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The University of Southampton
Medicine
Phone:
(023) 8120 4665
Email:
R.I.G.Holt@soton.ac.uk

Professor Richard Holt MA, MB, BChir, PhD, FRCP, FHEA

Professor in Diabetes and Endocrinology, Honorary Consultant Physician

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Professor Richard Holt is Professor in Diabetes and Endocrinology within Medicine at the University of Southampton.

Richard Holt trained at the University of Cambridge and the London Hospital Medical College. He undertook his post-graduate training in diabetes and endocrinology in the South East Thames Region. While a Medical Research Council Clinical Training Fellow, he completed a PhD on the growth hormone – insulin-like growth factor axis in childhood liver disease. He was appointed as Senior Lecturer in Endocrinology & Metabolism at the University of Southampton in May 2000, was promoted to Reader in March 2006 and became Professor in Diabetes and Endocrinology in September 2008.

Richard’s current research interests are broadly focussed around clinical diabetes and endocrinology. These encompass studies of the relationship between mental illness on diabetes and the psychosocial aspects of diabetes. Richard also has interests in the physiology of GH and has worked to develop a test for GH abuse in sport.

Richard’s clinical responsibilities include the diabetes and pregnancy clinic, young adult diabetes clinic and the cystic fibrosis related diabetes service. He is the past Chair of the Council of Health Care Professionals of Diabetes UK.

Qualifications

1983-1986 St Catharine's College, Cambridge University MA, MB BChir
1986-1989 The London Hospital Medical College
1992 The Royal College of Physician MRCP
1994-1998 King's College School of Medicine & Dentistry PhD
2006 The Royal College of Physician FRCP
2007 Higher Education Academy FHEA 

Appointments Held

Current appointment

Sept 08 - present Professor in Diabetes and Endocrinology
University of Southampton

May 00 - present Honorary Consultant Physician
Southampton University Hospitals Trust

Previous appointments

Aug 89 - Jan 90 House Physician
The Royal London Hospital, Whitechapel

Feb 90 - Jul 90 House Surgeon
Oldchurch Hospital, Romford, Essex

Sept 90 - Sept 92 Medical SHO rotation
The Royal London Hospital, Whitechapel

Sept 90 - Nov 90 SHO in Genito-urinary Medicine

Dec 90 - Feb 91 SHO in Accident and Emergency

Mar 91 - May 91 SHO in General Medicine

Jun 91 - Aug 91 SHO in the Care of the Elderly

Sept 91 - Feb 92 SHO in Nephrology

Mar 92 - Sept 92 SHO in General Medicine Harold Wood Hospital, Essex

Oct 92 - Sept 94 SE Thames Registrar rotation in General Medicine,
Endocrinology and Diabetes

Oct 92 - May 93 Medical Registrar
Thanet District Hospital, Margate, Kent

Jun 93 - Jan 94 Registrar in Medicine and Endocrinology
Professorial Dept of Medicine, King's College Hospital, London

Feb 94 - Sep 94 Registrar in Medicine and Diabetes
King's College Hospital, London

Oct 94 - Mar 98 Medical Research Council Clinical Training Fellow
King's College School of Medicine and Dentistry, London

Honorary Senior Registrar in General Medicine, Endocrinology and Diabetes
Dept of Medicine, King's College Hospital, London

Apr 98 - Mar 99 Senior Registrar in General Medicine, Endocrinology and Diabetes
Eastbourne District General Hospital, Eastbourne

Apr 99 – Apr 00 Lecturer in Diabetes and Endocrinology
Guy's, King's & St Thomas' School of Medicine
King's College, London

Honorary Specialist Registrar
Guy’s & St Thomas's Hospitals

May 00 – Feb 06 Senior Lecturer in Endocrinology and Metabolism
University of Southampton

Feb 06 – Aug 08 Reader of Endocrinology and Metabolism
University of Southampton

Research interests

I am a clinical researcher and am driven by the need to research clinical problems in the area of diabetes and endocrinology with the aim of translating these research findings into improved clinical care for my patients. Since I arrived in Southampton, I have attracted over £13 million in research funding.

