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Dr Richard Oram

Dr Richard Oram

Harry Keen Fellow and Clinical Senior Lecturer

+44 (0) 1392 406819

NIHR Exeter Clinical Research Facility 

Richard is a Diabetes UK Harry Keen Fellow and Senior Clinical Lecturer specializing in nephology, diabetes and transplantation at the NIHR Exeter Clinical Research Facility. Richard finished his Diabetes UK funded PhD in 2014. He studies endogenous insulin production in people with type 1 diabetes. Using a new method developed by the NIHR Exeter team (urine C-peptide creatinine ratio), and using patients recruited as part of the Wellcome funded UNITED study, he studied endogenous insulin production in 1500 patients with type 1 diabetes and showed that most people with type 1 diabetes still make small amounts of their own insulin. He is now an Investigator on the JDRF funded TIGI study to look at mechanisms of persistent C-peptide secretion in Type 1 diabetes.

Working with Mike Weedon he has developed a cheap simple method to assess genetic risk in type 1 diabetes – The T1D genetic risk score (T1D GRS). He has shown this can be used as a diagnostic test to differentiate type 1 and type 2 diabetes, and with Kash Patel has shown it can be used to identify monogenic diabetes. Recently Diabetes UK awarded Mike Weedon a project grant to further translate the T1D GRS into a tool that could be used in routine clinical care. With MIke Weedon, Bill Hagopian and the NIH funded SEARCH study, Richard is working of uses of the T1D GRS in the US population. The recent Harry Keen Career Development award and a Helmsley Foundation Breakthrough Grant funds him to study the causes of a rare subtype of type 1 diabetes - those who are diagnosed under the age of 1 year. 

Richard spent a period of his training at the University of Alberta with the world leading clinical islet transplant renal transplant programs. During this time he performed analysis of complications related to immunosuppression post-islet transplantation, and with Peter Senior and Shareen Forbes developed a new method to assess graft function - The Beta2 Score.

Qualifications

PhD, BMBCh, BA(hons), MRCP

Research

Research interests

Endogenous insulin production in Type 1 diabetes

Genetic, Clinical and Immune associations of preserved C-peptide in Type 1 Diabetes
Transplantation for Type 1 diabetes
The Renal Cysts and Diabetes Syndrome

Research projects


• The UNITED study (Wellcome/NIHR funded) - Using Pharmacogenetics to Improve Treatment in Early-onset Diabetes
• The ‘Biomedical and Psychosocial Outcomes of Islet Transplantation’ research study - Using Urine C-peptide creatinine ratio as a novel tool to monitor islet transplant recipients.
• Type 1 Diabetes, Immunology, Genetics and endogenous Insulin production (TIGI) JDRF funded - Assessing genetic and immunological predictors of endogenous insulin production in Type 1 diabetes
 

Grants/Funding

 

The Helmsley Foundation 2016-2017. Understanding beta-cell destruction through the study of EXtremely Early-Onset Autoimmune Diabetes (EXE-T1D). (PI 267,700)

Diabetes UK 2016-2019. Developing a type 1 diabetes genetic risk score to get the right diagnosis and the right treatment for patients with diabetes (Co I 241, 113)

JDRF 2014-2017 - TIGI  predictors of preserved C-peptide in T1D (CI Hattersley, PIs Oram, McDonald, Tree, Roep) $1.1m

Diabetes UK - Clinincal Training Fellowship 2011-2014 (180k)

Alberta Health Services Transplant Fellowship 2014-2015 (50k)

AHS Seed Grant - Towards better diagnosis in Celiac Disease (CA$ 15k)

 

 

 

•DUK Clinical Training Fellowship

Research grants

  • 2015 Helmsley Foundation
    A pilot study to investigate mechanisms of extremely early onset T1D
  • 2014 Juvenile Diabetes Research Foundation
    This is a study the investigates the mechanisms of persistent C-peptide in Type 1 Diabetes
  • 0 Diabetes UK
    This is a study of the mechanisms that lead to children presenting with autoimmune type 1 diabetes in the first year of life, before the immune system has fully developed.

