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This annual event is one of the largest diabetes conferences in the world, and Breakthrough T1D staff, partners, and funded researchers were in attendance to participate, share new data, and stay current on the state of type 1 diabetes (T1D) research and the pathway to cures.

EASD 2025 shared insights into the latest on beta cell replacement therapies, smart insulins, screening and early detection and making clinical trials more diverse and inclusive across the full spectrum of the T1D community.

Updates on beta cell replacement therapies

Insulin producing cells (known as beta cells) are destroyed by the immune system in type 1 diabetes (T1D). Finding ways to replace these cells and have them produce insulin again in someone with T1D is one of the more promising pathways to cures. There were a number of beta cell replacement therapies discussed at EASD, from investigations in their early stages to research trials which involve humans.  

Vertex FORWARD trial of zimislecel (previously called VX-880) is currently the most advanced stem-cell derived islet replacement trial. Of the 12 individuals that have reached the one-year mark post-transplant, all have resolved severe hypoglycemic events, reduced HbA1c to 7% or less, and 10 of 12 are off insulin.

Breakthrough T1D’s support for Doug Melton, Ph.D. ( USA)—whose proprietary lab-created beta cells are now being advanced by Vertex—goes back decades, both via research grants and an investment from the T1D Fund: A Breakthrough T1D Venture. We look forward to what data emerges when the Phase 1/2/3 trial is completed in the coming months.

Dr. Maria Nostro, Ph.D. (Toronto, ON), a Breakthrough T1D Canada-funded researcher, also presented on her beta cell replacement protection strategy: macrophages. Macrophages are a type of white blood cell that we have learned are present in the developing pancreas. The idea is that the macrophages can be implanted alongside the beta cells during islet transplant and it will help protect and vascularize the cells. This research is still pre-clinical but represents another “shot on goal” to keep these cells safe.

Adocia (France) presented pre-clinical data on a product called AdoShell. This is an implantable device which contains insulin producing beta cells and does not require immune suppression. The company is acquiring funding to move to their first-in-human trial in 2026.  

Allarta (Ontario, Canada), funded by Breakthrough T1D International, also presented pre-clinical data regarding implanted immune-evasive solutions which have the potential to replace insulin for people with T1D. Their unique design has been tested in animal models, with promising initial results. The company has said their products are scalable and there is a clear path to clinical use. 

Orizuru Therapeutics (Japan) presented data on their investigational cell therapy composed of human manufactured islets derived from adult cells that were reprogrammed to precursor cells and eventually islets. This is one of the first cell therapies for T1D derived from reprogrammed adult cells, and this therapy is suitable for manufacturing at large scale. Earlier this year, these cells were implanted into a person with T1D as multiple “sheets” in the abdominal wall. Orizuru expects to share results in the coming months.

Early detection and beta cell protection

A significant discussion at EASD was the importance of early detection for T1D. Presenters discussed benefits, harms, and methods of T1D screening; who should be screened and how often; and how to effectively communicate screening results. In Canada,  CanScreen T1D is a screening research consortium funded by Breakthrough T1D and CIHR to investigate population-level screening. Benefits of screening, such as prevention of diabetic ketoacidosis (DKA) at diagnosis, time to prepare for diagnosis, early control of hyperglycemia that can reduce the risk of complications, and opportunities to delay progression with approved therapies or experimental therapies in clinical trials. 

Disease-modifying therapies are those which alter the course of disease progression, including therapies that are taken in early stage T1D to delay or prevent the onset of T1D. Tzield (teplizumab), which was recently approved by Health Canada is the only regulator-approved biologic that can delay the onset of clinical T1D by an average of two years.

Experimental therapies presented at EASD include:

Anti-thymocyte Globulin (ATG): Results from the MELD-ATG study were presented by Chantal Mathieu, M.D., Ph.D. (Belgium). This therapy, which is routinely used in organ transplants, was investigated at a minimal low-dose in individuals aged 5-25 newly diagnosed with T1D. Participants who received low dose ATG demonstrated clinically significant higher C-peptide levels (an indicator of beta cell function) during the treatment period compared to placebo. This was accompanied by lower HbA1c levels.

