Category: Research

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://breakthrought1d.ca/t1d-and-covid-19/hospital-visits-during-covid-19/

For more tips on maintaining more consistent blood sugar readings: https://breakthrought1d.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.

Exciting news: stem cell-based treatments producing insulin in participants with type 1 diabetes

*Image taken from viacyte.com/pipeline/

A significant focus of JDRF is funding the most promising research that could lead to potential cure therapies for type 1 diabetes (T1D).

ViaCyte, a cell replacement company long supported by JDRF, has three separate stem cell replacement therapy products in development, all with the aim of reducing or eliminating the need for external insulin for people with T1D.

Researchers look for ways to use stem cells as a renewable source of insulin-producing cells which, when transplanted, would replace the beta cells that are destroyed in a person with T1D, allowing them to produce insulin again. This would lessen or eliminate the amount of external insulin required by someone living with T1D (either by injection, pen, or pump) for months or even decades.

The biggest challenges to stem cell replacement therapy are identifying the appropriate stem cell source (i.e., pancreatic cells, or liver cells) and ensuring that they both function well and will not be rejected by the recipient’s immune system. Much like a transplanted organ – most stem cell replacement therapies require immunosuppressing medications to prevent rejection.

Updates on ViaCyte Clinical Trials

PEC-Encap (VC-01™; see middle figure) was ViaCyte’s first product including a stem-cell derived precursor that once implanted in humans has demonstrated that they will mature into beta cells that produce insulin.

The company’s second technology, PEC Direct (VC-02™; see top figure), has now been the subject of two papers that report the preliminary results of its clinical study, which involved an international team of clinicians and researchers including several at the University of Alberta and at the University of British Columbia’s Faculty of Medicine and Vancouver Coastal Health (VCH).

The UBC-VCH study is part of larger international clinical trials led by ViaCyte, which is also studying the effectiveness of cell-replacement therapy on participants in sites across Canada, the U.S. and Belgium.

One of the new papers reports on 15 trial participants studied at the Vancouver site. At the start of the UBC-VCH study, each participant had several ViaCyte cell-containing devices implanted just below the skin. Each device, thin as a credit card, contained millions of lab-grown cells that originally came from a single stem cell line. These cells had been trained to mature into insulin-producing beta cells.

Six months after implantation, the cells had not only survived but successfully matured into insulin-producing beta cells, which helped the trial participants to sense blood sugar levels and release insulin when needed.

This study used levels of C-peptide (released into the blood as a byproduct of insulin production) to measure insulin produced by the implanted cells. The researchers found C-peptide levels rose after patients ate a meal—evidence of normal beta cell function. This is significant as external insulin (either received via injection, pump or pen) does not generate C-peptide.

Participants also spent 13 per cent more time in target blood sugar range and some were able to reduce the amount of insulin they injected.

The insulin produced through the implanted cells was not enough for participants to forgo external insulin altogether, but the cells did survive and maintain function a full year post-transplantation. This demonstrates the potential for durability of this kind of cell replacement therapy, and may ideally prevent frequent implantation, which must be done surgically. Importantly, the trial did not reveal any safety concerns.

This research was supported by funding from JDRF Canada, as well as Canada’s Stem Cell Network, Vancouver Coastal Health Research Institute, Canadian Institutes of Health Research, ViaCyte Inc. and California Institute for Regenerative Medicine.

What does this mean for people with T1D?

These studies offer hope and cautious optimism about cell replacement therapy as a possible pathway to a T1D cure.

“Our findings demonstrate the incredible potential of this stem cell-based treatment. With further research, this treatment could one day eliminate dependence on insulin injections and transform the management of Type 1 diabetes,” said the study’s senior author Dr. Timothy Kieffer, professor in UBC faculty of medicine’s departments of surgery and cellular and physiological sciences, who was recently appointed as ViaCyte’s chief scientific officer.  

The next step is researchers need to determine what cells are optimal for transplantation, and the best transplantation site. There also needs to be further study on how long the cells work effectively, remain safe, whether ta greater number of cells is required for long-term insulin production, and whether it is possible to eliminate immunosuppressive therapy.

