Category: Uncategorized

March 4, 2021

For anyone impacted by type 1 diabetes (T1D), the term ‘biosimilars’ is one that will become increasingly familiar now that the patents of some biologic insulins are expiring. This means that biosimilar versions of these insulins may be approved, and some are already on the North American market. But how do they differ from insulins already on the market? And are they right for managing your 1 diabetes (T1D)?

Read more to find out what this means for you.

What is a biologic drug?

To fully understand what a biosimilar is, we need to first explain what a biologic drug is. A biologic drug is a product that is produced from living organisms or that contains components of living organisms, so it is more complex than a chemically synthesized drug. An originator or reference biologic drug is the first version of a biologic drug approved for use by Health Canada.

Examples of biologic drugs include insulin, other hormones such as growth hormones or thyroid hormones, and antibody treatments. Biologic drugs are used to treat many different conditions including anemia (low iron), cancer, diabetes, inflammatory bowel disease (like Crohn’s or colitis), psoriasis (an autoimmune skin condition) and rheumatoid arthritis.

Once the patent for a biologic drug has expired, a biosimilar version may be approved to be introduced into the market.

What are biosimilars?

A biosimilar biologic drug, more commonly referred to as a ‘biosimilar’, is a drug that may enter the market after the expiry of pre-existing drug patents.

A biosimilar is a drug that is highly similar to a biologic drug that was already authorized for sale. The biologic drug that was already authorized is called a reference biologic drug because it is the drug that the biosimilar compared against. This is similar to a generic over the counter pharmacy brand counterpart to the brand name drug.

However, a biological copy cannot be said to be identical to the reference biologic drug. Health Canada authorizes biosimilars for sale based on a thorough comparison to a reference biologic drug. There should be no clinically meaningful differences in efficacy and safety between a biosimilar and the reference biologic drug.

What are biosimilar insulins?

Biosimilar insulins (also called follow-on insulins) are designed to be highly similar to reference biologic drug product described in a patent.

Three biosimilar insulins currently on the market are:

• Basaglar (biosimilar of Lantus [insulin glargine]) – Lilly
• Admelog (biosimilar of Humalog [insulin lispro]) – Sanofi-Aventis
• Truapi (biosimilar of NovoRapid [insulin aspart]) – Sanofi-Aventis

Biosimilar insulins as a treatment option

The entry of biosimilar insulins into the market presents both opportunities and risks that need to be properly weighed before a person with diabetes begins on or moves to a biosimilar insulin.

Biosimilar insulins can be a safe and effective treatment option for people with T1D. Their introduction to the market is also helping to reduce the cost of insulin in Canada and around the world, making insulin more affordable for patients and payers. Thus, biosimilar insulins will ultimately increase accessibility of insulin treatment and provide more treatment options to people living with diabetes.  

However, some of these benefits of biosimilar insulins will be negated if reference biologic insulins are no longer available or accessible alongside biosimilar insulins – ie, if people using insulin are “forced” to switch from their existing insulin to a biosimilar insulin due to changes in availability or coverage.

JDRF supports and advocates first and foremost for choice in all aspects of diabetes management. The decision to start on biosimilar insulin, or to switch from a biologic to a biosimilar insulin – must be made by the person living with diabetes in consultation with their endocrinologist or diabetes team.

More information on biosimilar insulins can be found here.

March 5, 2021

Like most parents after their child has been diagnosed with Type 1 diabetes, Cindy Voss found herself overwhelmed, anxious and exhausted. With an active 10-year old whose glucose levels would drop quickly and unexpectedly, Cindy found herself constantly worrying and would get up every couple of hours throughout the night to prick her son Mathew’s finger to get a blood sugar reading. It is a story familiar to many parents in the T1D community.

After doing some research and consulting with Mathew’s doctor, they decided to try the Dexcom G6 Continuous Glucose Monitoring (CGM) System – and their life hasn’t been the same since.

Now, Mathew wears a sensor on his abdomen that continuously measures his glucose levels, without him having to prick his finger* to get a reading. His glucose data is displayed on his phone^†, and he can be alerted if his glucose levels are heading too high or too low so he can take action, especially since he doesn’t always feel his symptoms coming on.

Meanwhile, Mathew’s Mom Cindy has the Dexcom Follow app^‡, which allows her to see Mathew’s glucose levels remotely – whether he is at school, out riding his bike, or over at a friend’s house. Cindy also gets glucose level alert notifications on her phone, which she says have been enormously valuable – particularly when she can’t be with Mathew, and especially overnight. It has allowed her to sleep better and to give her son more freedom to be a kid, which has been such a blessing for their whole family. 

