Author: josephknowles

The American Diabetes Association’s 84^th Scientific Sessions were held from June 21- 24^th 2024. This annual conference brings together researchers and scientists to both present and learn about the latest in type 1 diabetes research and technological advancements. Many of the presentations features study results from researchers funded by Breakthrough T1D (formerly JDRF International) and JDRF Canada. The work presented at ADA will advance research and ultimately improve outcomes for people with diabetes (T1D).

Updates in Cell Therapy Research:

Cell therapy aims to replace the insulin-producing beta cells that are destroyed in people with type 1 diabetes so that they can produce their own insulin again.

Vertex Pharmaceuticals presented an update on their VX-880 product, a stem cell-derived replacement therapy with immunosuppression. Of the 12 patients who have been dosed, nearly all (11 of 12) have has a reduction or elimination of exogenous insulin use (via pump or injection). All patients have achieved an HbA1C below 7.0% and time-in-range above 70% on continuous glucose monitoring with the reduced or eliminated insulin administration. There have been no serious adverse events reported.  The trial is expanding recruitment for 37 participants to progress towards pivotal development.

Vertex is also now recruiting patients for their VX-264 therapy. This treatment will use the same cell therapy as VX-880 but encapsulate the cells within a device designed to shield the cells from the body’s immune system, meaning immunosuppression should not be required.

This research was made possible by years of funding by JDRF and the T1D Fund to Doug Melton, Ph.D., and Semma Therapeutics—a biotech company founded by Melton to develop a stem cell-derived islet therapy for T1D—which was acquired by Vertex Pharmaceuticals in 2019.

Cristina Nostro, University Health Network, presented an overview on her JDRF-funded work designing an optimal beta cell surrogate. Her work ranges from establishing optimized stem cell products to the use of microvessels for the purpose of increasing cell engraftment after transplantation.

Alice Tomei, University of Miami and Diabetes Research Institute is funded by Breakthrough T1D (formerly JDRF International) to examine immune protection strategies for immune protection of transplanted beta cells. She presented an update on research that looks to co-deliver immunomodulators via biomaterials along with transplanted beta cells to provide local, specific immune protection.

Jeffrey Millman, Washington University, presented work on his research looking into making stem cell-derived beta cells more functional so that they produce insulin levels similar to healthy human beta cells. To date, stem cell-derived beta cells have underperformed compared to healthy human beta cells.

Katy Digovich from Minutia presented ongoing research funded by an Industry Discovery & Development Partnership grant from Breakthrough T1D. They are developing nanoparticle trackers that provide real-time monitoring to assess and modify beta cell transplant health post-engraftment in patients with T1D.

Harald Stover from Allarta Life Science (Hamilton, ON) presented ongoing research funded by an Industry Discovery & Development Partnership grant from Breakthrough T1D. Their work focuses on synthetic gel coatings that are designed to both support (with nutrients and oxygen transfer) and protect (with immune evasion) beta cells during transplantation.

Updates in Disease Modifying Therapy Research

Kevan Herold, M.D., presented a secondary analysis of the phase III PROTECT clinical trial. In October 2023, Tzield™ (teplizumab-mzwv) showed that it can slow the loss of beta cells and preserve beta cell function in newly diagnosed (stage 3 T1D) children and adolescents ages 8-17. This analysis demonstrated that, in addition to slowing down the loss of beta cells in new-onset T1D, Tzield can decrease insulin dose and improve time-in-range. This reinforces our commitment to supporting therapies that preserve beta cells at onset, which is important for the prevention of complications and improvement in new-onset clinical factors.

Learn more: https://www.breakthrought1d.org/news-and-updates/ada-takeaways-day-1/

Updates in Screening and Monitoring of Early Stage T1D:

Breakthrough T1D spearheaded an effort to develop the first internationally agreed-upon guidance for anyone who tests positive for T1D autoantibodies, co-published in the journals Diabetes Care and Diabetologia.  

These provide guidelines for monitoring children, adolescents, and adults who test positive for T1D autoantibodies, along with recommended monitoring frequencies and actions for healthcare professionals when the risk of progression toward symptomatic T1D is high.  

The guidance also includes recommendations for educational and psychosocial support for positive T1D antibody individuals, including their families and caregivers, and may also lead to primary care doctors screening more frequently since there is actionable monitoring guidance available to them.   

For the first time, individuals, families, and healthcare professionals have concrete next steps to monitor early stage T1D progression and catch symptoms early to prevent DKA.   

