Priority 2

Peripheral neuropathy and diabetic foot syndrome

Priority 2 - Peripheral neuropathy and diabetic foot syndrome leadership team:


Professor Stephen Twigg (endocrinologist)

Approximately 50,000 Australians have diabetes related foot disease (DFD). It is the leading cause of amputations and a top 20 cause of hospitalisations. DFD mortality rates are worse than many cancers, and it costs Australia an estimated $1.6B annually. Peripheral sensory neuropathy (PSN) is a major complication of type 2 diabetes and in people with DFD, 80% exhibit PSN. Half of people with PSN experience symptoms such as frequent falls, balance issues and debilitating pain. There are limited treatment options.

Whilst most acute wounds in healthy people undergo orderly repair, people with diabetes are at higher risks of impaired wound healing and infection. Only 30% of all Diabetes Related Foot Ulcers (DRFU) heal within a 12-week treatment period. They often last 6-12 months, recur in 60-70% of patients, can lead to loss of function and decreased quality of life (QoL), and are a significant cause of morbidity. The longer an ulcer remains un-healed, the greater the risk of infection and amputation.

Explore our current projects below to find out what we're working on across diagnosis, treatment, management and new therapies.

  • | New Therapies |

    Led by Associate Professor Spiros Fourlanos from the University of Melbourne

    Nerve damage related to diabetes is called diabetic neuropathy. Neuropathy symptoms can range from mild to severe. About 20% of people with diabetic neuropathy develop a type of nerve pain called painful diabetic peripheral neuropathy (DPN). This condition is often linked to how long someone has had diabetes and poor blood sugar control. Unfortunately, besides controlling blood sugar, there aren't any specific treatments available.

    Recent research suggests that problems with cell powerhouses called mitochondria might be behind DPN. This study aims to see if a treatment targeting these mitochondria can help with DPN symptoms. We'll not only look at how it affects pain but also do tests to see if it improves nerve function.

    If this treatment works well, it could potentially be sold over the counter without needing a prescription. This could be a big breakthrough for people dealing with DPN making it easier to get treatment and bringing hope for better control of this challenging condition.

    Project Title

    Project 2A: A novel mitochondrial combination therapy for painful peripheral neuropathy in diabetes: the MitoPPND

    Project LeadAssociate Professor Spiros Fourlanos (University of Melbourne)

  • | New Therapies |

    Led by Professor Paul Breen from Western Sydney University

    Peripheral neuropathy is a type of nerve damage related to diabetes, commonly affecting the legs and feet. Symptoms range from numbness, tingling, sensitivity, sharp pain through to serious foot problems like ulcers and infections.

    Our project is all about designing and testing a special device, called the "Feeling Aid”, that can enhance the nerve signals and improve sensation in the foot for people with peripheral neuropathy or diabetic foot issues. The Feeling Aid uses electrodes to deliver electrical stimulation to the ankles. This acts like an amplifier, enhancing your natural nerve signals. Ultimately, we hope this will reduce the risk of future foot ulcers.

    What makes our device unique is that there's nothing else like it on the market that can restore protective sensation for individuals with peripheral neuropathy. It will be a valuable low-cost tool for clinicians to offer their patients, potentially lowering healthcare costs by preventing costly treatments for foot ulcers.

    But we're not just focused on the technology itself. We understand that for it to truly make a difference, it needs to fit seamlessly into people's everyday lives. That's why we're putting a lot of effort into codesign with patients and clinicians, making sure our device is user-friendly and practical for everyday use.

    Project Title

    Project 2B: “Feeling Aid” device for peripheral neuropathy/diabetic foot

    Project LeadProfessor Paul Breen (Western Sydney University)
    CollaboratorsProfessor Jorge Serrador (Western Sydney University), Associate Professor David Mahns (Western Sydney University), Neil Anderson (3 Aim Solutions).

  • | Management |

    Led by Professor Dinesh Kumar from RMIT University, Dr Rajna Ogrin (Bolton Clarke), Professor Elif Ekinci (University of Melbourne)

    When it comes to foot ulcers caused by diabetes, more than 30% don't heal the way they should. It's crucial for doctors to know if an ulcer is healing properly so they can make the right decisions and prevent serious issues like hospitalisation and potentially limb loss. Right now, there's no reliable way to predict how well these ulcers will heal.

    Our project aims to change that. We're developing and testing a special device that uses thermal imaging and analysis to predict if a diabetes related foot ulcer will heal within 12 weeks. This device will be portable and give real-time results, making it easy for doctors and other healthcare professionals to use in clinics, including in rural and remote areas. We're customising an existing prototype to make it more practical and user-friendly. With this technology, we hope to improve outcomes for people with diabetes related foot ulcers and prevent unnecessary complications.

    Project Title

    Project 2C: Using textural analysis of thermal imaging to predict healing status of diabetic foot

    Project LeadsProfessor Dinesh Kumar (RMIT University), Dr Rajna Ogrin (Bolton Clarke), Professor Elif Ekinci (University of Melbourne)
    CollaboratorsDr Quoc Cuong Ngo (RMIT), Dr Barbara Polis (RMIT), Nila Sari (RMIT), Sam Hanna (Austin Health), Kate Waller (St Vincent’s Hospital Melbourne), Justin Bradley (St Vincent’s Hospital Melbourne)

  • | Prevention |

    Led by Professor Slade Jensen from Western Sydney University, Professor Rob Fitridge (University of Adelaide) and Professor Allison Cowin (University of South Australia)

    When it comes to foot ulcers caused by diabetes, there are a lot of complex factors at play. Immune responses, biological processes, combined with microbial activity and cells that are not functioning properly, can all contribute to these wounds becoming chronic and hard to heal. Our project, known as the Australian Diabetes Foot Ulcer and Infection Genomics Research Alliance (UNICORN), aims to dig deeper into these processes.

    Our goal is to unravel the underlying mechanisms that affect health outcomes in people with diabetes-related foot ulcers. By identifying genetic biomarkers or specific biological/cellular pathways, we hope to pinpoint individuals who may be at risk of poor wound healing. This understanding could lead to several important advancements:

    • Developing treatments focused on repairing wounds and regenerating skin.
    • Creating therapies to fight off harmful microorganisms in wounds.
    • Tailoring treatment plans to address social or environmental factors that contribute to foot ulcers.

    Ultimately, our research aims to improve the lives of those affected by diabetes-related foot ulcers by developing more targeted and effective treatment strategies.

    Project Title

    Project 2D: Australian Diabetes Foot Ulcer and Infection Genomics Research Alliance (UNICORN)

    Project LeadsProfessor Slade Jensen (Western Sydney University), Professor Rob Fitridge (University of Adelaide) and Professor Allison Cowin (University of South Australia)

  • | Prevention |  Management |

    Led by Professor Tim Davis from the University of Western Australia

    For people with diabetes, one of the most common and potentially debilitating complications is neuropathy, a type of nerve damage in the feet. Our project aims to tackle this issue head-on by predicting who is at risk of developing this condition in the future.

    We're focusing on a specific protein 'signature' found in the blood of individuals with type 2 diabetes. By studying this signature, we hope to identify patterns that can predict the likelihood of nerve damage developing. If successful, this could revolutionise how we manage diabetes-related nerve issues.

    By pinpointing those at risk early on, we can take proactive measures to minimise the chances of complications like foot ulcers, deformities, and chronic pain. Our ultimate goal is to develop a simple blood test that can be used in routine clinical practice to help prevent and manage nerve damage in people with diabetes.

    Project Title

    Project 2E: Predicting Diabetic Neuropathy

    Project LeadsProfessor Tim Davis (University of Western Australia)

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