Month: March 2025

On March 27, 2025 Diabetes Canada released updated Clinical Practice Guidelines for the glycemic management across the lifespan for people with type 1 diabetes.

What are clinical practice guidelines and what do they mean for people with type 1 diabetes (T1D)?

Clinical guidelines are the guiding principles for health care practitioners to stay up to date on best practices in the management and care of people living with all diseases, including type 1 diabetes. As research advances, both in the medication and device landscape, clinicians and experts in the diabetes field meet to discuss the best available evidence and to craft or update the guidelines so that care is optimized.

Knowing your diabetes goals in the context of your life and your circumstances is the first step in deciding upon treatment options with your care team. As you manage your T1D, or the T1D of your family member, it is important to remember that your glycemic targets should be designed to fit into your life, and that conversations with your healthcare provider will help you understand the risks, benefits and considerations of all available treatment options.

This month’s updated guidelines, the first comprehensive update since 2018, are noteworthy because not only do they focus on managing one’s glucose levels across the lifespan, recognizing that children, teens and adults can all have T1D, they also include two exciting and important updates.

What are the new updates and what is their impact on Canadians living with T1D?

An AID system is a device that automatically adjusts insulin delivery based on blood glucose levels, measured from an accompanying paired glucose monitoring device. It’s also been called an artificial pancreas or hybrid closed-loop system, but AID is the preferred clinical terminology,

The updated guidelines now recommend that insulin be delivered ideally by an insulin pump integrated with a continuous glucose monitor (CGM) (AID) and that these devices be offered to all individuals with T1D, provided they are willing to wear the device and operate it:

Automated insulin delivery (AID) systems (insulin pump and connected continuous glucose monitor) are the preferred treatment method for all individuals to optimize glycemia and/or person-related outcomes, provided the individual is willing and able to wear and operate the devices.

The paradigm shift here is important, as previously the belief was that only those individuals who have met their glucose targets would benefit from this advanced technology. AID systems are beneficial for diverse individuals, regardless of their baseline, or starting glucose levels, and their age or socio-economic status for example. In other words, we need to change the thinking that implies a person with T1D needs to ‘earn’ an AID through already relatively stable management.

AIDs have been shown to keep glucose levels stable and in better range, while also improving sleep and reducing the burden of daily diabetes management (from reducing the fear of hypoglycemia, diabetes distress and improving overall quality of life).

Adjunct therapies for people with T1D

The second noteworthy recommendation is the first of its kind worldwide – adjunctive therapies may now be considered in adults with T1D, based on shared decision-making with the care provider. There is substantial research that has demonstrated the safety and effectiveness of these non-insulin agents such as metformin, glucagon-like peptide-1 receptor agonists (GLP1-RA) or sodium-glucose cotransporter-2 inhibitors (SGLT2i), or what you may know as Ozempic, Wegovy and other GLP-1 agonists, in type 1 diabetes to lower A1c, body weight and insulin doses, when added to insulin. 

It is important to recognize individual autonomy of people living with T1D and although this recommendation is not a strong treatment recommendation, as the authors suggest, it is a conditional recommendation that allows for people with T1D to consider their individual health goals and to advocate for treatments that work best for them:

In adults, adjunctive therapy, such as metformin, glucagon-like peptide-1 receptor agonists (GLP1-RA) or sodium-glucose cotransporter-2 inhibitors (SGLT2i), may be considered in addition to insulin to meet individual treatment goals while employing strategies to support safety, efficacy, and tolerability of these medications.

Breakthrough T1D Canada is pleased to see these updated clinical guidelines that will empower people living with T1D  to have important conversations with their healthcare provider(s) to discuss the best options for their care. We will continue to advocate for  coverage of these therapies and devices so that everyone has access to  the treatments and devices that meet their individual health needs.

Patient choice is paramount for diabetes devices, treatments, insulins and insulin administration, as such, Breakthrough T1D will continue to advocate and work with the T1D community to ensure better access, affordability and choice for all Canadians living with T1D.

If you would like to learn more about the updated guidelines, automated insulin delivery devices or adjunctive therapies, please speak to your diabetes health care provider.

Image reproduced in its entirety from Halperin, Wicklow, Amed, et al., on behalf of the Diabetes Canada Clinical Practice Guidelines Steering Committee (2025) Canadian Journal of Diabetes; 49, 5-18. https://www.canadianjournalofdiabetes.com/article/S1499-2671(25)00001-2/fulltext

Canada’s federal election is underway, and Breakthrough T1D Canada is calling on our T1D advocates across the country to come together and make sure that research and device coverage is part of the discussion.

