Exciting update in Sernova’s type 1 diabetes (T1D) trial

Principal researcher confirms trial participants with a history of hypoglycemia unawareness are now insulin independent.

Funding cell replacement therapies research is one of JDRF’s most critical undertakings globally, in its efforts to support the most promising cure-based research into type 1 diabetes (T1D).  

On January 10, 2022, Sernova Corp. provided a progress update on its Phase 1/2 T1D clinical trial, a JDRF-funded clinical trial of its cell replacement therapy. The findings were presented by Dr. Piotr Witkowski, the clinical trial’s Principal Investigator at the University of Chicago.

Sernova is a clinical-stage regenerative medicine company and has continued to demonstrate promising results for its Cell Pouch System™. When transplanted with insulin-producing islets, this system has consistently demonstrated in ongoing trials that it can produce insulin in people T1D, and participants maintain more consistent blood sugar levels. Additionally, it has demonstrated ongoing safety and tolerability of the system. In Sernova’s current clinical trial, patients must take immunosuppressive drugs to prevent rejection of the implanted cells.

Sernova’s approach for T1D involves transplanting purified islet cells (the cells in the pancreas that produce insulin and that are destroyed in people with T1D) from organ donors into the Cell Pouch™, an implantable medical device that allows these cells to survive long term and produce insulin. This is a cell replacement therapy that has the potential to be a T1D cure.

The objective of Sernova’s Phase 1/2 clinical trial is to assess the safety, tolerability and efficacy the Cell Pouch™ transplanted with insulin-producing islets in trial participants with T1D who have a history of hypoglycemia unawareness and severe hypoglycemic events.

To be in the study, participants must meet stringent eligibility criteria including, but not limited to, long-standing T1D, recent episodes of hypoglycemic unawareness and an absence of glucose-stimulated C-peptide detectable in their bloodstream (a biomarker that demonstrates the body is making its own insulin).

Hypoglycemia unawareness is a person’s inability to recognize the symptoms of low blood sugar before they become severe or even fatal. It typically occurs when blood glucose levels are below 3.0 mmol/L and is estimated to affect approximately 15% of people with T1D.

Highlights from the study include:

  • Maintained and ongoing safety and tolerability of the Cell Pouch™
  • Islet transplantation to the Cell Pouch™ resulted in the establishment of new, measurable islet function, documented by detectable levels of stimulated C-peptide in the first three participants who completed the course of transplants.
  • A supplemental, single intraportal islet transplant was enough for the first two participants to achieve and maintain sustained ongoing insulin independence and freedom from severe hypoglycemic events for over 21 and 2 months, respectively.
  • The third transplanted participant who recently completed their course of Cell Pouch™ transplants and a supplemental intraportal islet infusion, saw improvements in glucose control, near-normal levels of C-peptide, an absence of severe hypoglycemic events and reductions in daily insulin use.
  • Three additional participants are progressing through the study.

Sernova’s Cell Pouch™ System was created with the goal of one day treating people with T1D and other chronic diseases using stem cell-derived technologies, that will not require immunosuppression. Sernova is partnering with other companies to advance the Cell Pouch™ system to testing using a stem cell-derived source, as well as approaches that will reduce or eliminate the need for immunosuppression.

To date, between our partner organizations JDRF has invested more than $140 million USD in cell-replacement therapy research for T1D. As we celebrate the 100th anniversary in 2022 of the first successful insulin injection, this is another example of Canadian excellence in diabetes research that is accelerating us towards cures.

Back to School and Hypoglycemia

Starting a new grade, new school or beginning university can be very stressful even without having diabetes, particularly during the COVID pandemic.  Many students went to school virtually last year so this autumn may be the first time going to school in person in over a year. 

No matter the grade, getting back into the school routine requires a lot of preparation and planning.  It is always good to have a plan that includes emergency numbers along with insulin plan info, and how to treat low and high blood sugar levels. 

