One in Six Billion

One in Six Billion

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A podcast about diabetes and genes hosted by Andrew Hattersley and Maggie Shepherd.

Andrew Hattersley and Maggie Shepherd


    • Jun 10, 2025 LATEST EPISODE
    • every other week NEW EPISODES
    • 34m AVG DURATION
    • 42 EPISODES


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    Latest episodes from One in Six Billion

    Special episode 7. Maggie Shepherd (part 2). Inspirational nurse researcher and educator

    Play Episode Listen Later Jun 10, 2025 28:59


    Professor Maggie Shepherd reflects back on her career and how she made the massive steps from being a clinical nurse to becoming a nationally leading researcher and educator.Send us a text

    Special episode 6. Andrew Hattersley (part 2). Building the Exeter diabetes research team

    Play Episode Listen Later May 27, 2025 29:54


    Andrew Hattersley describes how teamwork and mutual support has helped the Exeter diabetes research team expand and flourish over the past 30 yearsSend us a text

    Series 3 Episode 16. Grace Bervoets and Amanda Stride. Cystic Fibrosis related Diabetes

    Play Episode Listen Later May 13, 2025 32:24


    Grace Bervoets talks about living with cystic fibrosis and cystic fibrosis related-diabetes.  Amanada Stride, who works as a diabetes consultant helping people with cystic fibrosis related-diabetes, explains the many challenges of this unusual type of diabetes.Send us a text

    Series 3 Episode 15. Tom Staniford. MDP syndrome

    Play Episode Listen Later Apr 29, 2025 42:58


    Tom Staniford talks about living with the MDP syndrome, an extremely rare genetic condition. MDP syndrome includes Mandibula hypoplasia, Deafness, and Progeroid features amongst its widespread features. Tom developed Type 2 diabetes as a teenager because of a loss of fat under the skin (lipodystrophy) despite being very thin and active.  Tom has used his communication and media skills to help other people with MDP syndrome get diagnosed and receive the right care.Send us a text

    Series 3 Episode 14: Farah O'Regan and Matt Johnson. Down syndrome and very young onset diabetes

    Play Episode Listen Later Apr 15, 2025 33:26


    Farah O'Regan talks about how her son who had Down syndrome and a severe congenital heart condition needing surgery diagnosed in pregnancy and then developed Type 1 diabetes on day 2 of life.  In early childhood he was diagnosed with 2 more autoimmune conditions, coeliac disease and hypothyroidism.  Researcher Matt Johnson explains his research which has established that Down syndrome directly results in very early-onset autoimmune diabetes. Send us a text

    Series 3 Episode 13. Abby Gardener and Tim Barrett. Wolfram syndrome / WFS1 Spectrum disorder

    Play Episode Listen Later Apr 1, 2025 34:53


    Send us a textAbby Gardener describes how she was diagnosed with Wolfram syndrome after developing both insulin-treated diabetes and diabetes insipidus (when the urine cannot concentrate) and how this has impacted her life.  Professor Tim Barrett talks about how, throughout his career, he has been researching and providing care for patients with Wolfram syndrome.  He explains that it is now recognised that there are a range of features that can result from the genetic change (WFS1 spectrum disorder) and that not every patient will have all the severe changes previously described in Wolframs syndrome.

    Series 3 Episode 12. Cassi Connelly. Familial Partial Lipodystrophy

    Play Episode Listen Later Mar 18, 2025 36:01


    Send us a textCassi Connelly talks about her experience of having familial partial lipodystrophy characterised by a loss of fat and muscular appearance of her arms and legs. She had multiple medical problems including diabetes for decades before the diagnosis of familial partial lipodystrophy was finally confirmed by a genetic test. Her treatment is now better tailored to her needs.

    Series 3 Episode 11. Rebecca Goodman. Living well with Bardet-Biedl syndrome.

    Play Episode Listen Later Mar 4, 2025 29:14


    Send us a textRebecca Goodman talks to Andrew and Maggie about what it is like to grow up with Bardet-Biedl syndrome. Features of Bardet-Biedl syndrome include extra fingers and toes, progressive blindness, kidney problems, obesity due to an uncontrolled appetite, insulin resistance and diabetes. Despite this long list of medical issues Rebecca lives independently and enjoys a full and fun life. 

    Special episode 5. John Dennis. Research breakthrough in Type 2 diabetes treatment.