This guidance was developed with over 60 international experts, representing 10 countries and endorsed by 11 national and international societies. 

The author list includes Dr. Diane Wherrett of SickKids Hospital, lead of the JDRF-CIHR funded CanScreenT1D Canadian Screening Research Consortium https://jdrf.ca/canscreent1d-screening-research-consortium-in-canada-announced/

Learn more: https://www.breakthrought1d.org/news-and-updates/breakthrough-t1d-spearheads-formation-of-monitoring-guidelines/

Updates in T1D Devices:

• Medtronic MiniMed 780G, especially the importance of initiating it as soon as possible following diagnosis (which is now recommended in the ADA Standards of Care for both children and adults), citing the CLVer trial, which found clinically meaningful and sustained improvements in blood sugar management following early AID initiation.
  
• Medtronic MiniMed 780G in high-risk youth with T1D, with 80 participants aged 7-25 years, who demonstrated an average HbA1c reduction of 2.5% (from an average baseline HbA1c of 10.5% to 8%), improvement in time-in-range, and a reduction in low blood sugar events.

Learn more: https://www.breakthrought1d.org/news-and-updates/ada-takeaways-day-2/

Updates in T1D Complications

SGLT2i Shown as Potential Solution to Help Manage Renal Complications and Improve Glycemic Control for Young Individuals Living with Type 1 Diabetes

Findings from Dr. Farid Mahmud’s JDRF funded ATTEMPT study, showed that a low-dose of SGLT2 inhibitor could safely be given to youth and adolescents with type 1 diabetes (T1D) to improve kidney function and glycemic management. ATTEMPT is the first of its kind, landmark trial designed to evaluate the effectiveness of SGLT2 inhibitors to optimize diabetes control and prevent early subclinical kidney complications in an at-risk pediatric population with T1D.

This medication was evaluated alongside safety protocols to mitigate the risk for diabetes ketoacidosis. It is not approved for T1D by Health Canada.

To learn more: https://ow.ly/FYuL50SoFxT

Updates in Psychosocial Aspects of Living with T1D

BETTER presentation

Maya Nehme, RD/Dt.P, Research Center CHUM presented results from a cross-sectional study that explored Diabetes Distress among Persons Living with Latent Autoimmune Diabetes of Adults in the Canadian Cohort BETTER. Initially funded through the JDRF-CIHR Partnership to End Diabetes, JDRF Canada has extended funding for the BETTER project for an additional 3 years.

The BETTER project includes a Canadian registry of people living with T1D, called the BETTER registry, in which people living with T1D (or LADA for Latent Autoimmune Diabetes in Adults) – or who have a child living with T1D – can share their experience through online questionnaires in order to enrich research and knowledge about T1D.

The study found that emotional burden is significantly greater in persons with LADA than in persons with type 1 diabetes. JDRF Canada is pleased to continue to support the BETTER project and enable such studies to shed light on the daily challenges of those living with T1D.

It often starts with one and becomes a reality with the support of many: one step to begin a walk, one truck to build a transport empire, and one idea to create a leading global charity.  

Like JDRF, Armour Transport Systems arose from humble beginnings in the 1940s, when Mr. Gordon Armour used his truck to haul hay and gravel out of a small farming community near Moncton, New Brunswick. It is now one of Canada’s leading transportation specialists, servicing locations throughout North America. The company is also known for its generous community support of health, youth, and education initiatives, and JDRF is honoured to be Armour’s long-standing charity of choice. 

From monthly employee giving programs, to special raffles and fundraisers, and partnering with JDRF for the Sun Like Walk to Cure Diabetes in Moncton, Armour Transport Systems has made a remarkable impact on type 1 diabetes (T1D) research. Armour recently reached $1 million in giving with their ongoing commitment to the Moncton Walk, which they have supported since 2003. 

“Diabetes has had an impact on many of us here at Armour which is why our employees have been so passionate about raising funds for this important cause,” says Ruby Murphy-Collins, Chief Operating Officer, Armour Transport Systems.  

For the T1D community in Moncton, which includes Jasmine LeBlanc, co-chair of the 2022 Moncton Walk, Armour’s consistent giving provides hope for a better future for everyone living with T1D. This future ultimately includes a cure for T1D, but in the immediate term also means improved treatments and more equitable access to life-saving diabetes technologies like insulin pumps and continuous glucose monitors (CGMs), especially in Atlantic Canada, where there is limited public coverage. 

