Report from the 26th EASD Scientists Training Course

Steno Diabetes Center Copenhagen, 17-23 November 2019

This November, a group of young scientists from all over Europe and beyond met in Copenhagen to train, develop practical skills, and gain new knowledge under the care of experts in the field of diabetes.

The first day of the course started with the warm welcome from Peter Rossing, who showed us an introductory presentation on what was going to happen during the next few days. He introduced us to the Steno Diabetes Center history and structure as well as the aim of the course and what we would experience during our stay in Copenhagen. After that, we started our first scientific session, which was focused on Continuous Glucose Monitoring and its use in diabetes research. Kirsten Nørgaard during her lecture introduced us to the new technologies currently used, what are the pros and cons of each device and what we should be concerned about when planning our studies using CGM/FGM as a research tool. Following the lecture, Anna Secher showed us possibilities of the flash glucose monitoring system. With that, we had a chance to initialise sensors on ourselves to wear them during the whole course. After the morning session, we started first of the three sessions entitled "Tell us about your research" when we shared our own experiences from research projects that each of us conducts.

The second part of the day involved practical exercises on how to generate, import and analyse data from Continuous Glucose Monitoring systems. Ajenthen Ranjan and Signe Schmidt prepared exciting cases for us, where we had a chance to see and analyse "real-life" data of patients and make conclusions based on their CGM records. The practical session was beneficial as we learned how that kind of data should be handled in a research setting and how we can implicate that in our projects.

When all the activities at the SDC were done for that day, we went back to the hotel to have dinner, followed by the International Evening when all of us gave a brief overview of our home country.

The focus of the EASD course day two was on vascular complications of diabetes. Frederik Persson, a senior researcher at Steno Complications research group, explained renal pathophysiology in diabetes and discussed the importance of a multifactorial approach to intervention in prevention or slowing progression of cardiovascular and/or renal disease, their complications and associated mortality in the  patient population with diabetes. Tine Willum Hansen, a senior researcher from the same research group, summarised what is essential and what is new in blood pressure measurement for achieving optimal accuracy and diagnostics in clinical practice.

In the afternoon, the program continued with a lecture by Prof. Allan Vaag, an expert in Diabetes Type 2 biology. Allan Vaag presented results of his extensive work in the field of type 2 diabetes, which have documented a range of risk factors, genetic, epigenetic as well as non-genetic, that play a role in the development of type 2 diabetes.

During the practical session, we had a chance to create various screening data sets that would target early detection of diabetic kidney disease, improve existing treatment, identify early signs of development or subjects at highest risk of renal disease. The aim was to identify new risk markers or find new treatment modalities to detect or prevent diabetic kidney disease. Authors of this great hands-on activity were Marie Frimodt Møller and Tine Willum Hansen, who were there guiding us throughout the session making sure we know what to look for, why and how.

The third day of the course was the day dedicated to the basic science of Diabetes research. We started the day with a lecture from Reza Yarani, a young and talented scientist who provided us with the big picture about the current state of the art of the beta cell dysfunction during type 1 diabetes research.

Yarani´s lecture contextualised the recent discoveries about the molecular mechanism that underlies the pathogenesis of type 1 diabetes on translational research and paves the way to have a better understanding of the cellular bioenergetics assessment, which was our second lecture of the day.

Verena Jensen and Joana Mendes Lopes de Melo gave us a lecture about how we can use Seahorse XF technology to understand cellular bioenergetics. They showed us what and how a Seahorse XF Flux Analyzer measures cellular bioenergetics, including the mito stress test, the glycolytic rate assay, the glucose-stimulated respiration. They finally provided us with a vivid example of an analysis of blood cell bioenergetics in a clinical study, which was very helpful for us to understand how we could use this technology in clinical research and how we can possibly apply it in our future research.

Finally, we had a wonderful practical training in two groups. First, we gained experience in Preparation of a Seahorse XF measurement with an immortalised beta cell line ourselves using the protocol of the study and then performing Example analysis of a Seahorse XF measurement with human peripheral blood mononuclear cells.

Another group with Min Kim performed chemometric analysis of three lipid samples and also we had the opportunity to get acquainted with the features of working with various devices for chemometric analysis, which are available in the Center, as well as with how you can analyse received data and use it in clinical research.

The main topic of Thursday was metabolomics in clinical research, which encompasses comprehensive metabolite evaluation, pattern recognition and statistical analyses. Min Kim spoke about chemometrics, metabolomics, prediction modelling and gave an update of advantages and disadvantages of different types of predictive models, namely generalised linear models, logistic regression, random forests, decision trees and neural networks. With Cristina Legido-Quigley we  studied metabolomics and targeted analytical methods molecular identification, multi-omics integration. She gave us information about five untargeted platforms: reverse phase chromatography, hydrophilic liquid interaction chromatography, lipidomics short high-throughput UPLC-QTOF, short and long gas chromatography.

After lectures, each of us gave a brief presentation on our current research, raising some questions and receiving actual advice.

On the practical course in the afternoon, we were divided into two groups and benefited from a scientist’s supervision. We were able to practice a lot of techniques in a short period, namely, one group had performed preparation of a Seahorse XF measurement with an immortalised beta cell line and the second one example analysis of a Seahorse XF measurement with human peripheral blood mononuclear cells.

The Friday was full of fascinating lectures. The majority of them covered the topic of databases and data analysis. Firstly, we were introduced to the national Danish Diabetes Register. Then Dorte Vistisen gave us a great lecture about machine learning methods. We got a chance to ask all questions about our prediction models and got to know the latest papers and projects of Steno Diabetes Center.

The day finished with a stimulating pharma-epidemiological case. Working in small groups, we designed our study about the influence of SGLT2 on gout incidence in a diabetic population. In the end, we presented our ideas and discussed them with the experts in the field of epidemiology.

Finally, Prof. Rossing summed up our week in Steno Center and awarded us with certificates. The time for saying goodbye came inevitably, but we took with us unforgettable memories. During this week, we gained not only new knowledge but also close friends. We came back home full of new energy and inspiration for our future researches.

First of all, we want to express our thanks to the course chairman, Prof. Peter Rossing, who not only organised the course but also took care of us and supported us with his knowledge and expertise during the whole week.

We would like to thank Steno Diabetes Center Team: the head of Steno research, Birgitte Brock and all lecturers: Kirsten Norgaard, Anna Secher, Frederic Persson, Tine Willum Hansen, Allan Vaag, Reza Yarani, Joana Mendes Lopez de Melo, Verena Hirschberg Jensen, Min Kim, Cristina Legido Quigley, Bendix Carstensen, Hanan Amadid, Dorte Vistisen and Marit E Jorgensen.

We do not know how to thank Mary Hata from EASD Postgraduate Courses Program for all her kindness, help, and extraordinary organisation skills.

We want to express our gratitude towards Lilly Diabetes for their generous sponsorship, thanks to which we gained the opportunity to take part in this fantastic experience.