Stigma and type 1 diabetes

An often under looked aspect of living with a chronic disease like type 1 diabetes (T1D) is the stigma that can accompany it. Generally, diabetes stigma can be defined as negative perceptions, judgment, discrimination, or a prejudice against someone because of their diabetes. The majority of T1D stigma derives from a lack of understanding of the disease itself, and a belief that lifestyle factors such as diet or lack of exercise – or eating too much sugar ‘caused it’.  

T1D is an autoimmune disease that cannot be prevented, but there remains a belief among many that simply changing habits can reverse or ‘cure’ T1D. And it can be exhausting for someone with T1D to have to repeatedly explain the mechanisms of their disease, or experience undue attention on their diet, exercise habits and overall health and lifestyle.

Over the long-term, diabetes stigma and discrimination can affect T1D management and self-esteem, to the point that it may lead to hiding visible cues of their disease, such as covering up diabetes devices like advanced glucose monitors, or pumps, performing less frequent checking of blood glucose levels, or injecting insulin in private to avoid being seen as having a chronic disease. It may even cause someone to avoid seeking healthcare when needed, which could lead to potential diabetes-related complications.
Experiencing this type of stigma can have implications both internally and externally. Absorbing the negative perceptions that come from diabetes stigma can lead to feelings of shame, failure and guilt. This can impact familial relationships, the workplace, relationships with friends and mental health.

“Sometimes, being open about my T1D can be challenging because I never know what preconceptions or assumptions others may have. More than once, people have asked me, “Should you be eating that?” or “You must have been overweight before your diagnosis?” These negative experiences often create a barrier to disclosing my disease and make me hesitant to share my journey with T1D for fear of being ridiculed, ostracized or shut down. But I do my best not to internalize ignorant comments and instead try to use them to educate on what life with T1D is really like! “- Lauren (29-years-old, diagnosed age 11)

Many teens and young adults with type 1 diabetes have acknowledged experiencing diabetes stigma and that it resulted in them taking less good care of their health, according to a Research Institute of the McGill University Health Centre in Montreal study from 2019, which included 380 participants found via the social media channels of Diabetes Canada (which also supported the study), as well as diabetes clinics and organizations across the country.

During the study, (380 participants) between the ages of 14 and 24 completed an online survey that asked whether they told others they had diabetes, and whether they dealt with their diabetes care (or felt embarrassed about doing so) when with friends and other people.

Two-thirds had felt embarrassed about their diabetes and were more likely to have poor blood glucose control than the one-third who did not experience stigma. Over the previous year, this larger group was also more likely to have had either one or more events of dangerously low blood sugar that required help from another person, or an A1C level above 9% (A1C is a measure of average blood glucose levels over the last two or three months; the target for most people with diabetes is 7% or less.) The study, which was published in the Journal of Medical Internet Research, also found that feelings of stigma were slightly more common among females (68%) than males (59%).

“I found it hard at times to be open about living with T1D in work and school settings because of how many misconceptions are out there about this disease. Multiple teachers and coworkers often took an infantilizing approach after I shared my diagnosis with them, often telling me what I should and shouldn’t be eating and different ways I should be living my life according to their preconceived notions about T1D. Although these situations are hard to respond to, I try to take the opportunity to educate and not take these comments personally!” – Alicia (25-years-old, diagnosed age 7)

Unlike most chronic diseases, T1D is nearly completely self-managed. Diabetes distress, the feelings of frustration, guilt, shame and worry – (what some people with T1D experience when they’re overwhelmed by the relentlessness of diabetes) can be exacerbated by external diabetes stigma. And diabetes distress can lead to diabetes burnout, and a reluctance to manage the disease.

Diabetes stigma can particularly affect people who have diabetes and struggle with maintaining a weight that is comfortable for them. Blaming or shaming someone with diabetes, particularly by watching or commenting on what they eat, or how much activity they are doing, could lead to disordered eating or resistance to discussing changes in diet and blood glucose levels with healthcare providers.

 “Although doctors are the ones who should help you the most with your T1D, they can often be the ones inflicting blame and shame if they don’t like the numbers they’re seeing at your appointments or feel that your HbA1c/time in range should be lower. I struggled with that until I found a more supportive endocrinologist and started seeing a psychotherapist living with T1D. I’ve learned that the best way to combat these feelings is to be more self-compassionate and remind myself that no matter what my blood sugars are doing, as long as I am trying my best, it’s enough!” Lauren (29-years-old, diagnosed age 11)

Although I love being open about T1D and the challenges that come along with it, it is hard to be vulnerable sometimes as there is still so much misinformation and misconceptions out there about this disease. I have had multiple people react in shock when I share that I am diabetic as they say, “but you aren’t fat!” Responses like this perpetuate the wrong idea of what T1D is supposed to look like or what a person living with T1D should look like. Although comments like this can be hard to respond to, I do my best not to internalize them and always try to take an empathetic and educational approach in my response. I truly believe most people mean well, they just aren’t always knowledgeable about the nuances of T1D.” Alicia (25-years-old, diagnosed age 7)

How people think and talk about T1D, including healthcare providers, colleagues, loved ones and friends is essential to improving health outcomes for people with the condition, and to reducing the negative perceptions and judgement surrounding it. Having good support and people willing to listen and learn is key to reducing diabetes stigma and empowering people to feel open and comfortable sharing about what it’s like to live with T1D.

Finding a community of people also living with T1D can help. JDRF Canada offers connection and support through its volunteer and community engagement program. Learn more about community resources and volunteer opportunities that connect the T1D community.

Most importantly, there is never shame in having type 1 diabetes. You may need to be prepared to educate others or correct common misconceptions. But be proud of who you are and acknowledge to yourself daily that you are doing your best, and that is all that can be asked of you.