“Dexcom CGM has given Mathew so much more confidence now and allowed me to worry so much less. It has changed our whole family’s life and I can’t imagine trying to manage Mathew’s diabetes anymore without it.”   

To see if the Dexcom G6 could be a valuable tool for you and/or your child’s diabetes management, ask your healthcare professional for a free sample.

Visit www.dexcom.com for more information about the Dexcom G6.

*If your glucose alerts and readings from the Dexcom G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

^† For a list of compatible devices, go to www.dexcom.com/compatibility.

^‡ Following requires the use of the Follow App and an Internet connection. Followers should always confirm readings on the Dexcom G6 App or Receiver before making treatment decisions.

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March 1, 2021

A JDRF-funded clinical trial is examining whether a drug currently (ustekinumab; pronounced oos·teh·KIN·yoo·mab) used for the treatment of psoriasis (which affects the skin), Crohn’s disease (an inflammatory bowel disease), and other autoimmune conditions can also work for type 1 diabetes.

Manufactured by Janssen and sold under the name Stelara®, it is a monoclonal antibody that inhibits two molecules that regulate the immune system.

Many autoimmune diseases have disease-modifying therapies; treatments that can slow, halt, and reverse disease progression. Currently, T1D remains one of the only major autoimmune diseases that does not have a licensed disease-modifying therapy.

Clinical trial overview

The researchers are investigating if the simultaneous inhibition of two immune cell pathways—interleukin-17 and interferon-gamma, believed to drive T1D can halt the progression of, or reverse, disease in participants who have been recently diagnosed with T1D.

The hope is that if the drug can block immune cells soon after the development of diabetes, any remaining insulin-producing cells may be protected and regenerate. This would ideally lead to the remaining beta cells producing enough insulin that people with T1D require less external insulin for a longer period of time, or at all.

As the drug is already approved for use in Canada, if the trial results are positive, moving forward to clinical use would not only be feasible, but rapid.

The phase II/III trial is taking place at BCDiabetes in Vancouver, under the leadership of Tom Elliott, MBBS, and the University of Toronto, under Bruce Perkins, M.D., MPH, both in Canada. There will be a total of 60 participants enrolled between the ages of 18-25 years old.

There is also a trial testing ustekinumab in teens aged 12-18, and within 100 days of diagnosis in various locations of the United Kingdom.

A JDRF grant to Megan Levings, Ph.D., at the BC Children’s Hospital Research Institute, will harmonize the biomarkers of response in both the Canadian and UK clinical trials, increasing the sample size and more rapidly identifying whether this is an effective therapy for T1D.

A pilot study by Jan Dutz, M.D.—who is also the lead on the phase II/III study—demonstrated that ustekinumab is safe in the treatment of participants with recent-onset T1D.

You can contact Marla Inducil, B.Sc. Pharm, M.D., CCRP, at 604-628-7253 ext. 7011 or minducil@bcdiabetes.ca. She is responsible for managing and executing all clinical trials at BCDiabetes located in Vancouver.

Updated on April 1, 2021:

As of March 29, 2021 NACI advised a temporary pause on administering AztraZeneca to people under the age of 55. For more information, click here.

Please know that we continue to monitor how this might impact prioritization of those with T1D for COVID-19 vaccination. We will share more details as they become available.

Updated on March 24, 2021:

The Government of Ontario for their updated COVID-19 vaccine rollout plan which prioritizes people living with diabetes. Ontarians with diabetes are now included in Phase 2 of the plan.

People living with type 1 diabetes aged 16 and up can now receive the COVID-19 vaccine, as per Health Canada approvals, and are now in Phase 2B of Alberta’s vaccine rollout plan. The vaccine priority list was also updated to include high-risk medical conditions, including: “Diabetes requiring insulin or other anti-diabetic medication to control.”

People with diabetes have now been prioritized for Phase 2 in Manitoba. Please refer to this link for more info.

The BC government announced that those who are “extremely vulnerable” can start booking their vaccine appointments as of Monday, March 29th. This includes people with diabetes who are on insulin. Details are here.

Updated on March 4, 2021:

We’ve received many questions about the COVID-19 vaccination rollout in provinces and territories across Canada, and specifically at what stage people living with type 1 diabetes (T1D) should expect to receive theirs.

The first two COVID-19 vaccines, from Pfizer-BioNTech and Moderna, began being administered to Canadians in late December, 2020. On February 26, 2021, Health Canada approved a third and fourth SARS-CoV-2 vaccine, one of them being more commonly known as the Oxford-AstraZeneca vaccine. Both the newly approved vaccines are the same formulation, but manufactured in different locations. They also both require a second booster shot as part of the inoculation scheme.

