Gastroduodenal Motility And Glycaemic Control In Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$393,750.00
Summary
The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate which the stomach empties food is abnormally slow in ~50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. Abnormal stomach emptying may contribute to a number of problems in diabetes, including sym ....The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate which the stomach empties food is abnormally slow in ~50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. Abnormal stomach emptying may contribute to a number of problems in diabetes, including symptoms such as nausea and bloating, and poor control of blood glucose concentrations. It is now recognised that the blood glucose level itself has a reversible effect on both stomach contractions and symptoms. For example, when the blood glucose is abnormally high (hyperglycaemia), the rate at which the stomach empties food into the intestine is slower and symptoms, such as fullness, are greater. The rate of stomach emptying and the absorption of glucose from the intestine affect the rise in the blood glucose level after a meal; this is an important issue because it is desirable to maintain blood glucose levels within the normal range to minimise the risk of both the development and progression of the complications of diabetes. In many people with diabetes eating a meal results in a substantial fall in blood pressure, which may cause fainting and falls. By slowing gastric emptying the magnitude of the fall in blood pressure is minimised. Our group has been the recipient of ongoing support from the NH and MRC for approximately 18 years to conduct research in this area. As a result we have performed the most comprehensive studies to date and developed new methods to evaluate stomach and intestinal function in people with diabetes, resulting in international recognition. The studies proposed in the current application represent a logical development from our previous work and have important implications for the management of diabetes.Read moreRead less
Gastric Motility And Blood Glucose Control In Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$354,947.00
Summary
The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate of which the stomach empties food is slow in up to 50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. It is now recognised that disordered stomach emptying may contribute to a number of problems i ....The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate of which the stomach empties food is slow in up to 50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. It is now recognised that disordered stomach emptying may contribute to a number of problems in diabetes, e.g. symptoms such as nausea and bloating and poor control of blood glucose concentrations. In some people symptoms are disabling and affect quality of life adversely. The effects of stomach emptying on blood glucose control is likely to be important, as it is desirable to maintain blood glucose levels within the normal range to minimise the risk of both the development and progression of complications of diabetes. In many people with diabetes, particularly older people with type 2 diabetes, there is a fall in blood pressure after a meal which may result in fainting and falls. The magnitude of the fall in blood pressure is determined by the rate at which the stomach empties; faster emptying results in a greater fall in blood pressure. In the past both slow stomach emptying and symptoms were assumed to result from irreversible nerve damage, however it is now recognised that the blood glucose level itself has a reversible effect on both stomach contractions and symptoms. Our group has been the recipient of ongoing support from the NH and MRC for approximately 15 years to conduct research in this area. As a result we have performed the most comprehensive studies to date and developed new methods to evaluate stomach function in people with diabetes, resulting in international recognition. The studies proposed in this current application represent a logical development from our previous work and have important implications for the management of diabetes.Read moreRead less
Discovery Early Career Researcher Award - Grant ID: DE120102503
Funder
Australian Research Council
Funding Amount
$375,000.00
Summary
Circulating tumor cell isolation and detection: an integrated microfluidic capture device based on alternating current (AC) electrohydrodynamics. The detection of circulating tumor cells in clinical samples plays a critical role in cancer diagnosis and management. This project aims to develop microfluidic technology by incorporating AC electric field-induced vortices with three-dimensional microstructured electrodes that will advance our ability to analyse rare cells and proteins in clinical sam ....Circulating tumor cell isolation and detection: an integrated microfluidic capture device based on alternating current (AC) electrohydrodynamics. The detection of circulating tumor cells in clinical samples plays a critical role in cancer diagnosis and management. This project aims to develop microfluidic technology by incorporating AC electric field-induced vortices with three-dimensional microstructured electrodes that will advance our ability to analyse rare cells and proteins in clinical samples.Read moreRead less
Tuneable “Nano-Shearing”: An Innovative Mechanism for the Accurate and Specific Capture of Cells and Molecules. Recent investigations have discovered a tuneable electro-hydrodynamic force which drives lateral fluid motion within a few nanometers of an electrode surface. Because the magnitude of this fluid shear force can be tuned externally (for example, via the application of an AC electric field), it provides a new capability to physically displace weakly (non-specifically) bound cellular and ....Tuneable “Nano-Shearing”: An Innovative Mechanism for the Accurate and Specific Capture of Cells and Molecules. Recent investigations have discovered a tuneable electro-hydrodynamic force which drives lateral fluid motion within a few nanometers of an electrode surface. Because the magnitude of this fluid shear force can be tuned externally (for example, via the application of an AC electric field), it provides a new capability to physically displace weakly (non-specifically) bound cellular and molecular analytes. By performing research to further understand and develop this tuneable effect, this project aims to build and test a new platform technology to enable highly efficient capture and specific detection of low concentration pathogenic molecules and circulating tumour cells (CTCs).Read moreRead less
Goodness-of-fit Testing Of Log-link Models For Categorical Outcome Data
Funder
National Health and Medical Research Council
Funding Amount
$260,863.00
Summary
Information about the health consequences of exposure to causal factors is obtained from mathematical models of observed data. Incorrect inferences are possible if the model does not adequately represent the data. Relative risk models are recommended for observations over time on a cohort of subjects, but it is not known how best to assess the adequacy of such models. This project will assess the performance of summary measures of goodness-of-fit when applied to relative risk models.
Design And Analysis Of Interrupted Time Series Studies In Health Care Research: Resolution Of Methodological Issues
Funder
National Health and Medical Research Council
Funding Amount
$307,125.00
Summary
An interrupted time series (ITS) study involves a population observed on multiple occasions before and after the implementation of an intervention program. However, methods for statistical analysis and designing such studies have not been well developed and many statistical analyses of such studies are flawed. This proposal will investigate appropriate methods for design and analysis, and develop guidelines and software for its implementation by health researchers.
STEP: Improving The Evaluation And Use Of Tests For Screening, Diagnosis And Monitoring In Healthcare.
Funder
National Health and Medical Research Council
Funding Amount
$9,566,865.00
Summary
Medical tests - for screening, diagnosis, and monitoring - are often poorly evaluated and poorly used. This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science, addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisio ....Medical tests - for screening, diagnosis, and monitoring - are often poorly evaluated and poorly used. This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science, addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-offs; how benefits weigh up against harms. This research is relevant to all partners in healthcare - consumers, clinicians and policymakers - who currently are being tested or implementing tests without being fully informed about the accuracy and effects of these tests.Read moreRead less