Disordered eating and type 1 diabetes: Unmet need highlighted in a new UK report

People living with type 1 diabetes (T1D) are more likely to experience mental health challenges compared to those without diabetes. This includes disordered eating and eating disorders: those with T1D are 3-4 times more likely to experience these conditions.

Eating disorders include anorexia, bulimia, binge eating disorders, and insulin omission or restriction to lose weight, commonly referred to as “diabulimia.” Eating disorders are serious in any individual but are particularly dangerous to people living with T1D. In particular, insulin omission can induce hyperglycemia or diabetic ketoacidosis (DKA) (dangerously high blood glucose levels), which can be very dangerous, in some cases leading to severe diabetes related complications, coma, or death.

The close relationship and strict monitoring of food, such as carbohydrate counting, required as part of T1D management can cause stress that may increase the tendency to develop eating disorders in people with T1D. As well, existing treatments for eating disorders may not be ideally suited for people living with T1D, as there are many special considerations, such as the fact that starting or changing insulin treatment can result in weight gain. Accompanying this, there are often feelings of guilt and shame associated with living with a condition that requires careful self-management, and people living with T1D are further at a greater risk of experiencing depression, anxiety, and diabetes distress – a clinical condition that refers to the negative emotions that comes with the burden of diabetes self-management. Although nearly 1 in 5 children with T1D show signs of disordered eating, the signs are often missed.

On January 23, 2024, a Parliamentary Inquiry report in the United Kingdom on the risks of type 1 diabetes eating disorders (T1DE) was released, chaired by Global Health Ambassador The Right Honourable Theresa May MP and The Right Honourable Sir George Howarth MP, both who have a personal connection to T1D.

The parliamentary inquiry, funded with support from JDRF International, identified several systemic gaps and barriers that fail to provide effective support and care for people affected by T1DE (type 1 diabetes specific eating disorders). This includes gaps in diagnostic criteria and terminology for T1DE, the effect of stigma, limited research and evidence in this area, lack of knowledge and training of healthcare professionals, and lack of funding and access to mental health providers and eating disorder support services. There are clearly many areas that must be addressed to improve the experiences of people who are affected by T1DE.

A clear finding from the report is the need for integrated mental health support into diabetes care, with a recommendation to introduce mental health checks along with the existing physical health checks and screening during annual diabetes care appointments, and a need for mental health providers to have training on diabetes and T1DE. People living with T1DE often receive mixed messages and advice from different care providers with conflicting care plans. This latter finding suggests a need for greater communication, collaboration, and integration of different health services within health systems.

Sara, who lives with type 1 diabetes and T1DE, in the Parliamentary Inquiry report shared:

“I was diagnosed with type 1 diabetes at the age of three in 1990 and have had no psychological support in those 32 years. The expectation of how I was supposed to control my diabetes was so high from other people it was unachievable and unrealistic. I couldn’t reach perfect, so the only thing I felt I could achieve was being uncontrolled, so I developed an eating disorder and that became a coping mechanism. My first signs of T1DE were in year eight of secondary school, where I started omitting insulin, and things got worse after leaving pediatric care, as I struggled with bulimia as many as four times a day. I would hide how I felt but underneath my smile I hated myself, my body and the stress that my type 1 diabetes caused my loved ones. By omitting insulin, I could numb the relentless burnout that managing type 1 diabetes brought. I could also eat any food I wanted, and without taking insulin, I would lose instead of gain weight.”

As research is lacking in this area, JDRF International has identified T1D and eating disorders as a key priority and are currently funding three projects to support this. These projects will explore innovative interventions, testing the efficacy of an Acceptance and Commitment Therapy (ACT) intervention delivered via a mobile app, a guide for healthcare providers to see warning signs of eating disorders, and a virtual eating disorder prevention program. This research will support reducing gaps in evidence and interventions for people affected by T1DE.

What can we learn from this report?

  • Greater investment in research in the area of T1D and disordered eating is needed to generate evidence-based best practices
  • Evidence needs to be integrated into practice – this means training our health teams to recognize early signs of T1DE and explore prevention initiatives
  • There is an opportunity for greater collaboration and communication among healthcare providers and care teams to improve patient care
  • Funding in mental health is sorely needed to allow people living with T1D the ability to have improved access to mental health treatment
  • Greater awareness of T1DE and the experience of stigma in diabetes and eating disorders must be addressed

What does this mean for Canadians with T1D?

Since JDRF Canada launched its mental health strategy in late 2021, we have been working to close gaps in mental health and T1D by creating the Mental Health + Diabetes Training Program to train mental health providers to have a greater understanding of diabetes, and recognize the need to further support eating disorders in this area. In late 2023, we co-hosted a webinar with the National Eating Disorder Information Centre (NEDIC) to introduce this important topic to healthcare professionals.

The Parliamentary Report recognizes the important role that peer support can play in treatment and recovery of T1DE, and “recommends the availability of in-person and online moderated peer support”. JDRF Canada is currently funding research in mental health and some studies are working to address the vulnerable years of transitioning from pediatric to adult care. These research projects are exploring peer support as a mechanism of reducing the feelings of isolation that often arise from living with a chronic condition, and to explore what impact that may have on mental health and diabetes related distress. As the risk of developing eating disorders is especially high during teenage years, it is vital that positive emotional and social support are made available during this time.

If you live with T1D, or have a loved one who does, and are struggling with disordered eating, or are restricting insulin to manage your weight, know that you are not alone, and reach out to your diabetes care team or someone else you trust. Help is available. Finding a mental health provider that is knowledgeable about diabetes can also help.

Supports and Resources


Introducing Fitness by Joanna

Hi, I’m Joanna! Born and raised in Ottawa, I now call Toronto my home. I’m passionate about health and fitness, PR/communications, all things food, travel and family!

