Month: June 2022

The American Diabetes Association’s 82nd Scientific Sessions, were held from June 3-7 both in person and virtually. This annual conference brings together researchers and scientists to both present and learn about the latest in type 1 diabetes research and technological advancements. Many of the presenters are funded by JDRF International, JDRF Canada’s affiliate in the United States.

You can view all the oral and poster presentations on the Diabetes journal website.

Updates in cure-based research:

Stem Cell-Derived Beta Cell Therapy

 Vertex, ViaCyte and Sernova  are making exciting progress in the areas of stem cell derived beta cell therapy, and have all received JDRF funding at some point for their research.

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). 

Vertex launched its clinical trial of VX-880, a stem cell-derived beta cell therapy in T1D, in combination with immunosuppressive therapy to protect the cells from rejection, in the summer of 2021. To date, three participants have received the therapy, and one is now insulin independent. ViaCyte, in partnership with CRISPR Therapeutics, initiated its first-in-human gene-edited, stem cell replacement therapy, without immunosuppression, called VCTX210.

Sernova provided an update on the phase I/II clinical trial of their Cell Pouch™—an implantable device designed to form a natural environment and allow the survival and function of insulin-producing (islet) cells. The first three individuals to receive the therapy into the Cell Pouch™, with a supplemental marginal dose of islet cells via the portal vein, have been insulin independent for 2 years, 6 months, and 3 months, respectively. JDRF continues to support Sernova to make their Cell Pouch part of the cure portfolio.

There were also presentations on clinical and preclinical data from several investigations on encapsulation and immune-tolerance strategies, including JDRF-funded James Shapiro, M.D., Ph.D. and Andrew R. Pepper, Ph.D., of the University of Alberta, Canada.

Disease-Modifying Therapies

T1D is caused by adaptive immune cells attacking and eventually killing the beta cells in the pancreas that are responsible for producing insulin – but beta cell stress and dysfunction precede the complete loss of cell function, and immune cells are responsible. The prohormone to islet amyloid polypeptide (proIAPP, for short)—as C. Bruce Verchere, Ph.D., and Rebecca Hull-Meichle, Ph.D., discussed in their presentations—is elevated prior to clinical diagnosis, in addition to proinsulin—the precursor to insulin. proIAPP, in turn, causes inflammation and innate immune cell damage.

Dr. Verchere has developed a test to measure two kinds of proIAPP in humans, which will ultimately provide new insight into beta cell function and pave the way for new therapies and biomarkers of beta cell stress. What does this mean? Potential medications or disease modifying therapies could be brought to market that could slow or stop the immune response responsible for killing the beta cells.

Dr. Verchere received a JDRF postdoctoral fellowship beginning in 1992 and Dr. Hull-Meichle received one in 2001-2003.

Dr. Verchere is now leading the JDRF Center of Excellence at the University of British Columbia, where he is working on immune and beta cell therapies, including stem cell-derived therapies, with Dr. Kieffer; James Johnson, Ph.D., who received a JDRF Career Development Award in 2005-2010; Francis Lynn, Ph.D., who was a JDRF postdoc from 2004-2006, advanced postdoc from 2007-2009, and a JDRF Alan Permutt Career Investigator from 2012-2016; and Megan Levings, Ph.D., who has received two JDRF grants since 2015 and has been a mentor to two JDRF postdocs.

Type 1 Diabetes Screening in the General Population

As a result of decades of JDRF-funded research, it is now possible to identify those at highest risk for developing T1D—those who have two or more autoantibodies present in people with type 1 diabetes.

Several JDRF-funded researchers presented on the current state of screening for both genetic risk and/or T1D-related autoantibodies. Chantal Mathieu, M.D., Ph.D., gave a talk about why it’s time to screen for T1D in the general population. She emphasized that T1D is a serious disease and that decreasing the incidence of diabetic ketoacidosis (DKA) a potentially life-threatening complication that is often the first sign of T1D in individuals – is cause to warrant population screening.

Post-screening, healthcare practitioners must be available for follow-up and guidance so families know what to do with autoantibody status, including potentially enrolling in clinical trials of disease-modifying therapies like teplizumab, a drug that may slow the development of T1D before DKA. Screening will help identify populations who can benefit from these therapies.

Screening is now a priority of the JDRF-CIHR Partnership to Defeat Diabetes, as it’s seen as a path to a cure by developing disease-modifying therapies to keep the disease from progressing and, ultimately, prevent it entirely.

Improving Lives

Artificial Pancreas Technologies

There were multiple presentations on the ‘artificial pancreas’, or automated insulin delivery (AID), systems.

