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Research outline - Institute of Endocrinology and Diabetes

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Research program

Prevention of Type 1 Diabetes and its complications

  • Epidemiology of type 1 diabetes in Australia. We are leading these multicentre collaborative studies examining disease trends in children and adolescents with type 1 diabetes. Type 1 diabetes incidence in Australia is increasing approximately 2.7%/year. Our research aims to identify epidemiological factors that improve our understanding of the triggers of diabetes with a focus on the role of viruses and vitamin D.
  • VIGR study: Viral etiology of Type 1 diabetes - research is being undertaken on how viruses infect and damage beta cells to trigger the onset of diabetes, with the ultimate aim being to develop vaccines to prevent diabetes. We are also studying other risk factors that may trigger diabetes, including vitamin D deficiency and dietary factors.
  • Prevention trials (TRIGR and others) – the effect of interventions (reduced exposure to cow's milk in the first 8 months of life and intranasal insulin in high risk individuals) are being studied in international randomised controlled trials
  • Prevention: we are involved in national and international collaborative multiplex and family studies aimed at further our understanding of the genetic contribution to type 1 and 2 diabetes (TrialNET and ACCDR). We are also involved in studies aimed at identifying individuals who are on the pathway to developing diabetes ('pre-diabetes') who may be eligible for intervention trials that may prevent diabetes. We are embarking on an international collaborative trial of intranasal insulin to prevent type 1 diabetes in children with prediabetes (INIT 11)
  • Genetics of diabetes complications – one of the largest global databases (cross sectional and longitudinal) of the eye, kidney and neurological complications of diabetes has been and is prospectively collected. The effect of gene variations on frequency and severity of complications is under study. We are studying the functional mechanisms by culturing white cells from adolescents with known genotype and complication phenotype; and examining their expression of antioxidant enzymes.
  • Vascular changes and soft tissue thickening in early diabetes complications, and their relationship to subsequent more severe complications. This is in collaboration with 2 investigators at the University of Melbourne.
  • ADdIT – this is an International randomised controlled trial evaluating the roles of blood pressure and cholesterol lowering drugs to reduce the development of kidney abnormalities in adolescents with type 1 diabetes (in collaboration with UK and Canada)
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Prevention of type 2 diabetes and insulin resistance associated with obesity

  • Using data from population based studies, we are examining environmental determinants of obesity, metabolic syndrome and cardiovascular risk and their change over time
  • Intervention studies in individuals with overweight/obesity and insulin resistance syndrome – we are leading randomised controlled trials on 1) the effects of modified carbohydrate intake and intense exercise, RESIST and 2) the effect of whole body vibration platforms on insulin sensitivity, VIBRATE
  • The inflammatory role of visceral and subcutaneous fat in obesity is being studied using molecular techniques
  • The evolution of insulin resistance in daughters of mothers with polycystic ovary syndrome
  • Epidemiology of type 2 diabetes in NSW and Australia. We are leading population based studies determining the incidence and risk factors associated with development of type 2 diabetes in youth.

Bone health

The major areas of bone research are:

  • The natural history of osteopenic disorders
  • Prevention and treatment of primary and secondary osteoporosis
  • Prevention and treatment of simple vitamin D deficiency
  • Exercise and bone health in children

Specific areas of interest include:

  • Natural history data of osteopenic disorders
    • Cerebral palsy
    • Neurofibromatosis type 1
    • Duchene muscular dystrophy
    • Spinal cord injury
    • Cystic fibrosis
  • Prevention and treatment of primary and secondary osteoporosis.
    • Intravenous bisphosphonate therapy in established osteoporosis
    • Oral bisphosphonate therapy in milder forms of primary osteopenia
    • Whole body vibration training in osteogenesis imperfecta, cerebral palsy, cystic fibrosis, mitochondrial disorders and other causes of secondary osteopenia
  • Prevention and treatment of simple vitamin D deficiency
    • Incidence of simple vitamin D deficiency in Australia
    • Stoss therapy for simple vitamin D deficiency
  • Exercise and bone health in children
    • Effect of exercise on bone of children undertaking various sporting activities
    • Effect of whole body vibration training on bone mass and muscle function in school children
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Research support (2008/09)

57 project grants over 5 years totalling ($7.9M)
(Y2005 $1.2 M, Y2006 $1.4 M, Y2007 $1.9 M, Y2008 $2.1 M, Y2009 $1.3 M)

  • NHMRC/ARC (n=15)
  • Other Government competitive funds (n=5)
  • Government non-competitive fund (n=4)
  • Funds from industry (n=8)
  • Other competitive fund (n=23)
  • Other non-competitive fund (n=2)
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