More choices for our T1D community: New Pumps Approved in BC

August 26, 2020

There’s good news for pumpers in BC! BC Pharmacare has added YpsoPump by YpsoMed to its Tier 1 list of approved insulin pumps. BC residents with type 1 diabetes of all ages can now choose between the Omnipod by Insulet or the YpsoPump under the province’s pump program.  

Thanks in part to our JDRF Advocates, the province has also added the Medtronic MiniMed 670g to its list of Tier 2 pumps. Medtronic pumps can be obtained under a special exemption based on a recommendation from the person’s doctor or endocrinologist. Patients may be responsible for paying some of the cost for a Tier 2 device.

Nearly 400 JDRF Advocates responded to our action last summer urging the BC government to add the Medtronic 670g and the Tandem t:slim X2 to their list of approved pumps. While Tandem’s pump is still not available through BC Pharmacare, the addition of the Medtronic 670g is a small victory for our community’s choice and means that some of the costs for this device will be covered.

At JDRF we continue to push for expand access to the medical technologies – insulin pumps and advanced glucose monitoring systems – that Canadians with type 1 diabetes need. We hope that one day soon sensors too will be covered. To learn more about JDRF’s #AccessForAll campaign check out breakthrought1d.ca/accessforall.

Access For All Goes West

August 26, 2020

JDRF’s attention has been focused on Canada’s west coast increasingly as the BC government inches closer to a decision on whether or not to cover continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) systems. BC Pharmacare commissioned a health technology assessment on these technologies more than a year ago but the results have yet to be released.

Things began heating up this spring for JDRF’s #AccessForAll campaign with youth Advocate Sage Stobbe’s testimony to BC’s pre-budget committee in support of JDRF’s 2021 Pre-Budget Submission studying these technologies for more than a year now. The Victoria teen testified about the daily “battles” she and others with type 1 diabetes (T1D) face against “unpredictable high and low blood sugars”. She also appealed to them on a cost-benefit basis pointing out that she often uses up to 15 blood strips in a single day, much higher than the cost of sensors for either FGM or CGM. Listen to Sage’s testimony here (she comes on around 08:10:30 am).

This summer JDRF made formal written submissions to the Canadian Agency for Drugs Technology and Health with respect to two different draft reviews of flash glucose monitoring, the first summarizing clinical and cost effectiveness evidence, and the second based on feedback from a panel of clinicians. 

We’ve also partnered with Diabetes Canada and Type 1 Together to develop a joint submission to the BC Pharmacare Your Voice patient consultation that was launched this August. The three diabetes organizations met with officials from BC Pharmaceutical Services Division via Skype to better understand the process and contribute feedback on behalf of the diabetes community.

Do you live in BC and have type 1 diabetes? Contribute your feedback in the Your Voice patient survey. If you’re a caregiver, the BC government would like to hear from you as well. Have your say via the caregiver survey.

Help us continue to advocate for the T1D community

London, UK sees localized increase in pediatric T1D diagnoses – but experts say too early to blame COVID-19

August 19, 2020 

A recent increase in type 1 diabetes (T1D) diagnoses in children under 18 in some hospitals in north-west London, UK, has triggered news stories that COVID-19 could cause the disease in children. But experts have stressed that the locally reported increase in diagnoses is not yet clearly linked to the pandemic. 

In the new study, 30 children at five hospitals across north-west London presented with new-onset T1D during the peak of the pandemic, approximately double the number of cases typically seen in this period in previous years. Increased cases were clustered in two of the five hospitals. 

21 children (70%) were tested for COVID-19, and only 14 (47%) had antibody tests to see whether they had previously been exposed to the virus.  Five (17%) of the children with newly diagnosed T1D had evidence of past or current coronavirus infection. 

No clear link between COVID-19 and T1D yet

Scientists have long suspected viral infections could play a role in triggering T1D – at least in some people. The authors of the study recommend a larger analysis to establish whether there is a definitive link between COVID-19 and new-onset T1D, and if so whether COVID-19 has any impact on the severity of the disease. 

Prof Deborah Dunn-Walters, Chair of the British Society for Immunology taskforce on COVID-19 and Immunology, said in a responsive statement: “This paper reports an increase in the number of type 1 diabetes cases in children in part of London during the months of April and May compared with previous years. As not all children in the study were tested for COVID-19, the findings do not show that this increase was linked to the COVID-19 pandemic – in fact, it is currently unclear what was behind this rise in cases.” 

Prof. Dunn-Walters said further: “Currently, there have been no comprehensive studies published linking COVID-19 to the development of any autoimmune disease, including type 1 diabetes. However, we are still in the early days of finding out about the longer-term effects of COVID-19 and follow-up studies in this area will be important.” 

