Chronic Gastrointestinal Symptoms And Diabetes Mellitus: Risk Factors And Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$271,527.00
Summary
Why many people with diabetes mellitus are afflicted by gastrointestinal (GI) symptoms remains uncertain. Irreversible damage to the nerves controlling the gut (autonomic neuropathy) is often considered to be important. An alternative cause of increased GI symptomatology in diabetics is poor glucose control. Some studies have shown that acute shifts in glucose levels induce changes in the gut relevant to the onset of GI symptoms. For example, high glucose levels acutely cause slower stomach empt ....Why many people with diabetes mellitus are afflicted by gastrointestinal (GI) symptoms remains uncertain. Irreversible damage to the nerves controlling the gut (autonomic neuropathy) is often considered to be important. An alternative cause of increased GI symptomatology in diabetics is poor glucose control. Some studies have shown that acute shifts in glucose levels induce changes in the gut relevant to the onset of GI symptoms. For example, high glucose levels acutely cause slower stomach emptying times, leading to feelings of fullness. Though the effects of chronic glucose levels are yet to be properly explored, population data show that poor control in the long-term is related to an increase in symptoms. The aim of this prospective study is to determine the roles played by both autonomic neuropathy and glucose control in the development of GI symptoms among diabetics. All past research has been cross-sectional, and so cannot tell us if one or both of these factors cause GI problems in diabetes. For example, it is possible that autonomic neuropathy causes an increase in GI symptoms such as nausea and fullness, which in turn induces poor glucose control though lack of appetite or inadequate stomach emptying. Upon study inclusion, all study participants will undergo a series of autonomic tests. At 3 month intervals for a period of 30 months, they will be asked to complete a 2-week diary card detailing their GI symptoms and glucose readings, and also supply blood and urine samples for analysis twice each year. Two years from the study outset, participants will again complete the autonomic test series. Psychiatric co-morbidity will be investigated using the Composite Diagnostic Interview (CIDI-Auto) at the autonomic testing time points. The study will be undertaken at the Gastroenterology Research Unit at Nepean Hospital, in collaboration with the Royal Adelaide Hospital, centres with proven track records in diabetes investigation.Read moreRead less
Adverse Outcomes Following Cataract Surgery In Western Australia: A Population Study Using Record Linkage
Funder
National Health and Medical Research Council
Funding Amount
$359,150.00
Summary
Cataract is a major cause of correctable visual loss with surgery the only treatment available. Cataract surgery is now one of the most commonly performed operations. With the ageing population, the number of operations is set to double within the next 12 years in Western Australia, from 10,000 procedures a year currently. Although surgery is successful in most cases, complications do occur. Endophthalmitis (infection of internal structures of the eye), incomplete cataract removal, detachment of ....Cataract is a major cause of correctable visual loss with surgery the only treatment available. Cataract surgery is now one of the most commonly performed operations. With the ageing population, the number of operations is set to double within the next 12 years in Western Australia, from 10,000 procedures a year currently. Although surgery is successful in most cases, complications do occur. Endophthalmitis (infection of internal structures of the eye), incomplete cataract removal, detachment of the retina and corneal decompensation (opacity of the clear front of the eye) are four major complications of cataract surgery. These complications may cause blindness and are expensive to treat. We propose to investigate these serious, potentially blinding, complications of cataract surgery by measuring how often these complications occur and to examine if changes in surgical technique over the past 20 years have resulted in better outcomes. We will also evaluate risk factors for endophthalmitis; and determine the quality of life and economic costs of endophthalmitis after cataract surgery. Our study findings will enable us to better inform eye surgeons, the general community, health policy makers and the scientific community about the cost versus safety of different forms of cataract surgery. Unless effective strategies can be found to reduce the rate of complications, the personal and community burden of these devastating complications will only increase as the number of operations continues to increase.Read moreRead less
ENDOPHTHALMITIS IN WESTERN AUSTRALIA (1980-2002): INCIDENCE, MANAGEMENT AND EFFECTIVENESS OF CHEMOPROPHYLAXIS
Funder
National Health and Medical Research Council
Funding Amount
$348,942.00
Summary
Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to p ....Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to prevent the infection that have not, as yet, been demonstrated beneficial. Our study will use a multidisciplinary team consisting of consultant ophthalmologists, public health researchers, a biostatistician and health economist to assess the impact of endophthalmitis in WA from 1980-2002 (around 480 cases). The population-based WA Linked Database provides a unique opportunity to produce what will be the largest population study of endophthalmitis. Data from the study will provide important information to develop best-practice treatment guidelines to prevent endophthalmitis following cataract surgery. The significance of this study will be that accurate information on the clinical epidemiology and true cost of endophthalmitis will be obtained for WA. By studying the records of patients with endophthalmitis and comparing them with matched patients, who did not have post-operative endophthalmitis following cataract surgery, we will characterise the risks for this severe complication by identifying the underlying factors that are responsible for the infection. We will also better understand the effect of methods used to prevent the infection. The use of a whole population-based study to assess methods of endophthalmitis prevention has not been done before and will have a significant beneficial impact on health policy and best-practice, not only in Australia, but also internationally.Read moreRead less
Evaluation And Planning Of Coronary Revascularization Services.
Funder
National Health and Medical Research Council
Funding Amount
$591,527.00
Summary
This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary opera ....This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary operations will be needed in Australia over the next decade. This is a vital step in planning hospital services for patients with coronary disease.Read moreRead less