The western region of Melbourne has one of the highest rates of diabetes mellitus in the country. One third of all inpatients of Western Health have diabetes, predominantly Type 2. Gestational diabetes is also very common affecting nearly 20 per cent of all pregnant women treated here. Western Health also cares for many people with Type 1 diabetes and unfortunately every year nearly 100 episodes of life-threatening diabetic ketoacidosis are managed in these patients. Our research activities focus therefore is predominantly on diabetes.

Our future research projects (in partnership with NWPHN) include:

  • A safe discharge project from clinic back to their GPs for patients of the Western Health Diabetes clinic;
  • Assessment of the metabolic and bone health effects of Androgen Deprivation therapy in males with prostate cancer;
  • Investigating the glycaemic impact of glucocorticoid treatment in medical inpatients.

OUR RESEARCH

  • Psychosocial Factors in Patients Presenting with Diabetic Ketoacidosis

Researchers: A/Prof Shane Hamblin, Dr Sylvia Xu, Dr Azni Abdul-Wahab and Cheryl Steele
Collaborator: Grey Searle

This project examines the prevalence of depression and diabetes distress and social factors (eg unemployment prevalence) in patients admitted with life-threatening diabetic ketoacidosis (DKA). By understanding the drivers behind our high rates of DKA we hope to be able to reduce overall presentations of this life threatening condition.

 

  • The Effect of Betamethasone on Blood Glucose in Pregnant Women With and Without Gestational Diabetes

Researchers: Dr Christopher Yates, Dr Amy Harding, Dr Anna Watts, Dr Ellissa McNamara and Cheryl Steele

Betamethasone is commonly given to pregnant women towards the end of pregnancy to help fetal lung maturation before delivery. However, this drug also elevates maternal blood glucose which may have deleterious effects on the fetus. This study uses continuous glucose monitoring technology to examine the extent of beta-methasone induced maternal hyperglycaemia and the effect of insulin dosing strategies used in clinical practice. The study aims to develop better insulin dosing strategies to optimise blood glucose control in pregnant women thereby minimising adverse effects on the baby

 