A third ViaCyte cell replacement product including a gene-edited stem cell source, VCTX210, developed in partnership with CRISPR Technologies, was recently approved for clinical trial by Health Canada. Unlike the PEC-Direct product used in the newly published results, this product would not require immunosuppression – a key next step on the cell replacement roadmap. (See Figure 3)

Read more here: breakthrought1d.ca/exciting-news-about-new-health-canada-approved-clinical-trials/

The ViaCyte clinical trials are one of several potential cell replacement cures therapies JDRF supports globally, as part of its overall research strategy.  Read more about it here: breakthrought1d.ca/research/

UBC team works to uncover new cell therapies that may one day lead to a cure for type 1 diabetes

UBC

JDRF Canada renews grant for UBC team identifying potential cell therapies for islet cell regeneration

JDRF is the leading charitable funder of research into type 1 diabetes in Canada, with a focus on research that will help improve lives today, and lead to disease prevention and cures

Verchere

JDRF Canada is pleased to announce continued support for University of British Columbia Researcher Dr. Bruce Verchere, the head of the Diabetes Research Program at the Child & Family Research Institute. Verchere and his team are exploring ways to regenerate the pancreatic insulin-producing beta cells that are subject to immune attack in type 1 diabetes (T1D).

Verchere’s lab investigates how certain types of white blood cells known as macrophages might be involved in activating the immune system. Macrophages are often called the ‘garbage eaters’ of the body, as they eat dead cells and bacteria in order to remove them safely. Research has also shown that these macrophages are involved in tissue repair and wound healing. By drawing on this knowledge, Verchere plans to see whether macrophages can produce proteins that will stimulate the production of new beta cells or even improve the function of existing beta cells. 

JDRF’s support will allow Verchere and his team to study how the islet macrophages respond to the death of neighboring insulin-producing beta cells. When faced with stressful situations, macrophages have the potential to release proteins that can regenerate beta cells. The team will closely examine the genes and proteins that are produced in response to the stress of the beta-cell death. By understanding the new genes and proteins made by islet macrophages under these conditions the team hopes to identify new therapeutic pathways to stimulate beta cell regeneration – and uncover new avenues to cure T1D.

The team will stress human islets in the lab and identify the genes that are subsequently expressed in islet macrophages. The goal of this simulated stress will be to see which of the produced proteins can stimulate new beta cell formation or enhance beta cell function.  Think of the initial beta-cell death as a trigger. This trigger then activates the neighboring islet macrophage to express, or turn on, specific genes. The macrophage machinery then produces, or pumps out, new proteins that can stimulate the production of new beta cells.

The 2-year $300,000 USD JDRF grant will support the team as they aim to identify a list of genes that can potentially stimulate human beta-cell regeneration. The team will also test out some of the lead candidate proteins that are produced by these genes. Ultimately the researchers plan to identify a list of proteins that can one day be used to develop new beta-cell therapies in T1D.

Thank you to our donors for supporting JDRF Canada. It is because of your generosity that JDRF can fund this exciting work and help us get closer to our goal of turning type one into type none.

Can we eliminate carb counting for people with type 1 diabetes?

Carb Counting

Research is exploring whether an insulin + pramlintide closed-loop system eliminate carbohydrate counting for people living with T1D.

JDRF is the leading charitable funder of research into type 1 diabetes in Canada, with a focus on research that will help improve lives today, and lead to disease prevention and cures.

Haider

JDRF Canada is pleased to continue supporting research led by McGill scientist Dr. Ahmad Haidar. Haidar and his team are looking at ways to improve the quality of life of people living with type 1 diabetes (T1D) using a novel insulin-plus-pramlintide artificial pancreas that may alleviate the need for carbohydrate counting.

Carbohydrate counting is the process of counting the number of carbohydrates in a meal – something that people living with T1D need to do every time they eat in order to be able to calculate the appropriate and safe amount of insulin needed for blood sugar control. Carbohydrate counting can however become burdensome as it requires an extensive knowledge base and detailed calculations, made multiple times a day. Haidar and his team aim to develop an automated insulin delivery system that can minimize this burden for people living with the disease.

A closed-loop system, or “artificial pancreas”, automates the delivery of insulin based on the blood sugar levels obtained from continuous glucose monitors. Evidence shows that individuals using a closed-loop system are often less burdened by the decision-making process of daily insulin management and can benefit from improved glucose control, fewer hypoglycemic episodes, and a better quality of life.

Haidar and his research team plan to study a closed-loop system that delivers both insulin and pramlintide. Pramlintide is a medication that resembles a natural hormone produced by healthy beta cells called amylin, which slows the movement of food through the stomach. This hormone can blunt the extent to which sugars are broken down, allowing for a meal to less severely elevate blood sugar levels. The team’s previous work showed that such a system was safe and effective in people with T1D. Now, they want to explore whether a combination of a fast-acting insulin and pramlintide can eliminate the need for carbohydrate counting without compromising glycemic control.

