May 15, 2020

The COVID-19 pandemic has touched everyone’s lives, changing the way we all live, work, and interact with each other. Its effects will be profound and long-lasting, which means that JDRF needs to understand and respond to its impact on both the type 1 diabetes (T1D) community and the research that still needs to happen. Knowing that many research institutes are closed or have temporarily diverted staff or resources to the COVID-19 pandemic, we are now asking the question: What does this mean for T1D research?

JDRF is working hard to navigate through the challenges of the current environment and to ensure that T1D research can continue in a way that prioritises the safety of researchers and research participants. With our unwavering commitment to finding better treatments and cures for T1D, critical research continues to be driven by JDRF-funded researchers in Canada and around the world.

“We realize those living with T1D don’t get a break,” says Dr. Tim Kieffer, Professor in the Departments of Cellular & Physiological Sciences and Surgery at the University of British Columbia in Vancouver, “and we remain committed to our research and finding creative ways to remain productive as we strive to contribute to the development of novel therapies, and ultimately a cure.”

Several members of Dr. Kieffer’s team have received exemptions to continue to work in the lab on long-term, critical projects that have already involved substantial investment. These team members are often working in the lab alone, using new procedures to ensure their safety.  For other team members who are working from home, efforts have shifted to analysis of data, writing papers and grants, planning new projects, and exploring ways to increase our lab’s efficiency.

It is unprecedented for world-class research facilities to have to limit activity to this extent – but there are some silver linings to the forced slow-down. “In my case, this has also been a great opportunity to re-assess the lab’s many projects, seek new ways to further innovate our approaches, recruit additional team members, and reach out to collaborators around the world, who while experiencing similar situations, are available to strategize and assist us in attaining our goals,” says Dr. Kieffer.

Most clinical research sites are requesting that clinical trial enrolment is paused during the COVID-19 pandemic – but clinical trials already in progress can continue, using virtual approaches to interact with patients wherever possible. Dr. Bruce Perkins, Professor of Medicine at the University of Toronto, is about halfway through an exciting clinical trial that is testing an oral medication called empagliflozin in people with T1D who are also taking insulin via an artificial pancreas system, with the aim of improving blood glucose control and making disease management easier. During the COVID-19 outbreak, Dr. Perkins and his team will continue to monitor patients on treatment through virtual visits, including advising them on troubleshooting issues with their artificial pancreas system.

Dr. Rémi Rabasa-Lhoret, Professor of Medicine and Nutrition at Montreal Clinical Research Institute (IRCM) and Centre Hospitalier de l’Université de Montréal (CHUM), was quick to adapt one of his key T1D research projects to address unmet needs in the T1D community in Quebec. He, his colleague Dr. Anne-Sophie Brazeau, and their team are developing a registry of people with T1D based in Quebec, through which registered participants can access a rich, interactive digital training platform whose content has an emphasis on hypoglycemia prevention and management. Given the importance of virtual resources during this period of social distancing, the research team altered the enrolment requirements, enabling a much broader base of people to benefit from the new online resource. They are also inviting registry participants to share information on how they have been affected by the COVID-19 outbreak, to better understand the effects of the pandemic and of COVID-19 illness in people with T1D – a topic where evidence is lacking but urgently needed. Finally, Dr. Rabasa-Lhoret and his colleagues are also contributing to an effort that will expand the use of continuous glucose monitors (CGMs) in hospitalized patients during the COVID-19 pandemic. Greater use of CGMs in hospitals will enhance patient comfort and safety, reduce spread of COVID-19 in the hospital setting, and limit the usage of personal protection equipment for healthcare professionals – important outcomes already addressed in part by the recent announcement that Abbott’s FreeStyle Libre Flash Glucose Monitor has been approved by Health Canada for use in hospitals during COVID-19.

“This pandemic situation has obliged us to revise our usual clinical care and clinical research process, requiring a very rapid shift to virtual care. Online training and tools are a great complement, allowing patients to tailor according to their personal needs. We could foresee that the changes we have made will result in durable, positive effects for people living with T1D and their families”, says Dr. Rabasa-Lhoret.