Key publications | Publications by category | Publications by year

Publications by category


Journal articles

Hope S, Wienand-Barnett S, Shepherd M, King S, Fox C, Khunti K, Oram R, Knight B, Hattersley A, Jones A, et al (In Press). Assessment of Practical Classification Guidelines for Diabetes in insulin-treated patients. British Journal of General Practice Full text.
Oram RA, Patel K, Hill A, Shields B, McDonald TJ, Jones A, Hattersley AT, Weedon MN (2016). A Type 1 Diabetes Genetic Risk Score can Aid Discrimination Between Type 1 and Type 2 Diabetes in Young Adults. Diabetes Care, 39(3), 337-344. Abstract.  Author URL.  Full text.
Patel KA, Oram RA, Mcdonald TJ, Hudson M, Colclough K, Ellard S, Weedon MN, Pearson EZ, Hattersley AT (2016). Classifying the unclassified using Type 1 diabetes genetic risk score: patients with young onset diabetes who are islet autoantibody negative and have preserved c-peptide. DIABETIC MEDICINE, 33, 188-189. Author URL.
Shepherd M, Shields B, Hammersley S, Hudson M, McDonald TJ, Colclough K, Oram RA, Knight B, Hyde C, Cox J, et al (2016). Systematic Population Screening, Using Biomarkers and Genetic Testing, Identifies 2.5% of the U.K. Pediatric Diabetes Population with Monogenic Diabetes. Diabetes Care, 39(11), 1879-1888. Abstract.  Author URL.  Full text.
Patel KA, Oram RA, Flanagan SE, De Franco E, Colclough K, Shepherd M, Ellard S, Weedon MN, Hattersley AT (2016). Type 1 Diabetes Genetic Risk Score: a Novel Tool to Discriminate Monogenic and Type 1 Diabetes. Diabetes, 65(7), 2094-2099. Full text.
McDonald TJ, Oram RA, Vaidya B (2015). Investigating hyperkalaemia in adults. BMJ, 351 Author URL.
Oram RA, McDonald TJ, Shields BM, Hudson MM, Shepherd MH, Hammersley S, Pearson ER, Hattersley AT, UNITED Team (2015). Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors. Diabetes Care, 38(2), 323-328. Abstract.  Author URL.  Full text.
McDonald TJ, Oram RA, Vaidya B (2015). RATIONAL TESTING Investigating hyperkalaemia in adults. BMJ-BRITISH MEDICAL JOURNAL, 351 Author URL.
Patel KA, Weedon MN, Ellard S, Hattersley AT, Oram RA (2015). Type 1 diabetes genetic risk score: a novel tool to differentiate monogenic diabetes from Type 1 diabetes. DIABETIC MEDICINE, 32, 21-22. Author URL.
Oram RA, Jones AG, Besser RE, Knight BA, Shields BM, Brown RJ, Hattersley AT, McDonald TJ (2014). Erratum to: the majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells. Diabetologia, 57(1). Author URL.
Oram RA, Brooks AM, Forbes S, Eckoldt S, Smith RM, Choudhary P, Rosenthal MJ, Johnson P, Rutter MK, Burling KA, et al (2014). Home urine C-peptide creatinine ratio can be used to monitor islet transplant function. Diabetes Care, 37(6), 1737-1740. Abstract.  Author URL.
Hamilton AJ, Bingham C, McDonald TJ, Cook PR, Caswell RC, Weedon MN, Oram RA, Shields BM, Shepherd M, Inward CD, et al (2014). The HNF4A R76W mutation causes atypical dominant Fanconi syndrome in addition to a β cell phenotype. J Med Genet, 51(3), 165-169. Abstract.  Author URL.  Full text.
