Managing Incidence

Predicting pathways ... Professor Lopez
Predicting pathways ... Professor Lopez

Diabetes mellitus – Type 1, Type 2 and gestational – will continue as an urgent health priority for Australia and globally throughout this century with 940,000 Australians estimated to have the disease.

Diabetes can lead to early death, as well as severe cardiovascular, eye and kidney complications, and limb amputations. University research is at the forefront of efforts to both predict the development of diabetes as well as manage its incidence in a society.

Predicting  Explosion

Health loss caused by Type 2 diabetes will more than double in Australia by 2023, as health loss from most other major causes falls, according to new research by the School of Population Health. The research, published in the Medical Journal of Australia, assesses and predicts the burden of disease and injury in Australia from 1993 to 2023, measuring the health loss from diseases, injuries and risk factors. Health loss is measured by the “disability adjusted life year” (DALY) with one DALY equalling one lost year of healthy life. The DALY represents the gap between current health status and an ideal situation of the whole population living into healthy old age.

The paper, by PhD student Stephen Begg, Associate Professor Theo Vos, Bridget Barker, Lucy Stanley and Professor Alan Lopez, reports 75 percent of health loss is caused by cancer, cardiovascular disease, neurological and sense disorders, chronic respiratory disease and injuries. While cardiovascular disease is the overall biggest cause of health loss in Australia, anxiety/ depression is the biggest cause for women while injuries (especially for males) and mental disorders account for most DALYs in early adulthood.

Mr Begg said DALY rates were also different among various “subpopulations” of Australia, with higher health loss occurring in disadvantaged communities. “Health loss was more than a third (31.7 percent) higher in the lower socio-economic quintile than in the highest and 26.5 percent higher in remote areas than in major cities,” he said. The study’s authors predicted, while many causes of health loss, including cancer, cardiovascular disease and injuries, will fall by 2023, some, including mental disorders, neurological and sense disorders (such as hearing loss), musculoskeletal disorders and Type 2 diabetes, in particular, would rise over that same period.

The researchers studied 14 key risk factors for these conditions. These included tobacco use, high blood pressure, high body mass, physical inactivity and alcohol consumption. Dr Vos said the findings emphasised that, despite steady improvements in Australia’s health over the past decade, significant opportunities remained to make further progress. “All of the health risks are open to modifi cation through intervention,” he said. “For example, the predicted strong growth in health loss associated with diabetes is notable as it is mostly due to increased body mass. If new approaches to encourage Australians to maintain a healthy body weight could be as successful as the anti-smoking campaigns that have helped reduce cardiovascular disease, we may be able to reduce increasing diabetes rates.”

Professor Lopez, Head of the School of Population Health, said the paper built on previous School research, including last year’s The burden of disease and injury in Aboriginal and Torres Strait Islander Peoples, 2003 and The burden of disease and injury in Australia, 2003, both produced for the Australian Institute of Health and Welfare.

“This kind of critical, comparable and comprehensive research is important, both to understand the magnitude and distribution of health problems in Australia, and to identify key opportunities for health gain,” he said. “It is central to health policy decisions that offer the best opportunities for progress towards improving the health status of all Australians.”

Story author: Vanessa Mannix Coppard 

Simple  Test


Above... Felicity Rose, Professor John Prins and Professor Ranjeny Thomas

Researchers are developing a simple test that may predict whether a child will develop Type 1 diabetes. Professor Ranjeny Thomas, and her colleagues from the UQ Diamantina Institute for Cancer, Immunology and Metabolic Medicine, have identified a cellular pathway known as NF-kappa B that is activated in blood cells of people with Type 1 diabetes. “Blood cells are the major infection and immune control cells of the body, called monocytes and dendritic cells,” she said.

“Monocytes from healthy people are ‘quiet’ in the blood and if we expose them to infection outside the body, the NF-kappa B pathway gets activated.

“In individuals with Type 1 diabetes, we found monocyte NF-kappa B was already activated in the blood, and, when exposed to infection, the pathway shut down. This tells us something fundamental about the problems of immune control that cause diabetes to develop in children.

“As a spin-off , by simply taking blood, we hope to now be able to identify if a child will develop diabetes.” She said Type 1 diabetes was caused by problems in the immune system, so that the pancreas was not tolerated – like an organ rejection. “The pancreas of people with diabetes gets inflamed, and then stops producing the hormone, insulin. Insulin is needed to control blood sugar,” she said.

The test would target families with a history of diabetes with the aim of picking up other children at risk, she said. “Currently available tests pick up this risk rather late and in relatively few people, when there is already evidence of intolerance of the pancreas,” she said.

The research was published in the Journal of Immunology.

Story author: Andrew Dunne

PREDICTING EXPLOSION

SIMPLE TEST

Photos: Chris Stacey

On this site