My current research interests are broadly focussed around two main areas, the physical health problems of those with mental illness and growth hormone misuse in sport. I have also recently obtained a further NIHR grant as chief investigator in a new research area to develop and test a pre-admission intervention to improve the outcomes of people with diabetes listed for surgery.

I am a clinical researcher and am driven by the need to research clinical problems in the area of diabetes and endocrinology with the aim of translating these research findings into improved clinical care for my patients. Since I arrived in Southampton, I have attracted over £13 million in research funding.

My current research interests are broadly focussed around two main areas, the physical health problems of those with mental illness and growth hormone misuse in sport. I have also recently obtained a further NIHR grant as chief investigator in a new research area to develop and test a pre-admission intervention to improve the outcomes of people with diabetes listed for surgery.

Diabetes and Mental Illness

My first area of interest encompasses studies of the effects of severe mental illness on diabetes and cardiovascular disease. This area is in keeping with the research strategy for Human Development and Health but I have also formed successful collaborations with other divisions within the Faculty of Medicine and outside Southampton.  I have become a world expert on the subject of severe mental illness and diabetes and have been asked to lecture internationally on this subject, at both major diabetes and psychiatric conferences. I have applied my research to the development of pragmatic guidelines for the management of diabetes risk in people with severe mental illness.

STEPWISE (Structured lifestyle Education for People With SchizophrEnia) trial

My biggest success in this area was the award of a NIHR HTA grant (£1.93 million) in 2013 to adapt the successful DESMOND programme for people with schizophrenia to help them address the problem of weight. I was the chief investigator of this multicentre study. It was hosted by the University of Sheffield Clinical Trials Unit and has involved monthly visits to Sheffield for trial management meetings. The trial recruited to target (414/396) in 12 months (15 months allowed in the original grant application) and maintained a retention rate of >80%. Unfortunately, the intervention was not successful in promoting weight loss. The results were presented at the World Psychiatric Conference in Berlin in September 2017 and the results paper is under review at the British Journal of Psychiatry.

Prediction and Management of cardiovascular risk for people with severe mental illness  (PRIMROSE) study

The PRIMROSE project is a recently completed a five year programme of research funded by the NIHR Programme Grants for Applied Research (RP-PG-0609-10156).  The aim of the project was to improve the detection and management of cardiovascular disease risk in people with severe mental illnesses in primary care. The project designed two new risk models to assess the risk of cardiovascular disease which outperform those used by the general population. We designed a primary care nurse-led intervention to identify and manage cardiovascular disease and tested this in a cluster randomised controlled trial. Although the primary outcome of total cholesterol did not differ between PRIMROSE and treatment-as-usual groups, the intervention was cost effective because it reduced the number of hospital admissions. The results were published in the Lancet Psychiatry

The programme was led by Professor David Osborn and researchers at University College London in partnership with Camden and Islington NHS Foundation Trust and Rethink Mental Illness. Co-investigators are also based at Kings College London, Imperial College London and the University of Southampton (Richard Holt and Rob Peveler).

Diabetes and mental illness: improving outcomes and services (DIAMONDS)

This programme of work is being led by Dr Najma Siddiqi at the University of York. (Dr Siddiqi is a co-investigator in the STEPWISE project). The aim is to improve the healthcare of people with severe mental illness and diabetes. The project has received initial funding from NIHR Programme Development Grant (NIHR PGfAR - RP-DG-1214-10002; £89,000) to undertake an in-depth analysis of people with SMI and diabetes, describing their health status and the care they receive. Following this initial grant, the project has received further funding from the NIHR Global Health Research programme, NIHR Health Services and Delivery Research Programme and Diabetes UK to continue this work (total funding awarded in 2017 = £5.3 million).

