Tag: Type 1 diabetes

JDRF commissions cost effectiveness study to demonstrate real quality of life value of diabetes technologies

JDRF’s #AccessForAll advocacy campaign aims to make type 1 diabetes (T1D) technology affordable and accessible for all Canadians living with the disease. With support from the T1D community, JDRF seeks to increase public and private coverage technologies such as continuous glucose monitors (CGM) and flash glucose monitors (Flash GM). The goal is to reduce the out-of-pocket costs for these technologies and improve access for Canadians with T1D. 

To support our advocacy for expanded public coverage, JDRF commissioned a study to examine glucose monitoring systems (flash glucose monitoring, continuous glucose monitoring and self-monitoring of blood glucose) and their population level impact on diabetes related complications, mortality, and cost effectiveness of each of techniques in adults with type 1 diabetes (T1D) in Canada.

An estimated 300,000 people in Canada live with T1D. Living with T1D means managing the disease through frequent checking of blood glucose levels, regular infusions of insulin, either by injection or through an insulin pump, and carefully adjusting each dose to balance against carbohydrate consumption and activity levels.

For years, the only way to measure blood glucose was through frequent and often painful finger-prick tests, and insulin needed to be administered through multiple daily injections. More recently, however, diabetes devices like advanced glucose monitors, like CGMs and Flash GM along with insulin pumps have offered more options for managing diabetes and more accurate readings.

Recently, JDRF commissioned a study to examine the population level impact on diabetes related complications, mortality and cost effectiveness of each of these three glucose monitoring techniques in adults with T1D in Canada. The study used a Markov cost-effectiveness model (a probability-based model that models the probability or chance of transitioning between states and their associated costs) and Canadian epidemiologic and economic data for adults aged 18-64 years with T1D.

The study found the following: 

Self-Monitoring of Blood Glucose (SMBG) is an approach whereby an individual pricks their finger, measuring their blood glucose manually using a glucose meter.

Average annual per person costs: $2,019

After 20 years, if all 180,000 Canadians aged 18-64 living with T1D use the traditional finger-prick method, an estimated 11,200 people would remain free of complications and there would be an estimated 89,400 deaths, at a total cost of $12.2 Billion.

A continuous glucose monitor (CGM) works through a tiny sensor inserted under the skin. The sensor measures the glucose level and provides a continuous reading.

Average annual per person costs: $3,930

Universal coverage of CGM would increase the number of people living free of complications by an estimated 7,400 and decrease mortality by an estimated 11,500.

A Flash glucose monitor (Flash GM) measures the glucose level through sensors and provides a blood glucose reading when the user scans the device over the sensor.

Average annual per person costs: $2,540

Universal coverage of Flash GM would allow an estimated 3,400 more people to live without chronic complications of T1D and prevent approximately 4,600 deaths.

Universal use of CGM and/or Flash GM in Canada for the T1D population would reduce complications and death at a cost-effectiveness threshold of $50,000/ Quality adjusted life-years (QALY). QALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is commonly used in health economic evaluations to measure the cost-effectiveness of medical interventions and is the standard measure of quality of life in cost-effectiveness models.  A value of 1 corresponds to one person living one year in perfect health; and a value of 0 is assigned when a person has died.

Quality Adjusted Life-Years (QALY):

Use of CGM and/or Flash GM over SMBG for the T1D population:
  • Leads to fewer complications such as:
Severe Hypoglycemia
Diabetic Ketoacidosis
Micro- or Macrovascular complications
  • Reduces long-term costs associated with hospitalization
  • Leads to improved mortality rates
  • Are at a much lower cost-effectiveness threshold than the acceptable threshold of $50,000/QALY ($35,017 QALY and $17,488 QALY respectively)

The study demonstrates that universal adoption of CGM and Flash devices would be anticipated to lead to a significant reduction in risk of developing severe hypoglycemia (a severe event where a person often loses consciousness due to low blood glucose), diabetic ketoacidosis (a severe event where a person has high levels of blood glucose and ketones in their blood.  These often require hospitalization) and micro- or macrovascular complications (chronic complications that affect the smaller blood vessels such as retinopathy, nephropathy, and neuropathy.  They can also lead to other severe complications like kidney disease, blindness, etc.) Macrovascular complications affect more major blood vessels which includes heart attack, coronary artery disease, etc.