Some presentations highlights included the results from the first randomized clinical trial testing of a do-it-yourself, or DIY, open-source, community-built AID technology, using the OpenAPS algorithm plus the DANA or YpsoPump insulin pump and the Dexcom G6 continuous glucose monitor (CGM).

The study included 100 children and adults in New Zealand who used the DIY system compared to those without the algorithm, headed by JDRF International grantees Martin de Bock, Ph.D. (who also gave the presentation), and Dana Lewis, the founder of the DIY artificial pancreas system movement. There was no severe hypoglycemia and no DKA, and more participants achieved time-in-range of ˃70% using the OpenAPS algorithm, especially at night.

As well, there was a presentation on the results from a randomized insulin-only iLet bionic pancreas pivotal trial. These were presented by Steven Russell, M.D., Ph.D., at the Advanced Technologies & Treatments for Diabetes (ATTD) conference in April 2022, but now we have reports from the participants, presented by Jill Weissberg-Benchell, Ph.D., a professor at the Ann & Robert H. Lurie Children’s Hospital of Chicago. The study included adult participants who reported decreased distress, with less burnout due to increased time-in-range and no need to carbohydrate count, and youth who reported positive experiences, including improved A1c, increased independence, and less time managing diabetes.

Diabetic Retinal Disease

Sobha Sivaprasad, M.D., reported on The Restoring Vision Moonshot, an approach to ending diabetic eye disease. The Early Treatment Diabetic Retinopathy Study (ETDRS) Scale was developed in the 1950s but was limited to point-in-time visual perception.

Dr. Sivaprasad is part of 50 global experts who will review the literature on diabetic eye disease in the next year, to develop an evidence-based updated retinopathy staging scale, creating recommendations that will incorporate decades of progress in functional imaging, other biomarkers, and metrics of quality of life. When this scale is completed, it will lead to the development of early preventive therapies to reduce vison-threatening retinopathy progression, and ultimately improve quality of life for people with T1D.

It’s an exciting time in type 1 diabetes research. JDRF will continue to monitor these studies and provide further updates as they become available.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Local partners

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Community partners

In collaboration with CIHR, JDRF Canada has recently announced a major funding opportunity in the area of screening for T1D risk. Here, we explain the reason why screening for T1D risk is central to our quest for cures. 

Researchers use the word ‘cures’ deliberately, as there are many pathways to a world free from T1D. One such path is screening and prevention – catching the disease before the onset of clinical symptoms. T1D is an autoimmune disease, where the body attacks the beta cells in the pancreas responsible for producing insulin. The key to protecting beta cells is to discover this autoimmune response early enough to slow it down or halt it entirely. 

Universal screening offers the potential to identify people who are at risk of developing T1D. Canada has one of the fastest growing rates of T1D diagnoses anywhere in the world – and we don’t know why. The more we screen people, the greater the likelihood of unlocking the mechanisms behind the development of the disease. 

JDRF-funded research previously discovered that the presence of two or more specific markers indicative of an autoimmune response to the pancreas – called autoantibodies – indicates that a person is almost 100% likely to develop T1D in their lifetime. Screening also provides the opportunity to educate those at risk about the signs and symptoms of T1D and provide supportive follow-up, preventing the life-threatening complication diabetic ketoacidosis (DKA) at diagnosis. Finally, we know that while first-degree family members of T1D are at an elevated risk of developing T1D, around 85-90% of newly diagnosed cases do not have a direct family connection. 

It’s not just about preventing DKA.  

The prevailing medical wisdom used to be that T1D developed quickly, with a sudden onset of symptoms including thirst, hunger, increased urination, weight loss, and fatigue. Thanks to advances in screening and a better understanding of the human immune system, we now know that T1D does not develop suddenly but in fact the disease process usually starts long before insulin is required. 

Once the immune system begins to attack the insulin-producing cells in the pancreas, we can detect markers in the blood (autoantibodies) that tell us a person is at increased risk. This is because the disease is otherwise asymptomatic or silent earlier on. 

T1D happens in 3 stages: 

Because most people do not have a family history of T1D, symptoms and a diagnosis often come out of the blue. In 25-45% of diagnoses in children in Canada, this unexpected diagnosis comes with DKA, a serious and life-threatening complication that can lead to death if not treated promptly. People with T1D know what to do to minimize the risk of DKA and to seek medical attention if it occurs—but people who have yet to be diagnosed do not. That’s why, unfortunately, a significant percentage of people experience DKA at diagnosis and require hospitalization.  