Dr. Gillian Booth, practicing endocrinologist and a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital in Toronto, has found that COVID-19 is shaping the way that she is approaching her research. Dr. Booth and her team are in the process of developing a platform for delivery of virtual care for patients with T1D that will decrease the burden of attending in-person appointments and improve health outcomes. “The need for virtual care during this pandemic is highlighting all sorts of things that we may not have appreciated were important in delivering high quality care remotely,” says Dr. Booth. Her team will continue to develop the virtual care platform and carry out planning and regulatory activities required to launch the clinical trial that will test the platform’s effectiveness, all while working remotely.

While bench work in the lab of Dr. Jayne Danska, Professor, Senior Scientist and Associate Chief, Faculty Development and Diversity at SickKids Hospital, Toronto has paused, her group remains highly active with data analysis, remote collaboration and group meetings, revising manuscripts, writing research ethics applications and launching the new JDRF-CIHR funded Microbiome Team on T1D she leads with collaborators from Calgary, Guelph and New Haven, USA.  She recently spearheaded a joint effort that collected and delivered personal protective equipment from all the SickKids Research Institute laboratories to frontline workers, demonstrating the commitment of the research community.

Like the T1D community, JDRF-funded researchers are strong and resilient: despite the set-backs caused by COVID-19, they will continue to innovate and pursue cures and better treatments for T1D. The field can anticipate new perspectives, renewed focus, and a surge of accelerated progress once work can fully resume.

Thanks to our donors, JDRF is ensuring T1D research doesn’t stop, and is providing Canadians living with T1D the resources they need to navigate the COVID-19 pandemic. Please consider making a donation to fuel critical research and the latest resources, advocacy and support while we continue to work toward a world without T1D.

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Talking to an expert on T1D and COVID-19

April 22, 2020

A Q & A with Dr. Rémi Rabasa-Lhoret, JDRF-funded clinical scientist and endocrinologist at the Institut de recherches cliniques de Montréal

JDRF invited leading type 1 diabetes (T1D) expert to discuss the probability of contracting COVID-19, who is at greatest risk of getting severely ill, and what people with well-controlled T1D should do to stay healthy.

Dr. Rabasa-Lhoret shared this information and more during our Facebook Live Q & A event, which you can watch below. 

Dr. Rabasa-Lhoret also answered several live questions from the audience. We share the top themes below.

Q. Are people living with T1D at greater risk of getting infected by COVID-19?

A. No evidence suggests that at this time. Of course, should you already have T1D-related complications, it is easier to contract an infection of any kind.

Q. Are people living with T1D who work in the health care system at risk of contracting COVID-19? Should they take specific precautions?

A. The level of risk is dependent on several factors including the individual’s age, his/her degree of blood glucose control and whether he/she has T1D-related complications. Yet as generally advised, social distancing, washing hands frequently and staying at home remain best practices for these people. As well, they should postpone all clinical visits and get in touch with their health care team whether by phone or online for regular follow-ups.

Q. Is there a worse prognosis for people living with T1D who get COVID-19?

A. We know that the consequences of a viral infection may be more significant among people with T1D as it can lead to uncontrolled blood sugar. Yet the prognosis depends on several factors including the individual’s age, his/her current degree of blood glucose control and whether he/she has a pre-existing T1D-related condition like heart disease and/or kidney disease.

Q. Is there a specific risk for contracting COVID-19 among children with T1D?

 A. We have not seen any reports with major or bad outcomes for children with T1D who have been infected with COVID-19. Even when the disease has manifested, it was extremely mild. However, blood sugar control needs to be carefully monitored in such cases and families should be prepared with extra supplies like insulin and ketone strips.

Q. Is there any risk for supply issues among companies that manufacture insulin and CGM materials?

A. At this time, all companies have stock and we anticipate no disruption in the supply chain.

Q. Which medications are safe to use?

A. Acetaminophens, like Tylenol, can be used as a first-line treatment. However, they are not anti-inflammatory and people with T1D should know these medications can sometimes interfere with certain CGMs, etc. Should you already be taking Ibuprofen (ex. Advil) for another condition such as arthritis, it is recommended to continue doing so following consultation with your health care practitioner.

For more info on T1D and COVID-19 please visit jdrf.ca/coronavirus.

May 5, 2020

At JDRF, we know that when it comes to fighting against type 1 diabetes (T1D), there is strength in numbers.

