Our envisioned future is to become a Centre for Innovative Clinical Research in Diabetes and Metabolic Disorders with the key emphasis on the following:
We have identified several key areas that offer SGH unique & competitive advantages in clinical research. These areas will provide the opportunity for SGH to achieve both academic excellence and address unmet clinical needs.
A) Obesity management and bariatric surgery: Weight loss model to study novel therapeutic pathways & test-bed novel interventions The LIFE Centre at SGH is the only unit in Singapore with a multi-disciplinary weight management programme that integrates lifestyle with medical and surgical management of obesity. Our centre has the largest volume of bariatric surgery procedures in Singapore (~120 cases in 2018) and this cohort has allowed us to complete several projects ranging from basic physiology research involving amino acid metabolism to clinical outcomes studies in diabetes remission and nutritional deficiencies. We will capitalise on this advantage by using bariatric surgery as a model to study the impact on weight loss on human physiology and identify new therapeutic targets. We also intend to test new hypotheses and conduct validation studies for innovative treatments of obesity-related metabolic disorders.
B) Non-alcoholic fatty liver disease (NAFLD): An emerging epidemicNAFLD is an emerging epidemic that is becoming the leading cause of chronic liver disease. The pathophysiology of NAFLD is incompletely understood. Furthermore, the diagnostic methods are in the early stages of development and the therapeutic options are of limited efficacy. Recently, we have initiated several studies in SGH to better understand the epidemiology of NALFD in our patient population and to develop better diagnostic tools. We have also collaborated with pharmaceutical companies to explore novel therapeutic agents.
We hope to capitalise on our core research capabilities to conduct investigator-initiated studies to explore pathophysiology that is unique to our Asian population, explore novel therapies and develop diagnostic/predictive tools.
C) SingHealth Diabetes Registry: Real world evidence for innovative treatment and models of care The SingHealth Diabetes Registry (SDR) holds patient data from 2007 onwards, collected from SingHealth Institutions including 4 Hospitals, 9 Polyclinics and 3 National Specialty Centres. Subjects with diabetes are identified through diagnosis codes and medications. As of June 2017, there are approximately 193,000 unique subjects within the SDR. The SDR is a rich source of real world data and we plan to make use of cutting edge computational approaches to personalise diabetes care, risk-stratify patients and predict disease trajectories. The data captured in the SDR can also be used to evaluate the real world effectiveness of new treatments and innovative models of care. D) Diabetic complications: Unmet clinical needs with clinical research potential Diabetic Nephropathy and Diabetic Foot Disorders are among the most serious morbidities in patients with Type 2 diabetes. End-stage renal disease (ESRD) and lower extremity amputations in Singapore are among the highest worldwide. Current measures to reduce these complications are hampered by the inadequate understanding of disease epidemiology, the lack of prognostic indices and biomarkers, as well as the inefficiencies in health services delivery. There is a pertinent need to adopt a systematic approach to tackle these two high stake diabetic complications. Hypoglycaemia: Lowering of blood glucose is the cornerstone for diabetes treatment but this is often limited by the development of hypoglycaemia. Hypoglycaemic episodes are often undetected and incorrectly treated. Hypoglycaemia represents an under-appreciated cause of morbidity, mortality and economic loss among patients with diabetes. We hope to capitalise on our huge disease burden here in SGH to perform clinical studies to better understand contributory factors, to explore novel biomarkers and prognostic scoring tools, and to utilise innovative technology to better detect and treat diabetic complications and hypoglycemia.E) Integration with Population Health Research (PULSES Central Grant)
The PULSES CG is a key effort of SGH to improve population health through health-services research. The integrated link between SGH DM Research Peak and Pulses CG extend beyond a shared long-term vision but is also complementary in research personnel, study population, innovative solution and target end-users of innovative research
Dr Tan Hong ChangSpecialty: EndocrinologySub-specialty: Diabetes, Obesity, Lipids Disorders
Senior ConsultantEndocrinologySingapore General Hospital
Dr Bee Yong MongSub-specialty: Diabetes, Lipids Disorders, General Endocrinology
Head ＆ Senior ConsultantSingHealth Duke-NUS Diabetes Centre