PUBLICATIONS 2016-17

  1. Sumithran P, Houlihan C, Shub A, Churilov L, Pritchard N, Price S, Ekinci E, Proietto J, Permezel M. How common is substantial weight gain after pregnancy? Obes Res Clin Pract. 2017 Nov 20. pii: S1871-403X(17)30119-9. doi: 10.1016/j.orcp.2017.10.007. [Epub ahead of print]
  2. Sumithran P, Purcell K, Kuyruk S, Proietto J, Prendergast LA Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population.. Clin Obes. 2017 Nov 8. doi: 10.1111/cob.12229. [Epub ahead of print]
  3. Ekinci EI, Kong A, Churilov L, Nanayakkara N, Chiu WL, Sumithran P, Djukiadmodjo F, Premaratne E, Owen-Jones E, Hart GK, Robbins R, Hardidge A, Johnson D, Baker ST, Zajac JD. Using automated hba1c testing to detect diabetes mellitus in orthopedic inpatients and its effect on outcomes.
    PLoS One. 2017 Jan 6;12(1):e0168471. doi: 10.1371/journal.pone.0168471. eCollection 2017. Erratum in: PLoS One. 2017 Feb 13;12 (2):e0172380
  4. Karahalios A, Somarajah G, Hamblin PS, Karunajeewa H, Janus ED. Quantifying the hidden healthcare cost of diabetes mellitus in Australian hospital patients. Intern Med J. 2017 Nov 29. doi: 10.1111/imj.13685. [Epub ahead of print]
  5. Lines KE, Vas Nunes RP, Frost M, Yates CJ, Stevenson M, Thakker RV A MEN1 pancreatic β cell mouse model for pancreatic neuroendocrine tumours, under temporal control. Endocrine Connections 2017 May;6(4):232-242
  6. Flynn A, Dwight T, Benn D, Deb S, Colebatch AJ, Fox S, Harris J, Duncan E, Robinson B, Hogg A, Ellul J, To H, Duong C, Miller JA, Yates C, James P, Trainer A, Gill AJ, Clifton-Bligh R, Hicks RJ, Tothill RW. Cousins not twins: intra and inter-tumoral heterogeneity in the context of syndromic neuroendocrine tumors. Journal of Pathology 2017 Jul;242(3):273-283
  7. Jiang H, Yates CJ, Gorelik AG, Kale A, Song Q, Wark JD Peripheral quantitative computed tomography (pqct) measures contribute to the understanding of bone fragility in older patients with low-trauma fracture J Clin Densitom. 2018 Jan – Mar;21(1):140-147. doi: 10.1016/j.jocd.2017.02.003. Epub 2017 Mar 9
  8. Kevat D, Chen M, Wyld D, Fagermo N, Lust K. Carcinoid tumour in pregnancy: case report and literature review. Obstetric Medicine 2017 Vol 2, 10: 142-149
  9. Wali JA, Galic S, Tan CY, Gurzov EN, Frazier AE, Connor T, Ge J, Pappas EG, Stroud D, Varanasi LC, Selck C, Ryan MT, Thorburn DR, Kemp BE, Krishnamurthy B, Kay TW, McGee SL, Thomas HE. Loss of BIM increases mitochondrial oxygen consumption and lipid oxidation, reduces adiposity and improves insulin sensitivity in mice. Cell Death Differ. 2018 Jan;25(1):217-225.
  10. Mollah ZUA, Quah HS, Graham KL, Jhala G, Krishnamurthy B, Dharma JFM, Chee J, Trivedi PM, Pappas EG, Mackin L, Chu EPF, Akazawa S, Fynch S, Hodson C, Deans AJ, Trapani JA, Chong MMW, Bird PI, Brodnicki TC, Thomas HE, Kay TWH. Granzyme A Deficiency Breaks Immune Tolerance and Promotes Autoimmune Diabetes Through a Type I Interferon-Dependent Pathway. Diabetes. 2017 Dec;66(12):3041-3050.
  11. Lee MH, McKelvie P, Krishnamurthy B, Wang YY, Caputo C. An intrasellar pituitary adenoma–gangliocytoma presenting as acromegaly. Endocrinology, Diabetes & Metabolism Case Reports. 2017;2017:17-0035.
  12. Mariño E, Richards JL, McLeod KH, Stanley D, Yap YA, Knight J, McKenzie C, Kranich J, Oliveira AC, Rossello FJ, Krishnamurthy B, Nefzger CM, Macia L, Thorburn A, Baxter AG, Morahan G, Wong LH, Polo JM, Moore RJ, Lockett TJ, Clarke JM, Topping DL, Harrison LC, Mackay CR. Gut microbial metabolites limit the frequency of autoimmune T cells and protect against type 1 diabetes. Nat Immunol. 2017 May;18(5):552-562. Erratum in: Nat Immunol. 2017 Oct 18;18(11):1271
  13. Trivedi PM, Graham KL, Scott NA, Jenkins MR, Majaw S, Sutherland RM, Fynch S, Lew AM, Burns CJ, Krishnamurthy B, Brodnicki TC, Mannering SI, Kay TW, Thomas HE. Repurposed JAK1/JAK2 Inhibitor Reverses Established Autoimmune Insulitis in NOD Mice. Diabetes. 2017 Jun;66(6):1650-1660
  14. Dickinson AM; Frescos N; Firth JC; Hamblin PS, The characteristics of wound pain associated with diabetes-related foot ulcers: a pilot study. Wound Practice and Research 2016; Vol 24 (3): 138-148
  15. Khong JJ; Burdon KP; Lu Y; Laurie K; Leonardos L; Baird PN; Sahebjada S; Walsh JP; Gajdatsy A; Ebeling PR; Hamblin PS; Wong R; Forehan SP, Fourlanos S; Roberts AP; Doogue M; Selva D; Montgomery GW; Macgregor S; Craig JE, Pooled genome wide association detects association upstream of FCRL3 with Graves’ disease. BMC Genomics 2016; Vol 17:939
  16. Ekinci E; Kong A; Churilov L; Nanayakkara N; Chiu WL; Sumithran P; Premaratne E; Djukiadmodjo F; Owne-Jones E; Hart G; Robbins R; Hardidge A; Johnson D; Baker S; Zajac J. Using automated HbA1c testing to detect diabetes mellitus in orthopedic inpatients and its effect on outcomes. PLoS ONE (2016) accepted
  17. Sumithran P; Proietto J. Maintaining weight loss: an ongoing challenge. Curr Obes Rep (2016) Oct 3
  18. Sumithran P; Prendergast LA; Haywood CJ; Houlihan CA; Proietto J. Review of 3-year outcomes of a very-low-energy diet-based outpatient obesity treatment programme. Clin Obes (2016) 6:101-7
  19. Sharifi A; Varsavsky A; Ulloa J; Horsburgh JC; McAuley SA; Krishnamurthy B; Jenkins AJ; Colman PG; Ward GM; MacIsaac RJ; Shah R; O’Neal DN. Redundancy in Glucose Sensing: Enhanced Accuracy and Reliability of an Electrochemical Redundant Sensor for Continuous Glucose Monitoring. J Diabetes Sci Technol. 2016 May 3;Vol 10(3):669-78
  20. Trivedi P; Graham KL; Krishnamurthy B; Fynch S; Slattery RM; Kay TW; Thomas HE. Perforin facilitates beta cell killing and regulates autoreactive CD8+ T-cell
  21. responses to antigen in mouse models of type 1 diabetes. Immunol Cell Biol. 2016 Apr; Vol 94(4):334-41
  22. Krishnamurthy B; Selck C; Chee J; Jhala G; Kay TW. Analysis of antigen specific T cells in diabetes – Lessons from pre-clinical studies and early
  23. clinical trials. J Autoimmun. 2016 Jul; Vol 71:35-43
  24. Jhala G, Chee J, Trivedi PM, Selck C, Gurzov EN, Graham KL, Thomas HE, Kay TW, Krishnamurthy B. Perinatal tolerance to proinsulin is sufficient to prevent autoimmune diabetes. JCI Insight. 2016 Jul 7;1(10):e86065
  25. Lee I; Maple-Brown LJ, Global hyperglycemia in pregnancy and challenges in its management in resource-limited settings, DIabetes Management Journal, 2016, Vol 56: 11-14
  26. Sharifi A, De Bock M, Jayawardene D, Loh M, Horsburgh J, Berthold C, Paramalingam N, Kumareswaran K et al. Glycemia, Treatment Satisfaction, Cognition, and Sleep Quality in Adults and Adolescents with Type 1 Diabetes When Using a Closed-Loop System Overnight Versus Sensor-Augmented Pump with Low-Glucose Suspend Function: A Randomized Crossover Study. Diabetes Technology & Therapeutics 2016 Dec, Vol 18(12):772-783

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