This vaccine is different from Pfizer and Moderna, and is based on an adenovirus vector, not mRNA. For more info: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/astrazeneca.html

The World Health Organization (WHO) recommends this vaccine for people with diabetes, although they have not specified or distinguished between type 1 and/or 2. This vaccine has an efficacy rate of 62 per cent and Health Canada has authorized it for use in all adults 18 and older. All currently approved COVID vaccines reduce severe disease and hospitalizations.

Vaccine roll-out plans are still being developed and vary in different provinces and territories. Vaccine roll-out plans are guided in part by recommendations provided by the National Advisory Committee on Immunization (NACI), who provides guidance on use of vaccines approved for use in humans in Canada.

Original post:

February 26, 2021

We’ve received many questions about the COVID-19 vaccination rollout in provinces and territories across Canada, and specifically at what stage people living with type 1 diabetes (T1D) should expect to receive theirs.

The first two COVID-19 vaccines, from Pfizer-BioNTech and Moderna, began being administered to Canadians in late December, 2020. Vaccine roll-out plans are still being developed and vary in different provinces and territories. Vaccine roll-out plans are guided in part by recommendations provided by the National Advisory Committee on Immunization (NACI), who provides guidance on use of vaccines approved for use in humans in Canada.

Both vaccines approved for use in Canada have data to date demonstrating the vaccine is safe and effective for people with T1D. If you have specific allergies, please discuss with your healthcare provider.

Vaccination will not be mandatory in Canada. However, for people living with diabetes, we encourage you to consult with your doctor about your specific health condition with regards to vaccination.

Will the vaccine work just as well in people with diabetes?

People with T1D are not immunocompromised, and previous research indicates that the immune response to fighting coronavirus in people with diabetes is no different to people without the disease. The length of protection any of the vaccines will provide is still unknown as we are in the early stages of the rollout.

For more information, please refer to this blog: https://breakthrought1d.ca/blog/covid-19-vaccines-and-t1d/

Should people living with T1D be prioritized to receive the vaccine?

Compared with people without underlying conditions, adults (especially older adults) with diabetes are at greater risk of severe disease and death if they develop COVID-19, and vaccines are the most effective way to prevent the disease. Thus, JDRF believes that people living with diabetes should be prioritized for vaccination, and we have been advocating with this message to the federal government.

How has JDRF Canada advocated on behalf of people living with type 1 diabetes?

In early January 2021, JDRF sent a joint letter with Diabetes Canada to Health Canada detailing concerns about guidance from NACI that may have resulted in people with diabetes being excluded from COVID-19 vaccination.  

In mid-January 2021, JDRF also sent a letter to NACI, highlighting that high-risk groups, including those with T1D, should be prioritized.

In these communications, we:

• Asked for clarification on ambiguous guidance provided about COVID-19 vaccination for those with autoimmune disease, which may have resulted in people with T1D being excluded from COVID-19 vaccination
• Provided clear rationale for those with T1D to be prioritized for COVID-19 vaccination
• Emphasized that people with type 1 and type 2 diabetes should be prioritized (not only type 2 diabetes, as occurred in the USA), as the risks of severe COVID-19 outcomes are similar or even greater in the T1D population.

Progress to date:

On February 12, 2021, NACI updated two key issues that are relevant to the T1D community:

• NACI has now clarified their definition of ‘persons with an autoimmune condition’ so that those living with T1D should NOT be excluded from receiving a COVID-19 vaccine.

NACI has now also outlined the key populations they are recommending receive the vaccine in stages 2 and 3 of the rollout. Stage three now includes “Adults 16-59 years of age with an underlying medical condition at high risk of severe illness due to COVID-19 and their essential primary caregivers”.

It is our hope that provinces and territories will soon communicate their roll-out plans for the next stage of vaccination, with timelines. We will continue to stay on top of updates and share any major developments as they become available. Our ongoing advocacy efforts will be based on whether and how provinces and territories are prioritizing people with diabetes for vaccination.

How you can advocate to your provincial and municipal governments.

If you want to voice any concerns you may have related to the vaccine roll out with your provincial or territorial government, consider writing to your province’s Chief Medical Officer, the Minister of Health, your MLA/MPP or all three.

At the municipal level you can also connect with your city/town’s– Chief Medical Officer/ Chief Public Health Officer – or your local representative (Councillor/ Alderman.)

