case-control cohorts with genetic information. Ultimately, this will result in improved prevention, diagnosis, prognosis, therapy development, and management of insulin co-occurring diseases.

The societal and economic impact

PRIME addresses two of the most pressing epidemics of the industrialized world: 1) the trio of type 2 diabetes, obesity, metabolic syndrome and 2) the dementias including Alzheimer’s disease. These conditions are already among the most common and disabling conditions in Europe, with both diabetes and dementia being among the top-10 most burdensome conditions among older people worldwide according to the World Health Organization, and their prevalence is still increasing.

• The global healthcare expenditure on people with diabetes was estimated to be USD $ 850 billion in 2017
• Estimates from the World Alzheimer Report 2015 suggested the global number of people with dementia to be 46.8 million causing an annual worldwide cost of US $ 818 billion; the report projected an increase to 74.7 million people by 2030 and 131.5 million by 2050
• Research into the underlying factors and causal mechanisms of dementia and especially into drug discovery have so far had limited success. These investigations have largely been limited to brain-specific processes. Type 2 diabetes, obesity and metabolic syndrome have merely been recognized as risk factors for dementia, but never seriously considered as causal mechanisms

The mental health of children and adolescents is another priority in research, defined by the WHO. In PRIME we are breaking into new ground by investigating the role of insulin dysregulation among early-onset neurodevelopmental disorders, especially autism spectrum disorders and obsessive-compulsive disorder. Through the large age range among the insulinopathies, PRIME provides unique opportunities for the prevention of lifespan comorbidity, decreasing costs in an already over-stretched healthcare system and improving the quality of life of patients.

Clinical impact

Delivering new approaches to treatment and prevention of insulin co-occurring diseases from young to old age will substantially alleviate the burden for patients. It also impacts on broader issues, such as the burden of these co-occurring diseases on the healthcare system and society.

PRIME works on developing pharmacological and non-pharmacological treatment and prevention strategies. This includes repurposing of existing drugs and lifestyle-based (diet/exercise) interventions, which modify insulin resistance across the lifespan and across environmental contexts. Using recently developed tools for continuous monitoring and evaluation of bodily (i.e. hearth rate) and behavioral (i.e. diet) information, we can have fast access to new data from patients and at-risk individuals.

We will use multiple strategies to bring new knowledge produced in PRIME into society and clinical care:

• Improvement of existing clinical guidelines
• Dissemination of standardized protocols for implementation of pharmacological and lifestyle strategies across cultural and national contexts
• Production of training e-learning material for clinicians
• Direct involvement of societal partners and patient groups
• Influencing of policymakers

Scientific impact

The highly multidisciplinary team of PRIME is the key to the success of our work and ensures its impact. Having opinion leaders from multiple disciplines in our consortium, we ensure broad dissemination of scientific findings. We make use of the existing longstanding collaborations between our groups as well as our involvement in other international consortia. This allows us to work on the edge of science and implement interdisciplinary scientific approaches that will maximize scientific impact.

PRIME will break new ground by investigating insulinopathies of the brain. Going beyond the neurodegenerative disorders in our project, we will open up an entirely new field of research by studying the role of the dysregulation of insulin signaling in neurodevelopmental disorders.