Using Conversational Computer Technology To Improve Diabetes Management: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$708,606.00
Summary
The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for a ....The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for achieving this. This research will evaluate a computer-controlled, interactive telephone system for improving the management and self-management of Type 2 diabetes in addition to routine care. Patients with Type 2 diabetes will be recruited from Brisbane and each patient will be randomly assigned to receive either this new program or just their usual care from their doctor or Diabetes Clinic. The first group will call the system weekly for six months using a regular phone or a mobile phone if they wish. During the call, they will answer questions by speaking into the phone, listen to feedback and strategies for improving management of their diabetes and then discuss their next targets and behavioural actions. They will receive systematic and tailored advice on blood glucose testing, nutrition and physical activity, as well as medication taking and foot care. The system individualises conversations according to the user s answers and responses over all the interactive sessions. The trial will formally evaluate the clinical impact on blood glucose control and the adoption and maintenance of the targeted health habits, as well as the intervention s cost-effectiveness and users satisfaction with the system. This project s significance lies in the excellent potential of using this new technology to provide a 'low cost' but effective program to help people better manage Type 2 diabetes.Read moreRead less
A Novel Lipid Sensitive Kinase And Its Role In Obesity-induced Inflammation And Insulin Resistance.
Funder
National Health and Medical Research Council
Funding Amount
$560,045.00
Summary
It is now apparent that obesity leads to chronic low grade inflammation which results in insulin resistance or pre-diabetes. The mechanisms that link obesity-induced inflammation to insulin resistance are not well understood, but involve lipid oversupply. We have preliminary data identifying that a protein, not known to previously play a role in metabolic diseases, is a critical mediator of lipid-induced inflammation. We will investigate the clinical potential of blocking this protein.
A Study To Investigate Alternative Regimens For Pneumococcal Vaccination Of Infants In A Developing Country
Funder
National Health and Medical Research Council
Funding Amount
$1,622,210.00
Summary
Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver thi ....Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver this vaccine, which are safe and effective. A recent WHO-GAVI meeting to address impediments to the introduction of these vaccines in developing countries recognized the need to evaluate other regimens of Pnc conjugate vaccine as an important research priority. This study has been deliberately formulated with that need in mind. The site for this research is Fiji. Although health services are good, Pnc disease, particularly pneumonia, remains the commonest cause of childhood morbidity and mortality. Fiji has good vaccine coverage and was the first Pacific country to introduce Hib vaccine. The arrival of the new, expensive Pnc conjugate vaccine presents a dilemma for Fiji and many similar countries. The expense of this vaccine would consume a large portion of the health budget. This study has two components: 1. A Phase 2 immunogenicity study (involving 750 infants) to evaluate regimens using reduced numbers of doses of Pnc conjugate vaccine, and using timing of dosing and combinations with the Pnc polysaccharide (PS) vaccine that may be more suited to the epidemiology of Pnc disease in developing countries. 2. An epidemiological study will measure the burden of invasive Pnc disease and pneumonia in Fiji. This will be part of a global effort to address these issues, and will be used to develop rapid assessment tools for these diseases in developing countries. We will seek cofounding for this component.Read moreRead less
TELEPHONE COUNSELLING FOR MAINTENANCE OF PHYSICAL ACTIVITY, WEIGHT LOSS And GLYCAEMIC CONTROL IN TYPE 2 DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$1,285,894.00
Summary
Regular exercise, a healthy diet and weight loss are key to managing type 2 diabetes, yet these are major challenges for most people with diabetes. This study will evaluate the impact of a telephone counselling program to assist people with type 2 diabetes to exercise, eat a healthy diet and lose weight, with the goal of helping them to sustain these changes over the long-term. It is expected that these lifestyle changes will also result in improved blood glucose control and quality of life.