Baricitinib: The Australian-run, Breakthrough T1D-funded BANDIT trial reported initial, very promising results last year, and presented updated 2-year results at EASD. In individuals aged 10-30 years newly diagnosed with T1D, Baricitinib (taken orally for 48-weeks) improved C-peptide levels compared to placebo at the 1-year follow up point. When treatment was stopped, C-peptide levels fell and insulin needs increased, demonstrating a progression of T1D without continued treatment. This justifies the need for further studies of longer duration treatment, particularly since the drug is administered orally and well tolerated.

Verapamil: The Ver-a-T1D trial across Europe presented results on the use of verapamil, a commonly used blood pressure medication, for beta cell preservation in newly diagnosed individuals aged 18-44 years. Despite some initial clinical studies that suggested it may protect beta cells, the results of the Ver-a-T1D study showed no significant improvement in C-peptide, insulin dose, or CGM metrics in the verapamil group compared to the placebo group. However, verapamil is still being explored as a high-potential candidate to lower beta cell stress given in combination with immunomodulatory disease-modifying therapies (such as the three listed above) to dampen the autoimmune attack.

Since ATG, baricitinib, and verapamil are already approved for use outside of T1D, they could be cost-effective prevention therapies for early stage T1D.  

New oral and smart insulins

New insulins are being developed to that more closely mimic naturally occurring insulin in the body of someone without T1D. These include both oral insulins and faster acting insulins.

Dr. Nicholas Hunt (Australia) presented initial research into the challenging topic of oral insulin. Initial results from the trial in various animal models showed a dose dependent effect which had a low risk of low blood glucose (hypoglycemia). The company is looking to move to phase 1 human trials next year in Australia. 

Dr. Matt Webber (USA) presented a topic on fast-acting insulins. He has recently been investigating smart insulins that work faster and are responsive to glucose. These insulins would form ‘depots’ under the skin and would be soluble in the presence of glucose. There would be challenges to use this insulin in T1D, as the insulin has a long duration of up to one week, which would increase the risk of hypoglycemia. With funding from the Type 1 Diabetes Grand Challenge, he will continue research to try and develop a once-a-day insulin for people with T1D, which would allow for greater freedom and flexibility in T1D management. 

Improving diversity and inclusion in T1D clinical trials

Data was presented that highlighted the lack of diversity and inclusion in T1D trials globally. Analysis of current research into chronic kidney disease (CKD) in diabetes showed the majority participants were of White-Caucasian background, which is not representative of the current population.

Daniel Newman (UK) a former Breakthrough T1D UK staff member offered his perspective as a Black man living with T1D. He spoke of experiencing diabetes distress and feeling under-represented within T1D research. He amplified that research is for everyone, and how representation matters.  

New EASD diabetes distress guidelines launched

Drs. Richard Holt (UK) and Jane Speight (Australia) presented the first-ever EASD guideline on diabetes distress. Three years ago, the EASD board committed to developing clinical practice guidelines in this area, recognizing how much diabetes distress can affect a person living with T1D.

Diabetes distress is defined as a range of emotional responses to living with and managing diabetes. This can include feeling overwhelmed with the burden of managing diabetes; fear and worries about complications or experiencing a severe low; feeling defeated, discouraged, or burned out when you are not meeting your blood glucose targets despite your best efforts to manage them.

It is important to recognize that living with diabetes distress is not the same as clinical depression. Diabetes distress can be a common response to living with a chronic disease. The EASD guideline aims to support primary care providers and other clinicians to better support their patients affected by diabetes distress.  

The guideline includes specific recommendations for healthcare professionals on regular assessment and management of diabetes distress in adults with diabetes in clinical practice, including use of validated tools to identify diabetes distress and referring to specialist support where needed. The guideline will help to better standardize care for diabetes distress across diverse healthcare settings. It may also help people with T1D to better advocate for themselves with their healthcare providers.