When were you diagnosed with type 1 diabetes, and can you share a little about what that was like?

On March 16, 1998, I vividly remember looking down at my bruised arms where two IVs dripped into my veins to help bring my blood glucose levels back into a normal range. Nearby machines beeped relentlessly. Doctors and nurses gathered around. I had been rushed to the hospital ER from a family vacation, where I was immediately diagnosed with type 1 diabetes (T1D). I was also told we were lucky we came when we did. It was a moment that will be ingrained in my memory forever.

Over the next week, the hospital became my home—as well as my family’s—where we learned how to manage my newly diagnosed condition. Those early days laid the foundation for my journey with T1D, teaching me that while diabetes is a part of me, it doesn’t define me.

How has fitness impacted your daily management?

Being active and incorporating fitness into my life has been a game-changer for my overall T1D management. The routine of exercise—the planning, the commitment, the follow-through—it all strengthens my resolve to manage my T1D with intention. With every movement, I’m reinforcing habits that keep me on track: monitoring my blood levels, adjusting insulin, being mindful of my eating.

But it’s more than that. It’s about the mornings I wake up feeling unstoppable and the evenings I go to bed knowing I’ve done something good for myself. This positive feeling spills over into other areas of my life, making me a more focused, more present individual. In a way, managing T1D with the help of fitness is one of the best ways to take care of myself.

Can you share what has impacted your daily management the most?

Honestly, my daily management got a lot brighter when I started using a continuous glucose monitor. I can see what’s happening with my blood glucose levels in real time, and it means I can live my life with a lot less stress about my diabetes. I’m forever grateful for the advancements in diabetes technology—it’s come a long way since my diagnosis.

(Learn more about JDRF’s advocacy program to ensure universal access to diabetes devices like advanced glucose monitors here: https://www.jdrf.ca/advocacy/access-for-all/)

Why is supporting the T1D community so important to you?

There’s something profoundly human about being part of the T1D community. It’s a place of courage, resilience, and an unspoken understanding that we’re all in this together. Living with T1D can be isolating, as I quickly learned after my diagnosis. As soon as I found a support system, my life, and my outlook living with T1D completely changed. It’s a community of hearts and hands ready to catch you, lift you, and celebrate with you. That’s what being part of the T1D tribe is all about and I want to give back to this incredible community as much as I can.

Anything else you would like to share with the T1D community?

At the end of the day, T1D has been my greatest teacher in life. Living with this chronic condition for 26 years has taught me to listen to my body better than ever before, it’s encouraged me to be patient—especially on the tough days, and it’s proven that I’m strong and can conquer anything, even when people have doubted me. I’ve completed several triathlons and cycling races, have traveled solo overseas numerous times and have lived and worked abroad. Accomplishing these goals, and many more, has proven that nothing’s off limits.

My advice to those living with T1D: Your T1D has shaped your life, and, it has inevitably developed your resilience, sense of independence and confidence along the way. Don’t let it prevent you from living life on your terms. With the right attitude, you can conquer anything you put your mind to.

You can follow Joanna on her Instagram page here: https://www.instagram.com/joannamariefit/

Learn more about JDRF’s support services to connect the T1D community: https://www.jdrf.ca/support

JDRF Canada announces new projects supported by the Mental Health and T1D Community Grants

People who live with diabetes are at an increased risk of mental health conditions such as anxiety, depression, eating disorders and diabetes distress (the feelings of stress, guilt and being overwhelmed that can result from diabetes management). There are diverse mental health needs across the type 1 diabetes (T1D) community in Canada, and a common theme among members is that greater mental health supports are needed. This need varies widely, from dealing with feelings of being overwhelmed when newly diagnosed, to battling the loneliness and isolation that may come from living with a chronic condition for years, and that it can feel like no one understands.

As part of JDRF Canada’s Mental Health Strategy for T1D launched in 2021 and a key fundraising pillar of the $100M Campaign to Accelerate, in May 2023 we opened the JDRF Canada Mental Health and T1D Community Grants Program as a new funding opportunity. This incubator initiative is designed to provide seed funding to organizations ready to transform innovative ideas into successful projects to support the mental health and wellness of the T1D community.

We received many excellent applications and are grateful to our diverse review panel made up of Canadians with lived and/or professional experience of T1D who helped decide which projects were to be funded. These projects, awarded up to $20,000 each will take place over an 18-month period. Each is unique, offering creative and interactive ways to improve mental wellness among the T1D community.

Partnerships are a crucial component of JDRF Canada’s Mental Health Strategy, and we are proud to be partnering with a variety of organizations across Canada to support these new community projects, and expand the capacity and diversity of supports for mental health and well-being in the T1D community.

“Mental wellness is central to living well with T1D, but we hear from our community time and time again that there is just not enough support for mental health and diabetes within or outside of the health care system,” said Jessica Diniz, President & CEO of JDRF Canada. “Each of these important new projects is a shining example of much-needed support for the T1D community, and we are excited to be enabling them as part of JDRF Canada’s goal to connect more people with the supports they need for improved mental health and wellness. By working as partners with other like-minded organizations, we can reduce duplication and achieve more for the T1D community.”

Bridging the Gap: Mental Health Integration into 2024’s Slipstream Programming​

Connected in Motion (ON)​

An established and well-respected diabetes camp for adults will add mental health programming to their traditional weekend offerings of outdoor pursuits and workshops on adult-life with T1D held in different locations across Canada. The project will create expert-led workshops as well as tools and resources for participants. Workshops and resources will cover a range of topics relevant to adults living with T1D, including body image, aging, and the impacts of the condition on relationships and family dynamics.

