The Edmonton Protocol: JDRF celebrates 20th anniversary of first islet transplant

This month, twenty years ago, a pioneering clinical trial in Alberta marked a major advancement in islet transplantation for the treatment of type 1 diabetes (T1D).

On March 11, 1999, the Edmonton Protocol – a new method of transplanting pancreatic cells to treat T1D – saw its first participant receive a transfer of islet cells from a donated pancreas into their liver at the University of Alberta. The production of insulin by the donor’s islet cells helped the transplant recipient regain control of his blood sugar levels, thereby eliminating or greatly reducing the need for insulin injections. According to an article published in The New England Journal of Medicine on July 27, 2000, the seven people who took part in the study became insulin-independent for the 12 months following the procedure.

In collaboration with the Medical Research Council of Canada, JDRF supported the preclinical studies that led to the Edmonton Protocol. It also established nine JDRF Human Islet Distribution Programs in 1998, including the University of Alberta, which provided the islet cells for the procedure in Edmonton. Dr. James Shapiro, a JDRF-funded investigator and a multi-organ transplant surgeon at the institution, led the team that introduced the Edmonton Protocol and optimized the medication given with islet transplants.

Today there is a growing demand for organ donors. In order to succeed, a minimum of 300,000 cells derived from the same pancreas are needed for a transplant. A donated pancreas contains about one million islet cells and researchers are currently able to isolate up to half of them, making more people eligible for the procedure.

“The Edmonton Protocol was a milestone achievement that significantly changed the T1D landscape,” says Dave Prowten, president and CEO of JDRF Canada. “The past 20 years have seen more people benefitting from islet transplantation and JDRF is proud to invest in this promising initiative that is bringing us one step closer to a cure.”

Despite the lifelong need for immunosuppressive drugs to prevent graft rejection, islet transplantation has been shown to greatly improve the quality of life for individuals with a severe form of T1D, while freeing them from multiple daily insulin shots that can lead to other problems, such as hypoglycemia (low blood sugar). As a result of new and improved methods to isolate islet cells, transplantation rates are expected to grow in the future until a cure for the disease is found.

Today JDRF continues to build on the Edmonton Protocol and Dr. Shapiro’s work. We are not only funding beta cell replacement therapy research, but also exploring the genetic modifications of transplantable stem cells and scaffolding technologies (encapsulation) to improve islet graft outcomes among people without the need for immunosuppressive drugs.

To learn more about beta cell therapy, click here.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog. 

JDRF Canada welcomes new Chief Scientific Officer, Dr. Sarah Linklater

We are pleased to announce Dr. Sarah Linklater has been appointed as Chief Scientific Officer (CSO). Sarah has over a decade of extensive experience as a professional scientific editor, with a focus on clinical diabetes and endocrinology, basic immunology and other areas of the life sciences. In her role as JDRF Canada’s CSO, Sarah will lead the progress of our research partnerships and support our efforts to effectively engage the type 1 diabetes (T1D) community.

“I’m really excited for the opportunity to shape T1D research in Canada, and work with a global organization whose mission is to improve the lives of people living with T1D and ultimately cure this disease,” said Sarah.

“We are thrilled to have Sarah join our passionate team of professionals. She brings a unique combination of scientific experience and communications expertise that will help us accelerate our research program”, said Dave Prowten, President and CEO of JDRF Canada.

Sarah completed her PhD in Experimental Medicine at the UBC Faculty of Medicine under the supervision of Professor Megan Levings, a JDRF funded researcher. She has published several peer-reviewed research articles, reviews and book chapters on the function of regulatory T cells in health and autoimmune disease. In her latest role, she helped to launch The Lancet Diabetes & Endocrinology, now the leading clinical diabetes journal worldwide, and became Editor-in-Chief in 2017. Sarah will start her new role on April 16, 2019.

Click here to read our press release.

New test offers better insight into genetic risk of type 1 diabetes in people of African descent

Our ancestry often plays a determining role when it comes to matters of health. In fact, genetics can help scientists establish which populations are at greater risk of contracting different diseases, including type 1 diabetes (T1D).

Recently, a team of researchers in the United States developed a test to identify individuals of African descent who are more likely to get the disease. Partly funded by JDRF, the project involved analyzing the genetic data of 1,021 people with T1D from African backgrounds – the largest number ever studied from this ethnic group. The investigators also examined a control group of 2,928 participants who didn’t have T1D. The team used the information to devise a genetic risk score for T1D specifically for people with African ancestry; the mark was then compared to European-based ones to see which more accurately predicted T1D risk.

Among their findings, there was an overlap of high-risk genes between people of European and African backgrounds. As well, those of African ancestry had certain high-risk sections of DNA that were specific to them. It was concluded that the African-specific genetic risk score was much better at identifying people at risk of T1D in people of African ancestry than the European risk scores.