The LOSE weight study

I am the chief investigator of the LOSE weight study which is a new 3 year study research to investigate whether Liraglutide 3 mg can support weight loss in people with schizophrenia. This study is hosted by Southern Health NHS Foundation Trust and is funded by Novo Nordisk through an investigator led grant. The study is in set up at present and the day-to-day running will be undertaken by Dr Clare Whicher, SpR in diabetes, who has also registered for a PhD.

Diabetes Attitudes Wishes and Needs (DAWN2) study

In 2001, the Diabetes, Attitudes, Wishes and Needs (DAWN) study showed that self-management of diabetes was considered poor by people with diabetes and healthcare professionals. The resulting ‘DAWN Call to Action’ encouraged multiple stakeholders to implement person-centred diabetes care, and actively involve people with diabetes in self-management with support from an interdisciplinary team of healthcare professionals. The 2nd DAWN study explores how people with diabetes, their family members and healthcare professionals perceive diabetes care and investigates the value of a person-centred model of diabetes care that emphasizes the needs of the individual in the context of current chronic care, self-management education and psychosocial support.

I am a member of the International Publication Planning Committee for the second Diabetes Attitudes Wishes and Needs (DAWN2) study.

Diabetes, depression and employment

It is well recognised that people with diabetes have a higher rate of depression than the general population. Together with researchers at the Steno Diabetes Center in Copenhagen, we have been exploring Danish population registers to assess the risk of depression in people with diabetes of working age compared with the general population and to assess whether there is a social or employment gradient in any effect. To date, three publication have come from this study.

The misuse of growth hormone

The second area of my research builds on my previous work on the growth hormone - insulin-like growth factor axis and has attracted considerable attention from the World Anti-Doping Agency, US Anti-Doping Agency, UK Sport and the UK government, not least in the run-up to the 2012 London Olympic Games. We have received over $3 million funding to develop a test to detect athletes abusing GH or IGF-I. I have acted as an adviser to WADA, USADA and UK Anti-Doping (formerly part of UK Sport). In addition to speaking at in camera meetings, I have spoken on this subject at international sporting and endocrinology conferences.

GH is believed to be widely misused by professional sportsmen and women for its anabolic and lipolytic properties. The detection of exogenously administered GH, however, poses a formidable challenge, as it is identical to that which is produced naturally in the body. We have developed a method based on the measurement of GH-sensitive markers, which rise in response to rhGH in a dose dependent manner. IGF-I and P-III-NP have been identified as the best markers and selected to construct age adjusted formulae that gave good discrimination between those taking GH and those taking placebo. The test was introduced at the London Olympic Games and two powerlifters were subsequently disqualified at the Paralympic Games.

The research is funded by the non-governmental organisations, the World Anti-Doping Agency, the US Anti-Doping Agency and Partnership for Clean Competition.  Our current work has been focussed on the implementation of the test by evaluating further assays, including non-radio-isotopic assays.

OCTOPuS Study

This is a new study funded by the NIHR HTA programme to evaluate whether a diabetes specialist nurse led intervention at the time of listing for cardiac surgery can reduce length of stay and operative complications. This study has three phases. The first phase is to develop the intervention based on an intervention currently running in Bournemouth. The intervention will then be piloted before being tested in a multicentre trial across the UK. I am the chief investigator of this study.

 

Department(s)

Human Development and Health

Affiliate Department(s)

Human Development and Physiology

Editorial Work

I am currently the Editor-in-Chief of for Diabetic Medicine, having previously served as the European Regional Editor and Associate Editor.

I was the reviews editor of Diabetes, Obesity & Metabolism from 2007-2015 and prior to that from January 2003 – August 2007, I was the news & views editor. I the reproductive endocrinology editor for Current Medical Literature in Endocrinology between May 2003 and January 2003.