CuriosiT1D: Getting Curious about Diabetes & Mental Health

Edmonton Diabetes & High Risk Foot Clinic partnered with Pineapple Therapy (AB)​

This project will develop an 8-week psychoeducation course to teach people living with T1D about the intersection between their condition and their mental well-being. The self-paced course is based on the practices of Acceptance and Commitment Therapy (ACT). Participants will build skills to increase resilience, reduce anxiety, and better manage their condition with self-compassion.

OPEN – D: Onboarding Platform for the Education of New patients with Diabetes

McGill University partnered with GoldBug Interactive (QC)​

Creation of a bilingual (French/English) webcomic for newly diagnosed children designed to be an engaging resource for kids aged 7-12 adjusting to life with T1D. The webcomic will cover topics including managing the routines of diabetes care, talking about your diabetes with classmates, and will also demonstrate healthy coping skills for managing the ‘big feelings’ that come with T1D.

Enhancing Resiliency for Families Living with T1D through Empowering Mental Health Program​

Langs Community Health Centre (ON)​

A community health hub will be developed to include a variety of in-person programming to address the psychosocial needs of a recent influx of people with T1D in their care​. The project will expand their Diabetes Education Program to cover mental health and well-being supports through educational workshops, peer support, and facilitated group activities to foster self-efficacy for tweens through adults.

If you are interested in learning how to support these projects, or JDRF Canada’s Mental Health Strategy, please contact Jen Bavli at jbavli@jdrf.ca.

For questions about the Mental Health and T1D Community Grants Program, please contact grants@jdrf.ca.

Learn more about our Mental Health Strategy and mental health research projects.

2023 Year in Review 

If 2022 was a year of hope, 2023 was one of turning that hope into progress. And thanks to our incredible community of donors, volunteers, and supporters – we saw significant progress across all areas of type 1 diabetes (T1D) research and developed an even closer relationship with the amazing T1D community.   

From the generosity of our donors, JDRF Canada had another transformative year– dedicating substantive funding to research, strengthening our partnerships in academia, continuing to support newly diagnosed families, while never losing focus on our goal of finding cures for T1D while improving the lives of people affected by the disease today. 

Highlights from the past year included: 

T1D research highlights 

In Cell Replacement: 

In Disease-Modifying Therapies: 

In Treatments to Improve Lives: 

  • The JDRF-CIHR Partnership to Defeat Diabetes announcement of 4 new grants in Precision Medicine, the goal of which is to get the right treatment to the right person at the right time. 
  • Funding programs devoted to improving mental health care and outcomes for people with T1D, including the CIHR-JDRF Mental Health grants 

In Screening: 

  • In collaboration with CIHR, JDRF announced the development of CanScreen, a new Canadian T1D screening consortium led by Dr. Diane Wherrett.  
  • JDRF continues to help facilitate screening for relatives of those with T1D at Sick Kids Hospital via TrialNet 

In Clinical Trials: 

  • A renewed focus on helping raise awareness of the importance of clinical trials for moving forward critical T1D research, through a social media campaign and new webpage 
  • A new tool to make finding T1D clinical trials recruiting in Canada easier and simpler – due to launch early 2024. 

To read more about research updates, please visit www.jdrf.ca/blog

2023 was truly a year of incredible progress and momentum both in type 1 diabetes research and at JDRF. As we head into 2024 and the 50th anniversary of JDRF Canada, we reflect on how none of this would be possible without the support of our donors, volunteers and the incredible T1D community. Thank you! We truly believe that a world free from T1D is closer than ever

A legacy of impact: Dave Prowten says goodbye to JDRF

Dear Friends, 

As I write this, my heart is overflowing with gratitude.  Today, I am retiring from JDRF and it has been an incredible honour and privilege to be the President and CEO for over 10 years. I feel fortunate to have met so many fantastic people in the type 1 diabetes community – your passion, commitment and perseverance each and every day is inspiring. Thank you! 

I have many great memories, and one that stands out is from a Kids for a Cure event in Ottawa. I remember that we gave the kids a JDRF hockey jersey to wear in their meetings. When I put mine on, it made me feel so proud.  I was proud to be part of a winning team – a team that digs deep each and every day to make lives better for everyone in the T1D family.  And of course, seeing all of these incredible youth champions tell their stories to MPs and Senators is the BEST!   

Another (humbling) highlight occurred in my first few months. We had secured an interview on a national TV morning show during Diabetes Awareness month, and we were going to discuss the many advances that have been made.   

We had all sorts of items – needles that were massive, to the latest pumps and monitors. For me, it was all very new and I had done lots of preparation to do my best to explain it. I was joined by a young boy named Anwar – he was one of the nicest and cutest kids I had ever met. After the interview, a good friend of mine who worked at the TV station came up to me and said I had done fine. Then he paused, looked me in the eye, and said, but Anwar stole the show!  It showed me how important and impactful it is to share your personal stories to bring this relentless condition to life and that our ability to work as a team makes us unstoppable. 

I often used the word “momentum” with our team. I believe it is important to build and keep momentum as an organization and this can happen in many ways – research breakthroughs, fundraising success, wins with governments. 

As a team of staff and volunteers, our momentum is like a snowball that starts rolling down a hill, getting faster and bigger. During my tenure, while several areas have tremendous momentum, I am so excited by the progress we have seen in research.  I remember when the first cell therapy trial was announced by ViaCyte several years ago, and now, there are so many trials and companies involved, and of course, amazing Canadian researchers continue to make global contributions in this area. With a disease modifying therapy, like TZield that can delay the onset of T1D, approved by the FDA, I am extremely encouraged that the next generation of treatments, that will move beyond insulin and give people freedom from T1D are incredibly close.   

I need to thank many wonderful people for making these 10 years the most rewarding and fulfilling part of my career. Thank you to the amazing JDRF team, in Canada and globally, for leaning in every day to make a difference; to our volunteers that multiply our efforts and are our secret weapon; to our Board for their leadership, guidance and trust. Our donors are incredible, fueling the best research in Canada and around the world.  To our partners, thank you for being so collaborative since making lives better and finding cures requires all of us to work in harmony. There is no doubt that together, we are stronger and more impactful! 