In a perfect world, all school teachers and staff would understand how to manage T1D. Since this isn’t always the case, communication is key.  It is important to educate teachers on T1D before school begins.  Providing information to the school and classmates on T1D management, especially recognizing the signs of hypoglycemia, will help kids feel comfortable returning to school and importantly will keep them safe and healthy, no matter what the school day brings.

Here’s some information on causes and signs of hypoglycemia.

Low blood sugar can be caused by1:

  • Changes to eating patterns such as skipping or delaying meals
  • More exercise or activity than usual, or exercising for a long time without eating a snack or adjusting insulin before exercise
  • Too much insulin or a change in the time taking insulin
  • Stress (presentations, tests, exams, etc.)
What are the symptoms chart


It is important always to BE PREPARED!

In case blood sugar levels fall below 4 mmol/L, school staff should be provided in advance with fast-acting glucose (e.g. Dex4 tablets, gels, and liquids).  If teachers notice a difference in behaviour related to the signs of low blood sugar or children feel warning signs of hypoglycemia, blood glucose should be checked immediately and treat low blood sugar promptly if needed. If a blood glucose meter is not available but low blood sugar is suspected, treat right away.

Treatment options include1:

Afterwards, wait 15 minutes, then check blood sugar again. If blood sugar cannot be tested, monitor the child closely to ensure symptoms of hypoglycemia improve. 

As low blood sugar can happen at anytime, it is important to be prepared.  Dex4 Glucose products help raise glucose levels FAST. 

Dex4 Glucose products are:

  • Fast-acting
  • Pre-measured so you know exactly how much glucose you are consuming
  • Fat-Free
  • Caffeine, gluten, cholesterol free
  • Great-tasting flavours

Additional Resources:

The Diabetes Hope Foundation supports mentorship programs for youth.  Buddy systems are available, for more information visit www.diabeteshopefoundation.com/mentor-biographies

1 Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37(suppl 1):S1-S212.

Disclaimer:

Information in this article is provided for informational purposes only and is not a substitute for professional medical advice.

T1D Research Round Up for Summer, 2021

Learn the latest on type 1 diabetes research updates  
Our research roundup brings you the most exciting type 1 diabetes (T1D) research stories globally, including new clinical trials, treatment advances and research projects that are making the biggest impact in curing and preventing T1D, while improving lives today.  

Here’s what you need to know in T1D research for the summer:  
American Diabetes Association Annual Meeting
Between June 25 – 29, the American Diabetes Association (ADA) held its annual meeting. Due to the pandemic, it was a virtual meeting, but still brought together researchers and clinicians from around the globe to share their research, clinical trial results and the latest innovations in diabetes technology.  

Of note was an update from ViaCyte Inc., a clinical-stage regenerative medicine company focused on developing cell therapies towards a functional cure for patients with insulin-requiring diabetes. They announced compelling preliminary clinical data from their stem cell-derived islet cell replacement therapy, PEC-Direct, for T1D. The results show that PEC-Direct lowers HbA1c, increases time in range, and results in production of C-peptide (a biomarker of insulin production by functional beta cells). These data represent the first time that of implanted pancreatic progenitor cells have been proven to produce C-peptide at clinically relevant levels in a participant in a clinical trial.  Further results of the study are expected next year.  

Read more here.

Other JDRF-funded researchers presented cutting-edge data on targeting the immune system to treat T1D, approaches to screening for T1D risk, next-generation closed-loop systems, telehealth to improve T1D outcomes, and glucose-responsive or smart insulins, which are designed to “switch on” only when needed to lower blood sugar, and “switch off” when blood sugars are in the normal range.
Update on Zucara Therapeutics’ hypoglycemia prevention drug
Hypoglycemia is a frequent, unintended consequence of insulin therapy for people with T1D and other types of insulin-dependent diabetes. Hypoglycemia is associated with significant morbidity and mortality, yet there are currently no available therapeutics to prevent the condition.