Oram RA, Jones AG, Besser REJ, Knight BA, Shields BM, Brown RJ, Hattersley AT, McDonald TJ (2014). The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells. Diabetologia, 57(1), 187-191. Abstract.
Oram RA, McDonald TJ, Vaidya B (2014). [In Process Citation]. Praxis (Bern 1994), 103(6), 341-345. Author URL.
Edghill EL, Stals K, Oram RA, Shepherd MH, Hattersley AT, Ellard S (2013). HNF1B deletions in patients with young-onset diabetes but no known renal disease. Diabet Med, 30(1), 114-117. Abstract.  Author URL.
Oram RA, McDonald TJ, Vaidya B (2013). Investigating hypokalaemia. BMJ, 347 Author URL.
Eininger AK, Oram RA, Friend PJ, Asderakis A, Winearls CG, Hattersley AT, Owen KR (2013). Simultaneous pancreas and kidney transplantation (SPK) should be indicated for patients with maturity-onset diabetes of the young (MODY) and end-stage nephropathy. DIABETIC MEDICINE, 30, 92-93. Author URL.
Oram RA, Rawlingson A, Shields BM, Bingham C, Besser REJ, McDonald TJ, Knight BA, Hattersley AT (2013). Urine C-peptide creatinine ratio can be used to assess insulin resistance and insulin production in people without diabetes: an observational study. BMJ Open, 3(12). Abstract.  Author URL.
Oram RA, Brooks AMS, Smith R, Rutter MK, Johnson PR, Choudhary P, Rosenthal M, Forbes S, McDonald TJ, Hattersley AT, et al (2013). Urine c-peptide creatinine ratio can be used for home monitoring of islet transplant function. DIABETIC MEDICINE, 30, 87-87. Author URL.
Jones AG, Besser REJ, McDonald TJ, Shields BM, Hope SV, Bowman P, Oram RA, Knight BA, Hattersley AT (2011). Urine C-peptide creatinine ratio is an alternative to stimulated serum C-peptide measurement in late-onset, insulin-treated diabetes. Diabet Med, 28(9), 1034-1038. Abstract.  Author URL.
Oram RA, Edghill EL, Blackman J, Taylor MJO, Kay T, Flanagan SE, Ismail-Pratt I, Creighton SM, Ellard S, Hattersley AT, et al (2010). Mutations in the hepatocyte nuclear factor-1β (HNF1B) gene are common with combined uterine and renal malformations but are not found with isolated uterine malformations. Am J Obstet Gynecol, 203(4), 364.e1-364.e5. Abstract.  Author URL.
Oram RA, Edghill EL, Adalat S, Bockenhauer D, Ellard S, Woolf AS, Bingham C (2009). HNF1B MUTATIONS: REVIEW OF 109 AFFECTED PROBANDS. PEDIATRIC NEPHROLOGY, 24(9), 1804-1804. Author URL.
Oram RA, Edghill EL, Woolf AS, Hennekam RC, Ellard S, Hattersley AT, Bingham C (2009). RET gene mutations are not a common cause of congenital solitary functioning kidney in adults. NDT Plus, 2(2), 183-184.
Edghill EL, Oram RA, Owens M, Stals KL, Harries LW, Hattersley AT, Ellard S, Bingham C (2008). Hepatocyte nuclear factor-1beta gene deletions--a common cause of renal disease. Nephrol Dial Transplant, 23(2), 627-635. Abstract.  Author URL.