    Play Episode Listen Later Feb 18, 2025 24:01


    Send us a textWe talk to John Dennis, a data science researcher working in the University of Exeter. He used data from 1 million people with Type 2 diabetes to discover how the clinical characteristics of a patient alter the glucose lowering with different treatments. John's 5 drug model, published in the Lancet in late February 2025, uses simple clinical information to identify, for the first time, the best glucose lowering treatment for a patient.  The model selected best treatment lowers the glucose most, doubles  the time before another medication is needed and reduces long term complications of diabetes. See www.1in6b.com for more details. 

    Series 3 Episode 10. Julie Reynolds and Kash Patel. Maternally inherited diabetes and deafness

    Play Episode Listen Later Feb 4, 2025 33:05


    Send us a textJulie Reynolds describes how she gradually lost her hearing in her 30's and developed diabetes in her 40's these 2 conditions also developed in in her mother, her children and other maternal relative. This led to a diagnosis of maternally inherited diabetes and deafness that results from a change in the mitochondrial DNA.  Kash Patel explains the science between diabetes, deafness and a maternal inheritance and why there is a lot of variation in the presence and severity of clinical features

    Series 3 Episode 9. Ru Kovvuri and Rhian Clissold Cognitive and medical impacts of the HNF1B deletion syndrome

    Play Episode Listen Later Jan 21, 2025 37:44


    Send us a textRu Kovvuri explains about her battle to get a diagnosis and support for her daughter who had multiple medical problems and learning difficulties as a result of a deletion of the HNF1B gene. Rhian Clissold discusses her research to improve the diagnosis of the HNF1B syndrome and recognise the associated learning difficulties seen with loss (deletion)  but not the spelling mistakes (mutations) in the HNF1B gene.

    Series 3 episode 8. HNF1Beta syndrome: kidney disease, diabetes, liver dysfunction and much more

    Play Episode Listen Later Jan 7, 2025 48:13


    Send us a textGrant King talks about his diagnostic journey where his low birth weight, childhood kidney disease, diabetes, liver dysfunction and infertility were at 32 years finally recognised as all being due to a change in the HNF1Beta gene. Dr Coralie Bingham explains how her research during her PhD in Exeter led to HNF1Beta being established as the commonest cause of inherited kidney disease and all the key parts of the HNF1Beta syndrome being recognised.

    Series 3 episode 7. Natalie Raphael and Alice Hughes Testing fetal genetics using mum's blood in Glucokinase pregnancy

    Play Episode Listen Later Dec 24, 2024 37:05


    Send us a textNatalie Raphael was diagnosed as having glucokinase MODY at the end of her first pregnancy. In her second pregnancy she had a recently introduced blood test that showed her fetus had not inherited her change in the glucokinase gene so was at risk of growing large. As a result of this she was given long-acting insulin to lower her glucose.  Alice Hughes is the researcher who did the key study that proved the new blood test was both practical and accurate in glucokinase pregnancy.

    Series 3 episode 6. Gill Preston, Gill Spyer, and Ali Chakera The challenge of diagnosing and managing glucokinase MODY in pregnancy

    Play Episode Listen Later Dec 10, 2024 37:38


    Send us a textIt was a great surprise for Gill Preston, who was active and slim, when she was diagnosed with gestational diabetes in her first pregnancy. Her raised fasting glucose did not come down with tablets or insulin. Luckily she met Andrew Hattersley in the diabetes pregnancy clinic, who recognised she had glucokinase MODY. Gill Spyer, working for her PhD as a research doctor showed that in glucokinase pregnancy the size of the baby depended on whether they inherited the genetic change from the mother and was not altered by insulin treatment. When the baby had the mutation it would grow normally and no treatment of the mother was needed. Ali Chakera continued research into glucokinase pregnancy; his research showed that slim women ( BMI

    Series 3 episode 5. Andrew Lotery and Amanda Stride: Glucokinase MODY – a mildly raised fasting glucose for life that should not be treated

    Play Episode Listen Later Nov 26, 2024 32:38 Transcription Available


    Send us a textIn this episode we talk to Andrew Lotery about how he was found to have a raised fasting glucose on an insurance medical. He was treated as Type 2 diabetes but he questioned this as he was young. slim and physically fit. A chance reading of a research funder's newsletter led him to the Exeter team and a diagnosis of glucokinase MODY.  Amanda Stride worked as a research registrar in Exeter.  She showed that in glucokinase MODY the fasting glucose was raised from birth and remained stable and regulated throughout life with treatment not changing the blood glucose. Anna Steele showed in her PhD that patients with glucokinase MODY did not get complications affecting the eye or kidney even after 50 years of raised glucose.  So in glucokinase MODY treatment with insulin or tablets is not needed and does not work; patients should be discharged and not followed up.