Please find attached this letter that you can fill out and email or mail to your provincial or local health authority to make your voice heard.

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For further information about the availability of COVID-19 vaccination in your community, refer to your Provincial or Territorial Health Authority. We advise everyone with diabetes considering COVID-19 vaccination to speak with their healthcare team to help make an individualized decision.

For more information on COVID-19 and T1D, please visit breakthrought1d.ca/coronavirus. 

February 1, 2021

On January 15, 2021 Sernova announced that patients in their ongoing clinical trial show persistent islet function and clinically meaningful improvement in glucose control.

Sernova, a clinical-stage regenerative medicine company, has continued to demonstrate promising results in a JDRF-funded clinical trial of its cell replacement therapy, using the Cell Pouch System™. This system has shown that it can produce insulin in people with type 1 diabetes (T1D) and help patients to maintain more consistent blood sugar levels. The study now shows sustained clinical benefit in study participants with type 1 diabetes and ongoing safety and tolerability of the system.

The Cell Pouch System™ technology involves purified islet cells (the cells that produce insulin and that are destroyed in people with T1D) transplanted into the Cell Pouch™, an implantable medical device that provides a vascularized environment for the therapeutic cells. This is a form of cell replacement therapy that has the potential to be a T1D cure. Cell replacement therapies aim to replace lost or damaged beta cells with insulin-producing cells, in people with T1D. In Sernova’s current clinical trial, patients must take immunosuppressive drugs to prevent rejection of the implanted cells.

The detection of C-peptide (a biomarker of insulin production) in the bloodstream of their first transplanted patients was an important success in this study.  

Sernova also plans to develop an unlimited source of locally immune-protected insulin-producing cells – removing the need for immunosuppressive drugs.

The overall objective of the current trial is to assess the safety, tolerability, and efficacy of the Cell Pouch in people with T1D. In addition to other criteria, patients must demonstrate long- standing T1D with severe hypoglycemic unawareness episodes and no glucose-stimulated C-peptide already in their bloodstream.

The leading researcher of the study, principal clinical investigator Dr. Piotr Witkowski MD, PhD, and a leading expert in islet transplantation, provided an update that focused on the first transplanted patients who are furthest in the study and who have received a second islet transplant.

These patients are showing sustained benefit from the transplants, including meaningful reduction in daily injectable insulin requirements and:

• Absence of life-threatening severe hypoglycemic events
• Sustained blood levels of C-peptide
• Reduction in HbA1c (a measure of long-term glucose control)
• Improvement in overall Continuous Glucose Monitoring (CGM) measured glucose control (e.g., blood glucose ‘Time in Range’).

One patient has now been insulin free (requiring no injectable insulin) for nine months with optimal glucose control.

Funding cell replacement therapies research is one of JDRF’s most critical undertakings globally, and between our partner organizations we have invested more $140 million USD to date.

This study is another example of the incredible Canadian innovation in diabetes research that is accelerating us towards cures.

January 27, 2021

Every year, Bell runs its #BellLetsTalk campaign, in an effort to raise awareness and combat stigma surrounding mental illness in Canada.

Living with T1D, whether it’s you, your child, or another family member, both at the time of diagnosis and throughout managing this chronic condition —affects more than just physical health. T1D can also impact social, behavioral and emotional well-being, known as psychosocial health. Mental health issues are common for people with T1D, at any age.

January 28, 2021 marks this year’s #BellLetsTalk day. This provides us the opportunity to talk freely and safely about mental health issues, and to raise awareness of the challenges faced by people living with T1D daily – and how JDRF Canada is looking to do more to address mental health in this community.

Life with T1D

T1D is an all-consuming chronic condition that currently has no cure. Once someone is diagnosed, disease management becomes a 24/7 task that lasts throughout a lifetime.

This means frequently checking blood sugar (at least 5-6 times daily), insulin doses that must be administered many times per day and calculated carefully based on food intake, exercise, stress, illness and other frequently unpredictable factors.

No matter how strict and careful someone is with their diabetes management, they likely will still experience frequent blood sugar highs and low – sometimes to dangerous levels.

T1D never gives you a day off. It can be exhausting. And it takes a toll on mental health.

How living with T1D can impact mental and psychosocial health

Throughout their lifetime, people with T1D often experience mental health issues that can include mild depression, major depressive disorder, anxiety, and “diabetes distress” – a term describing the powerlessness, stress, guilt, relentless worry and denial that comes with living with diabetes and the burden of self-management.

Compared to those without the condition, kids, adolescents and adults with diabetes are at greater risk of developing these mental health issues.