Canadian company Zucara Therapeutics is working on the answer. It is developing a once-daily therapy, called ZT-01, which restores a person with T1D’s natural glucagon response so that they can counter-regulate hypoglycemia – and thus prevents serious lows from happening. Previously, JDRF provided funding to move Zucara beyond the “valley of death”— the phase when discovery research is translated into a therapy or technology but lacks the funding to make it real. Then, in April 2020, Zucara secured the backing of a large venture capital fund to move ZT-01 into clinical trials.

Now the company is moving on to a Phase 1b study that will test the effect of ZT-01 effect on glucagon levels during hypoglycemia in people with T1D. In November 2020, Zucara also announced new funding to broaden development of ZT-01 for hypoglycemia prevention in people with insulin-requiring type 2 diabetes, indicating that even more people stand to benefit from the new drug.

Read more here.
Teplizumab was not approved by the US FDA….yet

A JDRF-funded clinical trial recently showed that an immune therapy drug called teplizumab delayed T1D onset in people at high risk by an average of 3 years. The drug, now being developed by Provention Bio, was recently submitted to the US Food and Drug Administration (FDA) – the first disease-modifying drug ever submitted for approval to the regulator. On May 27, 2021, an advisory committee to the FDA recommended that teplizumab be approved for prevention of T1D.

However, on July 2, the FDA issued a Complete Response Letter to Provention Bio, meaning teplizumab has not been approved for use in delaying clinical T1D in at-risk individuals at this time. However, this was expected, as Provention Bio previously reported that FDA raised questions about the comparability between the commercial product and the drug used in the clinical trial. Importantly, the Complete Response Letter “did not cite any clinical deficiencies related to the efficacy and safety data packages submitted.”

JDRF is thankful for the FDA’s consideration and review of this drug and looks forward to Provention Bio addressing the outstanding issues and working with the FDA to bring this therapy to market safely.

Read Provention Bio’s press release here.

Artificial Intelligence Identifies T1D Risk Factors in Children

A collaboration between JDRF and IBM has resulted in a publication that adds new information about T1D risk in children. In the Type 1 Data Intelligence (T1DI) Study — the largest one of its kind for predictors of childhood T1 – combined data from 5 studies in 4 countries and applied artificial intelligence to reveal new insights. The results indicate that children with multiple autoantibodies (markers of T1D autoimmunity) have a 90% chance of developing T1D within 15 years, whereas children who test positive consistently for a single autoantibody have only a 30% chance.

These results not only pave the way for better understanding of risk factors for T1D, and will help to develop guidelines for routine screening, monitoring, and management of at-risk children in different health care settings.

New Brain Canada and JDRF grant announced for mental health research
On June 29, Brain Canada and JDRF officially launched the JDRF Canada – Brain Canada Addressing Mental Health in Type 1 Diabetes Team Grants, a program to support research on the development, validation, or implementation of interventions that address mental health concerns in people with type 1 diabetes.  

This new funding opportunity is open to research teams of two or more independent investigators from different institutions, or distinct departments within the same institution.  

For more information on this collaboration and how it aims to help improve mental health outcomes in people with T1D, please read here.
JDRF-funded research is leveraged to develop virtual peer support platform for youth with T1D

With the support of a JDRF grant, Dr. Tricia Tang is developing an innovative digital platform called REACHOUT that connects peer-led mental health support for adults living with T1D in the BC interior. The platform has the potential to fill a major void for many people with T1D who experience diabetes distress, particularly for those in rural and remote areas where supports are limited.

With newly awarded funding through a BC Children’s Digital Health Research Award, Dr. Tang will adapt the platform for youth with T1D, and build REACHOUT NexGEN.

The ultimate goal is to translate the REACHOUT platform to deliver peer-led mental health support to kids and adolescents with T1D, as well as their parents, to reduce distress and improve quality of life and health outcomes.


We will keep you apprised of these trial results and what it will mean for potentially bringing the product from the lab to the market, as well as provide updates on these research advances and what it could potentially mean for our Canadian type 1 diabetes community.