    Series 3 episode 4. Janette and Alice: Big babies with dangerously low blood sugars in HNF4A MODY

    Play Episode Listen Later Nov 12, 2024 33:54


    Send us a textIn this episode we talk to Janette and her daughter Alice who were both correctly diagnosed with HNF4A MODY having been initially told they had Type 1 diabetes. The diagnosis not only allowed them to stop insulin but also explained the mystery of two of Jeanette's children that were born as large babies and collapsed soon after birth with low blood sugar. Andrew explains how it was discovered that babies that inherited the HNF4A genetic change were on average over 800g heavier and were at high risk of low blood glucose around birth

    Series 3 episode 3. Mary Lee and Ewan Pearson: Finding the best treatment for HNF1A MODY

    Play Episode Listen Later Oct 29, 2024 27:48


    Send us a textMary Lee was thought to have Type 1 diabetes for over 3 decades; she was finally diagnosed with HNF1A MODY and was able to stop her insulin injections and get excellent blood sugar control with a sulphonylurea tablet.  We hear from Ewan Pearson how sulphonylurea tablets were found to be excellent glucose lowering treatment when Andrew's clinical observations of his HNF1A MODY patients were followed up by Ewan with a clinical trial.

    Series 3 episode 2. Kevin Colclough and Bev Shields Making sure the right patients get the right genetic test for MODY

    Play Episode Listen Later Oct 15, 2024 26:25 Transcription Available


    Send us a textKevin Colclough describes how the genetic testing in diabetes has improved over the 2 decades he has worked in the Exeter NHS diagnostic lab.  His work means now over 60 types of single gene diabetes are looked for in one sequencing test. Bev Shields talks about how she developed the amazing MODY calculator that uses common clinical characteristics to work out how likely a person with diabetes is to have maturity onset diabetes of the young (MODY).

    Series 3 episode 1. Mary Humphries: The doctor didn't listen! A delayed diagnosis of MODY

    Play Episode Listen Later Oct 1, 2024 29:01 Transcription Available


    Send us a textMary Humphries tells how her son Dan was diagnosed with diabetes aged 16 and it was assumed he had type 1 diabetes and treated with insulin.  On insulin he had terrible problems with low blood sugars frequently losing consciousness and not managing to concentrate at school or at home.  Mary was very worried that he was getting worse on the insulin and asked about genetic tests because she had recently been diagnosed with Type 2 diabetes and there was diabetes in all generations of her family.  She was not listened to; the insulin was continued, and Dan got worse.  Searching the internet for answers she found the Exeter diabetesgenes.org website which led her to talking to Andrew and Maggie. They were able to rapidly diagnose that this was Maturity-onset Diabetes of the Young (MODY), subtype HNF1A . with a genetic test.   Maggie  helped Dan to stop his insulin and get excellent control on a quarter of the sulphonylurea tablet called gliclazide.  Dan rapidly improved off the insulin and passed his A levels with flying colours going to Bristol where he achieved his life's ambition to become a large animal vet.  

    Series 2 episode 9. Nick Thomas. Type 1 diabetes in the older adult

    Play Episode Listen Later Sep 17, 2024 24:04


    Send us a textDr Nick Thomas talks about Type 1 diabetes in the older adult. In an iconoclastic study he showed most cases of Type 1 diabetes occur in adults rather than children. In older adults it is very hard to recognise as 98-99% of people with diabetes have Type 2 diabetes. Older adults with Type 1 diabetes have just as rapid a decline in their own insulin and need all the expert care offered to children. 

    Series 2 episode 8. Simon Goode and Angus Jones. Diagnosing Type 1 diabetes is difficult in older adults

    Play Episode Listen Later Sep 3, 2024 38:57 Transcription Available


    Send us a textSimon Goode was diagnosed with Type 2 diabetes aged 28.  He explains how it took 6 months of feeling unwell before it was realised he had Type 1 diabetes instead. Exeter Professor, Angus Jones, has done research showing that mistakes in the diagnosis Type of 1 diabetes are common in the older adult and offers solutions to help doctors get the diagnosis right. 

    Series 2 Episode 7. Jean Claude Katte. Type 1 Diabetes in Africa: different in so many ways.