Haidar will examine how this closed-loop system will affect target blood sugar levels in adults and adolescents, as well as these individuals’ quality of life, in a randomized controlled trial. The study will be two weeks long, will take place outside of a clinic setting, and will compare a system that delivers both insulin and pramlintide versus a system that delivers insulin on its own. The study will also compare traditional carbohydrate counting techniques against a simple meal announcement notification.

JDRF is pleased to support two more years of Haidar’s ongoing work with a $760,000 USD grant in this important area of diabetes management, and thanks its donors for their continued support in T1D research.

Skin cells may be the key to unlocking better treatment for people with type 1 diabetes

Researcher

JDRF renews grant support for study examining stem cell transplants for diabetes

JDRF is the leading charitable funder of research into type 1 diabetes in Canada, with a focus on research that will help improve lives today, and lead to disease prevention and cures.

As part of this commitment, JDRF is renewing its support of an important study led by the University of Toronto’s Medicine by Design bioengineering department. Executive director Dr. Michael Sefton is being awarded almost $430,000 USD to study how skin cells may play a key role in establishing an environment that is suitable for successful stem cell transplants for people living with type 1 diabetes (T1D).

Sefton and his team are exploring new ways for insulin-producing cells to be transplanted into people living with T1D. Their research examines ways to engineer tissues so that transplanted insulin-producing cells are not rejected by the immune response. In clinical islet transplantation, insulin-producing cells are transplanted into the liver of people living with T1D. In this scenario, though, the immune system often acts up and makes the liver a hostile environment for the transplanted cells.

Even with the use of immunosuppressive drugs, the transplanted insulin-producing cells can stop working, and the people need to return to insulin therapy. The success of the transplant can therefore be short lived.

Sefton’s lab is exploring ways to use the skin, instead of the liver, as a transplant site. By using a more accessible site the hope is that the transplanted cells can receive nutrients from blood vessels, and ultimately survive and produce insulin when blood sugar levels are elevated. In addition, the team is investigating ways to prevent rejection of the transplanted cells that will not require use of conventional immunosuppressive drugs, which can have serious side effects.

The JDRF grant to Dr. Sefton will be pivotal in supporting his team as they continue to explore ways to create an environment that supports transplantation of insulin-producing cells. This renewed funding will support the team as they seek to answer the following important questions:

  1. Can blood vessels be created so that the skin has a better supply of nutrients for the transplanted cells to survive? Insulin producing cells that have access to blood vessels after transplant can be healthier and better able to produce insulin for longer periods of time. Having previously studied a material containing methacrylic acid (MAA) that can stimulate creation of new blood vessels, Sefton’s lab will continue to understand how MAA can support the insulin-producing cells’ transplant.
  2. Are there ways for the immune system of the person with T1D to not to reject the new transplanted cells? The team will explore whether they can minimize the immune response by delivering special immune cells found in the skin, known as dendritic cells, so that the transplanted cells are recognized by the immune system and not targeted as being foreign, and rejected. Using the natural ability of the immune system to protect, rather than reject, the transplanted cells will be pivotal in helping the transplanted therapy have potential clinical impact.

Medicine by Design, where Dr. Sefton’s lab is located, was founded in 2015, thanks in part to a $114-million grant from the Canada First Research Excellence Fund. Focused on regenerative medicine, Medicine by Design-funded researchers use engineering, mathematics, medicine and physical and life sciences to develop new therapies for diseases such as stroke, heart failure, and diabetes.

JDRF is excited to once again fund this innovative work and we look forward to sharing research updates as they become available. Thank you to our donors for supporting this important work.

Connect1d Canada aims to accelerate T1D research

Connect1d Canada is a digital platform that allows those living with type 1 diabetes (T1D) to easily learn about T1D research happening across Canada, and contribute to research in the areas that matter most to them. The platform also allows researchers to easily engage people living with T1D, enabling rapid recruitment of diverse people from across Canada into research studies. 

The overall goal is to accelerate T1D research by boosting enrolment into T1D clinical studies of diverse group of participants. Too often, clinical studies stall because appropriate participants can’t be found—that slows down the research process and delays access to potential treatments for everyone living with T1D. And one of the most common reasons people don’t participate in a research study is because they didn’t know about it.  

The platform also addresses some of the major barriers that exist in T1D research, including awareness and understanding of available research projects and which ones need participants By providing this direct link between people living T1D and researchers focused in this area, more people living with T1D become aware of opportunities, and research teams have access to a more diverse representation of the community. 

