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Lead Researcher:Associate Professor Maria Craig

Significance

The incidence of Type I diabetes in childhood is increasing rapidly (by 3% per annum) and even more rapidly in the very young, aged under 5 (annual increase 5% per annum). Type I diabetes affects 1:700 children. By the time these children reach adulthood (20 years) all will have significant retinopathy (eye disease); 10% will have kidney disease and 50% will have nerve damage. In the short term 40% of these children will have retinopathy within 6 years and 4% will have nerve damage. Lifelong Type I diabetes carries significant risk factors for heart attack, vascular disease, stroke and kidney failure and a reduced life expectancy.

Most significant advances or findings in past 10yrs

Professor Craig’s epidemiological (population) studies have shown for the first time the dramatic rise in the incidence of childhood Type I diabetes (increasing by 5% every year in those aged under 5; and by ). The cause for this alarming increase in Type I diabetes is unknown. However Dr Craig’s population based studies have provided evidence to suggest a link with the following 3 factors:

• Viral infection;
• Lifestyle factors (eg obesity and diet) as co-factor at least;
• Vitamin D deficiency

For example, her work has demonstrated that 15% of pregnant women are Vitamin D deficient; 11% of newborns are very deficient and 30% of newborns have low levels of Vitamin D. Vitamin D deficiency can contribute to immunological dysfunction. The potential impact of Vitamin D is particularly relevant given our ethnic population mix and education programmes aimed at limiting exposure to sunlight. Dr Craig has also demonstrated that Type II diabetes, once very rare in childhood, now constitutes one in 10 of every new case of diabetes diagnosed in adolescence. This is likely to be diet-related.

Most important aspects of current work

Current work is aimed at providing epidemiological evidence to explore causative links between putative viral infection or risk factors for this as well as vitamin D deficiency in the aetiology of childhood Type I diabetes. It is of fundamental importance that the cause of childhood diabetes is identified before a cure can be devised.

Recent publications

Craig ME, Howard NJ, Silink M, Rawlinson WD. Reduced frequency of HLA DRB1*03-DQB1*02 in children with Type 1 diabetes associated with enterovirus RNA. JID 2003:187;1562-70.

Craig ME, Femia, G, Broyda V, Lloyd M, Howard NJ. Type 2 diabetes in indigenous and non-indigenous children and adolescents in NSW. MJA 2007 Volume 186 Number 10. 497-99.

Craig ME, Jones TW, Silink M, Ping YJ. Diabetes care, glycemic control and complications in children with type 1 diabetes from Asia and the Western Pacific region. Journal of Diabetes and Complications 21 (2007) 280-287

Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D parathyroid hormone and calcium levels in pregnant women and their children and their neonates.