Month: September 2023

Study Suggests Semaglutide Increases Insulin Production in Newly Diagnosed People with Type 1 Diabetes

Semaglutide, brand names Ozempic®, Rybelsus®, and Wegovy®, is all over the news. It is Health Canada-approved to help people with type 2 diabetes (T2D) manage their blood glucose levels. It also decreases the risk of cardiovascular events and helps with weight loss. According to a recent commentary published in the New England Journal of Medicine [subscription required] by investigators at the State University of New York at Buffalo, it may also help newly diagnosed individuals with type 1 diabetes (T1D) make more insulin.

What Is Semaglutide?

Semaglutide is a peptide similar to naturally occuring glucagon-like peptide (GLP-1). It helps people with T2D in various ways, including by stimulating insulin production. These drugs have been on the market since the early 2000s.

Thanks to decades of JDRF-supported research, we know that most people diagnosed with T1D still have some functioning beta cells. They no longer make the amount of insulin needed by the body to function, but they do exist.

Preserving those beta cells, keeping them healthy and alive and, eventually, increasing their number and function through disease-modifying therapies is one of JDRF’s key priority areas when funding research.

 Study Results

The researchers in this study, who currently receive JDRF funding (via JDRF International in the United States) to investigate the use of semaglutide later in disease to assist with glycemic control, administered the drug to 10 individuals. These individuals were between the ages of 21 and 39 in stage 3, or new-onset T1D. They began treatment with semaglutide within three months of diagnosis with the goal of preserving beta cell function. Nine individuals tested positive for GAD, an antibody which can indicate the presence of autoimmunity for T1D; one tested positive for IA-2, another T1D autoantibody. Over the course of several months, all 10 individuals no longer had to administer insulin at mealtimes and six of the participants no longer needed basal insulin after six months. Additionally, participants saw an increase in C-peptide, which shows that their bodies were making more insulin after being on the therapy.

What Comes Next

These results are exciting, but much more work is needed.

The study raises additional questions for researchers. What effect does using semaglutide to increase insulin production by the remaining beta cells have on these cells? It’s possible that it may add further stress to these cells. Researchers still need to determine what the effect of this stress will be beyond the length of this study. Will the beta cells continue to produce insulin or will insulin production decline as it does typically with T1D? All of this must be investigated in a larger, follow-up study with a control group.

GLP-1s Are a Priority for JDRF

JDRF has been a central player in the discovery and development of GLP-1s for decades,  and funded many studies to better understand this hormone, how it functions, and how it can be used to help people with T1D. JDRF believes semaglutide has tremendous promise to improve glucose control and mitigate heart and kidney complications for individuals in stage 4, or established T1D.

That work continues today. There are several JDRF-funded clinical trials to see how people with established T1D can benefit. This includes research led by Dr. Viral Shah at the Barbara Davis Center at the University of Colorado—and in collaboration with three other leading diabetes centers (Henry Ford Hospital, Iowa Diabetes, and the Oregon Health & Science University)—which is investigating ways semaglutide may benefit people with T1D and obesity who are using artificial pancreas (AP) systems.

There are currently no T1D semaglutide trials active in Canada.

These drugs are also being explored by the JDRF T1D Fund. T1D Fund portfolio company i2O Therapeutics is developing several products leveraging GLP-1s, initially for T2D, including a refillable, implantable GLP-1 device that delivers 6 months’ worth of the hormone, an oral form of long acting GLP-1, as well as a combined oral GLP-1 with Amylin (another important pancreatic hormone).

Additionally, Code Bio, a T1D Fund portfolio company, has explored GLP-1 to target beta cells for targeted drug delivery. 

JDRF Canada will continue to monitor results of GLP-1 studies and report on findings as they become available.

New JDRF Canada Emerging Clinician Research Award (ECRA) awarded to Dr. Alanna Weisman

The JDRF Canada Emerging Clinician Research Award (ECRA) is designed to provide crucial support to investigators who plan to pursue a career in type 1 diabetes (T1D)-related clinical investigation. Awards are made in the late stage of training or early career to support the development of the awardee’s independent research program.  

These awards are given to clinicians who have demonstrated superior scholarship and show the promise for future achievement in clinical research, particularly in those areas that require the unique training of a clinical investigator. An important focus of these awards is the development of a patient-oriented research program and the mentorship of the awardee by an experienced clinician-scientist.

Dr. Alanna Weisman is a clinician-scientist and endocrinologist at the Leadership Sinai Centre for Diabetes in Toronto, Ontario and assistant professor in the Department of Medicine at the University of Toronto. She obtained her MD from Queen’s University, Kingston, Canada and her PhD in Clinical Epidemiology and Health Care Research from the University of Toronto.

Dr. Weisman’s research focuses on the use of diabetes technology (such as insulin pumps and continuous/flash glucose monitors) across Canada. Her primary focus is examining the rates of diabetes technology use among people from historically marginalized communities and identifying barriers to use that can be addressed.