Therefore, funding these devices is more cost-effective compared to traditional finger-prick methods, and while the cost of funding CGM and Flash GMs are higher in the near-term, they generate significant long-term cost savings due to lower costs of complications, potential hospitalization, and additional medical interventions.

Moreover, access to these devices brings users greater peace of mind and provides more accurate blood glucose measurements. T1D self-management is facilitated by these technologies through real-time readings that help to improve overall blood glucose (HbA1C) and time in target range (TIR). Better self-management and glucose control also help to relieve some of the anxiety that surrounds the disease. It allows people with T1D to better plan exercise, meals, and rest and greatly improves overall quality of life.

CGM and Flash GM devices are extremely cost-effective compared to traditional finger-prick methods. To learn more about Access for All and how to advocate in your community, please visit https://jdrf.ca/advocacy/access-for-all/

JDRF ambassador Sébastien Sasseville takes on the Race Across America in latest of endurance races

Sébastien was diagnosed with type 1 diabetes (T1D) in 2002. He made a commitment to himself then that T1D would never keep him from living life to the fullest, and he has followed through on that promise to himself. Since then, Seb has run across Canada, climbed Mt Everest, and participated in a number of the world’s hardest endurance races. On June 28th, 2021, he started a ride across Canada Canada in support of universal access to diabetes devices for all Canadians living with the disease. And this past June, he took on The Race Across America, or RAAM, an ultra-distance road cycling race held across the United States known to be the toughest in the world.

JDRF had the chance to connect with Seb and ask about his experience with RAAM.

What made you decide to pursue this race, and so close after riding across Canada?

“When I came back from the ride across Canada, I was tired, but I was happy and proud about what I had accomplished. There is always a recovery phase, it’s part of the deal that there is some suffering involved, Before during and after. Just a very small part of it. I don’t like to suffer more than anyone else, but it’s not the part I focus on – it’s what I learn, the impact, how I grow, that is the appeal. When you look at it from that angle, it’s tough not to continue doing these things.

RAAM is a much tougher ride, physically and mentally. People get hung up on it being shorter than the ride across Canada, but the course is far more demanding. It’s a lot more climbing, and it has a cutoff, it’s a race. So, it has a different context. And you have twelve days maximum to complete it. There is no margin of error. You must be on your bike 20-22 hours a day. 12 days of 1-2 hours of sleep. It’s the toughest ultra-cycling event in the world.”

This is an extremely intensive undertaking for anyone but competing in race of this kind while managing your diabetes adds another layer of challenge and complexity. How did that impact the race for you?

“It had a huge impact, and a big issue was the lack of cell phone reception – that was a massive surprise. We thought we would lose reception every once in a while, but the course goes through very remote areas throughout the course. That’s a safety thing so you aren’t riding on highways, it’s a set course. We ended up days without coverage, or very spotty coverage. The impact was that I was planning on checking my blood glucose on my watch, but that goes through the internet.  I couldn’t get it on my phone -so my team couldn’t see my blood glucose readings in real-time. So, we didn’t expect not having the data. And this impacted how I controlled my diabetes.

And honestly – it was a big source of frustration. A lot of people who don’t understand T1D believe – oh you have a CGM (continuous glucose monitor), and insulin pump – so you’re fixed. And some people think I must be different. That diabetes must be easier for me because I do these kind of endurance events. I’m not. I’m like everybody. I go through the same challenges. And I hate it sometimes. I try and embrace it as much as I can. But I’m human like everyone else. And if it slows me down, I tell myself that this is my life and journey. But it takes up time and space in your head and body. And it impacts everything.

There was a pharmacist there (at the RAAM), who probably understood it the most. And he came up to me almost every day, to say how amazing he thought it was that I was competing in this race and have T1D. Although it felt good, it was a reminder that most people don’t have his knowledge and don’t understand what we have to go through every single day.

But I must say – it was still far better than last year (the ride across Canada). Because we learned a lot from last year. These types of races are never going to be easy. So, you have to adapt.

Type 1 diabetes is the one thing that slowed me down the most during this race. And I’m immensely proud that I was even on the starting line. It’s by qualification or invitation only.  I was the only Canadian. To race, to race strong, to finish, to finish 12 out of 33 who started, that’s a very strong performance.”

How would you describe your endurance sport as a metaphor for living with T1D?