As a JDRF Advocate YOU can bring together people who have been affected by T1D, who want to make their voices heard and work together to build bonds with Members of Parliament, as well as provincial and municipal officials in order to drive change, influence the shape of policy and help new treatments reach the community, moving us closer to a world without T1D.

As an advocate, we need your help. In order to grow and have more people take important actions for those living with T1D, we ask that you reach out to friends and family today to join you as a T1D advocate by:

1. Asking your network to help build and sustain critical support for T1D research and raise awareness among decisionmakers of the financial, medical and emotional costs of the disease by becoming a JDRF Advocate.
2. Sharing our advocacy page with a personal message from you using the hashtag #WhyIAdvocate.
3. Sharing this blog on your networks.

As we strengthen our community together, we’ll be able to accelerate the pace of type 1 research.

Now YOU can invite others to use their voice to help secure continued Federal funding for important diabetes research, inform health and regulatory policy, and improve the quality of life for those affected by T1D – until we find a cure.

It’s because of the work that advocates like you do, we are able to drive change. Let’s carry this momentum forward and work toward a world without T1D.

May 5, 2020

35-year old Jenna Basson from the Pas, Manitoba was amongst the volunteer team sharing their personal stories at the Manitoba Legislature last March 11^th as they advocated for the provincial government to extend insulin pump coverage beyond the age of 18.

As a young professional, Basson would love the opportunity to better manage her type 1 diabetes and lower her A1C levels through the usage of an insulin pump, but the costs are just too high for her to be able to afford one. “The cost has always been so much that I could never afford it,” she said. “Over the years I’ve looked at the different options that are available, but they still remain inaccessible and unaffordable. Having this coverage would be life changing!”

The incredible volunteer advocates spent the day at the Manitoba Legislature on March 11^th alongside JDRF’s advocacy team to demand #AccessForAll. The day consisted of a morning training session for advocates, followed by individual MLA meetings, culminating with an evening reception in the Legislature’s Golden Boy Dining Room co-hosted by philanthropist and long-time JDRF supporter Mrs. Tannis Richardson and JDRF President and CEO Dave Prowten.

JDRF’s message to the government was straightforward and simple: Manitobans with type 1 diabetes at all ages need access to insulin pumps. Investing in an insulin pump program for all will not only benefit patients, but it will also be a win for taxpayers with proven reductions in direct healthcare costs and complications. This means a significant reduction in emergency room visits and hospitalizations which has long been a priority for the government. The unfortunate reality is that Manitoba is lagging behind other provinces, with BC having recently joined Ontario, Alberta and the three territories in covering the cost of insulin pumps for all ages.

The team was met with lots of support from both government and opposition members, with over 50% of MLA’s who took meetings and attended the evening reception. “While there is still work to do, it feels like we were heard despite competing priorities,” Basson added.

In 2021, we’ll celebrate the 100^th anniversary of the discovery of insulin; a discovery by Canadian researchers Frederick Banting and Charles Best that changed the lives of millions of people around the world. Announcing pump coverage for all in Manitoba would be an amazing way to recognize and celebrate this incredible contribution.

Until then, we continue to advocate and push for #AccessForAll.

Help us advocate for full insulin pump coverage in Manitoba by sending a letter to your representative today.

May 5, 2020

As COVID-19 continues to dominate global headlines, the journey to #AccessForAll remains. In fact, within a few short months, the investment into virtual healthcare and digital health technologies has become even more of a priority for provincial healthcare systems across the country. Patients and doctors are still finding a way to connect without having to meet in person, and that is becoming our new normal in light of the current pandemic.

When the dust settles and provinces start to open up again, virtual care will still be a viable option that will reduce hallway healthcare, save considerable resources, and be a convenient option for patients and doctors alike. In order to roll out virtual care successfully, and more permanently, considerable investments in digital health technologies such as Continuous Glucose Monitoring (CGM) and Flash Glucose Montoring (FGM) need to be made, and every patient who desires one should be able to have access through public coverage.

