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Sarah Finer, Title: DrBSc MBBS MRCP PhD

Sarah

Clinical Senior Lecturer in Diabetes

Email: s.finer@qmul.ac.uk  
Telephone: 020 7882 7326

Profile

Sarah studied medicine at UCL, qualifying in 2002.  After SHO jobs at UCLH, St Thomas’, and Barts and the London, she moved eastwards for SpR training in general medicine, diabetes and endocrinology.  She was an NIHR Academic Clinical Fellow at Barts and the London, and then obtained an MRC Clinical Resarch Training fellowship to pursue her PhD, which she obtained in 2013.  After 2 years as an NIHR Academic Clinical Lecturer at the University of Cambridge, she returned to east London to take up a post as Senior Lecturer at Barts and the London School of Medicine and Dentistry, and Honorary Consultant at Barts Health NHS Trust.

Sarah is an active clinician, with specialist interests in diabetes in pregnancy, community diabetes and type 1 diabetes (including pumps).

  • Steering Group member for the Diabetes UK James Lind Alliance Priority Setting Partnership for type 2 diabetes, 2016
  • Barts Health Diabetes network: I lead the research theme of this network, which represents the clinical academic strategy for diabetes at Barts Health NHS Trust.

Summary

 

Teaching

Sarah contributes to a range of teaching, including clinical teaching (at Barts Health NHS Trust), MBBS undergraduate core curriculum, and BSc/MSc programmes in global health. 

Topics for PhD supervision:

  • Early life origins of type 2 diabetes
  • Prevention of type 2 diabetes
  • Improving care for people living with diabetes
  • Diabetes in pregnancy
  • Global Health

Research

Research Interests:

Early life origins of type 2 diabetes:

During her MRC Clinical Research Training fellowship and PhD studies, Sarah investigated epigenetic mechanisms (DNA methylation) underlying fetal programming in the context of maternal gestational diabetes, and famine exposure, across a series of human cohorts in the UK and Bangladesh.  This work led into further work as a co-investigator on the GIFTS programme, a large EU-funded study across the UK, Bangladesh (Kishu Khan and Azad Khan, BIRDEM Hospital and the Diabetes Association of Bangladesh), India (Ranjan Yajnik, Pune).

She has since developed further work in this area, looking for miRNA signatures associated with varied maternal nutrient availability in cohorts based in The Gambia, in collaboration with MRC The Gambia, and through funding from the Bill and Melinda Gates Foundation.

Sarah is particularly interested in the translational applications of these molecular studies, and the potential to be able to characterise early molecular signatures of future diabetes risk.  She is developing work with East London Genes and Health, a large scale community genomics project (PI David van Heel) to build its translational potential to understand and mitigate diabetes risk in south Asian populations.

Prevention of type 2 diabetes, including after gestational diabetes:

Sarah has an emerging portfolio of work to develop strategies for preventing type 2 diabetes using community-level and participatory approaches, and focusing on women (and their families) after gestational diabetes.

Improving care for people living with diabetes using new care models:

Sarah is interested in applying participatory methods to health services-based research to design and evaluate improved ways of delivering care to people living with, or at risk of, diabetes.  She has been funded (as Chief Investigator) through a NIHR Health Services and Delivery Research grant  (£378,000, 2016 – 2019) to study whether group clinics offer a better way to meet the complex health and social care needs of young adults with diabetes in an ethnically diverse, socioeconomically deprived population.  This work brings together a strong collaborative team, including Prof Trish Greenhalgh, University of Oxford; Prof Martin Marshall, UCL; Dr Dougal Hargreaves, UCL; Association for Young People’s Health, Dr Shanti Vijayaraghavan, Barts Health.