Effect Of Sex Steroids, Inflammation, Environmental And Biopsychosocial Factors On Cardiometabolic Disease Risk In Men
Funder
National Health and Medical Research Council
Funding Amount
$1,817,271.00
Summary
Heart disease is more frequent and occurs at an earlier age in men than women. The reason is unknown. Apart from obesity and associated disturbances of metabolism, changes in sex hormones such as testosterone, together with the effects of inflammation may be important, and may in turn be affected by environment, lifestyle behaviours, and stress. To untangle these relationships, we will use cutting edge technology, in a large sample of men, in partnership with other international scientists.
Insulin resistance (the inability of ordinarily insulin-sensitive tissues such as muscle and adipose tissue to respond to insulin) contributes to a number of diseases including diabetes and obesity. A key metabolic step in these tissues is the uptake of glucose from the blood stream. This step is accelerated by insulin thus allowing efficient clearance of glucose from the bloodstream after a meal. Our laboratory has played a major role in showing that insulin regulates glucose uptake into muscle ....Insulin resistance (the inability of ordinarily insulin-sensitive tissues such as muscle and adipose tissue to respond to insulin) contributes to a number of diseases including diabetes and obesity. A key metabolic step in these tissues is the uptake of glucose from the blood stream. This step is accelerated by insulin thus allowing efficient clearance of glucose from the bloodstream after a meal. Our laboratory has played a major role in showing that insulin regulates glucose uptake into muscle and adipose tissue by stimulating the movement of a glucose transport protein from inside the cell to the cell surface (see http:--www.imb.uq.edu.au-groups-james-glut4 for an animated description of this process). The purpose of this proposal is to dissect the molecular mechanisms by which this glucose transporter can be held inside the cell in the absence of insulin and then allowed to be released from this site moving to the surface in the presence of insulin. Our studies over the past 5 years have brought us much closer to understanding this process in detail. The identification of the molecules responsible for this regulatory step will not only aid our understanding of this process but it will also provide a valuable target for development of therapeutic agents that can be used to combat insulin resistance.Read moreRead less
Alpha-2-Macroglobulin And The Transport And Uptake Of The Hormone, Hepcidin
Funder
National Health and Medical Research Council
Funding Amount
$533,541.00
Summary
Hepcidin is a peptide hormone that is a major regulator of iron metabolism. It has been suggested that hepcidin is free in the blood. However, we recently identified that hepcidin binds with alpha-2-macroglobulin (a2-M) in the plasma and this increases the efficacy of this peptide. The demonstration that a2-M plays a role in hepcidin biology will lead to a better understanding of hepcidin physiology, the development of methods for its measurement and improved treatment of iron related diseases.
Novel Retinal Architectural Vascular Signs And Risk Of Cardiovascular Disease: The AusDiab Study
Funder
National Health and Medical Research Council
Funding Amount
$754,254.00
Summary
Cardiovascular disease (CVD) and diabetes are major health problems. Identifying 'people at risk' is critical to design preventative strategies. We have developed new computer software to measure detailed characteristics of retinal vessels. By appling this system to predict CVD or diabetes in the AusDiab Study we aim to find 'the best combination of risk factors' to predict CVD and diabetes. This will open up the possibility of new risk assessment using a simple 'eye scan.'
Regulation Of Lipid Metabolism By AMP Activated Protein Kinase
Funder
National Health and Medical Research Council
Funding Amount
$478,776.00
Summary
Western communities are experiencing an epidemic of overweight and obesity that is contributing to diabetes, heart disease, and premature death. This project is investigating an enzyme, called AMP-activated protein kinase, that plays a pivotal role in controlling how our bodies control energy metabolism in response to exercise. Improved understanding about how this enzyme regulates the body's storage and breakdown of fat and responsiveness to insulin will enable the development of new medicines ....Western communities are experiencing an epidemic of overweight and obesity that is contributing to diabetes, heart disease, and premature death. This project is investigating an enzyme, called AMP-activated protein kinase, that plays a pivotal role in controlling how our bodies control energy metabolism in response to exercise. Improved understanding about how this enzyme regulates the body's storage and breakdown of fat and responsiveness to insulin will enable the development of new medicines for the treatment of obesity and the prevention of diabetes.Read moreRead less