Yet despite this, and our growing understanding that unaddressed mental health issues correlate with higher HbA1c and higher risk of complications in people with T1D, management of T1D most often focuses on glucose control, without sufficient attention given to psychosocial health needs.

It can become a continuous cycle, so T1D management should include a holistic approach that ideally includes psychosocial health needs as well. However, psychosocial issues in T1D are under-researched and underappreciated, and our healthcare system does not currently have the capacity to fully address them.

What is JDRF Canada doing to help?

In January, 2021, JDRF Canada launched its $100 Million Campaign to Accelerate, which includes a six-pillar approach to funding research and other programs that accelerate towards cures and improving lives for people living with T1D today. One pillar of the campaign is dedicated to addressing mental health issues and expanding support to the T1D community.

As we work towards developing a more fulsome approach to mental health support within the T1D community and healthcare system, we are actively engaged in offering programs that help foster connection and support for people with T1D today.

From the day of diagnosis to daily life decades later, we know that connecting with others who have been impacted by T1D can be an important source of support.

Our Let’s Talk T1D series, which moved virtual during the COVID-19 pandemic, helps to make these connections.
In this series, we bring experts from across the country to you for virtual educational events and community hang outs to help you and your loved ones live well with T1D. Participants can hear from new speakers, engage with other families and individuals with T1D and expand their knowledge on important topics – all from the comfort of home.

Our Connection Series is a national conversation held virtually for adults and parents in the T1D community to form new connections and engage in conversations across province lines. These series aim to help parents develop relationships with their peers who may share similar experiences, and understand the ever-changing demands of living with T1D.

Talk T1D is a mentorship program that provides one-on-one support to families who are impacted by T1D from trained volunteers who have been there. Our volunteers understand the daily challenges of living with T1D and are there to provide emotional support and connect you with resources across Canada.

On #BellLetsTalk day, and every day, we recognize the need to reduce the stigma around mental health issues. When we reduce the psychosocial challenges of T1D, the result is better overall health outcomes for the T1D community.

Sponsored by Omnipod

For years, Rebecca Redmond’s mantra was to “stick to the devil you know” when managing her type 1 diabetes (T1D). That meant injecting herself with insulin numerous times a day, even after developing a phobia of needles, resulting in debilitating anxiety attacks and sometimes even forgoing meals.

“It wasn’t until my son said, ‘If there’s a simpler way to do this or a way that wouldn’t be so hard on you, shouldn’t you do it?’ Kids have a funny way of motivating,” Redmond says of her decision to switch to Insulet Canada’s Omnipod® Insulin Management System two years ago.

The wearable, waterproof* pump – called a Pod – freed her from the injections she had been giving herself since being diagnosed with T1D in 1989 at the age of 17. “It totally changed my life,” the London, Ont. artist and blogger says. “I can switch my insulin pump out faster than I could ever give myself an injection, so it has given me the gift of time. It has also given me mental freedom because I’m not giving in to those fears of doing my needles.”

The innovative technology has special meaning to Redmond, whose grandmother’s cousin, Sir Frederick Banting, co-discovered insulin and was the first to use it on people to treat diabetes.

As this year marks the centenary of the discovery of insulin, she celebrates the advancements in life-saving technology for insulin delivery making it available for people like her who need it to survive.  “Without my cousin’s discovery, I wouldn’t be alive today,” she says.

The Pod has had such a positive impact on her life, Redmond is excited to be among the first in Canada to adopt the new Omnipod DASH® Insulin Management System, which recently earned Health Canada’s approval. It provides up to three days of non-stop insulin** delivery and combines the Pod with a Personal Diabetes Manager (PDM).

“This means users can tailor their insulin needs much more precisely now,” Hulton says. The Pod can be worn almost anywhere you’d give yourself an injection and the Pod site tracker helps you rotate your pod sites to make insulin absorption more effective.

“The DASH System is the next step in our mission to make diabetes a smaller part of your life by simplifying insulin management,” says Hulton.

Insulet Canada is launching the Omnipod DASH System on a province-by-province basis throughout 2021 to coincide with reimbursement by provincial health programs. Visit www.omnipod.com for more information.

Legal:

*The Pod has an IP28 waterproof  rating for up to 7.6 meters for 60 minutes. The Personal Diabetes Manager (PDM) is not waterproof.

**Up to 72 hours of insulin delivery

©2020 Insulet Corporation. Omnipod, the Omnipod logo, DASH, the DASH logo, Simplify Life, and Podder are trademarks or registered trademarks of Insulet Corporation. All rights reserved. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Insulet Corporation is under license. All other trademarks are the property of their respective owners. The use of third-party trademarks does not constitute an endorsement or imply a relationship or other affiliation.