The findings from the UK study contrast with those of studies from other parts of the world that instead suggest delayed diagnoses of T1D during the pandemic due to fears about accessing healthcare. For example, a recent report from Italy indicated that pediatric diagnoses of T1D in children were decreased 23% during the peak of the pandemic compared with the same timeframe in 2019, with a greater proportion presenting with diabetic ketoacidosis (DKA). However, the Italian study did not rigorously address whether COVID-19 may have been a precipitating factor to T1D diagnosis. 

Diane Wherrett, Professor and pediatric endocrinologist at The Hospital for Sick Children in Toronto, says: “This observation based on a very small number of cases suggests that diabetes researchers and care providers should examine larger national databases, particularly in countries with high rates of COVID-19, to determine if changes have been seen. Given that type 1 diabetes develops over many months to many years, it is very unlikely that COVID-19 triggered the process that causes type 1 diabetes.” 

Each person with T1D is different. If you are concerned about your health status and have questions about your own situation, seek guidance from your healthcare team. You can also write to us at T1Dquestions@JDRF.ca  or check out breakthrought1d.ca/coronavirus for more information. 

Type 1 diabetes and COVID-19: Going back to school

August 17, 2020 

Download this document here.

As students across Canada get ready to head back to school—some after nearly 6 months of being away—parents have many questions. The first is usually, “Is it safe to send my child back to school during this pandemic?”

Here are some things to consider when making a decision about sending your child with type 1 diabetes (T1D) back to school.

  • The situation in your community: The risk ofillness in schools depends to a large extent on how much virus is in a community. Your local public health authority is the best source of this information that can help you decide what the overall risk of illness is for all students.
  • The protocols your school has in place: Preventing students and school staff from getting the virus in the first place is the top priority. How is your school ensuring they are following public health guidance to create safer spaces?
  • Risk of your child getting sick: Type 1 diabetes is an autoimmune condition. This is not the same as being immune suppressed or immuno-compromised, which increases risk of COVID-19. Children with well-controlled type 1 diabetes face the same risk of getting COVID-19 as their peers without T1D. If children with T1D do get the virus, they are not at a higher risk of complications. But any virus may cause blood sugars to be higher, so proper sick day management is essential.
  • How you feel about the risk of illness: During a pandemic, there are many things we can do to reduce our chances of getting sick. But as long as the virus is in a community, there will always be some risk. Everyone feels differently about risk. Ask yourself whether you would be comfortable sending your child to school if they did not have type 1 diabetes.
  • The risk of serious illness and death: Children with COVID-19 infections have rarely become sick enough to be admitted to hospital. In fact, the chance of a child being hospitalized with COVID-19 maybe lower than it is for influenza, a virus that occurs in the community each year.
  • Your child’s overall health and well-being: The long and unexpected school closures, along with other restrictions on activities and socializing, may affect children’s physical, social, and emotional well-being. When deciding whether to choose remote learning or inperson schooling, think about how your child has done over the past few months.
  • Supports for your child with diabetes: Students with diabetes have the right to be safe, supported, and included at school. A global pandemic does not change this. Will your child be well supported in managing their day-to-day diabetes tasks?

 

Key Points

Type 1 diabetes is an “auto-immune” disorder. This does not mean that people with T1D have a weakened immune system. Children with well-controlled T1D are
not at an increased risk of getting COVID or of more severe COVID illness. Many factors will go into the decision about returning to school, including local conditions, your family situation, your child’s learning style and temperament, and so on. While each family’s situation is different, type 1 diabetes alone should not be considered a medical reason to delay return to school or work. Consider whether your child will receive the supports they need to help manage their diabetes during the school day.

 

Are children with type 1 diabetes at higher risk of contracting coronavirus?

You may have heard that people with diabetes are at higher risk of developing complications from COVID-19. This is based on information about adults, mostly with type 2 diabetes and not youth with type 1 diabetes. While we lack specific evidence about type 1 diabetes and COVID-19, leading medical experts say that children (and adults under 65 years) with well-managed type 1 diabetes are NOT at increased risk of contracting COVID-19 or developing serious complications from it.

 

How do I keep my child with type 1 diabetes safe at school?

Take steps to prevent getting coronavirus

When it comes to keeping students safe from COVID-19, all Canadian schools should have measures in place to help stop the spread of the virus. These will vary depending on what part of the country you are in and what is happening with infection rates in your community. Some ways that schools are helping to reduce the risk of COVID-19 include:

  • Smaller class sizes or cohorting (keeping small groups of students together for the day)
  • Frequent handwashing and/or hand sanitizing
  • Enhanced cleaning and disinfecting of schools, especially surfaces that are frequently touched
  • Physical distancing
  • Wearing masks or cloth face coverings
  • Changes to school schedules or other school-day routines
  • Not sharing personal or school-owned items like supplies or musical instruments
  • Limiting the number of people coming into the school
  • Reducing other high-contact situations, such as bus transportation (by driving, walking or cycling to school)

Help your child become familiar with the guidelines for their school and be sure they know what to do. Check your child every day for symptoms of coronavirus, and keep them home if they have symptoms or are sick.