To avoid this risk, everyone that wants to should have the opportunity to get tested for T1D autoantibodies. If a positive result is found, families could develop a plan for further monitoring with their doctor to avoid serious complications and lower the risk for life-threatening DKA at diagnosis. The hope is that in the future, there may be therapies that allow healthcare professionals to intervene and delay or even prevent T1D onset.  

How to Get Screened 

Currently, only family members of people with T1D can be screened for T1D risk through TrialNet. TrialNet is an international network of leaders in T1D research and clinical care with centers in the United States and internationally. A key goal of JDRF’s global research strategy is to support research that enables introduction of general population screening to identify high-risk individuals for early detection, reduce DKA at diagnosis, and accelerate the evaluation of disease-modifying therapies that could delay or prevent the disease. 

What’s Next for Screening in Canada? 

Now, JDRF Canada is pleased to announce a new funding opportunity in the area of T1D screening in partnership with the CIHR Institute of Nutrition, Metabolism and Diabetes. The goal of the CIHR-JDRF Type 1 Diabetes Screening Research Consortium is to develop a single nationally coordinated research network to explore key research questions about the feasibility and acceptability of a general population T1D screening program in Canada, building on experiences from other countries.  

Most T1D screening studies have up to now focused only on family members. However, as 90% of people diagnosed with T1D do not have any family history, family-based screening does not identify most people at risk. This new funding opportunity looks to address this gap and help us better identify why T1D develops in Canadians, with potential benefits globally. As well, it will help advance research into potential disease-modifying therapies that could be applied at the moment high risk is identified in an individual. 

Stopping T1D before it starts is the ultimate goal, and a universal screening program will be essential to prevent new diagnoses of this disease in the future. 

We strongly encourage you to consult with your or your child’s physician for input as you make decisions about screening for T1D risk. Considering various sources of expert guidance and that from one’s own physician is the best way to make personal health choices. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A focus of JDRF’s Improving Lives research is to improve glucose control and reduce the burden of self-management by advancing the development of new drugs and devices for people with type 1 diabetes (T1D).

The study: Can adding an approved glucose-lowering drug to treatment with a closed-loop insulin delivery system improve glucose control in T1D?

A JDRF funded collaborative team out of Mount Sinai Hospital and McGill University recently published findings in Nature Medicine about how an add-on treatment to insulin could improve glucose control in adults living with T1D. Empagliflozin is an already approved medication that is used to improve blood glucose levels in people living with type 2 diabetes.

Dr. Bruce Perkins and Dr. Ahmad Haidar, alongside their teams at the Research Institute of the McGill University Health Centre and the Lunenfeld-Tanenbaum Research Institute in Toronto, examined the individual and combined efficacy of the SGLT2 inhibitor empagliflozin – an oral drug that acts on the kidney to rid the body of excess glucose – on the time spent in the glucose target range (3.9-10.0mmol/L) over a 4-week period in people living with T1D. Participants in the study took empagliflozin while using either a closed-loop system or a sensor-augmented insulin pump. The study was placebo-controlled, meaning that some participants did not receive the drug and no participants knew which one they were being administered.

What did the study find?

Empagliflozin improved the time in range whether participants were using the closed-loop system (by 7.2%) or the sensor-augmented insulin pump (11.4%), and also decreased daily insulin doses. Compared with participants who used an insulin pump alone, participants who used a closed loop system plus empagliflozin spent 17.5% more time in range each day (i.e., over 4 hours). As per international consensus guidelines, an increase of the glucose target range of more than 5% is considered clinically meaningful. Since empagliflozin can increase the risk of ketoacidosis in people with T1D, the team also closely monitored daily ketone levels. Although ketone levels were higher in some participants, the researchers observed no episode of diabetic ketoacidosis (a hyperglycemic episode that requires immediate medical attention) with empagliflozin in this study. There were also no episodes of severe hypoglycemia.

What does this mean for people with T1D?

The addition of adjunct therapy to T1D management and especially closed-loop systems holds a lot of promise. Drugs like empagliflozin may also have protective benefits for the heart and the kidneys in people with T1D, and previous studies have shown that the drug can improve HbA1c, weight and blood pressure without increasing hypoglycemia.

What comes next?

Further research is needed with this drug and with other adjunct therapies for people living with T1D –as insulin alone is often not sufficient to help these individuals reach their target blood glucose goals and new therapies offer opportunities to reduce management burden. JDRF will continue to fund the most promising research into drug therapies, and partner with regulators to accelerate approvals, with the aim of driving those that show the greatest promise to market as quickly as possible.