Conferences

Oram RA, Hammersley S, Hill A, Shields B, Hattersley A, McDonald T (2016). Longitudinal study of extremely low c-peptide: evidence for persistent beta cells in all people with Type 1 diabetes.  Author URL.
Oram RA, McDonald TJ, Shields BM, Pearson ER, Hattersley AT, Team UNITEDR (2014). A large, population-based study demonstrates that most people with long duration Type 1 diabetes are insulin microsecretors and produce their own endogenous insulin.  Author URL.
Hope SV, Taylor PJ, Shields BM, Oram RA, Chakera AJ, Strain WD, Hattersley AT (2014). Non-specific symptoms associated with hypoglycaemia in the elderly are common in patients treated with metformin only, as well as those treated with insulin or sulphonylureas.  Author URL.
So K, Bewshea CM, Heap GA, Muller AF, Delaney MP, Daneshmend TK, Hart AL, Orchard TR, Irving PM, D'Souza R, et al (2013). 5-Aminosalicylate (5-ASA) Induced Nephrotoxicity in Inflammatory Bowel Disease.  Author URL.
Hudson MM, Shepherd M, Oram RA, McDonald TJ, Ellard S, Shields BM, Hattersley AT, Team UR (2013). A population-based approach to genetic testing defines the prevalence of maturity onset diabetes of the young (MODY) in patients with diabetes diagnosed under 30 years as 3%.  Author URL.
Oram RA, McDonald TJ, Jones AG, Besser REJ, Hattersley AT (2013). The majority of patients with over five years of Type 1 diabetes are insulin microsecretors and have functioning beta cells.  Author URL.
Sanders T, Oram RA, Shepherd M, Pearson ER, MacDonald TJ, Ellard S, Shields BM, Hattersley AT, Team UNITEDR (2013). Time to reconsider? Reassessment of diagnosis in long duration Type 1 diabetes with urinary C-peptide creatinine ratio and antibodies identifies people with alternate diagnoses.  Author URL.
Oram RA, Shepherd MH, Hudson M, Sanders T, Tiley S, Hammersley S, Shields B, McDonald TJ, Knight BA, Besser REJ, et al (2012). The prevalence of endogenous insulin production in a cohort of adults with type 1 diabetes.  Author URL.
Sansbury FH, Bromilow G, Bingham C, Powell R, Nicholls A, Oram RA, Strain L, Goodship THJ, Warwicker P, Turnpenny PD, et al (2010). Atypical haemolytic uraemic syndrome in one large kindred predisposed by factor H mutation penetrance data based on mutation testing and family history.  Author URL.

Publications by year


In Press

Hope S, Wienand-Barnett S, Shepherd M, King S, Fox C, Khunti K, Oram R, Knight B, Hattersley A, Jones A, et al (In Press). Assessment of Practical Classification Guidelines for Diabetes in insulin-treated patients. British Journal of General Practice Full text.

2016

Oram RA, Patel K, Hill A, Shields B, McDonald TJ, Jones A, Hattersley AT, Weedon MN (2016). A Type 1 Diabetes Genetic Risk Score can Aid Discrimination Between Type 1 and Type 2 Diabetes in Young Adults. Diabetes Care, 39(3), 337-344. Abstract.  Author URL.  Full text.
Patel KA, Oram RA, Mcdonald TJ, Hudson M, Colclough K, Ellard S, Weedon MN, Pearson EZ, Hattersley AT (2016). Classifying the unclassified using Type 1 diabetes genetic risk score: patients with young onset diabetes who are islet autoantibody negative and have preserved c-peptide. DIABETIC MEDICINE, 33, 188-189. Author URL.
Oram RA, Hammersley S, Hill A, Shields B, Hattersley A, McDonald T (2016). Longitudinal study of extremely low c-peptide: evidence for persistent beta cells in all people with Type 1 diabetes.  Author URL.
Shepherd M, Shields B, Hammersley S, Hudson M, McDonald TJ, Colclough K, Oram RA, Knight B, Hyde C, Cox J, et al (2016). Systematic Population Screening, Using Biomarkers and Genetic Testing, Identifies 2.5% of the U.K. Pediatric Diabetes Population with Monogenic Diabetes. Diabetes Care, 39(11), 1879-1888. Abstract.  Author URL.  Full text.
Patel KA, Oram RA, Flanagan SE, De Franco E, Colclough K, Shepherd M, Ellard S, Weedon MN, Hattersley AT (2016). Type 1 Diabetes Genetic Risk Score: a Novel Tool to Discriminate Monogenic and Type 1 Diabetes. Diabetes, 65(7), 2094-2099. Full text.

