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Professor Terence Wilkin

Professor Terence Wilkin

Professor of Endocrinology & Metabolism

6758

RILD Building 

Profesor Wilkin graduated from St Andrew's University Medical School and received his MD (commended) on thyroid autoimmunity from the University of Dundee. He spent the next 15 years with the Wellcome Trust, first as European Travelling Fellow at the University of Montpellier in Southern France and then as Wellcome Senior Research Fellow/Senior Lecturer/Reader at the University of Southampton. He moved to the foundation chair of medicine at the Plymouth Postgraduate Medical School in 1993, helped in the planning the Peninsula Medical School, and is currently Professor of Endocrinology and Metabolism within the IHR at UOEMS. He was asked out of retirement in 2012 to be chief investigator of the Accelerator Prevention Trial (APT), a randomized controlled intervention trial designed to test an alternative to the autoimmunity hypothesis in type 1 diabetes.

Broad research specialisms

Research interests have sought to question, where appropriate, major tenets in endocrinology. The resulting hypotheses have included Autoimmunity: Attack or Defence? (1988), which questions the dysregulation theory of autoimmunity, the Accelerator Hypothesis (2001), which suggests that type 1 and type 2 diabetes are essentially one and the same disorder of insulin resistance, set against different genetic backgrounds, the Activitystat Hypothesis (2004), which argues that that physical activity in children is biologically, rather than environmentally, regulated, and the Gender-Insulin Hypothesis (2008), which argues that the systematically lower birth weight and higher insulin resistance of girls reflects a sex-linked genetic difference in insulin sensitivity. Evidence has been gathered for all these hypotheses, and the most contentious of them - the accelerator hypothesis for type 1 diabetes - is currently being tested in a randomised controlled trial.

Qualifications

• MD
• MBChB
• FRCS
• FRCS (Edin)

Research

Research interests

Professor Wilkin’s early research revolved around thyroid disease, which lay the foundation for his MD (commendation) on the impact of its treatment on hormone control. Four months spent with Dr Brian Storey, a cybernetics engineer at the University of Dundee, left a life-long interest and understanding of biological feedback systems. The period at the medical school of Montpellier, where early biostators were being developed to achieve rapid control of type 1 diabetes, led to recognition of the impact of childhood diabetes as a disease, and a growing doubt that the autoimmunity paradigm used to explain it was correct. These doubts were formally expressed in the 1988 paper Autoimmunity: attack or defence? But it took a further 13 years to fully formulate (and get published) the accelerator hypothesis in the 2001 paper Weight gain: the link between type 1 and type 2 diabetes.

The accelerator hypothesis argues that type 1 and type 2 diabetes are the same disorder of insulin resistance, set against different genetic backgrounds. The hypothesis has gained currency because it explains aspects of diabetes that autoimmunity cannot, and because more than 20 immunotherapy trials in man have failed to prevent the disease. Terence’s focus now lies with a randomized clinical trial to test whether lowering insulin resistance in children at risk of type 1 diabetes will reduce type 1 diabetes, as it does type 2.

The need to first understand the natural history of insulin resistance during contemporary childhood before trying to alter it underpinned the period 2000-2012, during which EarlyBird Study, led by Terence and Dr Linda Voss, monitored the auxology, body composition, physical activity – and insulin resistance – of a single cohort of 300 children from the age of 5y to 16y. EarlyBird has published more than 60 peer-reviewed papers and unique data on the behaviour of insulin resistance during childhood. Visit the EarlyBird website for more details.
 

Research projects

The accelerator prevention trial (APT)
APT screens the siblings age 5-16y of all type 1 diabetic people in Scotland aged <25y, and is inviting those at high risk to participate in a five year randomized and placebo-controlled trial designed to establish whether metformin, a medication which reduces insulin resistance, can also reduce the incidence of childhood diabetes. The trial will start treating the first children in September, 2014, and will announce the final results in 2021. Visit the adAPT website for more details.