As I depart, I want to wish Jessica Diniz, tremendous success as the baton is officially passed to her. You will be a terrific leader! 

So let me conclude where I began.  Thank YOU for allowing me to be part of this incredible JDRF team and T1D community. You inspire me, and I know we are well on the way to turning type one to type none. 

Holiday gift guide for people living with type 1 diabetes

The holiday season is fast approaching, and you’re probably putting together your lists to choose the perfect gifts for the people in your life. Why not let JDRF help with your shopping.

We’ve put together a gift guide with a few creative ideas for your loved ones living with type 1 diabetes (T1D) – but that can also work for just about anyone on your list. Whether you choose to go simple or complicated, homemade, from a store or a gift card – gifts chosen with thought will always be received with gratitude.

For the person who loves to relax

Luxuriant skin creams

With the winter cold comes dry skin, and this can be a particular challenge for people T1D. It’s also better for glucose monitoring when the skin is properly moisturized. There are so many different brands and scents to choose from, so this can be a stocking stuffer that is practical, but also feels luxurious.

Fun, cozy socks and slippers

Tired and painful feet are uncomfortable for anyone, but especially people with T1D. Compression socks can help with fatigue and nerve pain in the feet. Non-skid, seamless, moisture-wicking socks, or a funky pair of slippers (make sure they’ve got a good sole and a closed toe and back to prevent slipping) can ease the dreaded cold floors of winter. Plus, there is nothing better than feeling toasty, warm and cozy.

Bath bombs and oils

Turn a shower or bath into a spa. Help ease dry skin with oils or bath bombs, there are so many scents to choose from you’re sure to find one that pleases even the choosiest person.

For the practical person in your life

It’s hard to go wrong with gifts that spruce up a living space. Easy to care for plants, like cactus or snake plants can add comfort and decoration while not requiring much maintenance.

Sweaters, blankets, tuques and mitts – we all need them in the winter in Canada, and they offer warmth and function.

Maybe there is a small appliance they’ve been wanting – an air fryer to make healthier versions of ‘fried food’, a new phone to better track blood glucose readings, or a new board or video game

For the fitness lover

Online exercise subscriptions

Bring the gym to their home, by giving your friend or loved one a subscription to High Intensity Interval Training (HIIT), yoga, Pilates or Peleton classes. With so many people making the switch to home workouts, there is a world of choice online at your fingertips.

A FitBit or Apple watch

Fitness trackers make it easier to track calories burned, the intensity of the workout etc., to help better track how much food and insulin they might need before and after.

Home exercise equipment

Free weights, exercise bands, yoga mats, even exercise clothing. Consider a gift card or purchase the equipment that they’ll use to stay fit throughout the winter and into the new year.

For the artist

Paint or colour by numbers

A good way to be creative while also getting in some stress relieving activities is a paint or colour by number set. It can be calming and mediative, and at the end you get a lovely piece of art.

Journaling

If there is a writer in your family, they might appreciate a personalized journal or diary., They can use it to help track blood glucose readings, food intake and exercise, or how they are feeling mentally that day. But it can also provide an opportunity to be creative, write short stories, poems or just doodle. Be sure they know it’s completely private and only to be shared if they want.

For the fashion conscious

Quirky and stylish diabetes supply bags

When you have T1D, you need to carry supplies with you, so why not make it fun! These fashionable accessories are often designed by people who have diabetes, which is win-win.

Gift the gift of philanthropy

Maybe your family doesn’t exchange gifts over the holidays. Or perhaps you are looking for the perfect gift for a colleague. Donating to a charity, including JDRF will help you to feel good while doing good. The gift of philanthropy goes a long way and supporting JDRF will help the close to 300,000 Canadians living with T1D – and their loved ones – live easier lives today while we invest in the most promising research into cures. 

Whatever gift you choose, if it’s chosen with care – it will always be right. From everyone at JDRF, wishing you and yours a happy and peaceful holiday season.

Click here to download your gift of hope holiday card to send to the loved one you are honouring this holiday season. 

Thank you for supporting JDRF and the T1D community. 

Immune Therapy Preserves Beta Cell Function in Newly Diagnosed Type 1 Diabetes

Insulin, administered either by pump or multiple daily injection, remains the only available treatment for type 1 diabetes (T1D). JDRF is aiming to change that and move beyond insulin by accelerating the development of medicines that prevent, delay, or reverse T1D by targeting the autoimmune response, beta cells, or both. Supporting studies that explore how drugs may preserve beta cell function is key to our disease-modifying therapies portfolio.

In a JDRF-funded clinical trial, published in the renowned New England Journal of Medicine , Thomas Kay, M.B.B.S., Helen Thomas, Ph.D., and others demonstrated that baricitinib—a small molecule that blocks Janus Kinase, which is critical to signaling pathways within both immune cells and beta cells in T1D—preserved beta cell function in the disease.

The BANDIT study investigated the use of baricitinib, a treatment already approved by Health Canada for other autoimmune diseases like rheumatoid arthritis, in newly diagnosed T1D individuals. This JDRF-funded study was funded by JDRF and JDRF Australia and conducted at St. Vincent’s Institute of Medical Research in Australia. The study was conducted after years of research by Thomas Kay and others, as well as important work by JDRF advocating for Eli Lilly to provide the baricitinib for the study.