Dr. Weisman is also leading studies of the real-world feasibility of recommended glycemic targets in type 1 diabetes and is examining the impact of government-funded insulin pump programs on the uptake of this technology in people with type 1 diabetes.

Dr. Weisman has published more than 40 primary research articles in peer-reviewed journals to date.
The award is $400K over four years and will support Dr. Weisman as a clinician-scientist. Her research will also have implications on JDRF’s Access for All program, which advocates both provincial and federal governments for greater access to diabetes devices and technology and more research funding for T1D.

JDRF had the chance to speak with Dr. Weisman to learn more about her research and how it will potentially impact people living with T1D.

What started your interest in type 1 diabetes? 

 What first sparked my interest was one of my mentors, Dr. Bruce Perkins. Early on when I was training to become an endocrinologist, I worked with Dr. Perkins on some of his research projects in type 1 diabetes and these experiences convinced me that I wanted to pursue a career as an endocrinologist and a researcher. I was drawn specifically to type 1 diabetes through my experiences in clinic seeing patients who live with type 1 diabetes. There were and continue to be many challenges for people living with type 1 diabetes that are unique to those of type 2 diabetes, and I felt there were many areas where we could improve.  

Can you please describe your current field of T1D research?

My research is currently focused on two major areas. The first area relates to the widespread recommendation that adults with type 1 diabetes meet a specific blood glucose target (a Hemoglobin A1c value of 7.0% or lower). I have been analyzing health care data in Ontario for large numbers of adults with type 1 diabetes to determine what are the trends in Hemoglobin A1c over time, and trying to understand the factors that drive this gap we see between what is being recommended and what actually happens in the real world. The second area is focused on understanding how technologies like insulin pumps or continuous glucose monitors are being used in Canada and how this relates to different funding policies for these devices. 

What are some of the existing barriers to diabetes technology in marginalized communities? 

 This has not been studied yet in Canada, and it is important to do so because of our unique health care system. In other countries, some of the barriers have been the costs of these devices, lack of access because of where someone lives or the type of diabetes team they see, or the devices not being recommended in the first place because of preconceived ideas about who would be able to use technologies or not.  

What novel interventions to improve outcomes for people living with diabetes do you foresee emerging from this research?
I believe our research will identify areas for improvement for governments, health care providers, and those living with type 1 diabetes. I hope we may see some policy changes to make technologies easier for all to access. I expect we will develop new tools and strategies for health care providers and patients that we can incorporate into clinics to increase awareness of the benefits of diabetes technologies and make them easier to use.  

$100M Campaign to Accelerate: A Labour of Love to Defeat the T1D Monster

The following is a guest blog by Ryan MacDonald, volunteer co-chair of JDRF Canada’s $100M Campaign to Accelerate – JDRF’s bold fundraising campaign to raise $100M by 2025 to accelerate research to defeat the monster known as type 1 diabetes (T1D). Generous donor support is fueling our campaign to help us reach our goal. Ryan provides an update below and shares why he volunteers with JDRF. 

Why I Co-Chair the $100M Campaign to Accelerate

My name is Ryan MacDonald, and I am a dad to a son with type 1 diabetes. Luke, now 13, was diagnosed when he was just five. It was a time in our lives we will never forget. His little body was not acting normal, and we didn’t know why until the doctors gave us the devastating news. Luke had T1D, immediately launching us into a new reality full of unknowns, injections, constant monitoring, and worry. Our family has been involved with JDRF and the T1D community ever since. It’s not a community we asked to be a part of, but we are so grateful for the support, for teaching us resilience, and for our collective ambition to find a cure. Luke and those living with T1D inspire me every day with their bravery which is one reason I am so committed to working with JDRF to find a cure.

One incredible T1D family in this community is the Oliver family. Peter Oliver was my campaign co-chair, confidant, and friend. It was truly an honour to co-chair the campaign with Peter for over two years before he sadly passed away in 2022. Peter had a charismatic and sincere energy that motivated everyone to work even harder to find cures for this disease. He was a T1D father too, driven to create a better future for his daughter, Vanessa, who is also a lead campaign volunteer.

Like the original founders of JDRF in the 1970s, we are a group of families and T1D community members whose lives are forever changed by this 24/7 disease and who want nothing more than to exceed our $100M goal and accelerate a cure. Peter never slowed his fundraising efforts in more than 30 years, and we will carry on his meaningful legacy. For Peter and the 300,000 Canadians impacted by T1D, I am committed to helping JDRF and my fellow volunteers exceed our campaign goal. This is a promise we will keep for Peter and for everyone living with T1D.

