Author: John

What if people at risk of developing type 1 diabetes (T1D) could curb the progression of the disease by a couple of years?

Earlier this month, TrialNet’s Teplizumab Prevention Study revealed that teplizumab, an immunotherapy drug that suppresses the immune system, delayed a diagnosis of T1D by an average of two years in children and adults at high risk. Results were presented at the American Diabetes Association’s 79^th Scientific Sessions and published in the New England Journal of Medicine.

Immunotherapy is a promising form of treatment that could one day become an insulin-free alternative to potentially cure T1D. It involves the use of substances, such as drugs, to stimulate or suppress the immune system to help the body fight diseases.

All participants in TrialNet’s Teplizumab study were relatives of people with T1D and thought to have close to a 100% chance of developing the disease in their lifetime. Of the 76 high-risk individuals who took part in the trial, 55 were under the age of 18.

Funded by JDRF and the National Institutes of Health (primarily through the Special Diabetes Program), this research represents a major breakthrough in the area of prevention. While previous studies showed teplizumab prolonged insulin production in people recently diagnosed with T1D, this is the first to demonstrate that a drug can delay a diagnosis in high-risk individuals.

“Delaying the progression of type 1 diabetes (T1D) is the only approach in the short-term to impact the incidence and prevalence of the disease,” says Dave Prowten, JDRF Canada’s president and CEO. “This study marks an incredible advancement in research that will not only affect many people living with  T1D, but also help bring us closer to our goal of turning type one into type none.”

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

It has only been a few months since Rowena Chan started as Senior Vice-President of Sun Life Distributors, and she has already decided to step into the role of Honorary Chair for the Sun Life Walk to Cure Diabetes for JDRF.

Our Honorary Chair plays a vital role in driving the overall success of our signature walk event. This exceptional corporate leader inspires their organization to form teams and walk in the largest diabetes fundraising event in Canada.

 “It’s incredibly humbling to be at the forefront of this dynamic movement, rallying our employees to come together to help defeat this disease,” says Rowena.

This is the sixth year that Sun Life has been a proud partner of the Walk, and their second year as the National Title sponsor. Rowena’s engagement as the Walk’s Honorary Chair continues to solidify their strong commitment to JDRF’s mission and to the fight against diabetes as part of their overall purpose of helping clients achieve lifetime financial security and live healthier lives. “Teaming up with JDRF is a natural fit for Sun Life. We want to help accelerate research breakthroughs to help alter the course of this disease and potentially find a cure,” says Rowena.

As Chair, Rowena will rally Canadians as well as Sun Life employees, advisors and clients to help raise awareness and critical funds for type 1 diabetes. “So much has been accomplished in recent years; we need everyone’s help to continue this momentum,” Rowena says. “I’ll be at the Toronto Walk on June 9. Register now and join me in the fight against diabetes either in Toronto or at one of the local Walks happening across the country. Together, we can move the dial on diabetes research and care.”

At JDRF we look forward to working with Rowena and Sun Life to raise these vital funds, and hope you will join us too.

To find your local Walk event, click here.

Evelyn Riddell vividly remembers the year she began university as a happy and hopeful student embarking on the first step towards her future career.

However, adjusting to university life was difficult. Evelyn, who lives with type 1 diabetes (T1D), suffered from burnout, which affected many aspects of her life.

“I realized that I wasn’t putting as much time into my self-management as I could have,” she recalls.  “T1D takes a lot of effort, but I understood why. When I allowed my blood sugars to remain out of range, all other aspects of my life were affected. My studies and my social life. I was losing out on experiences and couldn’t enjoy the moment.”

Although Evelyn did not have to be hospitalized, she knew she had to make changes to her lifestyle. Diagnosed at the age of 12, Evelyn was already well-versed in the daily management of T1D. However, exam season added much anxiety and often caused fluctuations in her blood sugar levels. That’s when she started to notice that it was affecting her exam performance.

“I have a heightened fear of having a low (blood sugar) during class,” Evelyn states. “Given the day-to-day schedule changes at school, I have to find a routine for basal insulin that works and eat at a certain time since everything will impact my blood sugar.”

Gradually, the realization set in that self-advocacy would be her best defence in ensuring a smooth process at school.

“Universities have Accessibility offices, which offer many resources for students, so I went to discuss my situation with them,” Evelyn recounts. “We worked together to create a plan personal to my T1D. I have such accommodations as only writing one exam per day. I am also allowed to take breaks during the exam and will get that time back at the end. It takes away the stress of treating a low blood sugar that makes me lose writing time. Now that I have more control over my T1D during exams I find that I do much better academically.”

According to Evelyn, people living with T1D can especially benefit from coping mechanisms for stress.