Study Overview

  • Participants were between 10 and 30 years old and began taking baricitinib within 100 days of diagnosis
  • Participants either received baricitinib or a placebo drug
  • The study ran for 48 weeks, and results were analyzed at 12, 24, 36 and 48 weeks
  • The primary outcome was average C-peptide (a measure of how much insulin is still being made by a person’s own beta cells) following a standard meal at week 48
  • Secondary outcomes were HbA1c (average glucose level over a 2–3-month period), insulin use, and continuous glucose monitor (CGM) measures

Results

In 60 newly diagnosed children and young adults, baricitinib:

  • Preserved insulin production, as estimated by C-peptide
  • Improved blood-glucose variability (blood glucose levels were more stable) and time-in-range (the percentage of your day within your set blood glucose targets), using a CGM
  • Decreased the requirement for external insulin
  • Was well-tolerated by the participants

The effect of baricitinib was achieved using a single daily oral tablet, and it’s the first immunotherapy trial to suggest a benefit on CGM measures. (Verapamil, a once-a-day tablet approved for blood pressure management , also preserved beta cell function, but without improvement in CGM measures or insulin requirement.)

What comes next?

Currently, baricitinib is approved for the treatment of rheumatoid arthritis in adults in Canada. It is not however a Health Canada approved therapy for people with T1D. JDRF has multiple lines of inquiry to make sure that this and other disease-modifying drugs get to the hands of people with T1D . There are several clinical trials that JDRF is exploring to see if baricitinib can be effective if used in conjunction with other therapies, such as Tzield™ (teplizumab-mzwv) or verapamil.

What does this mean for people with T1D?

These promising results show that this drug can extend the honeymoon period (the phase in early type 1 diabetes development where the body is still producing some of its own insulin), but more studies are needed before it can become available to the T1D community. As this drug is already approved for use in rheumatoid arthritis (RA) in Canada, the path to its potential use in T1D may be more rapid. Studies that explore the use of disease-modifying drugs, such as baricitinib or ustekinumab, in another JDRF-funded trial currently recruiting in Canada, are key to helping JDRF address the autoimmunity behind T1D.

This treatment is not currently available in Canada for people with T1D, but JDRF Canada will share further updates and results as they become available.

JDRF Centre of Excellence at UBC marks two years of innovation in type 1 diabetes cure research

On November 2nd 2023, the JDRF Centre of Excellence at UBC held its second annual meeting to review research progress, celebrate advances, brainstorm challenges, map out next steps, and exchange knowledge about the lived experience of T1D – all with a view to accelerate the path towards a cure for T1D via the Centre’s research program.

Year 2 at the JDRF Centre of Excellence at UBC has seen progress across all areas of the T1D research program, as well as expansion of its training program and establishment of a T1D Lived Experience Advisory Group.

“It was wonderful to come together and celebrate another strong year of progress on all three JDRF Centre of Excellence theme areas,” said Jim Johnson, Professor, Cellular & Physiological Sciences and Surgery, University of British Columbia. “I am continually inspired by the dedication and brilliance of our students and fellows who continue to drive breakthroughs. We are all, in turn, inspired by our partners with lived experience and thank them for their participation.”

Below are a few highlights shared at the annual event:

Theme 1: Building better beta cells for islet replacement therapy, led by Dr. Francis Lynn

The team has developed new tools that enable testing specific genes for their impact on beta cell function and survival. Using these tests, they now aim to identify genes that make stem cell derived beta cells stronger and better insulin producing cells eligible for transplantation purposes. The team is also gaining new insight into the importance of including stem cell-derived alpha cells in islet replacement products along with stem cell-derived beta cells. In healthy islets, alpha cells release the hormone glucagon, which helps to product individuals from experiencing hypoglycemia.

Theme 2: Protecting insulin-producing beta cells from immune attack, led by Dr. Megan Levings

Over the last year the team has made substantial advances in developing new, immunomodulatory products for prevention and treatment of T1D. One candidate product is being explored for patent protection. The other, a lipid nanoparticle (LNP)-based approach being studied in partnership with UBC spin-off Integrated Nanotherapeutics, found that treatment of animals prone to T1D stopped the majority of animals from developing the disease. Next, the team will test this therapy in animals with pre-existing T1D for its potential to reverse disease. 

Theme 3: Targeting and monitoring beta cell stress, led by Dr. Jim Johnson

The team is expanding our understanding of EIF2A, a protein that protects beta cells from dying. Using an artificial intelligence-based approach, the team has mapped the interactions between EIF2A and other proteins to identify protein combinations that may further increase the protection of beta cells. The team also discovered that an enzyme called PC1/3 involved in processing insulin inside beta cells appears to be defective in people with T1D. This discovery increases our understanding of beta cell dysfunction in T1D and increases the chance that we can identify new indicators of beta cell health, which potentially can be used to monitor individual responses to T1D treatments.

Clinical trials

Dr. Meiying Zhuang, Transplant Endocrinology Fellow at UBC affiliated with the Centre’s clinical core presented the latest data and future plans for islet replacement trials taking place in Vancouver. As the Centre’s work progresses, the Clinical Core will help to facilitate translation of discovery research being carried out in Themes 1-3 to clinical testing. Dr. Zhuang’s perspectives on the translation of research from bench to bedside reinforced the importance of the Centre’s unique opportunity for collaboration and prompted interesting discussions amongst attendees.

Seed grants

The Centre also celebrated the success of the seed grant competition with updates from the first grantees and an announcement of Year 2’s funded projects. Seed grants provide funding for pilot studies aimed at developing novel ideas aligned with the Centre’s goals, and are designed to expand the scope of the Centre’s research program and bring new investigators into the collaborative research team

Dr. Hongshen Ma (Professor, Mechanical Engineering, UBC) used their 2022 seed grant funding to collaborate with Theme 1 in order to engineer a new system for measuring beta cell function and insulin production at the single-cell level. This new tool allows the teams to more accurately study and compare the function of stem cellderived beta cells to donor islets, providing insights to the Theme 1 team as they develop improved products for islet replacement therapy. The other 2022 seed grant awardee, Dr. Dan Luciani (Professor, BC Children’s Hospital Research Institute, UBC) is using their funding to explore the potential of a protein called TFEB  to protect from T1D in an animal model.

