1. Sugarfix 1 - a study of the effects of high blood glucose on the eye and the potential for antioxidant protection Dr Jonathan Noonan BSc(Hons) MBBS PhD Student, CERA

2. Funding acknowledgement Sugarfix 1 is funded by a Pilot & Feasibility Grant from the Juvenile Diabetes Research Foundation (JDRF) Type 1 Diabetes Clinical Research Network

3. The eye in diabetes Diabetes mellitus Chronic high blood glucose levels Two main types – Type 1: the body attacks its own insulin-producing cells – Type 2: insulin resistance Affects 382 million (8.3%) worldwide with almost half unaware

4. The eye in diabetes Diabetic retinopathy Damage to the retina in someone with diabetes Affects roughly 1 in 3 people with diabetes More likely to occur with higher blood glucose levels

5. The eye in diabetes  Blood glucose Oxidative stress Blood vessel damage  Oxygen Fragile/leaky vessels Diabetic retinopathy Anti-VEGF injections Antioxidants?

6. Sugarfix 1 Purpose To study the effects of high blood glucose levels, with or without vitamin C, on: – Blood vessel function in the eye – Nerve cell function in the eye – Blood vessels in the rest of the body

7. Sugarfix 1 Details 12 otherwise healthy people with type 1 diabetes Blood glucose levels controlled with insulin/glucose infusions Vitamin C or placebo given at either visit (double-blind)

8. Sugarfix 1 Blood vessel function in the eye Flickering light causes blood vessel dilation Less dilation in people with diabetes We are studying how this changes with different blood glucose levels

9. Sugarfix 1 Nerve cell function in the eye Looking at a changing checkerboard pattern creates electrical signals These signals are smaller and slower in diabetes This may be due to problems with the ganglion (optic nerve) cells

10. Sugarfix 1 Stiffness of other blood vessels Radial artery in the forearm pulses with the heart beat Arteries become stiffer with high blood glucose levels Vitamin C reduces stiffening of arteries during high blood glucose levels

11. Sugarfix 1 Progress and future directions 3/12 participants completed (+4 seen once) Expected completion end September 2014 Results of Sugarfix 1 will be used to inform further research with antioxidants in diabetes STAY TUNED!