“Armour’s support is amazing – they have been such a big part of our Walk here in Moncton for so many years,” says Jasmine. “Their funding to support diabetes research will make a difference and help lead to a cure for the kids who are newly diagnosed today. And it’s not too late for me either.”

Jasmine was diagnosed at the age of seven and has been living with T1D for just over 20 years. Since her diagnosis, the Walk has provided her with a meaningful space to connect with the T1D community and volunteer her time.

With the pandemic sidelining in-person events for two years, Jasmine, her fellow co-chair Judy Roy, and about 70 others were thrilled to reconnect on a beautiful day at the 2022 Sun Life Walk to Cure Diabetes in Moncton. 

The same was true one province over in Bedford, Nova Scotia, where Brad Price, a longtime Armour employee and the current VP of Operations, attended the Halifax region Walk. To celebrate the company’s $1-million legacy of support, JDRF presented Brad with a certificate of appreciation – a small token of recognition for Armour’s tremendous support.

We would like to thank Armour Transport Systems and the communities in Moncton and Atlantic Canada for being such stalwart JDRF supporters throughout the years. Together, with their help we get ever closer to a world free from type 1 diabetes.

The 2022 Sun Life Walk to Cure Diabetes for JDRF was a huge success!

The Walk is the largest fundraising event in Canada to support type 1 diabetes (T1D) research. As a result of the pandemic, for the last two years, JDRF had to shift to a virtual event, and while our supporters still made the Walk an exciting and successful fundraiser – there’s nothing like the T1D community being together in person.

This year, we were so excited to reunite many communities across Canada. We asked you to Step Up to Cure Diabetes and did you ever! We were amazed by the dedication and commitment of our participants.

Almost 900 teams registered in more than 45 communities with each province and territory being able to support JDRF too.

As of June 28, more than $2M has been raised in support of the most promising diabetes research with additional Walks still set to take place.

We designated June as Walk Month and there were two ways to participate in the Walk.

JDRF led signature walks, in Vancouver, Edmonton, Regina, Toronto, Montreal, and Halifax on June 12 and across the country, volunteer-led community walks brought together the T1D community.

The Walk is more than just a fundraiser. It’s a chance for families living with T1D to get together, share their stories and offer support. For many first-year Walkers, they or their child were diagnosed during the pandemic, and this was the first time they could meet safely with others who have already been there. Families talked about going back to school for the first time with T1D, nutrition and exercise tips, and helped those who have been newly diagnosed know they were not alone.

Cassie’s son, Connor, was diagnosed with T1D in 2020 at the age of five. It’s important for Cassie that Connor knows that he is not alone.

“It’s not just about raising money, or awareness, it’s that sense of community. It’s about celebrating the resilience of all the kids who live with T1D and connecting with other parents and families who know exactly what you are going through. It meant the world to me to see Connor’s face light up when he saw other kids wearing fanny packs, sporting their pumps & CGMs. It’s one thing to see kids like him on social media, but it is on a whole different level when he sees them in person,” – Cassie Donnelly, Medicine Hat, Alberta.

Most signature Walks had a tent designated specifically for new families, supported by JDRF Volunteer and Community Engagement staff to provide the most up to date information and resources. Games were set up for the kids and emcees helped keep the energy going with music. Across the country, each Walk location had their own unique offerings for the T1D community.

We would like to express our sincere gratitude to all our sponsors, who helped us welcome Walk participants back to in-person events! With their support, we were able to offer an incredible day with pre-Walk stretching, delicious refreshments and valuable resources for T1D families.

At the Toronto location, MP Sonia Sidhu announced the renewal of the JDRF-CIHR Partnership to Defeat Diabetes, a commitment of $30 million in new funding for T1D research.

Walk Day was a day of fun, sharing, a lot of laughter and some tears. We are so grateful to everyone who helped to make it happen and are excited to see the T1D community gather at upcoming Walks.

Thank you so much to our Walkers, volunteers, donors and our national partners. We could not have done it without you. Every step that you took brings us closer to a world free from type 1 diabetes.

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Thank you to our onsite partners for welcoming participants back to
in-person events!

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Local partners

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Community partners

JDRF provides seed funding for highly innovative research with significant potential to accelerate the most promising type 1 diabetes (T1D) research in both cures and approaches to improve disease management. JDRF Innovative Grants address key outstanding questions in the field of T1D and have the potential to lead to changes in the traditional ways of approaching T1D research or spur groundbreaking discoveries.

JDRF is thrilled to announce that three Canadian researchers have recently been awarded one-year Innovation Grants for their T1D studies. 