“T1D is 24/7 and we don’t get a break,” she says candidly. “But I have learned that it is 100% worth it. When you prioritize your health, it creates a domino effect which positively impacts other areas of your life. For example, you will be performing at your best academically.”

Evelyn is one of the founding members of the University’s College Diabetes Network Chapter, which helps to raise awareness of the challenges related to T1D on campus.

“It is extremely important that you tell your peers about your T1D, so they can be there to help you,” she says. “Be open with your friends, and teach them about T1D. Having someone who can spot a low blood sugar, or who can be there to listen is a great way to help relieve stress.”

Evelyn is currently in her third year of university. She credits T1D for teaching her a lot about herself and shaping her into the woman she is today.

“T1D has given me a hyper-awareness of my body, which is pretty special because I understand exactly what it’s feeling,” she says. “It also gave me a strong sense of resiliency, as well as time management and many other skills which come in handy for school. Recognizing what I go through and realizing that everyone has something they are struggling with has also made me more empathetic.”

Over the years, Evelyn has become involved with JDRF, participating in its annual Walk and Ride, and serving as a spokesperson for the organization. She was also hired as JDRF’s marketing and communications intern last summer.

“It was my first real ‘grown-up’ job in an industry I wanted to work in,” she relates. “The position offered roles and responsibilities that were challenging, and all related to finding a cure for T1D. It was truly a powerful experience to collaborate with people who shared a common goal, and one so close to my heart.”

Since Evelyn’s experience with burnout, she has adopted a different outlook on living with a chronic illness.

“Health is always a priority,” says the 20-year-old. “Resources are available to help you, but you have to be your own advocate. And if you let it, T1D can be your personal superpower.

From left to right: Dr. Rémi Rabasa-Lhoret, Dr. Philip Toleikis, Dr. Mark Poznansky, Dr. Kathy McCoy and JDRF Chief Scientific Officer, Dr. Sarah Linklater

Earlier this month, JDRF celebrated a year of tremendous achievements and welcomed prominent scientists in the field to discuss their work at its You are JDRF Conference.

Held at Toronto’s BMO Institute of Learning from April 30-May 1, the annual event showcased revolutionary advances in type 1 diabetes (T1D) research and paid tribute to JDRF volunteers, staff and partners who helped make these successes possible. It also shared expert strategies on how to improve fundraising capacity throughout the organization to further its mission to find a cure.

“Thanks to the generous support we received, 2018 was a remarkable year for JDRF,” says Dave Prowten, President and CEO.  “Not only were we able to fund cutting-edge research that is paving the way to novel treatments, but we also made important inroads to improve access and affordability to technology for all Canadians living with T1D.”

Among the key research highlights of the conference were:

How does your gut microbiome affect development/progression of T1D?

Kathy McCoy, University of Alberta

Dr. Kathy McCoy is interested in the dynamic interplay between the gut microbiota and our immune systems. Her research aims to understand how exposure to intestinal microbes, particularly during early life, educates and regulates the immune system and how this can affect susceptibility to diseases, such as allergy, autoimmunity and autism.

Dr. McCoy’s lab also investigates how the microbiome regulates the immune system throughout life with the goal of identifying microbial therapies for the prevention or delay of type 1 diabetes onset in susceptible individuals.

Development of a new technology to enable transplantation of human stem cell-derived beta cells without immune suppression 

Mark Poznansky, Massachusetts General Hospital

Dr. Mark Poznansky founded the MGH Vaccine and Immunotherapy Center (VIC) 10 years ago with the mission to accelerate the development of broadly applicable, safe and cost-effective vaccines and immunotherapies for cancer, infectious diseases and type 1 diabetes. The use of cellular therapies to provide dynamic insulin replacement in people with T1D is one of VIC’s focuses.

As active members of the JDRF Beta Cell Replacement Consortium, Dr. Poznansky and his team have contributed significantly to the development of encapsulation therapy. With support from JDRF, they continue to explore and optimize using CXCL12, which is naturally secreted by our immune system to protect implanted beta cells against inflammation and immune attack in encapsulation systems without the use of immunosuppressive drugs.

Using new therapies and interactive technologies to reduce hypoglycemic risk

Dr. Rémi Rabasa-Lhoret, Montreal Clinical Research Institute

Dr. Rémi Rabasa-Lhoret is an endocrinologist best known for his work on the artificial pancreas. He is  collaborating on the development of a province-wide registry of people with type 1 diabetes in Quebec that will enable clinical trials aimed at measuring the impact of new therapies and cost-effective technologies to reduce the risk of hypoglycemia.