Grants/Funding

Juvenile Diabetes Research Foundation

 

Key publications | Publications by category | Publications by year

Publications by category


Journal articles

Mostazir M, Jeffery A, Hosking J, Metcalf B, Voss L, Wilkin T (2016). Evidence for energy conservation during pubertal growth. A 10-year longitudinal study (EarlyBird 71). Int J Obes (Lond), 40(11), 1619-1626. Abstract.  Author URL.  Full text.
Jeffery AN, Metcalf BS, Hosking J, Mostazir MBA, Voss LD, Wilkin TJ (2015). Awareness of body weight by mothers and their children: repeated measures in a single cohort (EarlyBird 64). Child Care Health Dev, 41(3), 434-442. Abstract.  Author URL.
Mostazir M, Jeffery A, Voss L, Wilkin T (2015). Childhood obesity: Evidence for distinct early and late environmental determinants a 12-year longitudinal cohort study (EarlyBird 62). International Journal of Obesity, 39(7), 1057-1062. Abstract.  Full text.
Pinkney J, Streeter A, Hosking J, Mostazir M, Jeffery A, Wilkin T (2015). Erratum: Adiposity, chronic inflammation and the prepubertal decline of sex hormone binding globulin in children: Evidence for associations with the timing of puberty (Earlybird 58) (Journal of Clinical Endocrinology and Metabolism (2014) 99:9 (3224-32) DOI: 10.1210/jc.2013-3902). Journal of Clinical Endocrinology and Metabolism, 100(2).
Metcalf BS, Hosking J, Jeffery AN, Henley WE, Wilkin TJ (2015). Exploring the Adolescent Fall in Physical Activity: a 10-yr Cohort Study (EarlyBird 41). Med Sci Sports Exerc, 47(10), 2084-2092. Abstract.  Author URL.  Full text.
Metcalf BS, Hosking J, Henley WE, Jeffery AN, Mostazir M, Voss LD, Wilkin TJ (2015). Physical activity attenuates the mid-adolescent peak in insulin resistance but by late adolescence the effect is lost: a longitudinal study with annual measures from 9-16 years (EarlyBird 66). Diabetologia, 58(12), 2699-2708. Abstract.  Author URL.
Wilkin T, Greene S, McCrimmon R (2015). Testing the accelerator hypothesis: a new approach to type 1 diabetes prevention (adAPT 1). Diabetes, Obesity and Metabolism, 18(1), 3-5.
Hyland ME, Jeffery AN, Wilkin TJ (2014). A biological, latent variable model of health (EarlyBird 68). Brain Behav Immun, 40, 104-109. Abstract.  Author URL.
Mostazir M, Jeffery A, Voss L, Wilkin T (2014). Gender-assortative waist circumference in mother-daughter and father-son pairs, and its implications. An 11-year longitudinal study in children (EarlyBird 59). Pediatr Obes, 9(3), 176-185. Abstract.  Author URL.
Voss LD, Hosking J, Metcalf BS, Jeffery AN, Frémeaux AE, Wilkin TJ (2014). Metabolic risk in contemporary children is unrelated to socio-economic status: longitudinal study of a UK urban population (EarlyBird 42). Pediatr Diabetes, 15(3), 244-251. Abstract.  Author URL.
Jeffery AN, Hyland ME, Hosking J, Wilkin TJ (2014). Mood and its association with metabolic health in adolescents: a longitudinal study, EarlyBird 65. Pediatr Diabetes, 15(8), 599-605. Abstract.  Author URL.
Clarke-Harris R, Wilkin TJ, Hosking J, Pinkney J, Jeffery AN, Metcalf BS, Godfrey KM, Voss LD, Lillycrop KA, Burdge GC, et al (2014). PGC1α promoter methylation in blood at 5-7 years predicts adiposity from 9 to 14 years (EarlyBird 50). Diabetes, 63(7), 2528-2537. Abstract.  Author URL.
Hosking J, Metcalf BS, Jeffery AN, Streeter AJ, Voss LD, Wilkin TJ (2013). Evidence of early beta-cell deficiency among children who show impaired fasting glucose: 10-yr cohort study (EarlyBird 56). Pediatric Diabetes, 14(7), 481-489. Abstract.
Wilkin TJ (2013). Is autoimmunity or insulin resistance the primary driver of type 1 diabetes?. Curr Diab Rep, 13(5), 651-656. Abstract.  Author URL.  Full text.
Metcalf BS, Hosking J, Jeffery AN, Voss LD, Henley W, Wilkin TJ (2011). Fatness leads to inactivity, but inactivity does not lead to fatness: a longitudinal study in children (EarlyBird 45). Arch Dis Child, 96(10), 942-947. Abstract.  Author URL.
Frémeaux AE, Mallam KM, Metcalf BS, Hosking J, Voss LD, Wilkin TJ (2011). The impact of school-time activity on total physical activity: the activitystat hypothesis (EarlyBird 46). Int J Obes (Lond), 35(10), 1277-1283. Abstract.  Author URL.
Voss LD, Hosking J, Metcalf BS, Jeffery AN, Frémeaux AE, Wilkin TJ (2010). Metabolic risk in contemporary children is unrelated to socio-economic status: longitudinal study of a UK urban population (EarlyBird 42). Pediatr Diabetes Abstract.  Author URL.
Metcalf BS, Jeffery AN, Hosking J, Voss LD, Sattar N, Wilkin TJ (2009). Objectively measured physical activity and its association with adiponectin and other novel metabolic markers: a longitudinal study in children (EarlyBird 38). Diabetes Care, 32, 468-473.