Dr. Jan Dutz and team were awarded a 2023 seed grant to test whether a modified version of methotrextate – a drug that has long been used for treatment of other immune diseases – may hold promise in T1D. The second 2023 seed grant was awarded to Dr. Marc Horwitz and team to investigate how the complex relationship between viruses and the gut microbiome can influence susceptibility to T1D, potentially shedding light on new avenues to T1D prevention or treatment.

Lived Experience Advisory Group

In 2023, the Centre established the T1D Lived Experience Advisory Group consisting of people with lived experiences of T1D from outside of the research teams. The Advisory Group will integrate the voices of people with lived experience of T1D into the Centre to ensure their interests and concerns are heard and translated into research aims and knowledge mobilization activities.

The Advisory Group and the Centre’s trainee committee co-organized a Knowledge Exchange Workshop during the annual meeting, which was a highlight from last year and equally impactful in year 2. Investigators and trainees from the Centre met with people with lived experience of T1D to share perspectives on what it means to live with T1D, what a cure would mean, and how researchers and the T1D community can better work together to accelerate research.

“Sharing my T1D experiences at the roundtable today was meaningful to me” said Doug Bourne, a member of the Centre’s T1D Lived Experience Advisory Group. “I sincerely pass along my gratitude to all those whose efforts, research and contributions help to make life better, easier and more manageable for people with diabetes. Without this work our lives would be much different.”

Developing the next generation of T1D researchers

The JDRF Centre of Excellence at UBC team includes several outstanding trainees, including undergraduate students, graduate students, and postdoctoral fellows. The collaborative nature of the Centre offers trainees an ideal environment to develop as researchers, communicators, and team members ready to become the next generation of experts.

A Trainee Committee was created in year 2 to organize events and develop workshops relevant to Centre trainees. During year 2, trainees participated in multiple workshops and many travelled to Michigan, USA, for an event involving all international JDRF Centre of Excellence trainees in May, 2023. During the second annual meeting in Vancouver, the trainee committee’s accomplishments were celebrated and capped off with a Graphical Abstract Competition. During this session, 10 trainees from Centre labs presented a 3-minute summary of their research to a lay audience with only a single slide for support, in a competition judged by people with lived experience of T1D, as well as researchers and JDRF staff in attendance.

During the annual meeting, the Centre also took the opportunity to celebrate and welcome the new J. Andrew McKee Postdoctoral Fellow, funded by JDRF and Canada’s Stem Cell Network: Dr. Sing-Young Chen. Learn more about Dr. Chen on our blog.

Looking ahead

As the Centre’s research program advances, the team is focused on continuing to expand multidisciplinary training opportunities for trainees, incorporating innovative new approaches and projects, and mapping out the path to clinical translation or commercialization for the different therapies and technologies being studied. In Year 3, the Centre’s clinical core will become more active, and engagement with the Type 1 Diabetes Lived Experience Advisory Group will guide evolution of the research program and external communications about the Centre’s progress.

“It was fantastic to share news of progress at this second annual meeting: discoveries made, milestones met, results published, trainees excelling, new collaborations forged,” said Sarah Linklater, Chief Scientific Officer at JDRF Canada. “But what is most exciting is the community that is growing around this initiative, and how this cutting-edge research is increasingly connecting with and being guided by the lived experience of T1D. This is the way forward.”

Future plans for the Centre are focused on the overall goal of bringing new cure therapies to the clinical testing stage. Read more about the Centre here or at UBC’s new dedicated webpage at jdrf.med.ubc.ca  

To learn more about supporting the Centre of Excellence, please visit: https://jdrf.ca/get-involved/accelerate/

New Trial Shows Benefits of Hybrid Closed Loop in Pregnancy  

A JDRF UK-supported trial published in the New England Journal of Medicine and presented at the 2023 European Association for the Study of Diabetes conference demonstrated that hybrid closed loop technology helps pregnant individuals better manage their blood glucose compared to traditional insulin pumps or multiple daily injections.  

Authors say that hybrid closed-loop technology should be offered to all pregnant people with type 1 diabetes.

How does type 1 diabetes (T1D) affect pregnancy?

Despite technological advances in monitoring blood glucose and delivering insulin, altered eating behaviours and hormonal changes during pregnancy mean that most pregnant individuals with T1D struggle to reach the recommended blood glucose levels, which increases complications for both the baby and pregnant individual.

These complications can include premature birth, need for intensive care after birth, and being too large at birth, which increases the lifelong risk of overweight and obesity. Low blood glucose, excess weight gain, and high blood pressure during pregnancy are common amongst pregnant individuals with T1D.

What did the study look at?

In the study, researchers trialed a hybrid closed-loop system also known as the artificial pancreas. They compared this technology with traditional continuous glucose monitoring and insulin systems, where pregnant individuals supported by specialist diabetes maternity teams make multiple daily decisions about insulin doses.

The study involved 124 pregnant individuals with T1D aged 18-45 years who managed their condition with daily insulin therapy. They took part for approximately 24 weeks (from 10-12 weeks gestation until the end of pregnancy). The study took place in nine NHS hospitals in England, Scotland, and Northern Ireland.

What did the study demonstrate?

Using the hybrid closed-loop technology helped to substantially reduce maternal blood glucosethroughout pregnancy.

Compared to traditional insulin therapy methods, the pregnant individuals who used the hybrid closed-loop technology spent more time in the target range for pregnancy blood glucose levels (68% vs 56% of time in range – equivalent to an additional 2.5-3 hours every day throughout pregnancy).

