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. 

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:

• COVID-19: Guidance for School Reopening (Joint statement from pediatric hospitals in Ontario)
• JDRF Canada: T1D and returning to work and school in the wake of COVID-19
• JDRF Canada: Type 1 Diabetes and Coronavirus
• Provincial Council for Maternal and Child Health: Illness management guidelines
• Diabetes at School: Video series
• Diabetes Canada: Kids with Diabetes at School

 

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).

 

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

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 monitors^1,2 and test strips and to learn about our CONTOUR®DIABETES App, click here. Remember #togetherwecan!

 

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 

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!*

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

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.

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.

 

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 20^th 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 14^th, 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?

 

May 27, 2020

If you haven’t yet heard, you’ve been invited to Canada’s largest virtual house party turning type one diabetes into type none…the JDRF House ParT1D for a Cure, presented by Omnipod!

This one-day, family-friendly event is intended to bring the T1D community together (virtually) and bring us closer to a world without type 1 diabetes. It’s an opportunity to get loud and raise funds to accelerate the pace of T1D research. And did we mention we have an amazing lineup of celebrities joining us? Read more about our famous attendees below!

Max Domi, NHL Player

JDRF Ambassador Max Domi is a young, up-and-coming NHL superstar.

In his 20 years as a professional athlete, Max has won a Gold medal in the 2015 World Juniors Championship, drafted 12^th overall by the Arizona Coyotes, held a captain position of the London Knights, and now proudly sports #13 for the Montreal Canadiens. Max is a prominent figure in the T1D community – inspiring youth athletes to follow their dreams, and not let anything – especially a disease like T1D– get in the way.

 

Gloria Loring, Actress

Singer, entertainer, recording artist and Academy Award nominee Gloria Loring is a woman with many talents.

The Days of Our Lives TV star is also the mother of actor Brennan Thicke and pop singer-songwriter Robin Thicke. Gloria dedicates her time advocating for type 1 diabetes as a JDRF spokesperson, as a result of Brennan’s diagnosis at age four. So much so, that she created and self-published two volumes of the Days of Our Lives Celebrity Cookbook, and donated over one million dollars to T1D research. Following the success of those reads, she published two more Kids, Food and Diabetes, and Parenting a Child with Diabetes. Her dedication to the arts, as well as her role as a mother of someone who lives with T1D makes her the perfect House ParT1D guest.

 

Brennan Thicke

Born into a family that is no stranger to the spotlight, Brennan Thicke is an inspiring actor who lives with type 1 diabetes – advocating for T1D alongside his family.

Son of Canadian actor Alan Thicke, Gloria Loring, and brother of Robin Thicke, Brennan is best known for his roles in MASK, Dennis the Menace, and Unusually Thicke. He’s been active in a number of diabetes charities including JDRF, and the self-born charity, Thicke Centre. Being diagnosed shortly after a family vacation in the 80’s, Brennan persevered and found strength through managing T1D, while living his dream as an actor.

 

Bobby Clarke, Former NHL Superstar

Former NHL superstar Bobby Clarke can be best recognized by his golden smile.

The talented professional athlete was one of Canada’s first notable T1D warriors on the ice – inspiring the country with his strength and leadership. Bobby never let T1D stop him from skating circles around other players, executing impeccable stick-skills, or becoming an NHL legend – playing over 1,000 games, scoring almost 400 goals, and over 1,000 points on the ice.

 

George Canyon, Country Superstar

National JDRF Canada spokesperson and famed Canadian country singer George Canyon has overcome plenty of adversity – singing his heart out while doing it.

After giving up his dream of becoming an Air Force pilot following his diagnosis as a young teen, he turned to his passion, country music, to inspire others like him who battle the stigma of T1D every day. The two-time Juno Award Winner is a hero to music fans, and people living with T1D across the globe.

 

Sébastien Sasseville

Endurance athlete Sébastien Sasseville is an exemplary case of turning adversity into strength and opportunity.

Years after his diagnosis of T1D in 2002, Sébastien successfully reached the summit of Mount Everest, completed multiple Ironman triathlons, and finished the legendary Sahara race. In 2014, he put his limits to the test, and completed the biggest marathon of his life: running across Canada – a 7,500 kilometer journey equivalent to running 180 marathons in nine months.

 

DJ MC Mario

DJ MC Mario knows a thing or two about a good house party. That’s why the Canadian Dance Hall of Famer is joining us – bringing his acclaimed DJ skills learned from his radio show, House Party, along with him.

Mario has celebrated 3 million albums sold in Canada, and he’s still counting! The Juno Award nominee knows how to raise spirits, get a party started and have a good time.

 

Kaleb Dahlgren

Kaleb Dahlgren is nothing short of a hero.

The young, talented hockey player manages type 1 diabetes on and off the ice and is a brave survivor of the horrific 2018 Humboldt Broncos bus crash. Kaleb did not let his experience stop him from pursuing his dreams. Every day, he continues to manage T1D, while defying odds, and does it with a smile on his face, while cheering his teammates on. Founder of Dahlgren’s Diabeuties – an outreach program for kids with T1D – he continues to work towards his goal of turning it into a non-profit, with proceeds going to a camp that he envisions for children who live with T1D.

 

So what are you waiting for? Our House ParT1D will be filled with these incredible celebrities, entertainment and so much more. You can tune in anytime and even live stream your own house party. It’s a party you won’t want to miss! Register at jdrfparty.ca

 

May 25, 2020

We are sharing information that addresses some of the top concerns of the T1D community. Note these responses are not intended to be medical advice, for that—as always—you must consult your own healthcare team.

The declining numbers of new COVID-19 cases and hospitalizations across Canada are positive news. But as provinces begin to release guidance as to how schools, workplaces, and public spaces can reopen, many people may be feeling anxious. People living with T1D and their families may have extra factors to juggle when making decisions and planning for return to work or school.