Breakthrough T1D Canada has long recognized the need for holistic T1D care that includes mental health considerations and a better understanding of diabetes distress and is pleased to see this be highlighted at EASD.

Advances in T1D technology

Diabetes technology companies from across the globe attended EASD, discussing their new technology to make managing T1D easier.  

Abbot Laboratories presented new research into their continuous ketone monitor (CKM) which will be integrated into their continuous glucose monitor (CGM) models. Alongside measuring blood glucose, it is important to measure blood ketones for people with T1D. If ketone levels become too high, it can lead to a life-threatening complication called diabetic ketoacidosis (DKA).

This would be a first-of-its-kind device that would enable people with diabetes to continuously monitor glucose and ketones in a single sensor. This device could redefine care for people with diabetes who are at risk for developing DKA. They will be seeking regulatory approval for this device when the clinical trials are completed.  

AccuCheck presented data on a predictive CGM model. This means that the CGM can estimate what your blood glucose level will be in the future (up to two hours) and work with an insulin pump to correct your levels. It also has low glucose prediction and a night-time low prediction function. These could help to significantly reduce the risk of hypoglycemia for people using the device.

These devices are not yet approved or on the market in Canada, but we will provide updates as soon as they become available.

The path to fully closed-loop automated insulin delivery systems

Hybrid closed-loop (HCL) or automated insulin delivery (AID) systems use a continuous glucose monitor (CGM paired with an insulin pump to adjust insulin delivery based on real-time glucose levels. These systems still require mealtime and physical activity announcements. These were recommended for all people with T1D in the recently published Diabetes Canada Clinical Practice Guidelines.

While these devices can be transformative for people with T1D, they can still be onerous to use and fully closed-loop systems aren’t widely available for T1D yet.

In this session, Moshe Phillip, M.D., Katrien Benhalima, M.D., Ph.D., and Charlotte Boughton, M.D., Ph.D., explored the benefits of currently available AID systems and fully closed-loop AID systems on the horizon.

• Based on clinical trial data and real-world evidence, hybrid closed-loop systems improve time-in-range (TIR) and reduce HbA1c levels without increasing the risk of hypoglycemia. This translates to better outcomes and quality of life for people with T1D.
• Different AID systems will work better for different people, depending on preferences for blood glucose management. Because there have been limited head-to-head trials comparing two or more AID systems, there is no evidence that any one system is definitively better than another.
• A clinical trial for the CamAPS HX fully closed-loop AID system in the UK increased TIR by 50% compared to 36% in people using standard pump therapy with a CGM—amounting to three additional hours each day of blood glucose in target range. Participants reported improved mood and sleep, less stress, and reduced diabetes burden. Similar improvements in blood glucose and daily life were reported in adolescents.

Next-generation AID systems under investigation include two or more hormones for optimal glycemic control, artificial intelligence, and “digital twin” simulation tools.

Initial clinical studies using fully closed-loop systems with T1D demonstrated significant improvements in blood glucose control and quality of life. In the meantime, hybrid closed-loop systems offer substantial benefits for people with T1D—and there are commercially available systems to choose from based on individual preferences in Canada.

Updates on heart and eye complications

Reducing T1D complications remains a major research focus area, and we fund research studies aimed at reducing eye, kidney and heart complications resulting from T1D. 

Data from the LENS trial (UK) was presented, which found that fenofibrate—a generic and affordable cholesterol-lowering medication—can reduce the progression of diabetic retinopathy in people with T1D and type 2 diabetes. A follow-up study in the UK found that fenofibrate is a cost-effective option for diabetic retinopathy, especially for those living with T1D. In conjunction with these studies, the recruiting Breakthrough T1D International-funded Protocol AF trial is further investigating fenofibrate in preventing progression of diabetic retinopathy in people with T1D.