Disclaimer: This story was created by Content Works, Postmedia’s commercial content division, on behalf of JDRF.

2020 was a year of challenges brought on by the COVID-19 pandemic. Despite the disruption to our normal way of doing things, thanks to your support, our JDRF-funded research was able to progress and produce some exciting new developments.

As 2021 marks the 100^th anniversary of the discovery of insulin, at JDRF we are moving into the next phase of our research strategy, transforming our approach and redesigning it for speed to give Canadians hope for freedom from type 1 diabetes (T1D).. With your help, we are building upon the Canadian legacy of Banting and Best to push aggressively towards cures; while supporting the vital research and programs that improve the lives of those living with T1D. To learn more about our bold and innovative $100M Campaign to Accelerate that aims to defeat the T1D monster that burdens 300,000 Canadians, go to Jdrf.ca/accelerate

Some highlights of the new initiatives we’ve been able to support over 2020:

Dr. Ahmad Haidar, Assistant Professor at McGill University in Montreal, QC 

Dr. Haidar is testing whether adding a hormone called pramlintide to insulin therapy can eliminate the need for carb counting in teenagers and adults with type 1 diabetes (T1D) using a closed-loop system.

Dr. Megan Levings, Professor, Department of Surgery, Faculty of Medicine, University of British Columbia and an Investigator at BC Children’s Hospital in Vancouver, BC

Dr. Levings is studying how the autoimmune response is curtailed by T1D therapies in clinical testing, and exploring new approaches to cure T1D by targeting the immune system.

Dr. Andrew Pepper, Assistant Professor, Faculty of Medicine & Dentistry at the University of Alberta in Edmonton, AB

Dr. Pepper’s work aims to advance an approach for long-lasting islet replacement therapy that will not require immunosuppression. Right now, islet replacement therapy is limited in scope to those who have very difficult-to-control T1D, who still stand to benefitfrom an islet trasnplant despite the risks of long-term immunosupression.

Watch a video about the 2020 research highlights:

For more information on our research strategy, please click here.

We will be providing research and other education updates in each issue of our bi-monthly T1D Insider Newsletter in 2021 as we mark this very important milestone of 100 years of insulin. Don’t forget to sign up to stay updated!

On behalf of the 300,000 Canadians living with T1D, thank you for supporting research that is bringing us closer to turning type one into type none.

December 21 2020

With the holiday season quickly approaching, it’s time to start thinking about shopping lists, holiday plans with friends and family members, and how to keep our children active during their time off from school, while adhering to the safety measures influenced by the global pandemic.

What should not be missed is being mindful that the virtual manner in which we communicate, combined with the colder weather brought on by the coming of winter can make isolation and inactivity a reality for many families during the 2020 holidays. It’s also a time that can be challenging for people with type 1 diabetes (T1D). During this time of year, it’s important to remember that having T1D doesn’t mean missing out on the celebrations.

On Tuesday, December 8th we held our final Let’s Talk T1D of 2020 with special guest Michael Watts, who led a discussion on Staying Connected during the Holidays.

Michael is a medical social worker, and a university sessional instructor. He is trained as a therapist and counsels on and psychosocial issues related to adolescents and families impacted by T1D, chronic respiratory challenges and weight and health issues.

Michael’s presentation explored diverse ways in which to protect against isolation while enhancing activity levels during the holiday season. References to the mind, body, spirit and emotional quadrants were explored, as well as practical strategies which aim to create appropriate levels of structure and routine during the holiday season.

This year, as gatherings should be kept small and limited to your household due to COVID-19 – there is more time for idleness and snacking. Pre-planning to try and keep your blood glucose as steady as possible can be very helpful. Work together with your family to plan exercise activities that you can do together; bake or prepare healthier snacks and make sure to carb count.

Navigating holiday time while living with T1D using these tips may help to decrease your stress, relax and recharge:

This year more than ever, the holiday season is about more than cookies and gifts. However you can reach out and connect to your loved ones and friends, whether it be over video chat, text or phone call – stay safe, stay well and look forward to a better year ahead.

• Stay active. You’ll feel better and have more energy, it will help you regulate your blood sugar and it’s something you can do as a family.

• Don’t skip meals in preparation for a larger one. Make sure to eat regular and balanced meals that include carbohydrates, protein and some fat. Not only will this help control your blood glucose, but it will make it easier not to overeat at a single meal.