Publications by year


2016

Mostazir M, Jeffery A, Hosking J, Metcalf B, Voss L, Wilkin T (2016). Evidence for energy conservation during pubertal growth. A 10-year longitudinal study (EarlyBird 71). Int J Obes (Lond), 40(11), 1619-1626. Abstract.  Author URL.  Full text.

2015

Jeffery AN, Metcalf BS, Hosking J, Mostazir MBA, Voss LD, Wilkin TJ (2015). Awareness of body weight by mothers and their children: repeated measures in a single cohort (EarlyBird 64). Child Care Health Dev, 41(3), 434-442. Abstract.  Author URL.
Mostazir M, Jeffery A, Voss L, Wilkin T (2015). Childhood obesity: Evidence for distinct early and late environmental determinants a 12-year longitudinal cohort study (EarlyBird 62). International Journal of Obesity, 39(7), 1057-1062. Abstract.  Full text.
Pinkney J, Streeter A, Hosking J, Mostazir M, Jeffery A, Wilkin T (2015). Erratum: Adiposity, chronic inflammation and the prepubertal decline of sex hormone binding globulin in children: Evidence for associations with the timing of puberty (Earlybird 58) (Journal of Clinical Endocrinology and Metabolism (2014) 99:9 (3224-32) DOI: 10.1210/jc.2013-3902). Journal of Clinical Endocrinology and Metabolism, 100(2).
Metcalf BS, Hosking J, Jeffery AN, Henley WE, Wilkin TJ (2015). Exploring the Adolescent Fall in Physical Activity: a 10-yr Cohort Study (EarlyBird 41). Med Sci Sports Exerc, 47(10), 2084-2092. Abstract.  Author URL.  Full text.
Metcalf BS, Hosking J, Henley WE, Jeffery AN, Mostazir M, Voss LD, Wilkin TJ (2015). Physical activity attenuates the mid-adolescent peak in insulin resistance but by late adolescence the effect is lost: a longitudinal study with annual measures from 9-16 years (EarlyBird 66). Diabetologia, 58(12), 2699-2708. Abstract.  Author URL.
Wilkin T, Greene S, McCrimmon R (2015). Testing the accelerator hypothesis: a new approach to type 1 diabetes prevention (adAPT 1). Diabetes, Obesity and Metabolism, 18(1), 3-5.