Data from the long-running FinnDiane cohort (Finland) were presented on the relationship between cumulative exposure to glycemia or lipids and heart failure, one of the leading causes of cardiovascular mortality in T1D. The study found that both cumulative glycemic exposure (defined as time spent with HbA1c levels > 7%) and cumulative lipid exposure (LDL, triglycerides, and cholesterol) are independently associated with increased risk for heart failure. The publication highlighting these findings includes a call to action for healthcare providers to help people with T1D minimize high blood glucose levels and lipid exposure, and support and encourage the best diabetes management possible to reduce risk for heart complications.

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Breakthrough T1D will be represented by Canadian and International staff at the International Society for Pediatric and Adolescent Diabetes 2025 Conference, which will take place November 5-8 in Montreal, Canada. We’ll provide updates from that research conference that targets the younger cohort of people living with T1D.

It’s never been a more exciting time in global T1D research both in projects aimed at improving lives today and those working tirelessly towards cures and our shared goal of a world free from type 1 diabetes.

Thanksgiving in Canada is often seen as the unofficial start of autumn, the air has turned crisper, and the evenings have a welcoming chill. Many people look forward to cozy season, donning a favourite sweater and feeling the crunch of the leaves under their boots.

But it’s also the start of the unofficial holiday ‘eating’ season and is known for being a carbohydrate-heavy and rich meal. This can bring with it stress for people with type 1 diabetes (T1D), particularly those who are new to living with the disease. But with a little preparation, you can enjoy all the holiday has to offer.

Below are some tips and suggestions to make managing Thanksgiving meals with T1D a little easier, along with a carb count table of some of the more commonly eaten foods, snacks and desserts.

Consider downloading a carb counting app, like Roche’s mySugr app, Diabetes M, Quin, which can be connected to a flash glucose sensor (Quin is free but only available on IOS) or apps from your device manufacturers. Visit the website of the manufacturer of your device to find out more.

Carbs and Cals lets you take a photo of your meal, and the app searches its library of over 19,000 foods to give you the nutritional information you need.

MyFitnessPal app includes a database of over 14 million foods so you can find out nutritional information about what you’re eating, including the amount of carbs. It has a handy barcode scanner for ready-made products, and you can also add your own foods.

There is a free version and a paid version which has more features. The app is compatible with iOS and Android.

If you’re not preparing the meal, speak to the host and ask what they’re planning on making. Being armed with this knowledge ahead of time can help you better prepare, including meals and snacks you’ll eat in advance of the Thanksgiving dinner. Knowing what’s going to be on offer can help you feel better prepared and more in control over your carb consumption. You could also offer to bring a lower carb side dish, or another protein.  

Don’t hesitate to use measuring cups if you’re still not confident in eyeballing portion sizes. Having more precise measurements can help with insulin dosage and help you stay in range.

You can still enjoy more carb heavy dishes like mashed potatoes, or candied yams but consider making more of your plate the lowest carb options, like green vegetables and proteins. If you’re going to partake in alcoholic beverages, make sure to factor them into your meal-planning as well.

Why not take a family walk after the Thanksgiving meal? A leisurely walk after a big meal is beneficial to everyone, and it’s a nice time to relax and bond with guests while also working off some of what you’ve eaten.

Thanksgiving is known as the holiday of relaxing – and eating. But T1D doesn’t take the day off for the holiday. However, with some preparation, you can feel comfortable, empowered and enjoy Thanksgiving as it’s meant to be.

Thank you to Beyond Type 1 for these commonly eaten holiday food carb counts.

Beyond Type 1 has a full page of resources to make navigating the holidays a little easier: https://beyondtype1.org/celebrations-holidays/

Managing T1D is a challenge at any time but can be made easier when you’re armed with information to help you plan accordingly.

So, grab your favourite sweater or flannel shirt and enjoy all Thanksgiving has to offer with confidence and excitement.

* Please note that your portion sizes may vary, and your carbohydrate counts will need to be adjusted accordingly.