“I hear a lot from people, when they learn about what I do that ‘It’s so out there, it’s hard to relate’ We were fully aware of it – a year ago when I started looking for sponsorship and funding, I did wonder how to connect this with the larger world outside of the T1D community, because it’s so outside the realm of most people’s experience (living with diabetes).

But for me, it’s such a parallel for life managing diabetes. One rider, a team of 10 people, working 24/7. It’s like with T1D, it’s the team that supports, the team that takes all the decisions. They prepare the bike and fix all the issues. It really is a collective effort and success. You can’t even get through day 1 without the team.

I relate this to how living with diabetes really takes a community too. None of us do this completely on our own.”

Do you see yourself continuing to pursue these types of high intensity endurance sports?

“I don’t plan on stopping. I don’t ask people when they play golf when they are going to stop. It’s something they love. I’m aware that isn’t a typical kind of life, but I have so much fun, I learn so much, I grow so much. I’m not an adrenaline chaser. I won’t jump out of a plane. But these I will keep doing as long as I can. They are life-enriching experiences. I finished, but at the end of the day – whether you finish or not, it’s a very rich experience. The team becomes like your family. We created something very special. I was a very magical and powerful experience. So, I plan to continue doing these things for a long time.”

Any final thoughts?

“We need a cure. There are people like me who live well with diabetes, and we all need to live a fulfilled life before there is a cure. We do need to live in the now. But the fact of the matter is that this is tough to live with. And there were bad diabetes days. And it slowed me down. I know a lot about type one and exercise, it’s my job and I keep it as well-managed as possible. And even still, I have highs, I have lows. I hate it sometimes. My reality is the same as others with this disease.

This is why I am an ambassador for JDRF. Because I want to be part of the cure.”

Follow his journey on Instagram

COVID-19 and type 1 diabetes (T1D) – an update

JDRF is committed to providing the T1D community with the most up-to-date and relevant information about the ongoing COVID-19 pandemic and its impact on those living with the disease.

As of January 2022, Canada is once again amid what appears to be the worst wave of the pandemic, with the emergence of the Omicron variant. This is not the place we imagined we’d be in the beginning of 2022, nearly a year after the vaccine rollout began and two years into the pandemic. It is a time of understandable uncertainty, fear, and frustration.

While we are undoubtedly exhausted and experiencing pandemic fatigue, until the rate of COVID-19 cases declines, we must continue to take every precaution to try our best to prevent exposure for both ourselves and those in our communities.

We recommend getting boosted (a third vaccine dose) if you haven’t already. There are also approved vaccines for children between 5- 11 years old.

Having T1D doesn’t increase the risk of contracting any of the COVID-19 virus variants, but people with T1D – particularly adults – do have an increased risk of serious outcomes if they develop the disease. And Omicron is exceedingly contagious.

Like other COVID variants, Omicron can also be transmitted when a person is asymptomatic or pre-symptomatic, so even if you are feeling fine, it is important to always follow these guidelines to protect yourself and those around you.

Important steps to take to limit exposure

COVID-19 is airborne. This means that tiny virus particles can linger in the air after being exhaled by someone who is infectious. Make sure whenever you leave the house and will be in an indoor setting to have a very well-fitting mask. Ideally, wear an N95 mask which can filter out up to 95% of microbes. If you can’t find an N95, double masking with a medical grade surgical mask (the blue masks you can find at pharmacies) with a tightly fitting cloth mask on top can work nearly as well as an N95. An effective way to check if the mask is tight enough is to wear glasses after you have put on your mask(s) and exhale forcefully. If the glasses fog up, this means air is escaping from the sides or top of the mask. Adjust accordingly until the seal is tight.

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Maintain strict hygiene. Wash your hands every time you come home, or after handling/opening a delivery/package etc.

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Good ventilation is essential in an indoor setting. Prolonged exposure to aerosolized particles, which are heavier in indoor spaces with low ventilation, significantly increases your risk of being exposed to COVID-19. If possible, avoid spending time indoors anywhere that is not your household, and do not go anywhere without a well-fitted face covering.

Minimize your social interactions and trips outside the house, if possible, and try to avoid busy times or crowds when you do. Always maintain social distancing from non-household members, including while outdoors. Wear masks whenever you are spending time with anyone who is not in your immediate household. This includes receiving deliveries etc.

What should I do if someone in my family with T1D tests positive, or I test positive and have T1D?