    Play Episode Listen Later Aug 20, 2024 35:45 Transcription Available


    Send us a Text Message.Dr Jean Claude Katte explains how in Sub Saharan Africa diagnosis, treatment and monitoring of Type 1 diabetes in children and young adults is so much harder than in Europe.  He discusses with Maggie and Andrew his own exciting research that has shown that around 60% of African children with diabetes do not have the typical autoimmune Type 1 diabetes seen in over 90% of children with diabetes in Europe. Jean Claude aims to do more research to discover what causes this new cause of severe young-onset diabetes in Sub Saharan Africa.

    Series 2 episode 6. Mendy Korer and Matt Johnson. Type 1 diabetes in very young children: a massive challenge for families and scientists

    Play Episode Listen Later Aug 6, 2024 47:35 Transcription Available


    We hear from Mendy Korer about the enormous challenges of living with a child who was diagnosed with Type 1 diabetes aged 11 months. Matt Johnson, a research fellow in Exeter talks about his exciting work understanding what makes the immune system destroy the insulin making beta-cells in very young children. 

    Series 2 Episode 5 Richard Oram – genius genetics improves diagnosis and prevention of Type 1 diabetes

    Play Episode Listen Later Jul 23, 2024 29:58


    Professor Richard Oram had the innovative idea of turning complex analysis of the genetic changes  into a single number that estimate the likelihood of developing Type 1 diabetes. He explains to Andrew and Maggie how this has helped diagnosis of Type 1 diabetes and is being used around the world in studies aiming to prevent or delay diabetes in children.

    Series 2 Episode 4. Partha Kar – the super hero who made sure Type 1 diabetes technology was for everyone

    Play Episode Listen Later Jul 9, 2024 40:51


    Contact the showProfessor Partha Kar has made sure the technical advances in measuring blood sugar are available to everyone living with Type 1 diabetes in the UK.  Partha had to overcame massive hurdles to make sure the technology was not just available to a privileged few. He discusses with Maggie and Andrew his inspirational leadership style and philosophy that have helped him to move mountains in the NHS.Vote for One in Six Billion in the British Podcast Awards: https://www.britishpodcastawards.com/voting

    Series 2 Episode 3. Jean Dudderidge and Jill Epton. Living with Type 1 diabetes for over 50 years.

    Play Episode Listen Later Jun 25, 2024 33:06


    Contact the showJean Dudderidge and Jill Epton talk about what it has been like to live with Type 1 diabetes for over 50 years. They discuss the massive advances in the measurement of blood sugar over the decades and how they now benefit greatly from continuous glucose monitoring.

    Series 2 Episode 2. Moira Murphy and Mark McCarthy. Defining the genetic susceptibility to Type 2 diabetes

    Play Episode Listen Later Jun 11, 2024 45:01


    Contact the showMoira Murphy and Mark McCarthy talk about how a unified UK team of scientists came to be world leaders in decoding the genetic susceptibility to Type 2 diabetes.

    Series 2 Episode 1. Tim Frayling and Rachel Freathy. Finding the Fat gene

    Play Episode Listen Later May 28, 2024 24:52


    Contact the showWe talk to Tim Frayling and Rachel Freathy about how they discovered the “Fat gene”.  Working with Oxford, the Exeter team showed a genetic change near FTO predisposed to obesity. This was the first and largest common genetic change altering weight. 

    Special episode 4. Tim Frayling – From PhD student to internationally famous polygenic team leader

    Play Episode Listen Later May 14, 2024 31:45


    Contact the showIn this special episode, we hear from Professor Tim Frayling who was Andrew and Sian's first PhD student in 1995. He rapidly became the head of the analysis for the genetic susceptibility for Type 2 diabetes.  His leadership has made Exeter an international leader in polygenic trait genetics.

    Special episode 3. Sian Ellard – establishing a world leading genetics lab from scratch

    Play Episode Listen Later Apr 30, 2024 42:30


    In this special episode, we hear from Professor Sian Ellard who, like Andrew and Maggie, started in Exeter in 1995.  Sian set up the Exeter molecular genetics laboratory from scratch.  Through Sian's leadership, this laboratory became world leading for both research and NHS diagnostic testing.

    Episode 10: Imran Bashir and Elisa De Franco –the epic human and scientific journeys after a girl was born without a pancreas

    Play Episode Listen Later Apr 16, 2024 46:42


    In this episode, Maggie and Andrew talk to Imran Bashir about the difficult journey he and his family have been on since his daughter was born without a pancreas.  They also hear from star scientist Dr Elisa De Franco about the long and challenging scientific journey to solve the genetic mystery of why her pancreas did not develop.