• Plan ahead. Learn the carb counts of holiday treats that you might love, like Christmas cookies or a glass of eggnog. Plan to accommodate them, so you don’t end up feeling deprived or resentful.

• Be considerate of what you eat. Do you really want something placed in front of you, or are you just considering eating it because it is there? Eating mindfully can help keep your glucose levels steady and help you better enjoy the food you really want.

• Test your blood sugar levels frequently so you can stay on top of it and hopefully avoid any crashes or spikes.

• Be kind to yourself. This will be a different kind of holiday season. Everyone will be feeling the strain, give yourself time and space. If you find that your blood sugar levels drop or spike, correct, move on and don’t beat yourself up over it.

This year more than ever, the holiday season is about more than cookies and gifts. However you can reach out and connect to your loved ones and friends, whether it be over video chat, text or phone call – stay safe, stay well and look forward to a better year ahead

UPDATE: On December 23rd Health Canada authorized the use of the Moderna vaccine in the fight against COVID-19 for individuals of 18 years of age and older.

JDRF welcomes the authorization of the first COVID-19 vaccine by Health Canada, which we hope will be one of many to be approved in the coming months to address the pandemic. We are grateful for the unprecedented effort by the many research scientists, clinical trial participants, industry partners and government officials who contributed to global efforts to rapidly bring COVID-19 vaccines through the pipeline and to our communities.

The one vaccine approved thus far in Canada is the Pfizer-BioNTech vaccine, which has been approved for use in people aged 16 and over. The vaccine will be given in two doses, at least three weeks apart. Vaccinations have now begun in Canada, with vaccine roll-out plans still evolving. It is currently unclear whether and when people with diabetes may be prioritized for receiving the vaccine. However, JDRF will be advocating on behalf of the T1D community, making it clear to decision-makers that those living with diabetes must be included as a priority group to receive early COVID-19 vaccinations. Evidence does suggest that those living with diabetes, T1D or T2D, could face more severe disease and an increased risk of COVID-19 complications if they develop the disease. As such, JDRF strongly believes this group should be considered a high-risk population and have earlier and easier access to the vaccine. We will keep our T1D community up-to-date as further decisions are made around vaccine roll-out and administration.

Should I get the COVID-19 vaccine if I live with T1D?

Vaccination will not be mandatory in Canada. However, for people living with diabetes, we encourage you to receive the vaccine when you are offered one, pending consultation with your doctor about your individual circumstances. This is because adults, especially older adults, with diabetes (type 1 or type 2) are at risk of developing severe illness if they do get COVID-19, and vaccines are the most effective way to prevent that from happening.

Is the vaccine safe for people with T1D?

Thus far, the Pfizer-BioNTech vaccine is the only COVID-19 vaccine approved in Canada. Trials of this vaccine included people with diabetes, and the data to date show the vaccine is safe and effective for people with T1D.

Health Canada has issued specific guidance on the Pfizer-BioNTech vaccine for people with serious allergies.

Will the vaccine work just as well in people with diabetes?

People with T1D are not immunocompromised, and previous research indicates that the immune response to fighting coronavirus in people with diabetes is no different to people without the condition. In addition, data on the Pfizer-BioNTech vaccine made available by the US FDA indicate that the vaccine is just as effective in people with diabetes as without. However, there is still uncertainty about the length of protection any of the vaccines will provide.

For further information about the availability of COVID-19 vaccination in your community, refer to your Provincial or Territorial Health Authority. As well, please be sure to speak with your healthcare provider with any further questions you may have and to help you make the most informed decision around vaccination.

December 17, 2020

It’s been just over a year since the virus SARS-CoV-2, which causes the disease COVID-19, was identified.

The COVID-19 pandemic was declared in March 2020. As knowledge about the effects on people with type 1 diabetes (T1D) grew, we updated our information on a dedicated page and in numerous blogs. Unfortunately, most areas of Canada (with the exception of the Atlantic provinces) are deep into the second wave, and many communities are back in some form of modified lockdown.

However, there has recently been reason to have optimism as a number of COVID-19 vaccine candidates have been identified. The UK has already begun its vaccination program.

As of December 2020, Canada had sources more potential vaccine doses per capita than any other country in the world, and as of December 14, 2020, a selected few began to receive their inoculations, although most will be vaccinated in 2021.

As we head into the winter and the cold settles upon us, social opportunities that could take place outside will be limited – and many of us will again begin to feel the strain of isolation. Combine this with living with T1D and the everyday burden of maintaining healthy blood glucose levels, hydration and nutrition throughout the holiday season, when outdoor activities aren’t as accessible.

