Diabetic neuropathy causes severe disability, with pain, loss of sensation and weakness. The current project will assess the utility of a new testing method, known as nerve excitability assessment, as a method of detecting early changes in nerve function in diabetic patients. If this technique proves useful in detecting early nerve damage, it will assist in the development of therapeutic and preventative treatments for neuropathy in diabetic patients.
Nerve Excitability Assessment: A Novel Biomarker For The Early Detection Of Diabetic Neuropathy.
Funder
National Health and Medical Research Council
Funding Amount
$375,203.00
Summary
Australia has one of the highest rates of diabetes in the world. Diabetes may be complicated by the development of nerve damage, causing weakness and pain in the upper and lower limbs. The cause remains unclear and there are no tools available for its early detection. This study will provide further information about the cause of diabetic neuropathy and will investigate more sophisticated means for its early detection.
E-PREDICE Early Prevention Of Diabetes Complications In Europe
Funder
National Health and Medical Research Council
Funding Amount
$917,400.00
Summary
The e-PREDICE study will randomise 3000 people aged 45-74 with mild hyperglycaemia or early diabetes to treatment with intensive lifestyle modification alone, or plus metformin, or sitagliptin, or liraglutide, aiming to reduce diabetes eye, kidney and nerve damage. The Australian arm will be co-ordinated by the University of Sydney and other sites include Baker IDI Heart and Diabetes Institute, Royal Melbourne Hospital, St Vincent’s Hospital Melbourne and Royal Brisbane and Womens Hospital
A Novel Sensory Nerve Stimulator To Improve Neuropathy In Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$407,924.00
Summary
We have developed a painless, self-applied, cheap, battery powered electrical stimulation treatment that improves sensory nerve function in some people with diabetic peripheral neuropathy. We have tested this technique in laboratory animals and in people with diabetes and have shown it is effective in some. We now propose to test this technique in a large sample of people similar to the participants in the successful group of our pilot study - 55-65 year old people with diabetes of shorter durat ....We have developed a painless, self-applied, cheap, battery powered electrical stimulation treatment that improves sensory nerve function in some people with diabetic peripheral neuropathy. We have tested this technique in laboratory animals and in people with diabetes and have shown it is effective in some. We now propose to test this technique in a large sample of people similar to the participants in the successful group of our pilot study - 55-65 year old people with diabetes of shorter duration. In addition, older people up to 75 years of age, with up to 10 years duration of diabetes will be included separately. If successful, the electrical stimulation could improve sensation leading to fewer ulcerations and amputations. Much suffering and expense would be avoided. - The magnitude of reduction in suffering and expense can be judged from the fact that people with diabetes have 15 times the risk of amputation as do people without diabetes. In Australia half of non-traumatic amputations are done to people with diabetes. Foot ulcers precede amputations in most cases, and in themselves cause much suffering and expense. Australia needs to act on this now because, if current trends continue, the number of people with diabetes will increase as the population ages. -The number of people aged over 65 will increase from around 2.3 million at present to over 6 million in the next half century. The increase in those over 85 will be even more marked with numbers increasing four fold to over one million people. Diabetes affects approximately 23% of people aged 75 or older.Read moreRead less
Effects Of Pharmacological Modification Of Ion Channel Activity On The Excitability Of Normal And Diabetic Nerves.
Funder
National Health and Medical Research Council
Funding Amount
$389,232.00
Summary
Neuropathic disturbances due to diabetes can destroy the quality of life and place a major cost burden on society. This project will provide insight into the actions of specific pharmaceutical agents on human nerves in both healthy subjects and diabetic patients with a view to establishing how these drugs reduce neuropathic symptoms in real life. The study will provide information regarding the underlying causes of neuropathic symptoms in diabetes and may help guide future treatments.
Do Postjunctional Alterations Explain The Effects Of Diabetes On Neurovascular Transmission?
Funder
National Health and Medical Research Council
Funding Amount
$390,886.00
Summary
Diabetes produces disordered skin blood flow that increases risk of skin ulcers and gangrene. The project investigates nervous control of skin blood vessels in diabetes. It is assumed that all affects of diabetes on nerve function are explained by loss of nerves. We hypothesize that some affects of diabetes are due to dysfunction of blood vessels and not to nerve loss. The objective is to identify drug targets to improve blood flow in skin and thereby reduce the risk of skin ulcers and gangrene.
A Longitudinal Study Of Nerve Morphology In Diabetic Neuropathy Using Novel Non-invasive Ophthalmic Surrogate Markers
Funder
National Health and Medical Research Council
Funding Amount
$540,372.00
Summary
This research project will use two new ophthalmic instruments - the corneal confocal microscope and non-contact corneal aesthesiometer - to directly monitor changes in corneal nerves and corneal sensitivity, over a 5 year period, in diabetic patients suffering from a painful condition of the arms and legs known as diabetic neuropathy. This study will generate important new information that could allow diabetic doctors to more accurately monitor the progression of the disease.