 

Ensure your child has a diabetes care plan in place

The most important tool for keeping your child with diabetes safe at school is an Individual Care Plan. Many boards have their own forms, or you can use the one on the Diabetes@School website.

The care plan includes all the details of daily diabetes management at school including: when and where to do blood sugar checks and give insulin; how to deal with low and high blood sugars; and who has been designated to provide support to the student. Before school starts, make sure this plan is up to date, and ask your clinic for help if you need it.
If your child requires support for lunchtime insulin from an adult who is not on the school staff, ensure that you contact the school about these arrangements before school starts, since schools may be limiting the number of people allowed on site.
School staff will also need education or training to support your child. The Diabetes@School website has many tools, such as videos, that make it easy to do this training virtually or online if you are unable to do it in person.
Encourage your child to be extra vigilant with hand hygiene, especially when they are checking blood sugars, using their insulin pump, or doing any other diabetes task. You may want to include some extra hand sanitizer and/or wipes in their kits, as well as extra masks or gloves in case an adult at the school needs to provide help.

 

What if my child gets COVID-19?

Having any virus or illness can affect blood sugars in people with type 1 diabetes. Since the chance of high blood sugar and ketones are increased when your child is ill, make sure you are familiar with sick day guidelines. In particular, know:

  • How to check for and manage ketones, which can develop with high blood sugar. You can use a blood ketone meter or urine strips. Ensure you have supplies on hand at all times and be sure to check expiry dates.
  • How to prevent DKA (diabetic ketoacidosis), a serious complication of diabetes that needs hospital admission caused by not having enough insulin.
  • How and when to use mini doses of glucagon, for children with low blood sugar who are vomiting and cannot take fast-acting sugar. If your clinic has not trained you to do this, ensure you know when to call for help. Have an injectable glucagon kit on hand, even if you have a nasal glucagon product (Baqsimi) as well.

Since anyone with viral symptoms must stay quarantined for 14 days, be sure to always have a supply of prescriptions and diabetes medications at home.

 

How can I prevent DKA?

Symptoms of DKA (diabetic ketoacidosis) include abdominal pain, nausea, vomiting, high blood sugar and ketones (which cause fruity-smelling breath, and laboured, rapid breathing). Without treatment, DKA can be life threatening.
Here are some things you can do to prevent DKA:

  • If your child is sick and/or has ketones, follow your clinic’s sick day guidelines.
  • NEVER stop insulin: During an illness, even if your child is not eating well, insulin needs are usually higher.
  • If your child uses an insulin pump, make sure you have either syringes or an insulin pen on hand, in case you need to give fast-acting insulin by injection. Have a supply of basal (long-acting) insulin on hand in case your child’s pump malfunctions.
  • Keep your child well hydrated with sugar-free fluids.
  • Seek help from your team as directed.

If your child is showing signs of DKA, you need to seek medical attention immediately.

 

What else can I do?
  • Do what you can to prevent all family members from contracting coronavirus. That includes practicing physical distancing, hand hygiene, and wearing masks—especially when inside and when physical distancing is not possible. Follow the advice of the Public Health Agency of Canada and your local public health authorities.
    • To help minimize possible exposure, know what others in your circle are doing to prevent illness, including child care providers, friends outside of school, and extended family. If your child is taking part in extracurricular activities, ask what precautions are being taken.
    • Don’t send your child to school if they have any symptoms of coronavirus.
    • Ensure all your child’s vaccines are up to date and that they get an influenza vaccine as soon as they are available in the fall.

 

For more information:

 

www.diabetesatschool.ca

 

www.breakthrought1d.ca

 

www.diabetes.ca

 

Developed by Diabetes@School (Canadian Paediatric Society, Canadian Pediatric Endocrine Group, Diabetes Canada) and JDRF Canada, in collaboration with the diabetes teams from the Children’s Hospital of Eastern Ontario (Ottawa) and the IWK Health Centre (Halifax).

 

Landmark trial of T1D-related kidney disease misses primary outcome, but provides valuable lessons

August 10, 2020

In recent years, better ways to control blood sugar levels and blood pressure have led to a decrease in kidney-related complications among the type 1 diabetes (T1D) population. However, kidney disease remains one of the leading complications of diabetes, including the need for dialysis or kidney transplant. Identifying strategies to reduce kidney complications has been a key focus of JDRF’s research strategy. To date, several studies have demonstrated that individuals with higher levels of uric acid in their blood are more susceptible to reduced kidney function. This led to the Preventing Early Renal Loss in Diabetes (PERL) trial, a joint initiative between investigators across North America and Denmark. Partly funded by JDRF, the three-year study involved testing allopurinol – a drug that has been on the market since the 1960s to reduce uric acid levels in gout – in 530 participants with T1D and early to moderate kidney disease. On the basis of years of evidence, including a promising pilot trial supported by JDRF, the hypothesis was that allopurinol would reduce the incidence or severity of kidney disease in people with T1D.