The technology was safely initiated during the first trimester, which is a crucially important time for fetal development. The blood glucose levels improved consistently in the hybrid closed-loop users, regardless of their previous blood glucose levels or previous method of insulin therapy.

These improvements were achieved without additional hypoglycemic episodes and without additional insulin. The participants using the technology also gained 3.5 kg less weight and were less likely to have blood pressure complications during pregnancy.

Importantly, the pregnant participants using the technology also had fewer prenatal clinic appointments, and fewer out-of-hours calls with maternity clinic teams, suggesting that this technology could also be time-saving for pregnant individuals and for stretched maternity services.

The authors of the study say that, as a result of these findings, this type of technology should now be offered to all pregnant individuals with T1D to help improve maternal blood glucose management.

What do the researchers say?

“For a long time, there has been limited progress in improving blood sugars for women with type 1 diabetes, so we’re really excited that our study offers a new option to help pregnant women manage their diabetes,” says lead author, Professor Helen Murphy of the University of East Anglia.

“Previous studies have confirmed that every extra hour spent in the blood sugar target range reduces the risks of premature birth, being too large at birth and need for admission to neonatal intensive care unit. This technology will allow more women to have safer, healthier, more enjoyable pregnancies, with potential for lifelong benefits for their babies.

What does this mean for Canadians with T1D?

There is currently no Canadian recommendation regarding the use of hybrid closed-loop systems during pregnancy. Since 2021, the Diabetes Canada Clinical Practice Guidelines have recommended that “In pregnant people with type 1 diabetes, real-time CGM should be used to increase time-in-range and reduce the risk of overweight infants, neonatal hypoglycemia and intensive care admissions >24 hours.”

In Canada, there are currently two approved options for hybrid closed-loop systems (Medtronic Minimed 770 / 780G or Tandem t:slim X2 + Dexcom G6 with Control-IQ software). JDRF Canada regularly monitors Health Canada approvals for diabetes technology and will continue to review further studies on diabetes technology in pregnancy, and provide updates based on their results.

New results from a clinical trial of once-weekly insulin

We are getting closer to the possibility of people with type 1 diabetes (T1D) needing to administer basal insulin only once a week instead of every single day, with Novo Nordisk announcing the latest results of its ONWARDS 6 clinical trial.

What was the clinical trial studying?

ONWARDS clinical trials, which have been ongoing for the past few years, have been separated into six trials. The first five trials were in people with type 2 diabetes – comparing the once-weekly insulin (called icodec) with a daily insulin, either insulin glargine (a long-acting modified form of medical insulin) or degludec (an ultralong-acting basal insulin analogue).

The latest trial, ONWARDS 6, compared the once-weekly insulin icodec to daily insulin degludec in people with T1D.

The results of ONWARDS 6 were presented at the European Association for the Study of Diabetes (EASD) conference, and simultaneously published in The Lancet. ONWARDS 6 was a large-scale study of 582 adults with T1D comparing the basal insulins (weekly icodec vs daily degludec) in combination with fast-acting insulin aspart.

The study was primarily looking to determine if there was a difference in HbA1c (a blood glucose measurement), as well as time-in-range, diabetes treatment satisfaction, and number of severe hypoglycemic episodes.

The researchers found no difference in HbA1c or time-in-rangebetween the people who took icodec vs those who took degludec. The weekly icodec group did have more episodes of hypoglycemia compared to the daily degludec group, however, the numbers of these episodes were quite low overall (20 and 10 events per patient year for the icodec and degludec groups, respectively).

Moreover, both groups had improved scores on the Diabetes Treatment Satisfaction Questionnaire, somewhat favouring the degludec group.  While we may have expected treatment satisfaction to be higher in the weekly icodec group, the increased scores are likely attributable to receiving additional treatment and medical attention as part of the trial, as well as the fact that both groups improved their HbA1c scores by an average of 0.5%.

What do the trial results mean for people with T1D?

While weekly insulin icodec was as effective as daily insulin degludec at reducing HbA1c in people with T1D, it did lead to a higher rate of hypoglycemic episodes – although the overall rate of hypoglycemia was very low for both groups.

These results provide important information about the safety and effectiveness of weekly insulin and will inform the next round of icodec clinical trials. JDRF Canada will continue to monitor the progress and provide updates when available.

JDRF is deeply saddened by the loss of one of its founding family members, Susan Gold-Reich, a remarkable individual whose dedication and passion changed the landscape of Type 1 Diabetes (T1D) in Canada

Susan’s journey began when her daughter, Amy, was diagnosed with T1D at a young age. Determined to make a difference, Susan, alongside four other families, embarked on a remarkable journey. They established the very first JDRF Chapter in Canada, located in Montreal, and commenced their tireless efforts to transform the landscape of T1D research.

Working from her family’s basement, Susan poured her heart and soul into the mission of raising awareness and helping to ensure essential funding for T1D research.

“Susan was a devoted mother and friend, who invested an immeasurable amount of time and energy into ensuring that T1D research received the support it desperately needed,” remarked Jimmy Garfinkle, a close friend, a co-founding family member, and an unwavering supporter of JDRF Canada. Susan’s tenacity and vision continue to be a source of inspiration for all who knew her. Her contributions to the cause have been invaluable.

We extend our deepest gratitude to Susan for her instrumental role in founding JDRF in Canada and contributing to a lasting research and advocacy legacy. Her dedication has positively impacted the lives of hundreds of thousands of Canadians affected by T1D.

As we remember Susan, let us celebrate the indelible mark she leaves on the fight against Type 1 Diabetes. /  Her tireless efforts have brought us closer to a world without T1D

Link to Obituary – Susan Gold-Reich – Funeral Information, Obituary, Condolences – Papermans & Sons, Montreal, Quebec, Canada

Contributions in Susan’s memory may be made to the Juvenile Diabetes Research Foundation (JDRF).