Helminth infections and type 2 diabetes mellitus in Indonesia

Integrating parasitological, immunological, behavioral and metabolic studies (2012-2016)

Indonesia is a country in transition where environmental and lifestyle changes are altering the diseases landscape in the country, from infectious diseases to non-communicable inflammatory disorders, including type 2 diabetes mellitus (DM2). To get a grip on the precise mechanisms underlying this transition, this SPIN programme (Scientific Programme Indonesia – Netherlands) will take on the challenge of forming an interdisciplinary research to tackle:

  • type 2 diabetes
  • mechanisms of insulin resistance
  • risk factors for type 2 diabetes and
  • statistical models to understand complex interactions in type 2 diabetes

Together the work will be centered around a population on Flores Island where chronic parasitic infections are endemic and where life style changes are taking place at a reasonably rapid pace. The hypothesis that helminth infections, which are associated with a strong modulation of immune responses towards a T-helper 2 and regulatory mode, are associated with increased insulin sensitivity and thus a healthy metabolic phenotype will be tested through a rigorous placebo controlled albendazole trial within households.

In addition, through questionnaires all lifestyle and behavioral data will be gathered in the Ende district. Translational studies will be performed in animal models to get insights into the mechanistic links between helminth infections and carbohydrate metabolism. The consortium is acutely aware of the urgent need for specialized statistical models to deal with complex datasets that will be generated and therefore takes the important step of creating a project dedicated to development of methods that can be utilized for the gathered information. The information is complex; it encompasses:

  • clinical data
  • biochemical data
  • molecular immunological descriptive details through questionnaires

Each of these have their own special characteristics in terms of distribution, cut off and missing values. By creating the methods to deal with the data, it will be possible to integrate all the data together and to create plausible biological pathways that lead to insulin resistance. Whenever possible, the program will be dedicated to providing tools for policy makers who need to allocate the precious resources to proper control of diseases in Indonesia.

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This study is funded by The Royal Netherlands Academy of Arts and Science (KNAW), Ref 57-SPIN3-JRP

Sugarspin is a follow-up of the Immunospin Project