Until recently, genetic risk score tests have been almost exclusively based on European data, which made them less suitable for people from diverse ethnic backgrounds. The new method of screening will not only allow greater opportunities for targeted preventative interventions for those with African ancestry at greater risk of T1D, but also ensure that they receive appropriate care and treatment at the onset of diagnosis.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog

A JDRF legacy lives on with the Dr. Robert Goldstein Award

Dr. Esteban N. Gurzov, a talented young scientist from Brussels, Belgium, was recently named the first recipient of JDRF’s Dr. Robert Goldstein Award.

Dr. Robert Goldstein

This award is presented to a promising investigator in the field of type 1 diabetes research (T1D). It was established in 2018 in honour of the late Dr. Robert Goldstein who played a pivotal role in developing JDRF’s Research Department and who served as chief scientific officer for JDRF International and JDRF Canada for over two decades.

Dr. Gurzov has dedicated his career to investigating the origins of diabetes and obesity and the discovery of new treatment options. After his productive postdoctoral period in Belgium, he moved to Australia to continue his training in the biology of diabetes. In 2013, he established his own group at St. Vincent’s Institute of Medical Research in Melbourne. Four years later he received an associate researcher position to head the Signal Transduction and Metabolism laboratory at the ULB Center for Diabetes Research in Brussels.

Dr. Gurzov has since expanded his expertise to beta cell identity and function, and continues to demonstrate a high level of productivity and generate important contributions to the field of beta cell biology. His current research explores a class of enzymes called protein tyrosine phosphatases (PTPs) as novel therapeutic targets for beta cell survival.

Dr. Gurzov’s publication track record, growing integration into the T1D research community and success as an independent junior investigator suggest that he will become a key T1D academic scientist. An extraordinary addition to the JDRF family, he will ensure that the legacy of Dr. Goldstein lives on.

Paying it forward through research: From trial participant to T1D advocate


When Ash Hunkin was diagnosed with type 1 diabetes (T1D) at the age of nine, little did she know that she was about to embark on a journey that would see her advocating for others with the disease for the next 26 years of her life.

Ash Hunkin at JDRF offices
Raised in a family that viewed personal challenges as empowering, Ash soon got involved with JDRF and became a Walk participant. As her mother solicited donations from her networks for research into a cure, the annual event quickly became one of Ash’s favourite days of the year. It was during that time that she was also encouraged to take part in studies on T1D.


“We discussed it at the dinner table,” recalls Ash. 


“Our family believed that part of living with diabetes meant pitching in to help the next generation of people with T1D. Though I could have said no, it was a ‘pay it forward’ kind of thing. I saw it as a chance to take part in something new and exciting ahead of the curve.”

From the time she was a tween, Ash was enrolled in many trials at the Hospital for Sick Kids in Toronto.  Following her 10th birthday, she participated in a study to determine whether the outcomes for insulin administration using short needles were comparable to those using longer needles. 

“Being given the opportunity to try and change T1D, and getting to try treatments before anyone else was very rewarding,” she says.

Ash was also involved in an intense, two-year experiment on inhaled insulin that required a full-day hospital stay every couple of weeks.

“That study seemed never-ending and I skipped school often,” she relates. “Yet the best part was I got to use an insulin puffer, which meant no injections.”

Ash credits her experiences as a T1D trial participant with having had a positive influence on different aspects of her life.

“I developed resiliency,” she remarks candidly. “It also helped steer me in the direction of community engagement, guiding my career. And most importantly, it allowed me to feel like I was contributing because I was putting my heart and soul into something that – whether it worked or not – would still move the research along.”

Today, 35-year-old Ash continues to advocate for people living with T1D in her role as community engagement specialist at JDRF’s British Columbia Office.  Since joining the organization in 2016, she has been instrumental in cultivating strong working relationships and building capacity to draw greater support for JDRF’s mission.


Asked if she would recommend participating in trials to children living with T1D, Ash is quick to reply. “Absolutely,” she says. “It helps frame diabetes as a special thing over which we have power.”


For more information on JDRF’s clinical trials, click here.

New Quebec registry tracks hypoglycemia among diabetes patients to help reduce risks

Hypoglycemia (low blood sugar) is a serious concern among many Canadians living with type 1 diabetes (T1D). Yet thanks to an ambitious doctor and his team in Montreal, a new registry was recently launched in Quebec to track the incidence of hypoglycemic episodes and allow patients to better manage their disease.

Known as the BETTER (BEhaviors, Therapies, TEchnologies and hypoglycemic Risk in Type 1 Diabetes) project, the pilot study focuses on characterizing the causes, experiences and consequences of hypoglycemia. Dr. Rémi Rabasa-Lhoret, a JDRF-funded endocrinologist at the Institut de recherches cliniques de Montréal recognized for his work on the artificial pancreas, is overseeing the initiative to collect data for the province-wide registry of people with T1D.