Throughout the placebo-controlled trial, the key measurement of kidney function for patients was the glomerular filtration rate (GFR), which gauges how much blood is filtered every minute by the kidneys – a measure that drops as kidney function gets worse. The study’s findings revealed that levels of uric acid fell about 35 per cent on average among people given allopurinol over the course of three years compared with those who did not receive the drug. However, allopurinol had no impact on GFR leading investigators to conclude that it does not prevent T1D-related kidney disease.

“This is not the result that we wanted,” said Peter Senior*, a researcher at the University of Alberta and PERL collaborator, “but it does give a very clear answer to an important scientific question.” 

Clinical trials that specifically set out to measure kidney outcomes are relatively rare in T1D. The PERL trial was a true landmark by demonstrating that kidney trials can successfully be done in people with the disease. Moreover, the existing trial infrastructure and cohort, as well as learnings from the study, will be leveraged for future trials with other drugs.

“PERL was a textbook example of taking clinical observations and preliminary research findings suggesting the potential for a new use for an old drug, and then designing a study to definitively answer whether or not the drug would prove to be effective as a new treatment,” Senior* noted. “In this case, the drug did not show any of the anticipated benefit. But that is exactly why we do clinical trials, and how our scientific understanding advances. We don’t want to recommend treatments because ‘in theory’ they should work.”

Work to uncover ways to reduce the risk of kidney complications in T1D continues. JDRF is currently funding follow-up studies on biopsies from PERL trial participants, to obtain a better understanding of T1D-related kidney disease. In addition, a JDRF-funded Australian phase 2 trial is testing a completely new drug (referred to as GKT137831) in adults with T1D and early signs of kidney impairment. This drug works by reducing damage to the kidney caused by oxidative stress at the cellular level. The hypothesis is that reduction of oxidative stress by GKT137831 will prevent or slow decline in kidney function in people with T1D involved in the trial. Finally, JDRF Canada is funding a clinical trial of an oral drug called dapagliflozin that can be taken alongside insulin, with the aim of reducing biomarkers of complications, including kidney complications, in adolescents with T1D.

*as quoted in Folio, the University of Alberta’s daily digital magazine

Making the best of the COVID-19 situation

July 24, 2020

Sponsored content by Ascensia Diabetes Care Canada Inc.

 

 

 

If on January 1, 2020 you were told that life would change drastically as it has this year, you probably wouldn’t have believed it. However, here we are. The coronavirus pandemic has swept us into an unprecedented global health emergency and forced us to make significant changes to our way of life. The office is now downstairs instead of a short (or long) commute away; the children need to be homeschooled or entertained; and, we no longer have easy access to groceries, family and friends and our favourite restaurants. Is there a silver lining in the dark cloud? Yes, the adoption and a greater appreciation of technology.

 

With visits to healthcare professionals (HCPs) now mostly virtual, tele-health and Zoom meetings now the norm, there comes a heavier reliance on self-monitoring. For people with diabetes, this is where the benefit of having digital tools, such as an app, starts to become appreciated. Whether you use a blood glucose monitor (BGM) or a continuous glucose monitor(CGM), using a software or an app, such as the CONTOUR®DIABETES App, is a welcome part of the diabetes management jigsaw puzzle.

These technological gems can help you monitor and recognize patterns in your blood glucose levels, which you can share with your HCP.  But that’s not all, apps also alert you about critical highs and lows and advise on how to avoid these and get back into a safe range. Personalized testing schedules based around your daily routines are also provided, and the app can detect patterns in your glucose readings and help identify possible causes behind them.

As the battle with this virus continues, it is important to remember that you are not alone. We are here to support you and help you manage your diabetes effectively. For information about the highly accurate CONTOUR®NEXT family of blood glucose monitors1,2 and test strips and to learn about our CONTOUR®DIABETES App, click here. Remember #togetherwecan!

 

1. Christiansen, M. P. A New, Wireless-enabled Blood Glucose Monitoring System That Links to a Smart Mobile Device: Accuracy and User Performance Evaluation. Journal of Diabetes Science and Technology; 2017,11(3), 567-573.

2. Bernstein, R. et al. A New Test Strip Technology Platform for Self-Monitoring of Blood Glucose. Journal of Diabetes Science and Technology, 2013 7(5), 1386-1399.