Vascular And Neuro-glial Dysfunction In Diabetic Retinopathy
Funder
National Health and Medical Research Council
Funding Amount
$481,500.00
Summary
The retina is responsible for sight. Vision occurs by interactions between blood vessels, neurons (cells that transmit electrical signals for vision) and glia (cells that support the retina). In diabetes, high amounts of glucose in blood increases certain factors within retinal cells. These factors slowly cause damage, such that after 15 years of diabetes all patients will have some retinal disease and many will loose sight. Indeed, diabetes is the leading cause of blindness in working people. T ....The retina is responsible for sight. Vision occurs by interactions between blood vessels, neurons (cells that transmit electrical signals for vision) and glia (cells that support the retina). In diabetes, high amounts of glucose in blood increases certain factors within retinal cells. These factors slowly cause damage, such that after 15 years of diabetes all patients will have some retinal disease and many will loose sight. Indeed, diabetes is the leading cause of blindness in working people. The main treatment for diabetic retinal disease is to burn away damaged blood vessels, however, this treatment has problems. Firstly, the burns destroy healthy retina and the disease continues, secondly, the treatment is performed late in the disease and therefore does not prevent the early changes in retinal cells, and thirdly, changes in neurons and glia are often not considered. Therefore, there is an urgent need to understand how blood vessels, neurons and glia interact with each other to threaten vision in diabetes, with the intention of developing safer and more effective treatments. This will be the focus of the current project. Currently, there are no studies that have examined the sequential changes in retinal blood vessels, neurons and glia in diabetes. This is mainly due to the lack of an experimental rodent model that progresses from mild to severe diabetic retinal disease. In 2003, we established such a model in the diabetic Ren-2 rat. In this project the diabetic Ren-2 rat will be used to study retinal cell changes and also to identify the factors that damage these cells. We suggest that angiotensin, bradykinin and VEGF are involved. These factors are present in the normal retina and are increased in diabetes. We will block these factors with specific drugs with the intention of understanding how these factors affect retinal cells in diabetes, and also to develop new drug therapies for the treatment of both early and late diabetic retinal disease.Read moreRead less
Neuropathic Pain Drugs Based On The Endogenous Opioid Peptide Endomorphin 1.
Funder
National Health and Medical Research Council
Funding Amount
$209,470.00
Summary
We have developed a new pain drug based on the natural pain killing opioid peptide, Endomorhin 1. The new drug exhibits activity similar to morphine and gabapentin against neuropathic pain in animals but seems to act through a different mechanism. We will complete our preclinical investigation of this compound by assessing its side effect profile and tolerence inducing properties in animals. We will also continue our development of an orally active analogue of this important peptide.
Sensory Innervation Of The Anal Region In Normal And Diabetic Guinea Pigs
Funder
National Health and Medical Research Council
Funding Amount
$372,389.00
Summary
Until something goes wrong, we take it for granted that we can empty our bowels on a regular basis, at a time and place of our choosing. Failure to achieve this is very distressing and substantially diminishes quality of life, if it occurs regularly. Disordered defecation, fecal incontinence and constipation are surprisingly common and their prevalence will continue to increase as our population ages and the incidence of diseases such as diabetes increases. In many people suffering these problem ....Until something goes wrong, we take it for granted that we can empty our bowels on a regular basis, at a time and place of our choosing. Failure to achieve this is very distressing and substantially diminishes quality of life, if it occurs regularly. Disordered defecation, fecal incontinence and constipation are surprisingly common and their prevalence will continue to increase as our population ages and the incidence of diseases such as diabetes increases. In many people suffering these problems, there is a detectable dysfunction of the sensory nerves in the anal region. These nerves supply information from the anal region to the spinal cord that can cause us to sense activity in our lower bowel and initiate defecation reflexes. These sensory pathways are important for clinical gastroenterology, but remarkably little is known about them. We are now able to investigate what it is the sensory nerves in the anal region sense, what they look like and where they go to in the spinal cord - in a single project. To do this we will use simple, but novel techniques that have been developed in this laboratory in an animal model. Once we know this, we will compare the function of sensory nerves in the anal region in diabetic animals with normal animals. This will give us insight into the role of sensory nerves in the development of fecal incontinence an unpleasant symptom for many people suffering advanced diabetes. My systematic approach will provide understanding of the basic cellular mechanisms and nerve pathways that underlie sensation in the anal region, helping both clinicians and patients understand the cause of defecatory disorders and potentially pointing the way to new therapies and strategies for diagnosis.Read moreRead less