Our #AccessForAll campaign is working towards ensuring that every Canadian living with type 1 diabetes has access to affordable technology. CGM and FGM technologies represent an evolution in the self-management of the disease because they provide richer, more accurate and more timely data to doctors and patients about fluctuations in blood glucose and time in range. This rich data promises to revolutionize how health care teams interact with and guide patients, leading to better diabetes management over the long-term. More and better data means better decision-making for patients, which ultimately leads to better self-management of their disease. As a result, we will undoubtedly see substantial improvements to healthcare in the form of reduced hospitalizations, emergency room visits, and longer-term issues such as amputations, heart disease, stroke and kidney complications.

CGM and FGM have already been game changers for the type 1 diabetes community – they are already helping people live safer, easier and healthier. Unfortunately, they still largely remain unaffordable and inaccessible, especially for those who need it most.

JDRF continues to mobilize our #AccessforAll campaign, and we need your help to tell your provincial representative this story, in light of the new situation we find ourselves in with COVID-19. To support the campaign, take a few minutes to send a message to your representative, and you will be voicing important concerns in response to a new era of healthcare. Send a message today!

May 5, 2020

Tannis Richardson is a spirited woman who has devoted much of her life to local and charitable causes while touching countless lives. A founding member of JDRF’s Winnipeg chapter (1971) and founder of its annual A Starry Starry Night Gala, the nonagenarian is renowned in Western Canada for her extraordinary volunteerism and dedication to arts, health and cultural associations.

Giving back to others has been a way of life since Tannis was a young girl growing up in Winnipeg. Her parents were always community-minded, with her surgeon father establishing the first collective medical facility, the Winnipeg Clinic, and her mother lending support to various organizations. “My parents were extremely wonderful role models,” recalls Tannis.

Tannis’s first volunteer experience was with the Humpty Dumpty Club at the Winnipeg General Hospital. Each Saturday she would accompany her father to the hospital to play with, and read to, the young patients in the children’s ward while he completed his rounds. She would later become a volunteer nurse’s aide during WWII, which was also very rewarding.

“I’ve had experiences that I treasure,” remarks Tannis. “Through the journey in life one experiences encounters with strangers that you don’t expect to have, which enrich your own life and hopefully does the same for them.”

When it was discovered that one of their four children had type 1 diabetes (T1D), Tannis and her husband, George, found themselves thrust into unfamiliar territory, which would soon see them become catalysts of change. Diagnosed at the age of nine, their daughter, Pamela, fought a valiant battle against a disease that was not well known at the time and had few supports in place within Canada’s healthcare system.

“It is high time we had coverage because it is a dreadful burden to put on people. I am encouraged by the support that JDRF is giving to families and that type 1 diabetes is better understood by the general public.”

“There was very little communication about Pamela’s treatment in the medical field back then,” Tannis recalls. “We were required to go from one hospital to another and there were few to support us besides our family and friends because communication between different health services was lacking regarding type 1 diabetes.”

Pamela died at the age of 29 from complications of T1D. Not long after, Tannis and George attended a Toronto gala for JDF (now JDRF) where they met Helaine Shiff, another JDRF Canada founder, who challenged them with: “What are you going to do in Winnipeg?”

Shortly after returning home, Tannis and George attended a function where they met CBC entertainer, Donald Ferguson. In conversation he turned to Tannis to ask, “What are WE going to do about JDF in Winnipeg?” Tannis replied with, “Who are WE?” To which Donald replied, “CBC and you.”

In 1987 CBC was bringing the Royal Canadian Air Farce to Winnipeg and Donald suggested that JDRF should sell the tickets with the proceeds going to support juvenile diabetes research.

“With the Canadian Air Farce as entertainment we made $64,000 that night,” Tannis remembers fondly. “About half the committee had no diabetes in their family, and I was amazed by how many friends came to help. They were incredible people and it was a very special time.”

The following year the committee organized Winnipeg’s first JDRF gala, A Starry Starry Night, which was held at the plaza at City Hall. Today, some 33 years later, the annual gala remains one of Winnipeg’s premier events.

Tannis has chaired JDRF’s local fundraising committee and served on the National Executive Committee and Board of Chancellors, as well as with JDRF International. Forever keen, she remains committed to helping those with T1D. Currently, Manitoba only covers insulin pumps for people with T1D under 18 years of age. As a result, Tannis continues to work towards securing free coverage for insulin pumps for all Manitobans.

“It is high time we had coverage because it is a dreadful burden to put on people,” she says. “I am encouraged by the support that JDRF is giving to families and that type 1 diabetes is better understood by the general public.”