 

To our community and our partners: Thank you

July 24, 2020

This past June, we came together and rallied to get loud and raise funds for a world without type 1 diabetes. Despite the physical distance between us, our digital world allowed us to reach out to you through our biggest virtual house party yet – Sun Life Walk to Cure Diabetes for JDRF as the JDRF House ParT1D for a Cure, presented by Omnipod.  

Thanks to your incredible support, you helped raise over $2 million dollars for critical funds that will support cutting edge research and meaningful community programming. A HUGE thank you!  

By joining the JDRF House ParT1D for a Cure you helped support breakthroughs that get us closer to a cure and provide hope to the millions affected by this disease. Your fundraising dollars are helping support remarkable research projects, including a 3D-printed bio-artificial pancreas, stem cell technology and transplant advances.   

YOU joined a community dedicated to uniting to support the millions of people living with T1D. And together,  we made a difference.   

We would like to express our sincere gratitude to our sponsors, who helped make the House ParT1D a success and allowing us to surpass our fundraising goal. With their support, we were able to offer an incredible day filled with entertainment, celebrities, inspirational stories, research updates from the experts and so much more. 

Thank you to all of our sponsors who allowed us to host Canada’s largest house party turning type one diabetes into type none.  

We are incredibly grateful to our partners, and the entire T1D community for their commitment and support as we work together to move type 1 diabetes research forward faster than ever. All funds will move us further along our journey of uncovering better treatments and cures for those living with T1D and bring us closer to a world without T1D. We can’t wait to see you next year!  

Thank you to our corporate champions…  

Ascensia   

BMO JDRF Mastercard  

Capital Ford Lincoln   

Capital GMC Buick Cadillac    

Cascades   

Cavendish    

Diabetes Care Guelph   

Dr. Anthony Wiens Medical Corporation   

Enterprise   

Gateman Milloy    

Giant Tiger   

Harvard Developments   

James H. Brown   

Lawton Drugs   

Lions Club of Bedford   

Pizza Hut   

Redhead Equipment Ltd.   

Sobeys    

Stump Fire Protection  

TD Asset Management   

TrialNet   

Universal Collision Centre   

WestJet   

Winnipeg Goldeyes Field of Dreams Foundation    

Ypsomed   

 

  

 

 

Here’s why these families are In to End Diabetes

Here’s why these families are In to End Diabetes 

July 17, 2020

At JDRF our mission is to find a cure for type 1 diabetes (T1D) and its complications through the support of research. Every dollar we are able to direct toward this critical research comes from our donors. Some of them have joined our exclusive giving club In To End Diabetes” by committing to a monthly donation. With their ongoing generosity and dedication to ending T1D,  monthly donors are accelerating the pace of research for this invasive, and demanding disease which affects over 300,000 Canadians – children and adults alike. This month, we wanted to recognize some of our amazing monthly donors and thank them for their support. Their stories will help you understand why they’re In to End Diabetes. Check them out below.

Shelagh. Calgary, AB.

Shelagh’s nine-year-old son Graham was diagnosed with T1D two years ago. After feeling unwell for some time, he was eventually given an official diagnosis and now remains resilient as ever – bearing a tough exterior while rocking his ‘I have diabetes and I’m allowed to have candy’ t-shirt.

“I worry about him all the time,” said Shelagh, who says she’d do anything to take this 24/hour disease away from him and believes that nothing in his life should be restricted because of T1D.

Being a monthly donor for Shelagh means helping kids make this disease livable and manageable, and eventually turning type one into type none. She says aside from the research JDRF avidly funds, JDRF events also keep her son excited, and hopeful.

“The first gala we ever went to was a blast,” she said. “As we were leaving [Graham] turned to us and said ‘See? I told you diabetes can be fun!’”

Jill. Halifax, NS.

Watching her niece deal with the stressors that came with her T1D diagnosis back in 2016 was tough for Jill. Observing how she manages her disease every day, she says, is both inspiring and heartbreaking, and served as a trigger point for Jill to give back in any way that she could.

 “I heard of JDRF through the radio and thought I’d find a way to get involved.” Jill added that monthly donations provide her with the opportunity to regularly fund T1D research for people like her niece.

Jill says she wants to get to a place where her niece could go to bed at night, not having to worry about managing a 24/hour disease. Through monthly donations, she hopes to one day help find a cure for her, and give her a life free of worry.

“JDRF is an international organization – [they’re] all over and working hard to help people who live with type 1…I’ll do anything I can to make her life a little simpler.”

Michelle. Regina, SK.

Several years ago, Michelle used to spend most of her days in the air. She flew as a commercial pilot until she began to feel unwell. It wasn’t until she had an aviation medical examination done that she discovered she was living with type 1 diabetes. 

