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Australia’s rural communities are well behind their metropolitan cousins in screening for complications from diabetes. A Charles Sturt University research group is developing cost-effective methods for bringing specialist diagnostic tools to rural and remote health clinics to address problems with the rapidly growing disease, particularly among older Australians.

Diabetes is fast becoming a major disease across Australian society, especially in an ageing population [see box].

Concerned at the rapid growth of the disease among older rural Australians, Charles Sturt University researcher Dr Herbert Jelinek is leading a research group to develop simple, practical diagnostic tests and computer programs to help detect early complications caused by diabetes for rural and remote communities.

CSU diabetes researcher and project team leader, Dr Herbert Jelinek.
photo: Richard Williams

“Health care to treat complications from diabetes in Australians costs around $2.5 billion dollars per year,” said Dr Jelinek, a CSU health scientist and research project leader based in Albury.

“Diabetes damages victim’s eyes, feet, kidneys, heart and circulation and nervous systems. Early detection improves treatment and quality of life for people with diabetes.

“Early detection of some diabetes complications is much harder in regional and remote areas, for many reasons: a lack of local specialists, most rural health clinics and centres do not have comprehensive screening programs for detecting diabetes; diabetic sufferers face far more travel, time and cost pressures; and the limited health resources in regional areas are concentrated on the people known to have diabetes,” he said.

Highlighting CSU’s cross-disciplinary approach used to address this problem, Dr Jelinek was joined by senior researchers from New Zealand and Brazil to develop software that identifies changes in the eye associated with diabetes. Dr Jelinek also developed a program now nearing clinical trails that identifies early changes in heart function caused by diabetes.

Diabetes is a disease that is closely associated with an ageing Australia. According to the NSW Department of Health, four per cent of Australia’s population – around one million people – now have diabetes. This is expected to reach 10 per cent by 2010. Diabetes is caused by either insufficient insulin or poor response to insulin produced in the body. Insulin processes sugar in the body, so low insulin means the body cannot process sugar properly, resulting in high blood glucose levels. This causes a range of problems around the body, including failing eyesight, poor blood circulation in feet and heart disease. There is no cure for diabetes, but it can be managed through diet, exercise and medication.

CSU information technology researcher Dr David Cornforth was also called on to develop software to help sift through data obtained from a client’s screening tests for early signs of diabetes.

"I am asked ‘can a computer be as good as a medical specialist?’ The answer is ‘no’, but there’s many more computers, so they can help in areas where there is poor access to specialists."
Dr David Cornforth
photo: Richard Williams

“I am asked, ‘can a computer be as good as a medical specialist?’ The answer is ‘no’, but there’s many more computers, so they can help in areas where there is poor access to specialists,” Dr Cornforth said.

“We need to select suitable measurements so that, using computer-based artificial intelligence techniques and programs, the computer can ‘learn’ to identify clients with ‘no diabetes’ and ‘diabetes’ and estimate how ‘sure’ it is of its answer.”

Over the past two years, over 1 200 assessments for diabetes complications have been carried out on clients from the NSW Victorian Border region by Dr Jelinek’s group. To date, initial tests have been completed on computer hardware and software used to detect heart complications and the automated screening of eye photographs.

The research group used an image from a relatively simple retinal camera to show the blood vessels in the eye’s retina. Computer software then analysed the blood vessels in the retina to detect microaneurysms, shown as “blobs” on the photo, as well as the shape and size of blood vessels, to provide early detection of damage from diabetes to eyes.

This technique removes the need for the use of a special dye in the eyes for retinal photos, which can be invasive and carries a health risk to the patient.

Retinal image taken by a Polaroid camera and used for diagnosing early sight complications caused by diabetes.
photo: Richard Williams

CSU’s Allied Health Clinic, located on the Albury-Wodonga Campus, was the site for the research becoming an important source of primary health care in the region as well as enhancing the group’s research.

The CSU Diabetes Complications Research Group has received funding from private medical companies Roche, Sesamed and Briot Weco in the past year for this research, as well as assistance from the Albury-Wodonga community, Diabetes Australia and CSU.

Other collaborating organisations include the Far West Diabetes Clinic, based in Broken Hill in far western NSW, and the Rotary Club of Tallangatta in North East Victoria.

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Media Officer	: Wes Ward
Telephone	: 02 6051 9906

Editor's Note: Dr Herbert Jelinek is with Charles Sturt University’s School of Community Health and Dr David Cornforth with the School of Environmental & Information Services, both based on the University’s Albury-Wodonga Campus on the NSW-Victorian border.

Media Note: Contact the Media Office for interviews and pictures with the CSU Diabetes Complications Research Group. Print quality versions of these images are available from the Media Office.

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