Asked about the social footprint she would like to leave, Tannis keeps it simple. “I would like to be remembered as being approachable and caring about others’ well-being. I don’t like to be called a philanthropist because everyone can be aphilanthropist by giving of their time and support to others.”

Which brings Tannis to one of her favourite memories that she has “treasured in  her heart” throughout the years. It was in 1988, the morning of the first A Starry Starry Night Gala, and committee members were setting up at City Hall. A woman making her way down the steps to the plaza asked Tannis what was happening. Tannis replied “…that a wonderful evening was in store and that everyone attending would be donating towards finding a cure for type 1 diabetes.” The woman hesitated a moment before opening her well-worn purse. Taking out a dollar bill, she handed it to Tannis and said, “I hope this helps you find a cure for diabetes.”

“I remember thinking, philanthropy comes in many forms,” says Tannis. “As the woman walked away, tears came to my eyes and I thought that this person has given what she was able for the betterment of others, which is the definition of philanthropy.”

May 5, 2020

Islet transplantation is offered at selected, specialized hospitals as a treatment option for patients with difficult-to-control type 1 diabetes (T1D). The procedure involves isolating islet cells from one or more donor pancreases and transplanting them into the liver of a person with severe T1D. This therapy has been ground-breaking in recent years, and up to 50% of recipients are reportedly free from insulin injections up to five years post-transplant. Unfortunately, factors such as the scarcity of healthy human donor pancreases and the requirement of lifelong anti-rejection drugs pose great challenges to islet graft survival and patient quality of life. However, a new research project headed by Dr. Andrew Pepper – the recipient of JDRF’s 2019 Career Development Award – may help overcome some of the barriers that prevent islet replacement from becoming a readily available treatment for T1D. 

Dr. Pepper is a promising young Canadian scientist and a new assistant professor in the Department of Surgery at the University of Alberta. Along with his team, he is examining the underlying mechanisms that govern pancreatic beta cell survival and function, with the ultimate goal of developing islet replacement therapies that could become a universal treatment for a broader range of people living with T1D. This will be achieved through continued innovations in novel strategies to preserve beta cell mass, enhancing transplant therapies outside the liver and using stem cell-based insulin-producing cell sources.

“With the critical support of JDRF, my laboratory will strive to preserve the legacy of the Edmonton Protocol while ushering in a new era of cellular transplantation,” says Dr. Pepper.

“With the critical support of JDRF, my laboratory will strive to preserve the legacy of the Edmonton Protocol while ushering in a new era of cellular transplantation,” says Dr. Pepper.

“By reducing and potentially eliminating the need for life-long systemic immunosuppression, we hope to broaden the spectrum of T1D patients that can benefit from this life-alternating cellular therapy.”

Dr. Pepper was a JDRF postdoctoral fellow in the lab of Dr. James Shapiro, who pioneered the Edmonton Protocol for islet transplantation, first reported in 2000. If successful, Dr. Pepper’s research could lead to further exciting contributions in the field of beta cell replacement such as improved efficiency of islet engraftment and the development of minimal immunosuppressive and tolerance approaches for implantation. At the same time, his work could foster a better understanding of islet death early in the course of T1D and contribute to approaches that aim to stop disease progression in recent onset disease. 

I have type 1 diabetes (T1D) and am worried I’ll have to go into the hospital during the COVID-19 outbreak. How can I prepare?

April 22, 2020

2. Insulin and injection or pump supplies

 If you use a pump: sufficient supplies (including reservoirs and filling mechanism (or pods if you use OmniPod), infusion sets, inserter devices), charging cable and/or battery

March 31, 2020

The COVID-19 pandemic is a very worrisome time for everyone, especially those with additional health concerns. To support and inform the T1D community, JDRF Canada consulted a panel of Canadian endocrinologists (listed below) to provide answers to some of your most frequently asked questions.

First and foremost, the importance of good hygiene and social distancing in reducing the risk of infection or spreading infection to others cannot be stressed enough.   

Each person with T1D is different, and we would encourage you to discuss your needs with your healthcare team – the answers below should not be taken in place of medical advice. In addition, the situation with COVID-19 is changing rapidly, with new evidence emerging every day. This information is current as of March 25th, 2020.