2015

McDonald TJ, Oram RA, Vaidya B (2015). Investigating hyperkalaemia in adults. BMJ, 351 Author URL.
Oram RA, McDonald TJ, Shields BM, Hudson MM, Shepherd MH, Hammersley S, Pearson ER, Hattersley AT, UNITED Team (2015). Most people with long-duration type 1 diabetes in a large population-based study are insulin microsecretors. Diabetes Care, 38(2), 323-328. Abstract.  Author URL.  Full text.
McDonald TJ, Oram RA, Vaidya B (2015). RATIONAL TESTING Investigating hyperkalaemia in adults. BMJ-BRITISH MEDICAL JOURNAL, 351 Author URL.
Patel KA, Weedon MN, Ellard S, Hattersley AT, Oram RA (2015). Type 1 diabetes genetic risk score: a novel tool to differentiate monogenic diabetes from Type 1 diabetes. DIABETIC MEDICINE, 32, 21-22. Author URL.

2014

Oram RA, McDonald TJ, Shields BM, Pearson ER, Hattersley AT, Team UNITEDR (2014). A large, population-based study demonstrates that most people with long duration Type 1 diabetes are insulin microsecretors and produce their own endogenous insulin.  Author URL.
Oram RA, Jones AG, Besser RE, Knight BA, Shields BM, Brown RJ, Hattersley AT, McDonald TJ (2014). Erratum to: the majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells. Diabetologia, 57(1). Author URL.
Oram RA, Brooks AM, Forbes S, Eckoldt S, Smith RM, Choudhary P, Rosenthal MJ, Johnson P, Rutter MK, Burling KA, et al (2014). Home urine C-peptide creatinine ratio can be used to monitor islet transplant function. Diabetes Care, 37(6), 1737-1740. Abstract.  Author URL.
Hope SV, Taylor PJ, Shields BM, Oram RA, Chakera AJ, Strain WD, Hattersley AT (2014). Non-specific symptoms associated with hypoglycaemia in the elderly are common in patients treated with metformin only, as well as those treated with insulin or sulphonylureas.  Author URL.
Hamilton AJ, Bingham C, McDonald TJ, Cook PR, Caswell RC, Weedon MN, Oram RA, Shields BM, Shepherd M, Inward CD, et al (2014). The HNF4A R76W mutation causes atypical dominant Fanconi syndrome in addition to a β cell phenotype. J Med Genet, 51(3), 165-169. Abstract.  Author URL.  Full text.
Oram RA, Jones AG, Besser REJ, Knight BA, Shields BM, Brown RJ, Hattersley AT, McDonald TJ (2014). The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells. Diabetologia, 57(1), 187-191. Abstract.
Oram RA, McDonald TJ, Vaidya B (2014). [In Process Citation]. Praxis (Bern 1994), 103(6), 341-345. Author URL.