There are an estimated 300,000 people living with type 1 diabetes (T1D) in Canada and diagnoses are growing more rapidly than general population growth. Over 70% of new T1D diagnoses are in adults and over 80% of Canadians living with T1D are aged 18+​

But research works: in the last 50 years of progress, 25 years have been added to the lifespan of a person with T1D receiving the latest care in Canada​. Canada has been a world leader in T1D research from the discovery of insulin and stem cells to the creation of the Edmonton Protocol (method of implanting pancreatic islets to treat T1D). Breakthrough T1D has played a pivotal role in nearly every major T1D breakthrough in history—from how HbA1c (a blood glucose measurement) came to be more than 40 years ago to recent advancements like artificial pancreas/hybrid closed-loop systems.​

We currently help to fund 65 active research grants in Canada with a total grant value of $63.9M – we invest in the most promising research (e.g. research into new treatments that can halt autoimmunity, stem cell-based therapies that can restore insulin production and more precise diabetes technologies for improved self-management.

And our advocacy efforts have resulted in improved device access in all provinces and both territories, automatic qualification for the disability tax credit and $30M of government funding directed at T1D research through the Breakthrough T1D Canada -CIHR Partnership to Defeat Diabetes.

Great progress has been made, but we won’t stop until we achieve our ultimate goal, cures for T1D and a world free from this disease.

That is why we need your help to put issues concerning the T1D community at the forefront of this election. Consider meeting with your local candidates, sharing with your T1D journey, and advocating for federal support towards critical T1D research.

To assist volunteers in meeting with local candidates, Breakthrough T1D Canada will be hosting a webinar in both official languages to share best practices and how to make the most successful impact with candidates. This includes information on where to find candidates, how to connect with them, what message we are delivering, and what candidates can do to show their support for Canada’s T1D community.   

Click here to sign up

Additionally, we have developed a simple online form to help people write a letter to candidates and advocate for increased federal support for the T1D community. By filling out this form, a personalized letter will be sent and addressed to the local candidates for Member of Parliament in each riding, highlighting the need to prioritize T1D research and request that they stand with the T1D community. We invite anyone impacted by T1D to participate and share with friends and family to further amplify this message.

Click here to fill out the form

Together, we can raise awareness of the issues faced by people living with T1D in this country and ensure it remains top of mind for those who will represent us after the election.

If you have any questions or require any assistance, please reach out to Joey Wong at jwong@breakthroughT1D.ca. 

International Women’s Day (IWD) asks us to imagine a gender equal world. A world free of bias, stereotypes, and discrimination. A world that’s diverse, equitable, and inclusive. A world where difference is valued and celebrated. Together we can forge women’s equality. The theme for #IWD2025 is that we can all #AccelerateAction.

International Women’s Day (IWD) has been around for over a hundred years, and many of the issues it addresses unfortunately still remain. IWD reminds us to celebrate women’s achievement, raise awareness about discrimination and to take action to forge gender parity.

Breakthrough T1D Canada is proud to celebrate the achievements of the Canadian women researchers who have blazed a trail in the field of type 1 diabetes (T1D), and who have helped us in our mission of making everyday life better for people living with the disease as we work towards cures tomorrow.

Learn more about Dr. Priscilla White, an early pioneer in diabetes research and treatment, Dr. Dorothy C. Hodgkin who first discovered the three-dimensional structure of insulin, Dr. Helen M. Free, who along with her husband created Clinistix, allowing people to check their glucose at home, a significant advance in disease management. These women played a critical and essential role in advancing understanding of T1D, so that future generations of researchers could build upon their work.

Today, Breakthrough T1D Canada funding helps support many women T1D researchers who are continuing the legacy of those who came before them. They are now charting their own paths by investigating potential cures, new disease-modifying therapies, precision medicine, new and better refined diabetes devices, researching screening and T1D prevention and improving mental health supports to make life better for people living with T1D.