Mains

Item	Amount	Carbohydrates
Turkey	Any	0g
Ham	Any	0g
Beef	Any	0g
Chicken	Any	0g
Duck	Any	0g
Goose	Any	0g
Lasagna	1 Cup	30g
Brisket	1 oz.	0g

Sides

Item	Amount	Carbohydrates
Mashed Potatoes	1 cup	30g
Roasted Potatoes	1 cup	28g
Sweet Potato	1 Med.	28g
Candied Yams	1/2 cup	45g
Sweet Potato Casserole with Mini Marshmallows	1/3 cup	30g
Green Beans	1/2 cup	4g
Green Bean Casserole	1 1/2 cup.	9g
Corn	1/2 cup	9g
Sauerkraut	1 cup	6g
Glazed Carrots	1/2 cup	25g
Brussel Sprouts	1/2 cup	4g
Cheese	1 oz.	0-1g
Stuffing	1/2 cup	20g
Cranberry Sauce	1/4 cup	25g
Gravy	1/2 cup	5g
Dinner Roll	1	20g
Biscuit	1	25g
Cornbread	1 piece	28g

Deserts

Item	Amount	Carbohydrates
Sweet Potato Pie	1/8th Slice	35g
Minced Meat Pie	1/8th Slice	55g
Pumpkin Pie	1/8th Slice	35g
Apple Pie	1/8th Slice	45g
Pecan Pie	1/8th Slice	60g
Meringue Pie	1/8th Slice	50g
Ginger Snap Cookies	4 (1 oz.)	23g
Shortbread Cookies	4 (1 oz.)	21g
Chocolate Chip Cookies	2	20g
Peanut Butter Cookies	2	20g
Sugar Cookies	2	22g
Meringue Cookies	6	15g
Cheesecake	1 pc. (1/6)	20g
Vanilla Ice Cream	1/2 cup	16g
Chocolate Ice Cream	1/2 cup	18g
Whipped Cream (Unsweetened)	2 tbsp.	2g

Drinks

Item	Amount	Carbohydrates
Hot Cocoa with Water	1 cup	15-20g
Hot Cocoa with Milk	1 cup	30g
Spiced Apple Cider (Non-Alcoholic)	1 cup	30g
Hard Apple Cider	12 oz.	15-30g
Wine (White or Red)	5 oz.	4g
Champagne	5 oz.	3g
Regular Beer	5 oz.	12g
Light Beer	12 oz.	6g
Spirits	1 oz.	0g

Dr. Joshua N. Awoke, Associate Fellow of the Higher Education Academy (AFHEA), is the fourth recipient of the J. Andrew McKee Fellowship in Type 1 Diabetes (T1D), jointly funded by Breakthrough T1D Canada and the Stem Cell Network (SCN) based at the Breakthrough T1D Centre of Excellence at the University of British Columbia (UBC).

The J. Andrew McKee Fellowship in Type 1 Diabetes was developed to accelerate Canadian research, develop talent and augment Canada’s global leadership in T1D research. The Fellowship Program is named in honour and memory of John Andrew McKee, who was Past President and CEO at Breakthrough T1D (then known as JDRF) and a long-standing member and Chair of SCN’s Board of Directors. Andrew played a significant role in developing the future of both organizations and believed deeply in the important role of science in making Canada a better place for all.

Dr. Awoke will be joining the Breakthrough T1D Centre of Excellence from Nottingham Trent University (United Kingdom) where he was a PhD Researcher in Biomedical Science with focus on developing new therapeutics for metabolic diseases and their complications.

Dr. Awoke will be researching islet prohormones as biomarkers of disease prediction and response to immuno-and cell therapy, which has the potential to impact clinical practice and improve T1D prediction and treatment.

Dr. Awoke took some time out of his very busy schedule to discuss his research and what he hopes to accomplish through the Fellowship. 

Tell us a bit about your background:

I completed my BSc in biochemistry at Ebonyi State University (Nigeria). This offered me an excellent background knowledge on the molecular basis of disease development. Then, I went to the University of Aberdeen (Scotland), for my MSc in clinical pharmacology, where I engaged in studies related to obesity and diabetes for my research project.