In the new project, the team will build on this work to harness the function of selected genes to help promote beta cell survival, not only during transplant scenarios (stem cell-derived transplants that replace the beta cells that die during the process of T1D), but even to prevent the beta cell loss that triggers T1D in the first place. The team will explore whether already available drugs that can potentially “turn on” these genes can also promote the survival of human beta cells, and promising results could potentially lead to a drug therapy that could extend the life of cell replacement therapies or even prevent T1D from developing.

The team also aims to explore an existing regenerative drug library to find new drugs that may encourage these pancreatic cells to proliferate. The potential benefit of such cell activation is that a future therapy based on this work could avoid invasive surgery and maintain the vascular and spatial structure of the pancreas, both of which are important for beta cells to control blood glucose effectively and safely.

Severe defects in a protein named cystic fibrosis transmembrane regulator (CFTR) cause cystic fibrosis. This same protein, CFTR, when found in the pancreas of people with cystic fibrosis, causes pancreatic insufficiency. More recently, minor defects in CFTR have been associated with an increased risk of T1D. Once pancreatic insufficiency is better understood in people with T1D, Dr. Lesage can test drugs used to treat cystic fibrosis (initially in mice), to see if they may correct these defects in the CFTR in people with T1D who suffer from pancreatic insufficiency and improve diabetes management.

JDRF Canada will continue to support work that aims to prevent, treat and improve the lives of people with T1D. We will provide updates on these exciting Innovation Grants as they become available.

After years of struggling with the Disability Tax Credit (DTC), Wendell Dempsey breathed a sigh of relief last week when all members of the House of Commons Standing Committee on Finance (FINA) unanimously supported an amendment to the Federal Budget that would ensure all Canadians living with type 1 diabetes (T1D) can access this credit.

For Wendell, the update to the DTC would mean he gets taxed less on his earned income, alleviating some of the stress about the high costs associated with his growing list health complications resulting from T1D.

“This change would mean no more fighting with the doctor to sign off on documents, and no more trying to rationalize how many hours a week it does take to try and control this disease,” he says.

Despite living with type 1 diabetes for more than 20 years, Wendell has only been approved for the DTC a handful of times. “Sometimes I am approved, and sometimes I am not. But my diabetes has always remained constant, and my expenses have only increased.”

Thousands more expressed their gratitude online for this positive step in the right direction, including Joanna Stimpson who took to social media to say “Finally!” thanking her husband Matt who lives with T1D, and bravely shared his story with the House of Commons Committee. Matt  applied for the Disability Tax Credit at the same time as his 14-year-old daughter Tilly. Tilly was approved, and Matt was not, even though they both live with the same condition and the costs incurred and time spent on self-management are relatively the same.

Any Canadian with T1D can attest to the exorbitant costs that come with daily management of this disease. From insulin to devices to supplies, individuals and families can pay up to $15,000 per year out of pocket to survive. T1D is an autoimmune disease where the immune system attacks and destroys the insulin-producing cells in a person’s pancreas. People with T1D must administer an external form of insulin, either through injection, pump or pen multiple times a day in order to survive. There is no cure, but diabetes technologies and devices have come a long way to help people manage the disease better and live healthier, easier, and safer lives. But even with careful management, there remains the risk of diabetes related complications including coma, amputations, kidney failure and even death.

The purpose of the DTC is to provide for tax equity by allowing some relief for disability costs, since these are the unavoidable expenses that other taxpayers do not have.  However, it can be difficult for people with T1D to qualify. Many medical professionals, like Dr. Bruce Perkins, an endocrinologist at Mount Sinai Hospital in Toronto, Ontario, indicate that the current eligibility process is cumbersome. He has   attested that the 14-hour requirement is arbitrary, outdated and presents too many unfair challenges for people trying to access the benefit.

Dr. Perkins has been a staunch opponent of the 14-hour requirement saying that “the simple fact of a type 1 diabetes diagnosis means that one is already on life-sustaining therapy,  one carries additional weekly physical burdens, burdens with coping psychologically, and major financial burdens from the direct and indirect costs of type 1 diabetes. The requirement that a person with T1D must demonstrate an arbitrary number of hours spent on their disease does not resonate well with the medical community, places unfair burden on the health care provider, and introduces major bias in which individuals with T1D receive a tax credit.”

The proposed amendment to the Budget Bill can alleviate this barrier to access by automatically qualifying people who live with T1D and has the community saying, “Finally!”