2013

So K, Bewshea CM, Heap GA, Muller AF, Delaney MP, Daneshmend TK, Hart AL, Orchard TR, Irving PM, D'Souza R, et al (2013). 5-Aminosalicylate (5-ASA) Induced Nephrotoxicity in Inflammatory Bowel Disease.  Author URL.
Hudson MM, Shepherd M, Oram RA, McDonald TJ, Ellard S, Shields BM, Hattersley AT, Team UR (2013). A population-based approach to genetic testing defines the prevalence of maturity onset diabetes of the young (MODY) in patients with diabetes diagnosed under 30 years as 3%.  Author URL.
Edghill EL, Stals K, Oram RA, Shepherd MH, Hattersley AT, Ellard S (2013). HNF1B deletions in patients with young-onset diabetes but no known renal disease. Diabet Med, 30(1), 114-117. Abstract.  Author URL.
Oram RA, McDonald TJ, Vaidya B (2013). Investigating hypokalaemia. BMJ, 347 Author URL.
Eininger AK, Oram RA, Friend PJ, Asderakis A, Winearls CG, Hattersley AT, Owen KR (2013). Simultaneous pancreas and kidney transplantation (SPK) should be indicated for patients with maturity-onset diabetes of the young (MODY) and end-stage nephropathy. DIABETIC MEDICINE, 30, 92-93. Author URL.
Oram RA, McDonald TJ, Jones AG, Besser REJ, Hattersley AT (2013). The majority of patients with over five years of Type 1 diabetes are insulin microsecretors and have functioning beta cells.  Author URL.
Sanders T, Oram RA, Shepherd M, Pearson ER, MacDonald TJ, Ellard S, Shields BM, Hattersley AT, Team UNITEDR (2013). Time to reconsider? Reassessment of diagnosis in long duration Type 1 diabetes with urinary C-peptide creatinine ratio and antibodies identifies people with alternate diagnoses.  Author URL.
Oram RA, Rawlingson A, Shields BM, Bingham C, Besser REJ, McDonald TJ, Knight BA, Hattersley AT (2013). Urine C-peptide creatinine ratio can be used to assess insulin resistance and insulin production in people without diabetes: an observational study. BMJ Open, 3(12). Abstract.  Author URL.
Oram RA, Brooks AMS, Smith R, Rutter MK, Johnson PR, Choudhary P, Rosenthal M, Forbes S, McDonald TJ, Hattersley AT, et al (2013). Urine c-peptide creatinine ratio can be used for home monitoring of islet transplant function. DIABETIC MEDICINE, 30, 87-87. Author URL.

2012

Oram RA, Shepherd MH, Hudson M, Sanders T, Tiley S, Hammersley S, Shields B, McDonald TJ, Knight BA, Besser REJ, et al (2012). The prevalence of endogenous insulin production in a cohort of adults with type 1 diabetes.  Author URL.

2011

Jones AG, Besser REJ, McDonald TJ, Shields BM, Hope SV, Bowman P, Oram RA, Knight BA, Hattersley AT (2011). Urine C-peptide creatinine ratio is an alternative to stimulated serum C-peptide measurement in late-onset, insulin-treated diabetes. Diabet Med, 28(9), 1034-1038. Abstract.  Author URL.

2010

Sansbury FH, Bromilow G, Bingham C, Powell R, Nicholls A, Oram RA, Strain L, Goodship THJ, Warwicker P, Turnpenny PD, et al (2010). Atypical haemolytic uraemic syndrome in one large kindred predisposed by factor H mutation penetrance data based on mutation testing and family history.  Author URL.
Oram RA, Edghill EL, Blackman J, Taylor MJO, Kay T, Flanagan SE, Ismail-Pratt I, Creighton SM, Ellard S, Hattersley AT, et al (2010). Mutations in the hepatocyte nuclear factor-1β (HNF1B) gene are common with combined uterine and renal malformations but are not found with isolated uterine malformations. Am J Obstet Gynecol, 203(4), 364.e1-364.e5. Abstract.  Author URL.

2009

Oram RA, Edghill EL, Adalat S, Bockenhauer D, Ellard S, Woolf AS, Bingham C (2009). HNF1B MUTATIONS: REVIEW OF 109 AFFECTED PROBANDS. PEDIATRIC NEPHROLOGY, 24(9), 1804-1804. Author URL.
Oram RA, Edghill EL, Woolf AS, Hennekam RC, Ellard S, Hattersley AT, Bingham C (2009). RET gene mutations are not a common cause of congenital solitary functioning kidney in adults. NDT Plus, 2(2), 183-184.

2008

Edghill EL, Oram RA, Owens M, Stals KL, Harries LW, Hattersley AT, Ellard S, Bingham C (2008). Hepatocyte nuclear factor-1beta gene deletions--a common cause of renal disease. Nephrol Dial Transplant, 23(2), 627-635. Abstract.  Author URL.

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