2014

Hyland ME, Jeffery AN, Wilkin TJ (2014). A biological, latent variable model of health (EarlyBird 68). Brain Behav Immun, 40, 104-109. Abstract.  Author URL.
Mostazir M, Jeffery A, Voss L, Wilkin T (2014). Gender-assortative waist circumference in mother-daughter and father-son pairs, and its implications. An 11-year longitudinal study in children (EarlyBird 59). Pediatr Obes, 9(3), 176-185. Abstract.  Author URL.
Voss LD, Hosking J, Metcalf BS, Jeffery AN, Frémeaux AE, Wilkin TJ (2014). Metabolic risk in contemporary children is unrelated to socio-economic status: longitudinal study of a UK urban population (EarlyBird 42). Pediatr Diabetes, 15(3), 244-251. Abstract.  Author URL.
Jeffery AN, Hyland ME, Hosking J, Wilkin TJ (2014). Mood and its association with metabolic health in adolescents: a longitudinal study, EarlyBird 65. Pediatr Diabetes, 15(8), 599-605. Abstract.  Author URL.
Clarke-Harris R, Wilkin TJ, Hosking J, Pinkney J, Jeffery AN, Metcalf BS, Godfrey KM, Voss LD, Lillycrop KA, Burdge GC, et al (2014). PGC1α promoter methylation in blood at 5-7 years predicts adiposity from 9 to 14 years (EarlyBird 50). Diabetes, 63(7), 2528-2537. Abstract.  Author URL.

2013

Hosking J, Metcalf BS, Jeffery AN, Streeter AJ, Voss LD, Wilkin TJ (2013). Evidence of early beta-cell deficiency among children who show impaired fasting glucose: 10-yr cohort study (EarlyBird 56). Pediatric Diabetes, 14(7), 481-489. Abstract.
Wilkin TJ (2013). Is autoimmunity or insulin resistance the primary driver of type 1 diabetes?. Curr Diab Rep, 13(5), 651-656. Abstract.  Author URL.  Full text.

2011

Metcalf BS, Hosking J, Jeffery AN, Voss LD, Henley W, Wilkin TJ (2011). Fatness leads to inactivity, but inactivity does not lead to fatness: a longitudinal study in children (EarlyBird 45). Arch Dis Child, 96(10), 942-947. Abstract.  Author URL.
Frémeaux AE, Mallam KM, Metcalf BS, Hosking J, Voss LD, Wilkin TJ (2011). The impact of school-time activity on total physical activity: the activitystat hypothesis (EarlyBird 46). Int J Obes (Lond), 35(10), 1277-1283. Abstract.  Author URL.

2010

Voss LD, Hosking J, Metcalf BS, Jeffery AN, Frémeaux AE, Wilkin TJ (2010). Metabolic risk in contemporary children is unrelated to socio-economic status: longitudinal study of a UK urban population (EarlyBird 42). Pediatr Diabetes Abstract.  Author URL.

2009

Metcalf BS, Jeffery AN, Hosking J, Voss LD, Sattar N, Wilkin TJ (2009). Objectively measured physical activity and its association with adiponectin and other novel metabolic markers: a longitudinal study in children (EarlyBird 38). Diabetes Care, 32, 468-473.

Committee/panel activities

Retired


Editorial responsibilities

Formerly editor-in-chief of Autoimmunity


Invited lectures

Diabetes UK, International Society for Paediatric and Adolescent Diabetes (ISPAD), European Association for the Study of Diabetes (EASD), American Diabetes Association (ADA), International Diabetes Federation (IDF), National Institutes of Health (NIH), Bethesda. Center for Disease Control (CDC), Atlanta. UK All-party Parliamentary Committees on Obesity and Diabetes (2005); WHO Athens (2005); Department of Health (2003, 2005); Montreal Global Think-tank on Childhood Obesity (2008); Nestle Research Centre, Lausanne (2008, 2009, 2010, 2011, 2013); WHO Geneva (2010); EC High-level Group on Nutrition, Madrid (2010); Institute for Public Policy Research, London (2013); Monitor, London (2014).


Media Coverage

The Times, Sunday Observer, Independent, Daily Mail, Economist, Time Magazine (x2), BBC Radio 4 ‘Casenotes’ (x4), BBC Radio 4 ‘Frontiers’, BBC Radio 4 ‘Am I normal?’, BBC RADIO 4 Today Programme (x3), BBC Radio 2 Jeremy Vine show, BBC Radio 5 Live, Discovery Health Channel, Carlton TV, ‘Tomorrow’s World’, BBC 2 TV ‘The Men Who Made Us Fat’, BBC2 TV The Men Who Made Us Thin.

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