Sarah collaborates with the PAMBayesian Patient Managed Decision-Support using Bayesian Networks (PAMBAYESIAN) research team, funded through an EPSRC grant (£1,539,497), (PI Norman Fenton) and will be supporting the application of this work to care pathways for women with gestational diabetes

Publications

  • Finer S, Ogunkolade BW, Iqbal S, Lowe R, Mathews C, Smart M, Pervin S, Rakyan VR, *Alam DS, *Hitman GA. Is famine exposure during developmental life in rural Bangladesh associated with a metabolic and epigenetic signature in young adulthood?  A historical cohort study.  BMJOpen, 2016; 6:e011768
  • Greenhalgh T, Clinch M, Afsar N, Choudhury Y, Sudra R, Campbell-Richards D, Claydon A, Hitman G, Hanson P, Finer S.  Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.  BMC Medicine, 2015: 13: 120.
  • Barry E, Roberts S, Finer S, Vijayaraghavan S, Greenhalgh T. Time to question the NHS diabetes prevention programme. BMJ. 2015 Sep 7;351
  • Murphy H, Finer S. Gestational diabetes and the offspring – Jack and Jill are different still.  Diabetes Care 201538(3):345-6. 
  • Finer S.  Fetal programming via maternal diabetes: the controversy continues.  Diabetic Medicine 32(3): 29104. 
  • Finer S, Mathews C, Smart M, Hillman S, Foo L, Sinha A, Williams D, Lowe R, Rakyan V, Hitman GA. Maternal Gestational Diabetes Is Associated With Genome-wide DNA Methylation Variation In Placenta And Cord Blood Of Exposed Offspring.  Human Molecular Genetics, 2015. 1;24(11):3021-9
  • Adaikalakoteswari A, Finer S, McCarthy CM, Moore J, Voyias PD, Harte AL, McTernan PG, Kumar S, Hitman GA, Saravanan P, Tripathi G.  Vitamins B12 and folate imbalance causes adipocyte dysfunction: enhanced cholesterol biosynthesis due to altered methylation of SREBF1 and an induction of unfolded protein response.  Clinical Epigenetics, 27;7(1):14
  • Hillman SL, Finer S, Smart MC, Mathews C, Lowe R, Rakyan V, Hitman GA, Williams DJ. Novel DNA methylation profiles associated with key gene regulation and transcription pathways in blood and placenta of growth-restricted neonates.  Epigenetics, 2015. 10(1):50-61
  • Finer S, Saravanan P, Hitman GA, Yajnik CS .  The role of the one-carbon cycle in the developmental origins of type 2 diabetes and obesity.  Diabetic Medicine 31(3);263-272.
  • Finer S, Khan KS, Hitman GA, Griffiths CG, Martineau A, Meads C.  Inadequate vitamin D status in pregnancy: evidence for supplementation.  Acta Obstet Gynecol Scand  2012.  91:159-163.
  • Hitman GA, Finer S (2011).  Obesity and Type 2 diabetes: achieving weight loss.  Diabetic Medicine; 28(6):627
  • Finer S, Holland M, Nanty L, Rakyan V. The Hunt for the Epiallele. Environmental and Molecular Mutagenesis 52(1)1-11 (EDITOR’S CHOICE)
  • Bell CG Finer S (*Joint first author*),Lindgren CMWilson GARakyan VKTeschendorff AEAkan PStupka EDown TAProkopenko IMorison IMMill JPidsley RInternational Type 2 Diabetes 1q ConsortiumDeloukas PFrayling TMHattersley AT,McCarthy MIBeck SHitman GA.  Integrated genetic and epigenetic analysis identifies haplotype-specific methylation in the FTO type 2 diabetes and obesity susceptibility locus. PLoS One 18;5(11)
  • Rakyan VK, Down TA, Maslau S, Andrew T, Yang TP, Beyan H, Whittaker P, McCann OT, Finer S, Valdes AM, Leslie RD, Deloukas P, Spector TD.  Human Aging-associated DNA hypermethylation occurs preferentially at bivalent chromatin domains.  Genome Research 20(4):434-9
  • Yudkin J, Owens G, Martineau F, Rowson M, Finer S.  Health-worker shortage:  Cuba can teach the UK.  Lancet 371: 1397-9
  • Rakow T, Harvey N, Finer S.  Improving calibration without training: The role of task information.  Applied Cognitive Psychology 16: 1-23.
  • Finer S.  Strengthening governance for global health research. BMJ 322: 995.
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