If you have COVID-19 symptoms, please contact your healthcare professional. There is a shortage of PCR tests across Canada (nasal swab performed by a healthcare professional and tested at a lab). If you have access to rapid antigen tests, and that test shows you are positive, consider that a confirmed infection. You should then follow public health guidelines on isolation (these differ by province) until you are recovered and symptom-free.

Important steps to take when COVID-19 positive with T1D

COVID-19 elevates the risk of diabetes ketoacidosis (DKA). It is essential to more closely monitor your blood glucose levels and ketones. Making sure you are eating and drinking enough when sick is a challenge. Try and ensure you are eating a balance of protein and carbs and drinking plenty of liquids, even if it’s hard.

Additionally, you are likely taking over the counter medications to help manage your symptoms. Decongestants for congestion and cough can raise blood glucose levels. Suspension (or liquid) medication and cough drops frequently contain sugar.

Some fever reduction medications can be hard on the kidney and liver (like acetaminophen found in Tylenol) and should be taken with caution if you have kidney complications. Aspirin in large doses can lower blood glucose levels. Ibuprofen (found in Advil) can increase the hypoglycemic effect of insulin.

All of this can further complicate blood glucose management.

If you use a continuous glucose monitor (CGM), flash glucose monitor or finger sticks, checking your blood glucose level every few hours can help you better notice any unusual changes. You may also require more insulin. If you can, make sure you have an extra supply on hand.

As well, be extra vigilant checking for ketones (a sign that the body is using fat and muscle for energy, instead of sugar). DKA requires immediate medical attention. An added challenge is the symptoms of DKA can feel flu-like, as do the symptoms of COVID-19. If you notice increased and rapid breathing, and a fruity or sweet smell emanating from the body – this is a sign that the body is trying to rid itself of ketones.

If you or a loved one with T1D do end up needing to go to the hospital, here is more information on how to best prepare. https://jdrf.ca/t1d-and-covid-19/hospital-visits-during-covid-19/

For more tips on maintaining more consistent blood sugar readings: https://jdrf.ca/covid-19-and-t1d-together-we-can-keep-our-community-safe/

This has been an ongoing time of intense stress. Please ask for help, either from family, trusted friends or a professional if you are overwhelmed. Trying to manage your diabetes along with protecting yourself and your loved ones from COVID-19 is not easy. Speak to your healthcare provider or support network about accessing additional resources and help.

2021 Wrap Up

2021 was a year of strength and we believe that 2022 will be one of hope.

Canadians are resilient, and though this pandemic continues to challenge, the tenacious spirit of the JDRF community never wavered. As a result, JDRF was able to progress our important work in supporting the research that will bring us closer to a cure, while improving the lives of people affected by T1D today.

Thanks to the generosity of donors, JDRF had a ground-breaking year in 2021 – funding more dollars to research, building new strategic partnerships, continuing to support newly diagnosed families and sharing the latest updates impacting our T1D Community.

As well, 2021 marked the 100th anniversary of the discovery of insulin in Canada. Together, as we commemorated this meaningful milestone, raising awareness for type 1 diabetes (T1D), – we more importantly – recognized the urgent need to accelerate towards a cure.

Some highlights over the past year included:

  • The launch the $100M Campaign to Accelerate and raise nearly 50% of our goal in 1.5 years!
  • The launch the first JDRF Centre of Excellence in Canada at UBC, exclusively focused on a cure for T1D
  • The beginning of the work to address critical gaps in mental health care for the T1D community by launching our new Mental Health and T1D Strategy
  • Secure improved T1D device coverage in Saskatchewan, British Columbia, Manitoba and Ontario
  • Advocating the federal government to renew their commitment to the JDRF-CIHR Partnership to Defeat Diabetes, matched by JDRF donors for a $30 million investment, and expand access to the Disability Tax Credit  
  • Supporting two industry-wide challenges in the commercial real estate and wealth management sectors that brought $4.2 million to our JDRF-CIHR Partnership
  • Expanding our JDRF Bag of Hope® program by introducing new, age-appropriate No Limits Care Kits for teens and adults newly diagnosed with T1D
  • Rallying communities across the country in support of JDRF through Walk, Ride, Virtual Galas and other unique fundraisers
  • In Cell Replacement:
    • Vertex announced promising results of its stem cell-based therapy, originally developed by JDRF-funded researcher Douglas Melton.
    • JDRF-funded ViaCyte and CRISPR Therapeutics are launching a Canadian clinical trial of the first gene-edited cell replacement therapy for T1D.
  • In Disease-Modifying Therapies:
    • JDRF-funded researchers are performing advanced clinical trials on a drug called ustekinumab, already approved to treat other autoimmune diseases, that could help slow and halt the progression of T1D
  • In Treatments to Improve Lives:
    • JDRF is funding several studies to reduce the risks and impacts of hypoglycemia, as well as other studies to mitigate T1D complications such as kidney complications and diabetic eye disease
  • In Screening:
    • JDRF launched a Universal Childhood T1D Screening Project in Israel that could provide the basis for similar general population screening worldwide
    • JDRF is helping to facilitate screening for relatives of those with T1D at Sick Kids Hospital via TrialNet