“Our main goal is to identify successful measures that can be implemented daily to improve overall blood control,” says Dr. Rabasa-Lhoret. “It is our hope that this registry, as well as subsequent clinical trials aimed at optimizing technologies and therapies, will help reduce the risk and burden of hypoglycemia.”

Along with Dr. Anne-Sophie Brazeau (co-leader) and his team, Dr. Rabasa-Lhoret is also collaborating on an online educational component to support people with T1D in their self-care. Currently, instructive videos and bilingual resources are being developed for an e-learning platform, and reviewed by a panel of diabetes educators and patients’ families to ensure they are relevant to their needs.

“All scientific questions and materials for this trial have been developed by our patients’ partners – who were very involved in the process – in order to address any unmet needs as closely as possible,” says Dr. Brazeau.

The BETTER project also includes a series of trials. Dr. Rabasa-Lhoret is testing the efficacy of the “rule of 15” strategy (consuming 15 grams of carbohydrates when your blood glucose level is under 4.0 mmol/L [70mg/dl] and waiting 15 minutes before re-testing it) to address a non-severe hypoglycemia episode and evaluating whether this rule should be revisited in the context of modern diabetes treatments.

As medication and technology access varies across Canada, the first years of this bilingual study will focus on patients living in Quebec only. However, Dr. Rabasa-Lhoret and his team hope to expand this initiative across the country, along with extensions for families and health care professionals.


Studying the role of Vitamin D in the risk of type 1 diabetes

Over the years, doctors have been asked this question countless times by concerned parents. That is because Vitamin D, unlike many other nutrients, plays several key roles when it comes to our health. Not only does it help regulate calcium levels and bone metabolism, but it also functions as a hormone – a switch that occurs with the body’s absorption of the vitamin. This can impact the immune system, which is why getting ample Vitamin D is important for warding off certain medical conditions.

Dr. Despoina Manousaki, a JDRF-funded researcher at the Jewish General Hospital (Lady Davis Institute) in Montreal, is investigating whether having low levels of Vitamin D in the blood increases the likelihood of T1D.

Currently, researchers are using a recognized technique in genetics known as Mendelian randomization (which investigates causal relations between potentially modifiable risk factors and health outcomes) to provide evidence for or against the relationship between Vitamin D and the disease. Should a link be established, these results will be used to ensure that individuals at risk (such as those with family members affected by the disease) have adequate Vitamin D levels.

“The findings of this study, which are based on genetic information from more than 60,000 individuals, would, if positive, support vitamin D sufficiency as a measure to prevent T1D in individuals at risk, such as siblings of affected individuals,” explains Dr. Manousaki. “If negative, they will provide evidence that the association of vitamin D levels with T1D may be attributable to confounding lifestyle factors, which may provide more fruitful targets for disease prevention than vitamin D supplementation.”

Understanding whether Vitamin D plays a role in the predisposition to T1D could present a tremendous opportunity to prevent or decrease the risk of the disease. Individuals with low Vitamin D levels can be identified in the population through simple testing, and Vitamin D administration is both a safe and cost effective way to improve deficiencies.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog

Exploring oral therapy to safeguard beta cells and treat type 1 diabetes

Administering insulin on a daily basis can be a tedious task, particularly among individuals newly diagnosed with type 1 diabetes (T1D). To mitigate this, researchers are currently experimenting with islet (insulin-producing cells) transplantation as a promising therapy that eliminates the need for insulin injections. However, some limitations remain such as the supply of donor transplants, the need for lifelong immune suppression and graft failure (in which the recipient rejects the donor cells).

A JDRF-funded investigator at St. Michael’s Hospital in Toronto is currently exploring the benefits of a chemical secreted from nerve cells that is active in pancreatic islets in the treatment of people living with T1D. Dr. Gerald Prud’homme at the Keenan Research Centre for Biomedical Science has been examining the benefits of gamma aminobutyric acid (GABA), which is recognized for stimulating insulin secretion and human beta cell growth. A major agent for inducing beta cell regeneration, GABA also has prominent anti-inflammatory properties that protect beta cells from injury and death under various conditions of stress.

Beta cell death often results from an autoimmune attack that is characteristic of T1D. Through this research,
Dr. Prud’homme is hopeful that novel therapeutic approaches involving GABA will lead to an increase in the survival and proliferation of pancreatic cells.

Given that GABA can be administered orally and combined with other active drugs, this study has the potential to deliver a new therapy for the prevention of diabetes in high-risk populations and for the treatment of existing disease. It may also be effective in improving the success of islet transplantation in the future.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog.