Garvan to team with Shanghai researchers on diabetes project

By 2025, as many as 157 million overweight Chinese are likely to be suffering from non-insulin dependent (Type 2) diabetes, more than the total for the entire world today.

Prof David James, head of the diabetes and obesity program at Sydney's Garvan Institute, was stunned when he heard the statistic.

James and Garvan chairman Bill Ferris returned this week from China, where they attended a signing ceremony for an agreement between the Garvan and the Shanghai Institutes for Biological Sciences to pursue a cure for type 2 diabetes.

Affluent Western nations, including Australia, are already grappling with an epidemic of obesity and type 2 diabetes, but like most Western medical researchers, James assumed they would be relatively uncommon disorders in the world's most populous nation.

The traditional Chinese diet is high in rice and vegetables, and low in fat and sugar - hardly the fare for a rapid ride to Fat City.

But China's economic miracle, and its one-child-per-family policy to rein in rampant population growth, have collided to produce a seismic shift in the average body weight of younger Chinese.

James said China would be the epicentre of the diabetes pandemic. "There are already 50 million people in China with type 2 diabetes," he said. "At the current rate of increase, there will be 157 million Chinese affected by 2025, the same number of people affected throughout the world today.

"It's due to a combination of the single-child family and growing affluence. Where the average Chinese 20 years ago would eat rice at least once a day, and typically at every meal, it's now only three times a week.

"It's mainly the kids. Driving around in Shanghai with Bill Ferris, we didn't see much obesity among people in the street, but if you go into the schools, many children are overweight or obese.

"They're eating much more, and they're eating all kinds of stuff, rather than a traditional diet."

Alarmed at the rising tide of obesity-related disorders, especially type 2 diabetes, Chinese researchers have been taking a 21st century look at China's 10,000-year-old traditional pharmacopoeia for compounds to treat -- perhaps to cure -- diabetes.

James toured the Shanghai Institutes' high-throughput drug-screening facility, and was enormously impressed at its sophistication and scale -- robots perform much of the repetitive work involved in making extracts of traditional herbs, filtering them and sifting their individual compounds with high-pressure liquid chromatography, and preparing aliquots to be tested for activity.

The Shanghai facility has already developed a library of more than 200,000 compounds. For its part, the Garvan Institute team will contribute its sophisticated mouse models and assay systems to test compounds that may affect the development of obesity and diabetes.

The SIBS-Garvan Institute agreement also provides for extensive exchanges of scientists between the two institutions -- the initiative actually arose from discussions between the Garvan's director, Prof John Shine, and SIBS director Prof Gang Pei, who was a visiting fellow at the Garvan last year.

James said there were already strong hints that there anti-diabetes or anti-obesity compounds existed in Chinese traditional medicines. A number of reputable, modern Chinese hospitals prescribe traditional medicines for diabetes, and numerous studies in humans and animals indicate some herbs have glucose-lowering properties.

What is unclear, James said, is whether such compounds lower hepatic glucose levels, or act as appetite suppressants. Nor is it clear whether their therapeutic benefits stem from the activity of single compounds, or multiple compounds that act on different tissues.

"It's going to be a tough project," he said. "It's all a bit magical, and we're trying to demystify it. "Some of the magic lies in the fact that Chinese doctors actually prescribe these herbs almost on a personalised basis -- it may turn out that some of them work only for people of a particular genetic background.

The Garvan team will be approaching the research with eyes open. "After all, there are plenty of examples of modern drugs being developed from traditional herbs. Metformin, one of today's most popular diabetes drugs, comes from a herb called goat's rue."