Known as the BETTER project (Behaviors, Therapies, Technologies and Hypoglycemia Risk in Type 1 Diabetes), the study will track the incidence of hypoglycemic episodes among patients and employ innovative therapies, such as the use of an online platform that provides educational resources and support tested by registered participants. Dr. Rabasa-Lhoret and his team hope to identify successful measures that can be implemented into the daily care of patients to improve overall blood control, thereby decreasing the risk and burden of hypoglycemia. One of the goals will be to expand this approach to other health care systems to leverage their findings.

For highlights from the You are JDRF Conference, check out our Facebook, Twitter and Instagram pages.

 

 

Young people living with a chronic illness like type 1 diabetes (T1D) often experience anxiety which – if not treated – can quickly spiral downwards into depression. However, the link between diabetes and depression remains poorly understood and under-researched. Depression is often viewed as a natural outcome of “diabetes distress” – the emotional burden of living with the disease.

Dr. Patricia Pelufo Silveira, a Montreal-based researcher at McGill University and The Douglas Research Centre, is challenging this assumption. Her research examines the heightened risk of diabetes-linked depression, its impact on the development of mental-health resiliency among youth, and the possibility of a shared origin story – specifically the role of insulin function in the brain and increased risk for depression.

Dr. Silveira is exploring which combinations of factors may increase our risk for developing chronic diseases and mental illnesses, both the ones we inherit (genetic) and the environmental (epigenetic) ones we are exposed to in the womb and early childhood, specifically, those that increase exposure to excessive stress hormones and blood-sugar levels, among others.

 

 “Adolescents with T1D are learning to manage their condition, while also adapting to puberty, peer group pressure, autonomy from their parents and identity formation,” explains Dr. Silveira. “This can create psychological distress that negatively affects their blood sugar levels and their self-care.”

Indeed, metabolic abnormalities are associated with a high risk of depression in youth living with T1D. For example, T1D is considered an underlying contributor to dyslipidemia, a condition in which abnormally high levels of lipids are found in an individual’s blood, which may also be linked to the higher incidence of depression.

For those living with T1D, mental health needs to be taken as serious as physical health. The prevalence of major depressive disorder (MDD) symptoms among people with diabetes is approximately 10 percent – double the prevalence in individuals without a chronic illness, and increases the longer a person has diabetes.

According to Dr. Silveira, young people with T1D should have routine screening for psychological issues and regular assessments following their diagnosis. The early investigation of depression-like symptoms would not only encourage them to maintain their self-care, but also translate into significant cost-savings to the health sector. As well, regular visits with trained psychologists in the field would help reduce the likelihood of diabetes-related complications and possibly prevent suicidal incidents in the long term.

The development of encapsulation technologies to treat insulin-dependent diabetes has been at the forefront of type 1 diabetes (T1D) research in North America for many years. This is because new methods of cell delivery may offer a functional cure for people with T1D at high risk for life-threating complications.

Recently, the Center for Beta Cell Therapy in Diabetes, coordinator of an international consortium in translational medicine in diabetes, and ViaCyte Inc., a privately held regenerative medicine company, collaborated on their first European clinical trial involving human stem cell-derived implants among T1D patients.

Performed at UZ Brussel, the University Hospital of Vrije Universiteit Brussel (VUB), the pilot project saw participants receive ViaCyte’s product candidate, PEC‐Direct™, which delivers pancreatic cells in a device to individuals with severe hypoglycemic episodes, extreme changes in their glucose levels, and/or hypoglycemia unawareness. Upon maturation, these cells are designed to secrete insulin and other pancreatic hormones in response to blood glucose levels. The device not only replaces lost insulin-producing beta cells but also restores blood sugar control for T1D patients who are eligible for beta cell replacement therapy.

This work complements the clinical evaluation of PEC-Direct™ currently underway in North America. During the first phase of the European trial, implants will be evaluated for their ability to form beta (insulin-producing) cells; the second phase will examine their capacity to produce systemic levels of insulin that establish glucose control. The implantation in these first European patients is a major step in the development of cell therapies with the potential to cure T1D.

This trial, along with preclinical trials, was carried out by the Beta Cell Therapy Consortium with the support of a Horizon 2020 grant from the European Commission. The consortium is composed of clinical, industrial, and research teams at VUB, ViaCyte, San Raffaele Hospital Diabetes Research Institute in Milan, Nestlé Institute of Health Sciences in Lausanne, the University Medical Center in Leiden, and Institut du Cerveau et de la Moelle Epinière in Paris.

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

By Abidah Shamji, National Manager of Government Relations, JDRF Canada

In partnership with Advocates from the type 1 diabetes (T1D) community, we put forward one important recommendation for this year’s provincial budget: that the Government provide access to advanced glucose monitoring technologies such as continuous glucose monitoros (CGMs) and flash glucose monitors (FGMs) to patients and families living with type 1 diabetes. Such measure would not only drastically improve their quality of life and health, but also reduce the complications of the disease leading to increased costs to our health care system.