To read more about research updates, please visit www.jdrf/ca/blog to see stories about even more incredible progess that took place over the last year in T1D research and development.

Despite the challenges brought by the continued pandemic, JDRF is more committed than ever to doing all we can to accelerate life-changing breakthroughs for everyone affected by T1D.

One hundred years ago, Canada discovered insulin. With the power of our JDRF community, we believe that Canada can cure diabetes.

Nancy Tout’s Story

When Nancy Tout pursued her passion for science with a PhD in Immunology, she didn’t realize just how much her work and personal life would intersect. Her son Alex was two years old when Nancy and her husband noticed his insatiable thirst and frequent urination. Though Nancy had studied autoimmune diseases and knew the signs and symptoms of type 1 diabetes (T1D), she didn’t suspect her son was living with the condition. But a trip to the doctor revealed his diagnosis, changing their lives forever.

“He was a toddler and therefore couldn’t articulate how he felt, so there was a lot of guesswork and calculation,” Nancy recalls. “I would weigh all his food and always had a calculator on hand to determine a safe range of carbs. I remember him looking up at us when we had to hold him steady to give him the needles. He was such a trooper.”

Shortly after Alex’s diagnosis, the Tout family reached out to JDRF. This was the start of a nearly 20-year volunteer relationship that has flourished thanks to the family’s incredible commitment to JDRF’s mission. This has included involvement in our Walk to Cure Diabetes, lobbying the government for device coverage, and supporting JDRF research.

“We jumped in with both feet and I think we’ve done probably every volunteer gig with JDRF,” Nancy says. “JDRF’s mission to treat, prevent and cure type 1 diabetes through research really resonated with me.”

“A cure just takes one breakthrough in the lab”

Now in his twenties, Alex is living provinces away and managing his diabetes thanks to advances in technology since his diagnosis – many made possible by JDRF-supported research and advocacy efforts, and by Nancy and her family.

When Nancy and her husband uprooted from Guelph and moved to Edmonton in 2019, she made one call right away. Within a month, she was touring Dr. James Shapiro’s lab, where he works tirelessly on stem cell research into a cure for T1D.

“A cure just takes one breakthrough in the lab,” Nancy says. “And to have Dr. Shapiro open his doors to me and show me the place where the Edmonton protocol was born was really nice.”

Nancy is most excited about JDRF’s beta cell replacement research, which she believes will lead to a cure in her son’s lifetime. Until that cure is found, she is happy to support research that improves lives today, like the artificial pancreas that greatly reduces the constant burden of checking blood sugar and dosing with insulin. Her son uses the world’s first hybrid closed-loop insulin delivery systems and this helps ease Nancy’s mind as Alex begins a new chapter with a demanding but rewarding career that includes shiftwork.

Her desire to affect change both now and in the future is why she gives to JDRF in several strategic ways. She donates annually to ongoing research initiatives, and she has also made a gift in her Will.

“When we sat down with our financial planner and were asked: ‘What are the most important things to you?’ JDRF was at the top of the list,” Nancy says. “JDRF has changed our lives forever and we want to ensure they can change others’ lives for years to come.”

Nancy believes that making a gift in her Will now as opposed to in her retirement years is a smart way to ensure that everything is taken care of well in advance. With her two children nearly finished their post-secondary education and financially independent, she felt it was time.

She also recognizes that others are not as fortunate as her family. Having in-depth knowledge of autoimmune diseases and access to good health care and technology helped her son navigate living with the disease and avoid the complications that can be all too common with T1D. Nancy and her family want nothing more than for T1D research to make life easier for everyone with T1D today – and lead to an eventual cure.