OTHER POSITIONS

I am the immediate post-Chair of Council of Healthcare Professionals of Diabetes UK, having previously served as the Chair of the Programme Organising Committee for the Diabetes UK Annual Professional Conference in Glasgow 2005. I was also Vice-Chair of the Diabetes UK Science and Research Group, as well as a member of the Diabetes UK Research Committee. Since my term as Chair of Council of Healthcare Professionals ended in December 2011, I have continued to work with Diabetes UK as a member of the Governance Committee until December 2015.

I was a member of the conference organising committee for the annual meeting of the European Association for the Study of Diabetes in Amsterdam 2007, in Rome 2008 and Lisbon 2011 and Munich 2016. I represented the EASD on the collaborative European Psychiatry Association/ EASD/ European Society of Cardiology working group. I am currently the programme lead for the EFSD Servier INTENSE programme. I am a faculty member of the EASD postgraduate training programmes and have lectured in Poland, Kazakhstan, Azerbaijan, Jordan, UAE, Bulgaria, Oman and Albania. I have represented the EASD at the Korean Diabetes Association meeting (2016) and the Cardiovascular Society of India CAD meeting in Mumbai (2017). I am a member of the EASD Committee on Clinical Affairs.

I was a member of the 2008 NICE guideline development group for Diabetes and Pregnancy and a member of the NICE programme development group for the prevention of diabetes. I am a member of the National Pregnancy in Diabetes Audit Steering Group.

I was the trial steering committee chair of the REPOSE study based in Sheffield and the HEELS and Leucopatch II studies based in Nottingham.

I am a member of the NIHR HTA Women and Children’s Health panel.

I was an expert witness for Dutee Chand and Caster Semenya during their hearings at the Court for Arbitration in Sport

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Book Chapters

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Reviews

Working Paper

I am involved in teaching 2nd to 5th year students both in formal lectures and in clinical situations. I sit on the MSc in Diabetes steering committee and the BM5 Research for Medicine and Health module. I am an academic tutor to 8 students. I have supervised 4 MD theses and 3 PhD thesis to completion. I am currently supervising two medically qualified PhD students. I am a Faculty of Medicine Fitness-to-Practise investigator.

I was responsible for setting up the Diabetes UK Innovators in Diabetes programme, which is designed to bring together a network of young UK scientists to drive forward diabetes research in the UK and increase commitment to this specialty.

I have acted as an internal examiner for all years of the undergraduate medical curriculum and was previously an external examiner the University of Bristol and Brighton Medical. I am currently an external examiner for the University of Newcastle.

I have acted as an internal MD/PhD examiner and external examiner for the Universities of Nottingham, London, Surrey, and Manchester for an MD thesis and for the Universities of Ulster, Manchester, Brighton, East Anglia, Tilburg, Copenhagen and Perth (Western Australia) for a PhD thesis.

Clare Whicher: Liraglutide and the management of overweight and obesity in people with schizophrenia: a pilot study. Supervisors: Richard Holt, Hermione Price, Shanaya Rathod. The study is funded through an Investigator led grant by Novo Nordisk Ltd. The work was also partly supported by the National Institute of Health Research (NIHR) Research Capability Funding allocation to Southern Health NHS Foundation Trust (supporting the Clinical Research Fellow CW).
 

Sarah Brewster. A community pharmacy delivered intervention to improve attendance at the diabetes annual review in people living with diabetes traditionally thought of as “hardly reached”. Supervisors: Richard Holt, Hermione Price. The work is partly funded by the National Institute of Health Research (NIHR) Research Capability Funding allocation to Southern Health NHS Foundation Trust (supporting the Clinical Research Fellow SB)

Professor Richard Holt
Professor in Diabetes & Endocrinology Human Development and Health Academic Unit Faculty of Medicine University of Southampton The Institute of Developmental Sciences (IDS Building) MP887 University of Southampton Southampton General Hospital Tremona Road Southampton SO16 6YD UK

Room Number: SGH/DC015/MP887

Telephone:(023) 8120 4665
Facsimile:(023) 8120 5255
Email:R.I.G.Holt@soton.ac.uk

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