“I am proud of Canada’s community of people with diabetes, and its community of dedicated researchers,” says Dr. Bruce Perkins, an endocrinologist and the Director of the Leadership Sinai Centre for Diabetes in Toronto. “Connect1d Canada boosts interaction between them, so that together we can reach our common goal to meaningfully transform the lives of those living with T1D.”  

Perkins, who himself lives with T1D, is co-leading the scientific arm of the program with Dr. Peter Senior, an endocrinologist and Senior Scientist with the Alberta Diabetes Institute. They are joined in this by Kate Farnsworth, who is a co-lead on the project and the parent of a child with T1D.  

Connect1d Canada was co-designed by people living with T1D and researchers, ensuring that the needs and wants of both groups were incorporated. It is an opt-in registry, which means that any Canadian adult with T1D can choose to share their information with research teams. Those participating control how their information is shared and with whom.  

Extensive consultation with the T1D community, as well as having those with the condition at the table, is something the program team sees as critical to its success. “When we originally brought our ideas to those living with T1D, they made it clear that what we were suggesting did not add sufficient value for them,” says Senior. “That opened up the dialogue that continues to this day, as we have made it a priority not only to have people with diabetes and those who care for them consulted, but to have them completely embedded into our planning and development.” 

As such, the Connect1d Canada team is developing a Community Advisory Committee that will provide guidance from the T1D community as the project grows and develops. It is clear to all involved that this project cannot be successful without all stakeholders fully invested. 

For Farnsworth, this consultation is another essential ingredient to true community engagement. “For too long research has failed to have the voice of those living with type 1 diabetes at the table, or people felt they were being represented in a tokenistic way,” she says. “This led to projects that failed because they were not appropriate for the community, often after millions of dollars had been invested. With Connect1d Canada we want to make sure people with T1D are front and centre in every aspect.” 

Currently, there are multiple studies posted on the Connect1d Canada website. Canadians with T1D can register their interest in specific projects, fill in research surveys and subscribe to receive updates about new projects that may be of interest to them.  

With funding from JDRF Canada and support from Diabetes Action Canada, in partnership with the UHN’s eHealth Innovations, this project presents a digital solution to a longstanding and complex problem.  

Register for Connect1d Canada now! 

Interested in joining the Community Advisory Committee? Apply here! 

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.

Manipulating the Microbiome to Prevent Type 1 Diabetes

Type 1 diabetes is an autoimmune disease resulting in a lifelong dependency on insulin treatment and a risk of serious long-term complications. The cause of the disease is unclear, although both genes and factors in the environment seem to be important. As new cases of this burdensome and costly disease are on the rise in almost every country around the world, finding ways to prevent and better treat type 1 diabetes are top research priorities.

In the past decade, research has shown that changes in the gut microbiome – the microbial community that colonizes the intestine – precede the onset of type 1 diabetes in young children. Most of these studies highlight a potential link in the first years of life when the microbiome is highly dynamic and heavily influenced by environmental factors such as mode of birth delivery, diet, infections, and antibiotic use. JDRF and other funders have invested heavily in this area, supporting studies such as the DIABIMMUNE Study, BABYDIET, and TEDDY, which all helped to point researchers towards new therapeutic opportunities. In addition, for many years, JDRF led an international consortium that brought researchers working in this area together on a regular basis to share ideas, compare data, and accelerate progress.

The field is now focused on testing whether manipulation of the microbiome with drugs or diet can delay or even prevent the disease altogether. Other studies are attempting to figure out how changes in the gut microbiome could signal a person is at risk of developing type 1 diabetes.

Dr. Jayne Danska, a professor at the University of Toronto Faculty of Medicine and a senior scientist at The Hospital for Sick Children, is working at the cutting edge of this field. In late 2019, she was awarded a $2 million CAD team grant from JDRF and the Canadian Institutes for Health Research (CIHR) to advance her work studying the role of the gut microbiome in altering risk and progression of type 1 diabetes. She and her team previously showed that deliberate manipulations of the gut microbiome can inhibit autoimmune responses in an experimental model of type 1 diabetes. The new five-year project seeks to understand how environmental changes influence the gut microbiome in infants with genetic risk for type 1 diabetes. The team will attempt to define exactly what risk-associated microbes do inside a developing infant, and how they affect the immune response to either protect against or potentiate the disease. The ultimate objective of Dr. Danska’s work is to identify new therapeutics to prevent type 1 diabetes.

We are facing a moment in time that can forever change the landscape of type 1 diabetes research, with better treatments and cures on the horizon. JDRF is striving to speed up research progress in any way we can. We are constantly scouting for the best ideas, the brightest talent and the innovative project that will bring us the next real breakthrough.

In partnership with Media Planet

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