Meet the women researchers who have been supported by Breakthrough T1D Canada funding over the past year:

3 new trainees in partnership with the Canadian Islet Research and Training Network

Dr. Summer Helmi. Postdoctoral Fellow
Optimizing Neonatal Porcine Islet Differentiation Using the PBS Mini Vertical-Wheel ® Bioreactor: Advancing Xenotransplantation for Type 1 Diabetes

This innovative project explores a promising approach to treating type 1 diabetes using neonatal porcine islets (NPIs) as a cell replacement therapy. While NPIs offer advantages over other methods, optimizing their production for clinical use remains a challenge. This work could overcome critical hurdles in NPI production, bringing us closer to a more effective and accessible treatment for type 1 diabetes. The project aims to advance porcine islet differentiation strategies and transform diabetes care worldwide.

Dr. Nayara Rampazzo Morelli, Postdoctoral Fellow
Investigating a potential drug target in human beta cells during type 1 diabetes

Type 1 diabetes (T1D) is well known for its autoimmune aspects which leads to loss of most of the beta cells in the body and insulin deficiency. How the process of beta cell loss occurs remains uncertain, but recent work indicates that the accumulation of stressed beta cells can accelerate T1D onset. The aim of this study is to evaluate a particular drug target in stressed human beta cells to determine whether this approach could be used to delay the progression of T1D or improve symptoms in people living with T1D.

Dr. Shreyasi Sarkar, Postdoctoral Fellow
Assessing the potential of targeting 14-3-3z to restore functional beta cell mass

Dr. Sarkar’s research focuses on identifying new ways to increase beta cell number (mass) to treat T1D. I study a protein called 14-3-3z, and earlier work from Dr. Lim showed that targeting this protein during early development in mice improved insulin secretion and beta cell mass, making this protein a promising target for diabetes treatment. Dr. Sarkar is now exploring a new approach using Antisense Oligonucleotides (a synthetic strand of nucleotide that can modulate protein expression) to target this protein after birth and explore whether similar improvements can be achieved. This may represent a new approach to treat diabetes.

J. Andrew McKee Fellowship in Type 1 Diabetes

Dr. Alyssa Weinrauch, Breakthrough T1D Canada Centre of Excellence at UBC
Dr. Weinrauch’s work focuses on understanding how lipids affect the development and maturation of stem cell derived beta cells. Stem cell derived beta cells offer unlimited potential for curative therapy of T1D. However, currently they do not mature to the same level as human islets, and we believe that lipids may be involved in getting the immature stem cell derived beta cells to that final maturation stage.

The Knowledge Mobilization in Diabetes Prevention and Treatment operating grants, led by the CIHR Institute of Nutrition, Metabolism and Diabetes, in partnership with Breakthrough T1D, provide researchers and knowledge users the opportunity to work together to use research evidence to improve health services, programs, and policies.

Anne-Sophie Brazeau, McGill University – Integrating an online training platform into type 1 diabetes clinical care to empower self-management

Dr. Brazeau and her team will evaluate the implementation strategies for integrating SUPPORT, an online training platform, as part of clinic care and put in place activities to help make health care practitioners aware of the innovation. The aim will be to increase the use and uptake of the platform as well as shorten the time needed to translate research results into practice, ultimately improving the lives of people with T1D.

Valeria E Rac, University Health Network – Connecting diabetic retinopathy screening programs in Ontario.

Dr. Rac and her team will develop a pathway towards the creation of a provincial diabetic retinopathy screening program that includes a provincial registry. The team will also assess the screening needs of different patient populations living with diabetes across the province and set up knowledge gathering workshops to improve access to diabetic retinopathy screening programs, thereby improving eye health for those individuals living with diabetes.

Liris P Smith, Yukon University – Yukon experiences in management of type 1 diabetes: Patient and provider perspectives

Dr. Smith and her team will explore and describe the experiences of people and caregivers of people with T1D in Yukon, recognizing that the needs of the community are unique and that access to care is often limited in rural settings. The grant will allow the team to also describe the experiences of Yukon primary care providers for people living with T1D, with the ultimate goal to improve access to care and management supports.

Principle investigators on Breakthrough T1D-funded research projects

Dr. Shazhan Ahmed
Precise Treatment for Pediatric Diabetes: Providing the right care, for the right patient, at the right time, over time.

