Macrovascular and Microvascular Complications of Diabetes
Our research
Research activities relate to the prediction, mechanisms, and prevention of the micro and macrovascular complications of diabetes mellitus and of atherosclerosis in other high-risk groups, such as those with pre-existent vascular disease, renal or connective tissue disease and Indigenous Australians. Markers and mediators evaluated in clinical and related laboratory based studies include quantitative and qualitative changes in lipoproteins, glycation, oxidative stress, Advanced Glycation End-Products (AGE), inflammation and insulin resistance. These measures are applied to local groups, including islet transplant recipients, and to major national and international studies including the Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC), the Veterans Administration Diabetes Trial (VADT), the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, the Melbourne Collaborative Cohort Study (MCCS) and the Perindopril Protection Against Recurrent Stroke Study (PROGRESS).
Non-invasive measures of vascular health and tissue AGE burden evaluated and utilized in local clinical studies include pulse-wave analysis, detailed echocardiograms, retinal vascular photograph analysis, electroretinograms, and ocular and skin fluorescence. Emerging clinical practice devices for diabetes care such as Continuous Glucose Monitoring Systems (CGMS) and insulin pumps integrated with real time glucose sensors are evaluated.
Laboratory-based studies evaluate qualitative changes in human (diabetic and non-diabetic) vascular tissue, ex vivo vascular growth, and cultured macro and microvascular cell responses to glucose, AGEs and lipoproteins. Various aspects of lipoprotein function, in particular the anti-oxidant, anti-thrombotic and vasoactive properties of High Density Lipoprotein (HDL) are evaluated.
Our staff
- ASSOCIATE PROFESSOR ALICIA JENKINS
- DR ANDRZEJ JANUSZEWSKI
- MS CONNIE KARSCHIMKUS
- DR PETROVA LEE
- DR DAVID O'NEAL
- DR HARRY SCHLEN
Our students
- MR BEN MA
- DR NIRUPA SACHITHANANDAN
Our collaborators
- NHMRC Clinical Trials Centre, University of Sydney
- St Vincent's Institute of Medical Research
- Children's Hospital at Westmead Department of Endocrinology
- Bernard O'Brien Institute
- Department of Ophthalmology, The University of Melbourne
- Department of Cardiothoracic Surgery, St. Vincent's Hospital
- Cancer Council of Victoria
- Medical University of South Carolina
- Oklahoma University Health Sciences Center
Our major current grants
- Biomarkers and genetic determinants of cardiovascular risk in diabetes: the FIELD study. NHMRC 2007-2010 $1.8million
- HDL dysfunction in Type 2 diabetes and coronary artery disease NHMRC 2007-2010 $322,000 CIA
- Clinical Science in Diabetes. NHMRC Centre for Clinical Research Excellence #454461 2006-2010, $2m. J Best, K O'Dea, H Taylor, T Kay, A Jenkins, D Young
- Insulin resistance, inflammation and oxidative stress in islet transplant recipients. Project leader on Program Grant JDRF and NHMRC 2006-2010 $100,000 pa. Overall PI Tom Kay $2million pa
- Effects of non-enzymatic glycation, oxidation and AGE modification of lipoproteins and albumin on endothelial dysfunction, which may accelerate atherosclerosis in diabetes mellitus. NHMRC Peter Doherty Fellowship 2007-2011
Our key publications
- Jenkins A, Best JD, Klein RL & Lyons TJ. 2004. Lipoproteins, glycoxidation and diabetic angiopathy. Diabetes-Metabolism Research and Reviews. 20: 349-368
- Jenkins A, Lyons TJ, Zheng D, Otvos JD, Lackland DT, Mcgee D, Garvey WT, Klein RL & Dcct/Edic RG. 2003. Lipoproteins in the DCCT/EDIC cohort: association with diabetic nephropathy. Kidney International. 64: 817-828
- Wilson AM, O'Neal DN, Nelson CL, Prior DL, Best JD & Jenkins A. 2004. Comparison of arterial assessments in low and high vascular risk groups. American Journal of Hypertension. 17 (4): 285-291
- Nelson CL, Karschimkus C, Dragicevic G, Packham DK, Wilson AM, Becker G, O'Neal DN, Best JD & Jenkins A. 2005. Systemic and vascular inflammation is elevated in early IgA and Type 1 diabetic nephropathies and relates to vascular disease risk factors and renal function. Nephrology, Dialysis, Transplantation. 20 (11): 2420-2426
- Kalogerakis G, Baker A, Christov S, Rowley KG, Dwyer KM, Winterbourn CC, Best JD & Jenkins A. 2005. Oxidative stress and high-density lipoprotein function in Type 1 diabetes and end-stage renal disease. Clinical Science. 108: 497-506
Further information
Contact - enquiries @ medstv.unimelb.edu.au