“Leaving this gift in our Will was a no-brainer for us. We hope that other families supported by JDRF consider the impact they can make by doing the same. The money is going to be well-spent, and that makes me proud and happy to be part of.”

To learn more, please fill out a request for information, or contact:

Leanne Scott
National Manager, Annual Giving
1.877.287.3533
plannedgiving@jdrf.ca
Charitable Number: 111897 6604 RR0001

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.

Consider joining us as we advocate for Access For All

There has been some great progress made recently towards greater access to diabetes devices and federal commitments to funding and incorporating a national diabetes strategy. These have only been achieved through collaboration with partners and other diabetes organizations and on the strength of our volunteers.

We rely on a network of passionate volunteer advocates to help Canada’s decision-makers understand the impact and severity of type 1 diabetes (T1D) and what needs to be done to improve the lives of those living with this disease.

We have a variety of volunteering opportunities and are always open to suggestions. Please visit our website to see some of the ways our volunteers help and consider joining us too.
www.jdrf.ca/get-involved/advocate

JDRF-funded clinical trial of adjunct-to-insulin therapy seeks T1D teen participants

Adolescence can be a challenging time to manage type 1 diabetes (T1D). Life (and hormones!) change in all sorts of ways, and many teenagers experience higher than recommended blood glucose levels as a result, which can mean an increased risk of complications later in life. The study of novel therapies that can improve glycemic control in teens with T1D and reduce the risk of diabetes complications and is critical to improving the lives of youth living with diabetes.

Adjunct-to-insulin therapy – ie, taking another drug alongside usual insulin treatment – is one approach that could help on both fronts. For example, SGLT2 inhibitors are a class of oral medications approved for type 2 diabetes that stop glucose from the blood from being absorbed by the kidneys, instead encouraging glucose to be released in urine. Dr. Farid Mahmud and his team at the Hospital for Sick Children in Toronto are now recruiting for a JDRF-funded clinical trial that will test the safety and efficacy of an SGLT2 inhibitor called dapagliflozin in teens with T1D.

The research team is seeking participants aged 12-18 years with established type 1 diabetes in the Greater Toronto Area (Hospital for Sick Children) and Southwestern Ontario (Children’s Hospital of Western Ontario, London) who may be eligible to participate in the Adolescent Type 1 Diabetes Treatment with SGLT2i for Hyperglycemia & Hyperfiltration trial – also known as ATTEMPT attempt.study@sickkids.ca.

SGLT2 inhibitors such as dapagliflozin can improve blood sugars, increase time in range and decrease kidney pressure, called hyperfiltration. Studies in adults with T1D have shown that SGLT2 inhibitors can lower HbA1c, insulin dose and weight. By alleviating glucose absorption in the kidneys, these drugs can also help prevent long term damage to these organs.

What is the ATTEMPT study?

ATTEMPT is a 22-week clinical trial that aims to determine the safety and effectiveness an SGLT2 inhibitor called dapagliflozin on managing blood glucose and on improving kidney function in adolescents aged 12 to 18 with T1D. The study is being conducted to determine how this therapy can benefit and be used effectively in adolescents with T1D.

ATTEMPT is led by Dr. Farid Mahmud, an endocrinologist and researcher at The Hospital for Sick Children in Toronto. Dr. Mahmud’s overall research focus is diabetes, clinical and translational research relating to other autoimmune conditions (such as celiac disease), and early evaluation and prevention of diabetes-related complications. His research interests include the evaluation of medication and lifestyle interventions in high-risk pediatric groups and the evaluation of impact of the social determinants of health in youth with diabetes. He is also actively engaged in patient-centered research as part of the CIHR Strategies for Patient Oriented Research (SPOR- Can-SOLVE CKD) and as part of the JDRF-funded AdDIT (Adolescent Diabetes Cardio-renal Intervention Trial). 

What does joining the ATTEMPT study entail?

Once enrolled in the study, a participant can expect:

  • 5 in-person visits over 22 weeks
  • A random assignment to the dapagliflozin group, or the placebo group (a small pill that contains no active medicine)

While part of the study, participants will:

  • Keep taking insulin
  • Wear a continuous glucose monitor (CGM)
  • Test for blood ketones
  • Report any adverse events

Study participants will be compensated and provided support for costs associated with travel or parking. To learn more about the study and how to enroll, please contact: 416-813-7654 ext. 204517 or email  attempt.study@sickkids.ca