As a result, Michelle was forced to change careers, and now works as an engineer.

“I almost don’t remember life before diabetes,” she said, adding how much of the day she spends thinking about, managing and monitoring her diabetes.

She decided that JDRF was an organization she wanted to give back to, and on top of being a monthly donor, she now volunteers. “JDRF does such important work…having a sense of community is a huge, and just normalizing the physical and mental side of type 1 is something I want to help with – supporting families and people [with T1D] the best I can.”

Giles. Toronto, ON.

Giles describes his fourteen-year-old son as the ‘poster child for T1D.’

Between school and AA hockey, he maintains stellar blood glucose levels and continues to adapt to the ever-evolving diabetes technology, rocking his pump and continuous glucose monitor (CGM) on and off the ice.

“He doesn’t really like doing T1D-specific things,” says Giles, “He likes playing regular sports, and doesn’t want to be defined by [his disease].”

The family has been part of JDRF’s monthly giving program for yearsand while they are lucky to have coverage for their son’s diabetes equipment, Giles recognizes other families aren’t. “Everyone should have access to that kind of technology…we know JDRF is advocating for that.”

“This is a disease that can be cured, and we will give as much as we possibly can to help achieve that.”

Feeling inspired by these amazing monthly donors? You can also join the movement to help drive diabetes research forward. Join us today and tell the world that you are In to End Diabetes.

Join us today and tell the world that you are In to End Diabetes.

Become a monthly donor by September 15 and thanks to a generous family from Vancouver, your first 6 gifts will be doubled!*

*Up to 20,000

Advocacy in a post-Covid-19 world

June 23, 2020

Your stories make all the difference.

The COVID-19 pandemic we’ve all been living through presents both a problem and an opportunity in terms of JDRF’s advocacy efforts.

As quarantine restrictions are lifted and we begin to see the light at the end of the tunnel, the stark reality we’re facing is that all levels of government have had to expend vast sums of public money on unbudgeted COVID-19 relief efforts. In the post-pandemic world, securing public funding for diabetes technologies is sure to be an uphill battle.

At the same time, these governments are increasingly seeing the value of virtual care models to help deliver health care at a distance.

The crisis has also demonstrated the important role that remote monitoring technologies such as continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) can play in reducing physical contact between frontline health care workers and their patients.

Working together, we can still achieve public funding for these technologies, making them affordable and accessible for all and helping reduce the out-of-pocket costs for Canadians living with T1D.

Please email your provincial or territorial representative today in support of JDRF’s #AccessForAll campaign.

When submitting your email it’s important to personalize your message by explaining how public coverage for continuous glucose monitoring (CGM) and/or flash glucose monitoring (FGM) would be life-changing for those living with type 1 diabetes. This will ensure you are sending an impactful message to decisionmakers.

Before approving public spending, elected officials want to know about the difference that spending will make in the lives of their constituents. Your personal story will make all the difference. It’s the impact the technology will make on your life that will move them to action.

Personalizing your letter is easy. Here are a few examples of Advocate emails sent this June:

“Our daughter was diagnosed at age 4 1/2 in January of 2018…[S]he suffered a severe hypoglycemic event where she was losing consciousness and ended up in the hospital. We got a CGM days after this happened and have had much better results… [CGM] allows us to keep her in range longer and have a better A1C. This will prevent long term health complications and is more cost effective than hospital visits and complications from T1D.~Susan Sinclair, Vancouver, BC”

***

“Our daughter has had type 1 diabetes for 10 years and her continuous glucose monitor has been life changing. It helps keep her safe – she doesn’t always feel her low blood sugars and used to have problems during the night. The continuous glucose monitor allows our family to get much needed rest during the night with the comfort of knowing she is safe. ~Michele Patton, Misssissauga, ON”

***

“This device allows my daughter the independence she deserves, while keeping her safe. Something as simple as going to bed for the night, isn’t simple with diabetes. A CGM with it’s alarms is a game changer! ~Ann-Marie Hulse, Newmarket, ON”

***

“I’ve been a type 1 diabetic for 27 years, always struggling with low blood sugars with no symptoms… Five years ago I seized, again, and I knew if I wanted to live I needed to get a CGM… I have had perfect blood sugar… [and] two healthy, uncomplicated pregnancies with the help of the CGM… CGM and FGM is not just life changing, its life saving. It needs to be covered! ~Jennifer Dyck, Winkler, MB”

***

“Myself and two of our three children live with Type 1 diabetes. Having the Dexcom cgm for all of us helps me to sleep at night knowing that I’ll be woken up if any of us go low. It makes a super stressful life a little bit easier! ~Robyn Devine, Blackfalds, AB”

