Clinical Modulation Of The Hyperglycaemic Effect Of A 10-second Sprint In Type 1 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$567,207.00
Summary
Although regular exercise provides a number of health benefits for individuals with Type 1 diabetes, it increases the risk of hypoglycaemia, which if severe can result in convulsion, coma and irreversible brain damages. Recently, we have made the surprising discovery that it is possible to prevent hypoglycaemia if exercise is combined with one or several short sprints. Our goal is to identify some of the clinical factors likely to interfere with the glucoregulatory benefits of sprinting.
Mechanisms Of Hypoglycaemic Damage In Developing Brain- A Protective Role For The Insulin-like Growth Factor System
Funder
National Health and Medical Research Council
Funding Amount
$408,055.00
Summary
The developing brain in the newborn infant or young child is vulnerable to many damaging influences. It is highly dependent on its essential fuel, glucose. Hypoglycemia, or lack of glucose availability, is therefore among the most damaging insults to the young brain, potentially leading to learning difficulties, developmental delay, cerebral palsy or epilepsy. Babies born premature or very small are at risk, as are those exposed to excessive insulin, such as infants of diabetic mothers. Children ....The developing brain in the newborn infant or young child is vulnerable to many damaging influences. It is highly dependent on its essential fuel, glucose. Hypoglycemia, or lack of glucose availability, is therefore among the most damaging insults to the young brain, potentially leading to learning difficulties, developmental delay, cerebral palsy or epilepsy. Babies born premature or very small are at risk, as are those exposed to excessive insulin, such as infants of diabetic mothers. Children with diabetes are also at risk, when their therapy with insulin may at times be excessive, leading to hypoglycaemia and impaired glucose availability for the brain. This proposal is examining at the cellular level the mechanisms involved in loss of brain cells in the face of glucose starvation in these various conditions. We are using several in vitro models where we can grow segments of developing mouse brain or human nerve cells in a dish, compared to studies with mice subjected to low blood glucose (hypoglycemia). After establishing that our laboratory models are representative of the whole animal, we will explore the cellular mechanisms involved in neuronal death following hypoglycaemia, particularly the interaction between the insulin-like growth factor (IGF) and other cell survival genes. We will also examine the possibility that treatment with IGF will reduce the loss of nerves in the brain after an episode of hypoglycemia. This may offer new and effective early treatment for this damaging brain injury in both newborn babies and children with insulin-dependent diabetes.Read moreRead less
Non-invasive Detection Of Hypoglycaemia In People With Diabetes Using Brain Wave Activity
Funder
National Health and Medical Research Council
Funding Amount
$330,447.00
Summary
Hypoglycaemia remains a major cause of morbidity and mortality in people with both type 1 diabetes and type 2 diabetes who require insulin therapy. Current treatments for nocturnal hypoglycaemia are usually ineffective. Combining brain wave recording and artificial intelligence, we will identify the changes that precipitate an episode of hypoglycaemia allowing the development of a non-invasive device to prevent or alleviate these fearful and potentially life-threatening events.
Hypoglycaemia In Young Patients With Type 1 Diabetes: Pathophysiology, Predisposition And Preventive Strategies
Funder
National Health and Medical Research Council
Funding Amount
$2,680,000.00
Summary
The vision of this proposal is to bring together an active team of experienced investigators that will address important clinical problems affecting the management of children and adolescents with type 1 diabetes. Along with facilities and resources already under development, the program will further establish a core of investigators dedicated to patient centred and clinical research that will facilitate scientific advances to be put into practice. The incidence of type 1 diabetes is continuing ....The vision of this proposal is to bring together an active team of experienced investigators that will address important clinical problems affecting the management of children and adolescents with type 1 diabetes. Along with facilities and resources already under development, the program will further establish a core of investigators dedicated to patient centred and clinical research that will facilitate scientific advances to be put into practice. The incidence of type 1 diabetes is continuing to increase particularly in the young. As we enter the 21st century, insulin treatment aimed at restoring blood glucose levels as close to the normal as possible remains the most effective way to prevent the devastating long-term complications of the disease. Unfortunately this is difficult to achieve largely because insulin therapy is frequently associated with the development of low blood glucose or hypoglycaemia. Hyperglycaemia results in unpleasant symptoms if mild but if severe it can produce convulsions or unconsciousness. The fear of hypoglycaemia is ever present for the patient and their family, this not only significantly impairs quality of life but importantly also severely restricts attempts to control diabetes. One of the major goals of this research program will be to address important unanswered questions related to the development of hyperglycaemia in children and adolescents with diabetes. The research team will examine in detail the protective physiological mechanisms against hyperglycaemia that are deranged in diabetes, they will also study more closely those situations that are known to predispose to hyperglycaemia such as sleep and exercise as well as how the brain is affected as blood glucose falls. By taking this approach we hope to be able to devise management strategies that will lessen the impact of hyperglycaemia in diabetes treatment. It is anticipated that this in turn will contribute to the prevention of diabetes complications as well as reduce the burden of the disease for the patient and his or her family. A second goal of this research program will be to develop an internationally unique resource that will be available to all diabetes investigators. We will build on an already established population based database of all the children and adolescents with diabetes in Western Australia as well as complete a DNA bank of these patients and their families. Thus in addition to bringing together an effective team of researchers, this program will further develop resources that can be central to addressing other important questions related to the causes of diabetes and its complications.Read moreRead less
Understanding The Relationship Of Incretin Hormones, Gastric Emptying And Reactive Hypoglycaemia
Funder
National Health and Medical Research Council
Funding Amount
$132,743.00
Summary
Low blood glucose levels following a meal occur frequently in otherwise healthy people and those who have had surgery for weight loss. It affects quality of life adversely and current management is unsatisfactory. The proposed studies will use sophisticated techniques to evaluate the roles of the rate of stomach emptying and the so-called 'incretin' hormones which stimulate the release of insulin after a meal. The outcomes will have major implications for more rational management.