Q: Are people with T1D at higher risk of being infected with the virus that causes COVID-19?

There is no evidence that people with T1D are at increased risk of being infected by SARS-CoV-2, the virus that causes COVID-19. Reports from other countries that have implied that people with diabetes may be at higher risk of coming down with COVID-19 might be explained by the fact that people with diabetes had more frequent interactions with other patients and healthcare providers early during the outbreak, when the importance of social distancing was not yet known.

Q: Why do people with diabetes have a worse prognosis when they get COVID-19?

Based on what is known about other viral infections, if a person with T1D comes down with COVID-19, the consequences might be more severe, particularly if they have other health concerns or complications from diabetes (such as heart disease, heart failure, kidney disease) and/or are above the age of 70. In addition, managing blood glucose during an infection is difficult and adds an additional layer of complexity to treatment. If someone with T1D is struggling with illness management when sick with COVID-19, they could be at increased risk of ketosis and diabetic ketoacidosis (DKA), of other (bacterial) infections if they have very high blood sugar, or of hypoglycemia.

A large proportion of people who have died from COVID-19 in China had diabetes – but most of these were likely people with type 2 diabetes, who are on average older than people with type 1 diabetes. It is also not yet clear whether diabetes itself causes worse outcomes, or whether worse outcomes are seen because people with diabetes often have other medical conditions (such as heart or kidney disease) that increase risk. Research in progress will hopefully provide more information on these uncertainties soon. As with any disease, each individual is different, and we encourage you to consult your healthcare team to discuss your risks.

Q: Do people with T1D need to take extra precautions to avoid getting COVID-19, above and beyond those recommended for the general population?

Social distancing is crucial at this time to protect yourself and others from exposure. We all have a part to play in minimizing the impact of the COVID-19 outbreak in Canada, and each of us can set a good example: stay home as much as possible, use virtual options for work or socializing, ask a delivery service or a friend to bring groceries, and keep 2 m away from others if you must go out. For clinic visits, please check with your healthcare team about options for video or phone visits, and delay routine lab work unless there is a clear and urgent need.

If you struggle with your glucose control and have a complication such as heart or kidney disease, or if you are older (~60 years or older), we would encourage you to consider taking all steps possible to minimize potential exposure. If you have high HbA1c (>9%), you may also wish to monitor blood sugar closely and work with your healthcare team (by phone or video) to safely reduce this over the coming weeks when COVID-19 may remain a problem, as lowering your HbA1c could mean a lesser impact of COVID-19 if you do become sick.

Q: My child has T1D – is he or she at high risk compared with a child who does not have T1D?

In general, children who become sick with COVID-19 have mild disease. There is still no published evidence about COVID-19 in children with T1D, but anecdotal evidence from Europe suggests that children with T1D who become ill usually have mild disease and that many children can be managed safely at home with appropriate management of illness.

However, children and youth are not immune to serious illness and in this situation it is important to prevent possible DKA (a serious and life-threatening condition), severe hypoglycemia, and dehydration. During times of illness, it is important to monitor blood glucose and ketones as indicated, follow guidelines as well as connect with your local diabetes team as needed. We recommend ensuring that ketone testing supplies (urine and/or blood strips) have not expired, and being ready to give extra rapid-acting insulin, if required, if your child has elevated glucose and ketones  ̶ as often as every 3-4 hours if indicated. Following illness management guidelines through your diabetes clinic is recommended. For example, here is a useful link to information on illness management from Ontario’s Provincial Council for Maternal and Child Health. Additional details in English and French can be also accessed here.

Q: Is our insulin supply in Canada under threat? How about diabetes supplies or devices?

Thus far, we are aware of no disruptions to the supply chain for medications including insulin, or for diabetes devices. For a list of notices from specific manufacturers, please visit www.jdrf.ca/t1d-and-covid-19/. However, the availability of some medicines (including insulin) in individual pharmacies is being affected as many consumers have been requesting more medicines than usual. We are continuing to monitor the situation and provide information and support. If you cannot obtain insulin, we encourage you to reach out directly to your insulin manufacturer’s customer care team.

Q: I’ve heard that certain blood pressure-lowering medications (ACEis and/or ARBs) might increase my risk of coming down with COVID-19. Is it safe to keep taking these medications?

