Early signs of diabetes complications in childhood onset diabetes mellitus

Summary

Early signs of diabetes complications in childhood onset diabetes will focus on newer methods to assess heart rate variation, peripheral nerve function, colour vision and vascular changes.

Supervisor(s)

Professor Kim Donaghue

Research Location

Westmead - Childrens Hospital at Westmead Clinical School

Program Type

PHD

Synopsis

Childhood-onset diabetes confers a risk of the long-term complications of blindness due to retinopathy, renal failure due to nephropathy, severe pain and increased mortality due to neuropathy and macrovascular disease. The Diabetes Complications Assessment Service at CHW has been operating since 1990. Its role is to detect complications prior to clinical signs and symptoms. Adolescents and older children are assessed for early signs of retinopathy, nephropathy and neuropathy. Young people come for a 3-4 hour assessment every 1-2 years. To date over 2000 adolescents have been screened. We are world leaders in these assessments and so new areas of assessment can be compared against already well established (and published standards from our unit). Possible areas for research are:

  1. Autonomic nerve testing: we have established methods of measuring cardiovascular tests and pupillary function, and have possibilities to expand further models of nonlinear analysis of heart rate variation which may be a prognostic indicator of subsequent mortality.
  2. Early changes in vascular dimensions predate retinopathy and early functional changes such as poor colour discrimination.
  3. Peripheral nerve function changes may predate the diagnosis of diabetes so could be investigated in a study cohort at high risk of diabetes due to high antibody tests or obesity.
  4. Plantar fascia and skin thickness measured by ultrasound as an index of tissue glycation or a separate complication
  5. Genetic susceptibility of complications and functional correlates
  6. Subanalysis of lipid fractions in relation to microalbuminuria
  7. Quality of life studies

Additional Information

Clinical assessments Chaos theory PCR and RFLP

  1. Peripheral and autonomic nerve function in adolescents with diabetes, prediabetes and obesity
  2. Genetic susceptibility to peripheral and autonomic nerve dysfunction in adolescents with above conditions
  3. Quality of life in adolescents with type 1 diabetes
  4. Colour vision and development of retinopathy in type 1 diabetes
  5. Novel methods of measuring tissue glycation in type 1 diabetes
Funding possible from Diabetes Organisations

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Keywords

Nephropathy, Plantar fascia thickness, diabetes, Obesity, Adolescence, Retinopathy, Heart rate variation, Microalbuminuria, Vascular health, Genetic susceptibility, Pupillometry, Liver & hormonal disorders, Human body

Opportunity ID

The opportunity ID for this research opportunity is: 82