The inspiration factory

The University of Sydney will spearhead new research on diabetes thanks to the support of the Australian Diabetes Council, writes Chris Rodley.

The eating habits of locusts may sound like an unlikely place to start in the search for new ways to tackle diabetes. But by understanding how the insects regulate their intake of protein – they tend to keep eating until they reach a target level of protein – University of Sydney researchers could help us take an important step forward in the fight against Australia’s looming obesity and diabetes crisis.

Work by biologist and locust expert Professor Stephen Simpson has raised the possibility that falling protein levels in our food could be preventing us from feeling full, triggering us to overeat, and thereby driving up rates of obesity: a major risk factor for type 2 diabetes.

His team recently confirmed this hypothesis through experiments in which human subjects had the protein concentration in their diet covertly manipulated over a three-week period. As predicted, diluting the protein content resulted in overeating – even when subjects had no idea how much protein their diet contained.

Professor Simpson’s research project is just one of many surprising fields of study arising from a major new effort to combat obesity, diabetes and cardiovascular disease using a cross-disciplinary approach. The University’s state-of-the-art Centre for Obesity, Diabetes and Cardiovascular Disease, to be completed in 2013, aims to become a global hub for innovative research into the three related conditions.

At the heart of the centre will be the newly created Australian Diabetes Council Chair of Diabetes, which will spearhead research specifically into type 1 and 2 diabetes as well as being an advocate for greater awareness. More than one million Australians have type 1 or type 2 diabetes, and prevalence is growing; around 100,000 people develop the condition each year.

The Chair will be funded by a generous $5 million endowment from the Australian Diabetes Council, the nation’s largest diabetes charity. “We were inspired by the University’s vision to break down the barriers between traditionally individualistic disciplines,” says Dr Neville Howard, president of the Council. “The scale of the epidemic, and its cost in human and monetary terms, is such that we have to continually think of new ways to try and combat the disease.”

Leading the fight will be researchers doing basic scientific work on animal and cell-based models, as well as those undertaking clinical and translational research – with much cross-fertilisation between the different areas.

“Key questions will include why the pancreas fails (leading to diabetes), how to prevent and treat diabetes complications, and how to optimise health care service delivery for diabetics, who often need highly personalised medical care,” explains Professor Stephen Twigg, Associate Professor in Medicine at the University of Sydney Medical School and theme leader for diabetes at the centre.

Another area under the spotlight will be risk factors for diabetes, such as obesity and a sedentary lifestyle: “Much of the focus will be on how we can have a healthier community, which means trying to minimise obesity, increase physical activity, and maintain as normal a body weight as possible.”

To address these issues the centre will take a world-first interdisciplinary approach, bringing together public health and policy experts, social scientists, urban planners, architects and engineers, whose combined expertise can help society build more active communities where people drive less and walk more. Meanwhile, legal scholars will have a role in asking how society might better regulate unhealthy food.

On top of all that, the centre will examine the family, ethnic and genetic factors that can combine with lifestyle to predispose some people to diabetes, and determine why some people appear more prone to developing diabetes complications than others. “As you can see, we have our work cut out for us,” says Professor Twigg.

Professor Stephen Twigg (right) and colleague

The Australian Diabetes Council’s members are hopeful that the Chair will bring us closer to a potential cure for diabetes as well as unlocking practical ways to manage the disease.

If current research at the University is anything to go by, the centre is likely to bring tangible improvements to diabetics’ lives. One Sydney researcher, Professor Anthony Keech, is having great success using the cholesterol-lowering drug fenofibrate to prevent complications such as human diabetic eye disease.

As well, animal models are being developed that better mimic human disease and provide a clearer research window into human diabetes and its complications.

Professor Twigg witnesses the results of university research every day in his practice. He gives the example of a patient he treated recently: a woman in her 20s with type 1 diabetes who had unstable blood glucose.

“By putting our research knowledge into practice, including new technologies, we were able to avoid a hospital admission by reversing the excess acid which was developing in her blood. At the same time we stabilised her blood glucose to help prevent unconscious low-blood-glucose episodes from occurring in the immediate and long term,” he says.

“This is a very exciting aspect of patient management; seeing that quality of life as well as lifespan can be improved in people with diabetes. And it’s only by applying key learning acquired through research that we can find the best way to do it.”

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