A Novel Portable System For Day And Night Closed Loop Automated Insulin Delivery In The Patient With Type 1 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$251,133.00
Summary
For patients with Type 1 Diabetes, improved glucose control has been shown to reduce the development of diabetes complications. Although advances have been made in therapy, most people with diabetes do not achieve optimal treatment targets and the burden of care is high. Technologies now exist that allow the development of automatic insulin therapy and the artificial pancreas. These experiments will test a novel portable system that represents a significant step advancing toward this goal.
Hypothalamic Orexin Neurons And The Medullary Sympathoadrenal Centre: A Key Role In Glucose Homeostasis
Funder
National Health and Medical Research Council
Funding Amount
$577,957.00
Summary
Hypoglycaemia or low blood sugar is a major side-effect of the treatment of diabetes. Exposure to hypoglycaemia results in changes in the brain (neuroplasticity) that reduce the awareness of hypoglycaemia, often with serious consequences. Hypoglycaemia triggers the production of several hormones including adrenaline which restore normal blood glucose. This process is incompletely understood. This research project will identify key components of the neurocircuitry that controls blood sugar.
Glycaemia-increasing Effects Of Sprinting In Type 1 Diabetes: Toward The Validation Of New Clinical Guidelines For Hypoglycaemia Prevention
Funder
National Health and Medical Research Council
Funding Amount
$600,323.00
Summary
Recently, we found that the risk of hypoglycaemia associated with moderate intensity exercise in type 1 diabetic individuals is opposed by one or several short sprints performed during or after exercise. Our goal is to examine if exercising several hours before sprinting decreases its protective effect, and whether sprinting may impair several hours later the counterregulatory responses to hypoglycaemia. Finally, we will determine if guidelines advocating the use of short sprints reduce the risk ....Recently, we found that the risk of hypoglycaemia associated with moderate intensity exercise in type 1 diabetic individuals is opposed by one or several short sprints performed during or after exercise. Our goal is to examine if exercising several hours before sprinting decreases its protective effect, and whether sprinting may impair several hours later the counterregulatory responses to hypoglycaemia. Finally, we will determine if guidelines advocating the use of short sprints reduce the risk of hypoglycaemia under free living conditions.Read moreRead less
Proactive Specialist Diabetes Inpatient Team To Improve Outcomes In Hospitalised Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$124,761.00
Summary
Diabetes is a major epidemic in Australia. Current care of hospitalised patients with diabetes is complex, suboptimal and contributes to longer hospital stay, poor outcomes and strain on healthcare resources. This research aims to improve diabetes care in hospitalised patients by implementing a proactive specialist diabetes team that will autonomously identify and provide specialist care for these patients. The expected findings have potential to shape a new approach to hospital diabetes care.
Optimization Of Glycaemic Control And Prevention Of Hypoglycaemia And Microvascular Complications In Children And Adolescents With Type 1 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$452,051.00
Summary
Type 1 diabetes is a complex life-long disease that has onset in the young and carries a significant burden. Good management is crucial as it helps prevent the serious long term complications of the disease such as blindness and kidney disease. Low blood glucose or hypoglycaemia is a common side effect of insulin treatment. This research aims to explore ways to treat the disease more effectively, prevent hypoglycaemia and other diabetes complications and in so doing improve the outcomes for youn ....Type 1 diabetes is a complex life-long disease that has onset in the young and carries a significant burden. Good management is crucial as it helps prevent the serious long term complications of the disease such as blindness and kidney disease. Low blood glucose or hypoglycaemia is a common side effect of insulin treatment. This research aims to explore ways to treat the disease more effectively, prevent hypoglycaemia and other diabetes complications and in so doing improve the outcomes for young people with diabetes.Read moreRead less