There is no good evidence to tell us that these drugs worsen the risk of getting COVID-19 or the consequences once infected (see a statement from Hypertension Canada from March 13^th, 2020 here). If your doctor started one of these drugs to protect your heart or kidneys you should keep taking it, unless you have diarrhea, vomiting, or are dehydrated, in which case consult your healthcare team for advice.

Q: How about ibuprofen?

Despite some suggestions in the media that ibuprofen should be avoided with COVID-19, as of yet there is no evidence to suggest it is unsafe, although some health authorities (such as the NHS in the UK) are recommending acetaminophen as a first choice to treat a fever with suspected COVID-19. However, for anyone that takes ibuprofen for other conditions (such as arthritis), there is no need to stop at this time. Patients with advanced kidney damage should be cautious about using ibuprofen in general and this situation also applies to the current situation. Some CGM sensors (including Dexcom G4 and G5, Medtronic Enlite, and possibly others) are affected by acetaminophen and cause the sensor to show a higher reading than the true blood glucose level over the 3-4 hours after taking a typical dose. Thus, if you use one of these sensors and suspect you may have COVID-19, we encourage you to use a back-up glucose monitoring method (fingersticks) if taking acetaminophen.

Q: How can I support my family in learning about and preparing for COVID-19?

Families must find appropriate ways to speak to their children about the pandemic and teach or reinforce important health behaviours that lower risk of exposure. Each family must find their own solutions to adapt to restrictions such as social distancing or quarantine. A helpful resource can be found here.

Q: Should I avoid attending in-person medical appointments right now?

It’s best to contact your local healthcare team for advice. Many clinics are offering appointments by phone or video call to minimize the risk of contracting COVID-19, as well as delaying routine lab work. Rest assured, if there is an urgency to be seen, your teams will be able to see you. It is just not wise to have large groups of people congregating at health care facilities right now.

For additional information on preventing COVID-19, being prepared, and what to do if you think you might have symptoms of COVID-19, please visit jdrf.ca/coronavirus.

We sincerely thank Dr. Farid Mahmud (Associate Professor, Pediatrics, Endocrinology, Hospital for Sick Children), Dr. Remi Rabasa-Lhoret (Professor of Medicine and Nutrition at the L’Institut de recherches cliniques de Montréal (IRCM) and Le Centre hospitalier de l’université de Montréal (CHUM)), Dr. Bruce Perkins (Professor of Medicine, Endocrinology, University of Toronto), and Dr. Peter Senior (Professor of Medicine, Division of Endocrinology, University of Alberta) for offering insights.

March 26, 2020

Dear JDRF family,

Over the last few weeks, I have been blown away by the strength, resilience and generosity demonstrated by you, our JDRF family. I am reminded of how privileged we are to have your continued support. Thank you for everything you do.

Because of you, JDRF is providing people living with type 1 diabetes (T1D) resources and support to navigate these challenging times. Here’s what has been done so far:

• We have set up an information page about T1D and COVID-19, as well as a mechanism to answer your questions via email.
• We are hosting regular online events so you can ask experts your questions about T1D and COVID-19. Check out our Facebook Live with one of our researchers, endocrinologist Dr. Rémi Rabasa-Lhoret.
• We are working with industry partners to ensure people with T1D can continue to get the diabetes supplies they need.
• We have created a panel of medical experts from coast-to-coast to consult on the virus and T1D.

While we all do our part to stop the spread of COVID-19, the day-to-day challenges of living with T1D remain. Our commitment to better health and quality of life for people living with T1D is stronger than ever and, with your help, we will continue to champion the short and long term needs of people living with T1D and their families.

In a time when social distancing is required, it is more important than ever to feel connected. We are working to find the best ways to remain engaged with you during this exceptional time. We are here for you and thinking of you.