Help us continue to advocate for the T1D community

Updates from the Teplizumab Trial: You’re Not Going to Believe the Results

June 19, 2020

Last year, at the American Association for Diabetes (ADA) Scientific Sessions, a drug, called teplizumab, was able to significantly delay—for over two years—the onset of type 1 diabetes (T1D) in participants with a high risk of developing the disease. This was the first ever study in humans to show a delay in the onset of T1D. But it doesn’t stop there. JDRF has very promising updated results. Over the past year, the investigators were able to follow up on the individuals who didn’t develop clinical diabetes, and the effect of teplizumab had been sustained: 50% of those treated with teplizumab remain diabetes-free, compared to only 22% of those taking placebo, and the delay in diabetes onset was close to 3 years (35 months). These were presented by Emily Sims, M.D., an assistant professor of pediatrics at Indiana University and a JDRF-funded investigator, at ADA’s Scientific Sessions.

Additionally, the participants, both the teplizumab and placebo groups, had had a progressive decline in the biomarker that measure’s the body’s ability to produce insulin—C-peptide—preceding the trial. But the study team found that production of C-peptide actually went up following treatment with teplizumab, especially in the first 6 months after treatment. Teplizumab could reverse the downward trajectory of C-peptide loss that was there before the trial.* And there’s more: the increases in C-peptide were correlated with induction of a state of “exhaustion” in “bad” immune cells.

So, could the exhaustion of “bad” immune cells result in not getting T1D or significantly slowing down the time to getting it or even stall or reverse the progression of T1D once you have it? Well, we’re not there yet, but we’re close, and closer to a day when T1D might be prevented or cured, forever.

JDRF Leadership: JDRF co-funded one of the first clinical trials of this drug, results of which were integral to the teplizumab prevention trial. The trial took place internationally including some Canadian sites. The study in this report was conducted by TrialNet, a T1D trial consortium funded by NIDDK and by the NIH’s Special Diabetes Program for which JDRF is the leading advocate. Multiple studies involving samples and data from teplizumab trials have continued to receive JDRF funding. Teplizumab (now called PRV-310) is currently being tested in a phase 3 clinical trial in people recently diagnosed with T1D, headed by Provention Bio, a company with an investment from the JDRF T1D Fund. If successful, this could become the first immune therapy approved for T1D.

*In the placebo group, C-peptide still declined.

Virtual care for T1D during the COVID-19 pandemic – and beyond

June 9, 2020

The type 1 diabetes (T1D) community has always embraced new technology – with insulin pumps, continuous glucose monitors (CGMs), flash glucose monitors (FGMs), and a variety of T1D-focused apps rapidly becoming essential tools for many people. It’s no surprise, then, that the T1D community has quickly adapted to accessing healthcare virtually.

During the COVID-19 pandemic, most healthcare providers no longer prefer to see patients in person, as reducing the number of patients attending clinics, hospitals, and labs reduces risk of exposure for patients and healthcare providers alike. So, what are the options for interacting with healthcare teams remotely? And are these options here to stay?

Virtual care explained

Virtual care is defined as any remote interaction between a patient and any members of their care team, using various forms of communication or information technologies. Means for interacting with care teams can include phone calls, text messages, online communication portals, video calls on a computer or mobile device, apps – or a combination of these methods. Like care delivered in person, virtual care can involve interacting remotely with different types of healthcare providers, including doctors, nurses, pharmacists, and many other types of professionals.

By interacting with your healthcare provider through these digital technologies, they can hear, see, and discuss symptoms with you and offer solutions for many concerns. They can diagnose many common ailments, discuss lab results, and order prescriptions for you.

Virtual care has been evolving for many years, and in Canada has mostly been used to interact with patients who have difficulty accessing care in person, such as people in rural or remote locations. The COVID-19 pandemic means that virtual care is suddenly being used in different ways and by a much wider range of people.

Virtual care is now being used to support people with T1D for needs such as:

  • Reviewing blood glucose and making insulin dosing adjustments with a doctor
  • Reviewing food logs or blood sugar records with a diabetes educator
  • Troubleshooting diabetes device issues
  • Remote insulin pump starts and support
  • Addressing mental health concerns

How do I access virtual care?

During COVID-19, medical clinics across Canada have adapted to provide virtual care for interacting with patients. If you have a non-urgent health concern, the first step is to contact your usual healthcare team to ask about what options are available to you under the current circumstances. Different clinics will differ in their approach to booking and holding appointments and providing follow up – but the important thing to remember is that they are still there to support you, even if from a distance.

If you can’t access your usual healthcare team virtually, or you have a concern that does not require your usual healthcare team, there is an increasing number of virtual care providers available, some of which offer services that are covered, at least in part, by provincial healthcare plans. These providers include: Maple (multiple provinces), Babylon by TELUS Health (BC), MCI Doctor (Alberta, Ontario), and CloudMD (BC, Ontario), among others. Notably, Maple can provide remote access to diabetes educators (for a fee; Ontario only).