Well, the budget came out last week with no commitment to fund CGMs or FGMs. This was not entirely unexpected as we have only just recently launched the Access for All campaign so a quick win in Budget 2019 was always a bit of a long shot. After hearing the T1D community tell us how important this issue is for them, we launched this campaign just over a month ago to encourage the government to add CGMs and FGMs to coverage programs in Ontario.

The results of this budget mean that your voice is now more important than ever. You can immediately support this initiative by writing, calling or meeting with your provincial or territorial representative by simply clicking here.

The good news is, there is still time, and we are not giving up. Armed with data including the Ontario Health Technology Assessment Committee’s (OHTAC) Report and JDRF patient advocates, we are continuing to aggressively push this issue forward.

Over the next few months, we will be:

• Planning town halls in 3-4 Ontario communities
• Meeting with those responsible for deciding which medical devices get covered in Ontario
• Targeting MPPs to continue to talk about the impact of CGMs and FGMs on patients
• Targeting private insurance companies who don’t currently cover advanced glucose monitoring technologies as standard in their plans
• Providing you with an online toolkit so you can advocate to your own insurer/employer effectively

Were you disappointed that type 1 diabetes was not included in the 2019 Ontario Budget? Just five minutes of action will help put more pressure on decision makers and advocate for better benefits for the T1D community. Please meet, call or write your provincial representative and urge them to support reimbursement for these technologies.

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. 

 

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.

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 10^th 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.

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.

New technologies for people with type 1 diabetes (T1D) can significantly improve quality of life, but only a limited number of individuals have access to them. Such is the case with continuous glucose monitoring (CGM) systems in Canada, which have the power to revolutionize diabetes management, yet are not covered under provincial health plans. Those Canadians with T1D whose private or group insurance plan does not include CGM or who have no such insurance must go out-of-pocket.

Continuous glucose monitoring involves a thumb-sized, wearable sensor that tracks your blood sugar levels throughout the day and night, notifying you of highs and lows so you can regulate your glucose and insulin intake. Worn with or without an insulin pump, it leads to better glycemic control and lessens the risk of T1D complications.

Continuous glucose monitoring devices help improve self-management of T1D by regulating overall blood sugar, enabling people to spend more time in target range and relieving them of the anxiety that surrounds the disease, as well as aiding them to achieve excellence in exercise and in life. Furthermore, a recent JDRF-funded research study has shown that CGM leads to a reduction in neonatal health complications, and is a viable option for pregnant women with diabetes and their children.

In an interview with the Montreal Gazette, Dr. Preetha Krishnamoorthy, an endocrinologist at the Montreal Children’s Hospital, says CGM is a promising technology from which many children have benefitted.

“In children who have difficulty feeling whether their blood sugar levels are low or high, this can be really a wonderful technology for them,” she explains. “It is certainly something that can help in gaining control of their diabetes and is also fantastic for families to be able to know what the blood sugars are doing.”

At present, no province extends medical coverage for CGM systems. Continuous glucose monitoring has also not been a standard offering for most Canadian insurers. However, the Yukon recently announced a two-year pilot project to provide free CGM to residents under the age of 18, and a provincial advisory panel in Ontario recommended the public funding of CGM for people living with T1D who are “symptom unaware.” The Government of Quebec has also publicly stated that the reimbursement of CGM devices is under consideration.

Through advocacy initiatives and collaboration with The Government of Canada, JDRF is hopeful that CGM coverage will be accessible to all in the near future.

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

As the incidence of type 1 diabetes (T1D) continues to grow, Canadians have long speculated whether environmental factors – namely pollution – could be responsible for triggering an autoimmune attack.

While a number of chemicals, including those found in pesticides and some of which are now banned, have been linked to type 2 diabetes, exposure to pollution is not a significant factor in the development of T1D, according to a new study. In fact, researchers from the University of Helsinki have excluded 27 common pollutants and chemicals as possible causes after analyzing hundreds of blood samples from Finnish and Estonian children at genetic risk of T1D. The young participants, who were part of two existing studies, were tracked to see if they had developed the condition by 2017. The researchers also looked at cord blood samples from the children’s mothers following delivery in order to determine whether exposure to pollution in the womb and in early childhood plays a role.

Among their findings, children who lived in the larger, capital city of Helsinki had higher levels of chemicals in their blood than those residing in smaller cities or the outskirts. As well, there was no connection between the levels of chemicals present in the blood and an increased risk for T1D.

The use of harmful substances has grown considerably among industrialized countries in recent years, and researchers will continue to explore environmental factors with the hope of discovering a link to T1D.

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