    Episode 9: Elisa De Franco –the world leading gene discoverer

    Play Episode Listen Later Apr 2, 2024 27:40


    In this episode, Maggie and Andrew talk to Dr Elisa De Franco, the Exeter based genetic scientist whose research has discovered more genetic causes of diabetes than anyone else in the world.

    Special episode 2: Maggie Shepherd - The journey to a career in Diabetes Research

    Play Episode Listen Later Mar 19, 2024 27:26


    In this special episode Andrew Hattersley talks with co-presenter Maggie Shepherd to identify what led to her joining the Exeter team in 1995 and ending up becoming the leading nurse for monogenic diabetes with a role combining clinical care, research and education 

    Episode 8: Carsyn Underwood, Karla Underwood, Donna Taylor and Tim McDonald. Early correct treatment is excellent! How can we treat everyone early?

    Play Episode Listen Later Mar 5, 2024 43:56


    In this episode, Maggie and Andrew start by talking to Carsyn Underwood and her mums Karla and Donna about Carsyn's diagnosis of neonatal diabetes and how she got the right treatment very early and had an the excellent outcome as a result,.  They go on to talk to Professor Tim McDonald, a top NHS laboratory scientist, who has been researching into how we can make sure everyone is diagnosed early by developing universal screening for neonatal diabetes in the first week of life.

    Episode 7: Pam Bowman – writing the next chapter in neonatal diabetes

    Play Episode Listen Later Feb 20, 2024 24:49


    In this episode, Maggie and Andrew talk to Dr Pam Bowman, the doctor scientist, whose research has greatly advanced our understanding of neonatal diabetes. Pam showed treatment with sulphonylurea tablets control the glucose excellently in the long term and she transformed our understanding of how thinking, and development are altered by the change in the potassium channel gene.

    Episode 6: Dame Francis Ashcroft – scientist extraordinaire!

    Play Episode Listen Later Feb 6, 2024 38:37


    In this episode Maggie and Andrew talk to Dame Francis Ashcroft the remarkable Oxford scientist who has dedicated her life to understanding the key role of potassium channel in insulin secretion by the pancreatic beta-cell.  Her work was crucial both before and after the Exeter genetic discovery in neonatal diabetes

    Episode 5: Laurie and Mike Jaffe: Spreading the word (USA)

    Play Episode Listen Later Jan 23, 2024 27:15


    In this episode, we hear from Laurie and Mike Jaffe from Chicago, USA.  They spread the word about neonatal diabetes to over 100M people around the world by an inspirational media campaign focused on their daughter, Lilly and how the diagnosis and resulting treatment change transformed her life. 

    Episode 4: Agnes Graja & Helen John – spreading the word (UK)

    Play Episode Listen Later Jan 9, 2024 32:05


    In this episode we hear from Agnes Graja and Helen John, two of the national team of Genetic Diabetes Nurses that spread the news about neonatal diabetes across the UK. They identified and improved treatment in insulin-treated adults who had been diagnosed with diabetes in the first 6 months of life.

    Special episode 1 : Andrew Hattersley - The journey to a career in Diabetes Research

    Play Episode Listen Later Dec 26, 2023 34:11


    In this special episode Maggie Shepherd talks with co-presenter Andrew Hattersley exploring what led to him ending up as a research scientist and diabetes consultant in Exeter in 1995.  They go back into how he became a doctor and what took him into research including surprising revelations about a transformative time in Africa as an 18-year-old!  

    Episode three: Ewan Pearson - an unexpected and remarkable treatment

    Play Episode Listen Later Dec 12, 2023 36:25


    In this episode we hear about how sulphonylurea tablets were discovered to be an unexpected. and remarkably effective, new treatment for neonatal diabetes.  Maggie and Andrew talk to Professor Ewan Pearson, the  doctor scientist, who worked with doctors around the world to prove how good this treatment was and how it worked. More on www.1in6b.com

    Episode two: Anna Gloyn - the gene detective

    Play Episode Listen Later Nov 28, 2023 37:14


    In this episode Maggie and Andrew talk to Anna Gloyn, the  scientist who discovered the gene that was altered when very young babies were diagnosed with neonatal diabetes.  

    Episode one: Jack - a life transformed

    Play Episode Listen Later Nov 13, 2023 58:20


    In this episode Andrew and Maggie are joined by Emma Matthews. Emma talks about her son Jack who was diagnosed with diabetes when 2 weeks old. Jack's life was transformed when a genetic cause was found for his diabetes.

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