In addition, the Government of Canada has recently announced a new virtual platform to support mental health and substance use concerns for all Canadians during the COVID-19 pandemic.

Can virtual care address all medical concerns?

Not every medical concern can be addressed remotely. Procedures, surgeries, and certain physical examinations must be done in person. Lab tests – such as HbA1c – usually need to be attended in person, although many tests can be deferred unless your doctor advises that they are essential at this time. Virtual care options may also not be available for new patients (unless related to COVID-19). Finally, some people may require or prefer an in-person consultation, which can still be arranged, especially at this time with many provinces preparing to relax restrictions.

Importantly, urgent concerns that require prompt medical treatment, such as possible diabetic ketoacidosis (DKA), must be seen in person at an emergency department. Virtual care cannot substitute for emergency care, and Canadians should be reassured that hospitals are implementing all measures possible to prevent the spread of COVID-19.

How can I best prepare for a T1D virtual appointment?

Once you’ve successfully booked a virtual appointment, ensure that you are all set to make the most of your time with your healthcare provider.

  • Check with your healthcare team, or the virtual care provider, about coverage and any associated fees
  • If using an online portal or app, log in at least 10 minutes before your appointment to ensure your technology is working well
  • If you use a CGM, FGM, or insulin pump, download the relevant data and share them with your healthcare provider in advance. If you are unsure how to download or share your data, visit your data platform website for instructions, or reach out to your healthcare provider for help
  • Create a list of questions before your appointment and prioritize those you would like to tackle first so that you can make the most of your time
  • Allow for extra time – just like in an office setting, virtual appointments might run late, and some clinics are finding that virtual appointments are taking longer than usual
  • Remember that virtual care is new to many of us – if your experience is less than perfect, keep in mind that virtual care will improve rapidly in the near future as clinics adapt to delivering care in this way

Is virtual care here to stay?

COVID-19 means that virtual care options will continue to evolve rapidly, and probably remain an important part of healthcare from now on – probably as a complement to traditional care, rather than a replacement. Many people with T1D are finding that virtual appointments fit better with their lives than traditional appointments. It’s a safe and efficient way to have regular follow-ups, without the hassle and expense of travel, parking and waiting rooms. In some cases, video calls can even help clinicians get to know their patients a bit better.

There’s also been a big increase in the number of people who are sharing CGM or FGM data with their healthcare team electronically – something that clinicians have been encouraging for years. Increased use of virtual care and the power of blood glucose data to optimize care when delivered remotely means that better access and affordability of CGMs for people with T1D is more urgent than ever – a need that JDRF is addressing through advocacy in our #AccessforAll campaign.

Thanks to generous donor support, JDRF is also funding several research projects that seek to inform how virtual care for T1D can be delivered to ensure the best health outcomes. Please consider making a donation to help us sustain this crucial investment in research.

 

“Without my cousin’s discovery, I wouldn’t be alive today”

By Rebecca Redmond

May 26, 2020

My name is Rebecca Redmond, and I am #MoreThanT1D.

I’m a writer, a public speaker, a mom, a wife, a sister, a daughter, a friend…and Sir Frederick Banting’s cousin.

Not that long ago, my cousin and a team of amazing researchers in Canada successfully created insulin – the drug that keeps me, and millions of people around the world alive every day.

Before insulin, people living with T1D had a life expectancy of just over one year, following their diagnosis. One in five people lived 10 years long, but experienced severe complications including blindness, kidney failure, stroke, heart attacks and the potential of amputation.

Today, our life expectancy is almost normal.

I’ve lived with type 1 diabetes for over 20 years, experiencing highs lows, frustration and pain. When I discovered JDRF and attended one of their events last year (coinciding with my 20th diaversary) I was so moved by the sense of community I felt. I spent the day with thousands of others who live with T1D, making me feel so much less alone, and understood.

In these times of social distancing, we have to think differently about how we can connect families living with T1D together. We have found a virtual way to come together from the comfort of our own homes to accelerate the pace of T1D research at the JDRF House ParT1D for a Cure presented by Omnipod.

On June 14th, you can join the largest house party in Canada for those touched by T1D. Celebrities such as NHL player Max Domi, country superstar George Canyon, former NHL player Bobby Clarke, endurance athlete Sébastien Sasseville, DJ MC Mario and more will be in attendance. You can also win prizes and hear inspirational stories from the community, as well as research updates.

My cousin never gave up. He and his team pushed through adversity together – and we must do the same. We are #MoreThanT1D! Let’s come together, have some fun and turn type one into type none!

I’ll be there, supporting people like myself who live with a 24/hour/365 day disease. Will you register and fundraise with me?