It’s a lot – and it’s understandable if COVID fatigue is starting to set in. Protecting yourself from the virus on top of everyday diabetes management is a lot to deal with.

Fortunately, we are now better equipped with knowledge of how the virus works and how to best protext ourselves from contracting it. And there is hope on the horizon.

What we know now

How it’s most likely transmitted

At the beginning of the pandemic, it wasn’t immediately clear how COVID-19 was spread, or how contagious the virus was. We didn’t know if was spread by ‘fomites’ (virus particles that remain on surfaces), droplets (from sneezing and coughing) or aerosols (meaning it spreads through the air and can be passed on by an infected person through talking or breathing).

We now know that fomites are not a likely source of virus spread – but that the virus itself is highly contagious and infectious. And that it can be spread via both droplets and aerosols.

Initial advice about protecting yourself and others still stands. Being diligent about frequent handwashing and trying not to touch your face remains true today. The best measures people can take are practicing hand and respiratory hygiene, physical distancing, wearing a face covering, sanitizing high touch surfaces and keeping social contacts limited.

Are people with T1D at greater risk of contracting the virus that causes COVID-19?

There is still no evidence that people with T1D are at any increased risk of being infected by SARS-CoV-2 than anyone else in the community. At the beginning of the pandemic, there may have been higher infection rates among the diabetes community as they had more healthcare contacts.

Are people with T1D at a greater risk if they do develop COVID-19?

People with T1D do not generally have a compromised immune system. However, they may be at higher risk of complications if they do become infected, especially if they are older or have other risk factors, such as kidney disease.

There is no new evidence to indicate that children or young adults with T1D are, on average, at increased risk of complications of COVID-19 if they develop the disease. However, as with any viral infection, blood glucose can be much more difficult to manage, meaning that extra glucose and ketone monitoring is advised for anyone with T1D who develops COVID-19.

Can COVID-19 cause T1D?

A small number of case reports have proposed that COVID-19 can cause diabetes in selected individuals. However, most larger studies do not support this finding. Thus, to date, there is no compelling evidence that COVID-19 can cause T1D. Some effects of the pandemic – such as changes in exposure to the usual, seasonal viruses due to public health restrictions and wearing masks – could potentially affect incidence rates of T1D in the future.

Are COVID-19 vaccines safe for people living with T1D?

The Pfizer and Moderna COVID-19 vaccines use new and cutting-edge technology – known as mRNA vaccines. This is different from other vaccines you get from your doctor, like the MMR or flu inoculation, most of which use an attenuated (or ‘weakened’) form of the virus to trigger an immune response in the body.

These new vaccines work by injecting genetic material called mRNA (messenger RNA) into the body. The mRNA carries instructions that direct the body make the “spike” protein found on the outer surface of the coronavirus (the red edges poking out the ball), and in turn generates a protective response against it – or to the coronavirus, if you should later be exposed to it.

The National Advisory Committee on Immunization (NACI) has issued preliminary guidance on waves of vaccine roll-out. Prioritized groups will include immunocompromised individuals and those with high-risk conditions. Every province and city will have different vaccine roll-out plans. It’s best to speak to speak to your healthcare provider about your specific community.

There is no information to date to suggest that the COVID-19 vaccine would not be safe for people with T1D, should they choose to receive it. Generally, people with diabetes have been prioritized for vaccines for infectious diseases, such as the flu.

This information should not be taken as medical advice. Every individual is different and will have unique healthcare needs. Speak to your primary care physician and endocrinologist to come up with the treatment plan that works best for you or your child with T1D.

What you can do now

Stick to the basics

The basics are still the best way to keep yourself and your family safe.

Try to find time for hobbies, books, movies and games that bring you joy and relaxation. Turning off devices and taking a break from news can also help. Filling your time with activities that bring you satisfaction and fulfillment can help ease some of boredom and isolation that may occur over the winter months.

How to get support

JDRF offers a series of virtual events and seminars to help foster connection to other members of the T1D community. Our Let’s Talk T1D Education and Connection series are held monthly to bring people together to discuss issues important to families living with T1D and provide the opportunity for social engagement. These series are meant to both educate and help ease potential loneliness and isolation. Both are offered in both English and French.

The COVID-19 pandemic has been a time of incredible emotional and physical strain. The burden has been even greater for those with T1D. But there is light at the end of the tunnel. With each day that passes, we get one day closer to our new normal.

If you don’t already, please follow us on our social media platforms, where we post tips and articles of interest and encourage you to engage and provide feedback.