Each province or territory is outlining public health guidance on practices such as social distancing, and a locally relevant approach for returning to schools, workplaces, and public spaces. Familiarize yourself with guidance from your provincial or territorial health authority, and keep up to date on changes.

Regardless of where you live, maintaining practices of social distancing and good hygiene will continue to be crucial to minimize exposure for ourselves and those around us, as restrictions are loosened. Universal practice of these measures will help to minimize risk of infection and mean we continue to “flatten the curve”. In these early phases of loosening restrictions, everyone should continue to practice:

• Frequent handwashing or, when in public places, frequent use of hand sanitizer with a minimum of 60% alcohol base
• Avoid touching face, mouth, nose and eyes
• Minimizing trips to grocery stores and other locations visited by a high volume of people
• Maintaining a 2m (6 foot) distance from others when you do need to leave home
• Wearing a face covering when physical distancing is not possible (e.g. when shopping, on public transit, etc). A non-medical face covering will not protect you from COVID-19, but it can protect others by reducing the spread of droplets from the wearer. For more information on non-medical face coverings, see Health Canada guidance.
• Adhering strictly to local guidance on joining social gatherings with others, and applying the above practices during social gatherings wherever possible.
• Staying home for a minimum of 10 days if you have cold or flu symptoms.
• Familiarizing yourself with local COVID-19 testing practices and get tested if you are eligible – testing capacity in Canada is expanding, which is crucial for tracking cases and preventing spread during early phases of re-opening.

Will it be business as usual when we return to school or work right now?

As they prepare to reopen, schools and workplaces are putting safety procedures in place to minimize risk of exposure to the coronavirus. These can include:

• measures to ensure social distancing in classrooms or workplaces
• policies around how to interact with others
• cleaning procedures
• in some cases, provision and use of personal protective equipment

Reaching out to your school or employer to understand exactly what practices are being implemented may help to make decisions about and prepare for your return.

Is it safe to return to work or school with T1D?

Even with safety procedures in place, returning to work or school may mean an increase in risk of exposure at this time. It’s important to understand what the risks of COVID-19 are for people with T1D in planning to return.

Evidence thus far indicates that children and adults less than 65 years old with well-controlled T1D and without other health conditions are not at greater risk of getting COVID-19 and do not necessarily have worse outcomes of COVID-19 than their peers without T1D. Thus, T1D itself may not be a medical reason to delay return to work or school.

Recent data from the UK indicates that older age, high HbA1c (e.g. >10%), and obesity (BMI>30) put people with T1D at increased risk of death from COVID-19. Although similar data are not yet available from Canada, this new information indicates that older people with T1D, and those who live with them, should take every possible precaution to reduce their risk of exposure.Each person with T1D is different and if you are concerned about your health status and have questions about your own situation, seek guidance from your healthcare team. Factors that may mean a person with T1D is at higher risk of the consequences of COVID-19 include:

• Age 65 or older
• High HbA1c (>10%)
• BMI >30
• Complications or other conditions that have been associated with poor outcomes of COVID-19, including heart disease, hypertension, chronic respiratory diseases, and cancer
• Immune compromised status due to medical treatment, such as immunosuppressive drugs (for example after a kidney or islet transplant), chemotherapy, or a medical condition (note that T1D itself does not cause immune suppression)

If one or more of the above applies to you or someone you live with, and your school, workplace, or commute does not allow you to practice all of the social distancing practices recommended, consider delaying returning to work or school for a period of time – if you can. It’s best to discuss your individualized plan with your healthcare team and your school or employer.

If going back to school or work, is there anything we should do differently?

• In the short-term, if you can work or attend school effectively from home, you may choose to continue doing so while safety procedures are being established.
• If you physically return to work or school, ensure to practice all of the recommended safety measures at all times to minimize risk of COVID-19 to yourself and others. This is also important to remember during break times such as recess.
• If you usually take public transit, consider adapting your commute to minimize social contacts – for example by driving, travelling at low-peak times, or walking or cycling if possible.
• Avoid bringing items to school that would be quickly shared with other children, such as stationery (pencils/pens), books, or toys.
• If your child has T1D and is returning to school, add a good supply of disinfectant wipes, gloves and face coverings (ideally well-fitting medical masks for adults and children, if you can obtain them) to their T1D supplies kit and communicate with teaching and support staff in advance. This means that if your child needs physical assistance at school, the person assisting them will have quick access to protective equipment. More information on diabetes at school can be found here.
• If you have T1D and are returning to work, bring your own disinfectant wipes, gloves and face coverings (ideally well-fitting medical masks, if you can obtain them) along with your usual T1D supplies, and communicate with your employer in advance. This means that if you need physical assistance while at work, the person assisting you will have quick access to protective equipment. In communicating with your child’s school, or your employer, take the opportunity remind them about the life-saving potential of glucagon in the event of severe hypoglycemia.

If a person has had COVID-19, are they immune to getting it again?

Because the coronavirus is new, researchers cannot say for certain that an initial infection guarantees lasting protection. But based on the experience with other viruses, including other coronaviruses, they expect that people who recover will be shielded for perhaps at least a year or two, and from there the immunity might start to wane (but not disappear). Evidence suggests they would also be less likely to pass the virus on to others.

How long will it take to develop a vaccine for COVID-19?

A vaccine for COVID-19 is still many months away, and restrictions are being loosened at this time in Canada without availability of a vaccine. However, intensive research into prevention and treatment of COVID-19 is ongoing around the world, with many trials being led here in Canada.

If you have additional concerns not addressed here, write to us at T1Dquestions@JDRF.ca  or check out breakthrought1d.ca/coronavirus for more information.