Blood glucose after a meal might be key to unlocking glucose regulation in people with diabetes

Adelaide researchers will be given opportunities to explore blood glucose management and perhaps improve life for the millions of Australians who have diabetes.

Last week five research projects led by the University of Adelaide’s Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health secured almost $350,000 in grant funding from the Diabetes Australia Research Program.

Professor Michael Horowitz, an endocrinologist and the Director of the CRE says the five projects are linked by a focus on optimising blood glucose levels for diabetes treatment, which is imperative for improving the quality of life for people living with diabetes across Australia.

“The central theme is how to normalise fluctuations – both elevations (hyperglycaemia) and, in people who are on insulin, abnormal reductions (hypoglycaemia).

“The majority of the projects also focus on the function of the gastrointestinal tract in blood glucose control. Particularly in the rate that the stomach empties.”

A composite image of the researchers involved in the cre
The University of Adelaide’s Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health. Credit: supplied

Horowitz says it’s only recently been appreciated that, in the majority of people who have diabetes, whether it’s type one or type two, the rise in blood glucose after a meal, not the blood glucose before the meal, is the major determinant of average blood glucose.

Caroline wells
Caroline Wells, Diabetes Australia’s Director Health Advisory and Research. Credit: supplied

“So there needs to be a focus on what determines the rise in blood glucose after a meal. It may have to do with what you eat, or the timing of how you eat, or how potentially the rate your individual stomach empties,” he says.

Caroline Wells, Diabetes Australia’s Director Health Advisory and Research, told Cosmos that, from a health perspective, diabetes is one of the biggest challenges facing Australia.

“Currently, 1.5 million Australians are living with diabetes. We’ve got 120,000 diagnosed each year, we’ve got 400,000 people that are at high risk, and we’ve got 500,000 living with undiagnosed diabetes,” she explains.

And, according to Wells, the burden of diabetes is only growing: “We’ve seen a 220% increase in number of people diagnosed with diabetes in Australia since 2000.”

Read more: The small implant which could change how type 1 diabetes is managed.

Diabetes is a chronic condition that can result in serious long-term health complications; Wells says that it’s the leading cause of preventable blindness in working age Australians.

Two thirds of Australians with type two diabetes report some form of cardiovascular disease, it increases the risk of stroke by 1.5 times, and is the leading cause of preventable amputation.

The program has provided about $36 million in diabetes research funding over the past 12 years.

“Ultimately, a cure is the Holy Grail, so to speak. But there’s so much research that goes into making people’s lives better, the quality of life that people have, and that’s a really important part of research,” Wells says.

Optimising blood glucose levels in people with diabetes

Diabetes is a state of persistently high blood glucose levels. When a person eats, glucose is absorbed from the gut into the bloodstream. But in a person with diabetes, because their body cannot produce sufficient insulin, this glucose remains in the bloodstream instead of entering the cells where it’s needed.

It’s these high blood glucose levels that are central to both the development and the progression of the complications from diabetes, as it can damage small- and large-blood vessels.

Another of the research projects, led by Dr Chinmay Marathe – an endocrinologist and a National Health Medical Research Council (NHMRC) Early Career Fellow in the Adelaide Medical School – will focus on whether pay cycles, which are likely to influence food availability and choice, affects blood glucose levels in Indigenous Australians who have type two diabetes.  

Aboriginal and Torres Strait Islander people are almost four times more likely to develop type two diabetes than non-Indigenous Australians.

You can read the full list of projects here.

Read more: Reactivating Type 1 diabetics’ pancreatic stem cells to produce insulin.

This cross-disciplinary research group, which includes investigators with backgrounds in endocrinology, gastroenterology, nutrition, nuclear medicine, physiology, epidemiology, nursing, and basic sciences is, according to Horowitz, the only one of its kind in Australia and one of the very few in the world.

“I believe we’re unequivocally the strongest research group in this area in the country, which is a very unusual thing for Adelaide,” he says.

Wells explains that the program is targeted at new and emerging researchers.

“It’s about giving new researchers starting out in their career, in the first 10 years or so, the assistance to really get into their area of expertise,” she says.

“We focus on new and emerging researchers to give them further opportunities in the research community, such as getting an NHMRC grant.”

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