Please stay safe,

Dave Prowten
President & CEO
JDRF Canada

March 24, 2020

Sponsored Content by Ei Lilly Canada 

Eli Lilly Canada is pleased to announce the approval and availability of Baqsimi^TM, a new rescue treatment for severe hypoglycemia, demonstrating Lilly’s commitment to simplifying the management of severe hypoglycemia through medicines and patient solutions. The formulation was invented in Canada and is changing the lives of people with diabetes around the world. Baqsimi (glucagon nasal powder 3 mg) was approved by Health Canada with ethical status, making it available at the pharmacy with or without a prescription. Baqsimi is indicated for the treatment of severe hypoglycemic reactions when impaired consciousness precludes oral carbohydrates, which may occur in the management of insulin-treated patients with diabetes mellitus, whether type 1 or type 2.ⁱ Baqsimi is a compact nasal spray that is portable and does not require reconstitution. It is indicated in children 4 years and above and is now widely available in pharmacies across Canada.

For Canadians who have diabetes and who are treated with insulin, the fear of going ‘low’ (hypoglycemia) never goes away. When an individual has a severe low (severe hypoglycemia), they are unable to treat themselves, and they need help from someone else to recover. For people with type 1 or type 2 diabetes who are on medications like insulin, there can be many causes of severe hypoglycemia. These include not eating enough, over-exercising, drinking alcohol, or even using diabetes medications incorrectly.ii

“The daily worry of a ‘severe low’ and the complexity of using injectable glucagon creates an emotional toll for both the person living with diabetes and their caregivers,” says Dave Prowten, President and CEO at JDRF Canada. “Having a new rescue option that is easy to administer with a single nasal puff by a caregiver will alleviate a significant burden, and it has the potential to save lives.”

Baqsimi is a ready-to-use form of glucagon, which requires no reconstitution or priming. It is administered in a single fixed dose that is sprayed in the nose, where it is passively absorbed. Baqsimi does not need to be refrigerated and can be stored at temperatures up to 30°C/86°F in its shrink-wrapped tube.

For more information about Baqsimi and how you can be prepared for an unexpected severe hypoglycemic event, please visit, www.baqsimi.ca.

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March 5, 2020

Type 1 diabetes (T1D) is an autoimmune disorder that is often difficult to manage. Despite recent advances in innovative medical devices and educational tools, many people with T1D often experience blood sugar swings that can put them at risk of complications including hypoglycemia and hyperglycemia. Adding adjunct therapy to existing insulin treatment regimens could soon change that.

The artificial pancreas (also known as a closed-loop) is a promising technology consisting of a system of devices that closely mimics the glucose-regulating function of a healthy pancreas. It comprises a continuous glucose monitor (CGM), an insulin pump, and a computer algorithm that enables these devices to communicate and automate insulin delivery according to a person’s needs in real time. The artificial pancreas systems that are currently available automate basal insulin, and still require the user to give manual boluses via their insulin pump, but research working to develop a fully automated system. One approach towards a fully automated system is incorporating additional hormones or drugs.

Drs. Ahmad Haidar, Laurent Legault, Michael Tsoukas and Jean-Franҫois Yale are a team of JDRF-funded researchers at McGill University (Montreal) who are the first to test the addition of pramlintide (a synthetic form of amylin, which is a hormone co-secreted with insulin by the healthy pancreas) to an artificial pancreas system – a combined treatment they hypothesize would help patients achieve optimal glucose control during the day. Previous studies have shown that pramlintide prevents blood sugar spikes following a meal through affecting digestion and the release of other hormones. Pramlintide – which is already approved and available in the USA – can be taken by injection, but is rarely used. In this study, the researchers set out to test the effects of pramlintide when delivered together with insulin in an artificial pancreas system.

Blood sugar levels in people wearing an artificial pancreas (AP) with insulin alone vs an AP with insulin + pramlintide.

Starting blood sugars were 5-10 mmol/L. Adapted from Haidar et al, Diabetes Care 2020; 43: 597-606.

To test their hypothesis, the researchers conducted a clinical trial in adults with T1D who wore artificial pancreas systems with or without pramlintide during inpatient visits at the Research Institute of McGill University Health Centre. The results of the trial showed that adding pramlintide to rapid-acting insulin in an artificial pancreas system improved glucose control compared to rapid-acting insulin alone, without increasing hypoglycemia. In the next stage of their research, Dr. Haidar and his team are conducting another clinical trial to test whether the insulin-plus-pramlintide artificial pancreas system can eliminate the need for carb-counting in adolescents and adults with T1D.

This exciting research into insulin adjunct therapy brings us closer to less burdensome management of T1D and a better quality of life.