Where We Are Now

Generous donors helped us achieve incredible early campaign success. Industry leaders stepped forward to spearhead challenges in the commercial real estate and wealth management sectors, galvanizing corporate Canada. Let’s Make History Again raised critical awareness and record-breaking donations for JDRF. Temerty Foundation’s gift of $10M, the largest single donor contribution to T1D research, helped bring us to the over $72M raised as of today. This nationwide effort is a tremendous testament to the community, and we are so grateful.

But now, it’s time to challenge ourselves again.

 We need our community’s continued support. The $100M Campaign to Accelerate is a major gift campaign, meaning the $100 million will be raised through gifts of $5,000 or more to ensure we accelerate our shared mission of finding a cure and improving lives, making the greatest impact on the T1D community. These gifts can be made by a single donor, a family, a business, a foundation, or a group collectively donating the full amount at once.

What the Campaign Supports

Campaign gifts are needed to fuel our mission, accelerating initiatives such as:

A matching partnership with the federal government through the JDRF-CIHR Partnership to Defeat Diabetes, in which the Canadian Institutes of Health Research match 1:1 all donor investments in this partnership. This partnership supports 19 high-impact projects in stem cell cure research, mental health, and more, as well as a new nationwide screening research consortium in Canada. 

When I think of how traumatic it was when doctors diagnosed my son, I can only imagine how much less scary and dangerous it would have been had he been screened for the autoantibodies of T1D first. And with companies developing drugs now that can delay and possibly prevent the disease, kids and adults with T1D autoantibodies can live more carefree years. Major gifts to the JDRF-CIHR partnership have the power to do this. 

New Research Trainees and Clinical trials in Canada and worldwide. JDRF funding helps research that gets to the clinical trial stage. JDRF also helps to promote T1D trials across Canada, whether JDRF-funded or not. Clinical research is the best way to accelerate scientific discovery from the lab to patients. Many clinical trial scientific teams include new diabetes researchers bringing in novel, out-of-the-box ideas or belonging to startups leveraged by donor dollars. 

Think of how the pandemic ignited the medical field and brought in new researchers to fast-track clinical trials for the COVID vaccine. Donating to JDRF’s Global Research pillar or T1D Fund accelerates worldwide innovation to bring T1D cures and treatments to people faster. 

Canada’s first JDRF Centre of Excellence at the University of British Columbia, which is laser-focused on cures. World-renowned BC researchers are collaborating in unique ways to speed up cure therapies. Donors who support the Centre with gifts of $25,000 and up are featured on a beautiful permanent donor wall at UBC.

I went to Vancouver last year to visit the Centre and was blown away by the breadth and pace of cure research. It gives me so much hope for Luke to have his diabetes cured in the future!  

Access for All, JDRF Canada’s program that works with the T1D community to advocate provincial and federal government for better device coverage, treatment access, and research funding. Since the launch of the program, donors have helped our advocates improve diabetes device (advanced glucose monitors and insulin pumps) coverage in eight provinces and inspired federal research funding. Continued donor support will help to further remove inequities by lowering out-of-pocket diabetes costs, ensuring patient choice, and reducing or eliminating diabetes-related emergencies, thereby easing the strain on the healthcare system.

I live in Alberta with my family now, but I grew up in Cape Breton, Nova Scotia. Both provinces have their healthcare challenges. In Alberta, we are fortunate that JDRF advocates have lobbied for changes to insulin pump and advanced glucose monitor coverage, meaning my son’s tech will be covered until he is at least 18. But in Nova Scotia, no coverage exists for advanced glucose monitors, and people must pay out of pocket for these expensive devices or still use the less reliable finger-prick method. 

JDRF’s Mental Health Strategy for T1D to fill critical gaps support. People with diabetes are more likely to experience mental health challenges such as depression, anxiety and eating disorders and can benefit from interventions that prevent or treat these mental health conditions. But standard care for diabetes doesn’t always address mental health concerns, despite evidence that mental health challenges affect the physical management of the disease. Donors to this strategy are directly addressing this vital and underserved need in Canadian healthcare by funding research studies testing different mental health interventions, supporting education initiatives, and investing in a bilingual Mental Health + Diabetes Training Program for Canadian mental health providers who can then apply to be listed in our national directory where people living with T1D can connect with a mental health provider in their area.

Beyond the overwhelming burden of self-care, diabetes can be life-threateningly stigmatizing. My son used to turn his glucose alarms off at school to avoid drawing attention to himself, which could have had dire consequences. The mental health impact of T1D is profound, and I am so glad Canadians are rallying behind this critical area of diabetes care. 

We need supporters now more than ever to help us reach our $100M goal and get us closer to a world finally free from the monster known as type 1 diabetes. We cannot do it without you.

You can contact me at ryan@jdrf.ca or reach out to Nicole Robson, VP of Philanthropy at JDRF, at nicole@jdrf.ca to learn more about how you can support the $100M Campaign to Accelerate.

On behalf of my family and the JDRF family, thank you!