Dr. Gillian Booth
Evaluating innovative health care solutions to improve outcomes for persons with type 1 diabetes using a novel electronic data repository

Dr. Sonia Butalia
Aiming for Something Sweeter: Supporting youth with type 1 diabetes during transition from pediatric to adult diabetes care

Dr. Yi-Chen Chun
Translational and post-translational regulation of islet prohormones in T1D

Dr. Deborah Da Costa
Adaptation and pilot evaluation of a digital intervention targeting the psychosocial needs of individuals with pregestational diabetes: A mixed-methods multi-phase study

Dr. Jayne Danska
Microbiome regulation of beta-cell autoimmunity and type 1 diabetes

Dr. Megan Levings
Two studies:
Harmonizing biomarkers in clinical trials of ustekinumab

Innate & adaptive immune regulation in type 1 diabetes

Dr. Caitlyn Maikawa
Polymer materials for glucose-responsive delivery of amylin analogues

Dr. Despoina Manousaki
Development of a trans-ancestral genetic risk score for type 1 diabetes

Dr. Shweta Mital
Economics of screening and prevention of type 1 diabetes in Canada

Dr. Cristina M. Nostro
Three studies:
Macrophage-mediated strategies for promoting vascularization and immunotolerance in islet cell replacement therapies

Immune evasive islet-like cells by reduced immune recognition and local immune control

Using novel transplantation strategies and HLA-edited hypoimmunogenic hPSCs to develop a superior islet-like product for T1D treatment

Dr. Sara Nunes de Vasconcelos
Development of a new cell-based vascularization approach to improve b-cell survival

Dr. Amanda Oakie
Elucidating the role of Notch signaling in the proliferation of human stem cell-derived pancreatic endocrine cell development

Dr. Mahla Poudineh
A pH responsive hydrogel microneedle patch for continuous measurement of ketone bodies and glucose

Dr. Kacey Prentice
Elucidating the role of the Fabkin hormone complex in metabolic disease

Dr. Elizabeth Rideout
Leveraging biological sex and genetics for beta cell-directed precision medicine in type 1 diabetes

Dr. Marie Eve Robinson
Teaching adolescents with type 1 diabetes self-compassion (TADS) to reduce diabetes distress: A randomized controlled trial

Dr. Hyekyoung Sung
Enabling precision medicine in type 1 diabetes (T1D): leveraging integrative multiomics to understand T1D endotypes for therapy

Dr. Tricia Tang
Four studies:
Implementing a virtual care platform to improve mental health for type 1 diabetes in rural and remote regions of Interior British Columbia

Using a virtual care platform to deliver peer-led mental health support to rural and remote communities in BC: A randomized wait-list controlled trial of the REACHOUT intervention

Using a virtual care platform to deliver peer-led mental health support to rural and remote communities in BC: A randomized wait-list controlled trial of the REACHOUT intervention

The Mental Health and Diabetes Training Program: Preparing a new generation of providers

Dr. Alanna Weisman
Achieving equitable uptake and use of diabetes technologies among adults with type 1 diabetes

Dr. Diane Wherrett
Canadian population screening for risk of type 1 diabetes research consortium (CANScreen)

Dr. Holly Witteman
Find Your CommuniT1D: Customized virtual peer support for people living with type 1 diabetes

Dr. Xiao Yu (Shirley) Wu
Development of targeted nanoparticles for delivering therapeutics to islet cells for treatment of T1D

To read more about other Breakthrough T1D-funded women researchers: www.breakthrought1d.ca/research/meet-our-researchers/

Breakthrough T1D Canada – an all-women research department.
Chief Scientific Officer Dr. Sarah Linklater, along with her team Dr. Lara Green, Dr. Anne Marie MacDonald and Tafadzwa Kadye use their science backgrounds and passion for research to help Breakthrough T1D select and accelerate the most promising T1D research in Canada, and to effectively communicate this research to our stakeholders, government officials and collaboration partners in industry, academia and other non-profit organizations.

Christine Touringy, with support from Dr. Linklater oversees Breakthrough T1D Canada’s Mental Health + Diabetes Strategy as a maternity leave replacement for Amanda Hailman and is helping to maintain the momentum of this program, which works to address the critical gap in healthcare and community programming for mental health supports specific to diabetes.

Breakthrough T1D Canada – A woman led organization
In late 2023 Jessica Diniz took on the role of President and CEO of Breakthrough T1D Canada. In April 2023 Helena Gottschling was announced as Board Chair. Both work to ensure Breakthrough T1D Canada can deliver on its strategy, mission, and promise as an organization to donors, supporters, staff and all Canadians affected by T1D.

Breakthrough T1D Canada is proud to continue having both senior leadership and management teams that more than achieve gender parity, skewing heavily female. While acknowledging there is always more to be done, Breakthrough T1D Canada works daily to advance the IWD theme of #AccelerateAction.