Both degrees created the much-needed scientific curiosity and passion to engage in more in-depth studies to understand the molecular basis of obesity and diabetes. Then, I did my PhD in biomedical science at Nottingham Trent University, where I investigated the anti-inflammatory actions of carnosine in metabolic diseases.

I am now taking up postdoctoral training at Breakthrough T1D Centre of Excellence, UBC, where I will investigate islet prohormones as potential biomarkers of T1D prediction and response to immuno-and cell therapy. I am hopeful this will contribute positively to clinical practice and improvement in T1D, prediction, prognosis, and management.

What made you apply for this Fellowship?

As my PhD research was winding down, I was gearing up to move forward to the next phase of my career development, which is postdoctoral research training. More to this is that my MSc and PhD degrees were all done in the UK, so, I wanted to go elsewhere, like Canada, which is also a global leader in diabetes research. Therefore, I looked out for postdoctoral fellowships in Canada in the field of diabetes research like the J. Andrew McKee Fellowship in Type 1 Diabetes. This prestigious fellowship is open for young talented early career researchers like me from anywhere in the world to come to Canada and contribute to Canada’s global leadership in T1D research. 

So, I believed it was the ideal fellowship for me, and which will spark my dynamic career progression in T1D research in addition to my overall career goals and aspiration of becoming an independent researcher and a PI in the future.

What drew you to type 1 diabetes as a research field?

Sadly, I had a lovely foster sister who passed away as a teenager due to T1D. Growing up, I could still remember how she solely depended on insulin administration and how crucial the situation was anytime her supply of insulin was exhausted.

This sparked my interest, curiosity, and passion to know more about T1D. I also know other families and friends in my community who live with T1D and the enormous burden of the disease on them. I therefore thought that if someone could discover insulin that has continued to help millions of lives globally, then maybe I could help save additional lives through my research in T1D. So, I believe my research could bring great relief to those families with T1D and increase their quality of life. I know that perhaps seems too ambitious, but where there is a will, there is a way.

Tell us more about the research you will be conducting at the Breakthrough T1D Centre of Excellence at UBC?  

My research at UBC will focus on the islet prohormones as biomarkers of T1D prediction, prognosis, and response to immuno- and cell therapy. Firstly, insulin and islet amyloid polypeptide (IAPP) are the key hormones produced by islet beta cells.

These hormones are implicated in T1D due to their key roles in regulation of glucose metabolism and homeostasis. Interestingly, they are first produced as precursor peptides known as proinsulin and proIAPP. However, only healthy and differentiated beta cells can properly process these precursors to their fully mature and active forms. Incompletely processed proinsulin and proIAPP may therefore correlate with beta-cell dysfunction in T1D and may also be useful in predicting progression to T1D, response to immunotherapy, and beta-cell transplant failure.

So, I will utilize several advanced techniques at the Breakthrough T1D Centre of Excellence at UBC to discover, validate, and assess these prohormones in diverse lab/clinical T1D models. The overall goal is to utilize them as effective biomarkers to improve T1D prediction and prognosis, which will positively impact clinical practice in T1D treatment and management.

How is the Breakthrough T1D-SCN fellowship going to advance this research?  

This fellowship is so amazing and all-encompassing. I like the fact that it is tailored towards both the training of the Fellow and doing the actual research.

I will primarily be supervised by Dr Bruce Verchere whose lab has already shown strong preliminary evidence that some forms of incompletely processed proIAPP and proinsulin are disproportionately elevated in persons with T1D as well as in recipients of islet transplants prior to graft failure.

So, this fellowship will provide the needed resources to investigate these prohormones on more diverse and larger scale lab/clinical models, which have not been done before. Another fantastic aspect is that through the framework of this fellowship, we will also collaborate with other Breakthrough T1D Centre of Excellence labs in stem cell differentiation and beta-cell function assessment to effectively realize the overall goal of this project.

What are you most excited about with your move from the UK to Vancouver?

Firstly, UBC is within the top tier universities known for research excellence in various fields globally. They are also renowned for various research breakthroughs in diabetes both in Canada and globally. So, I am super excited to begin my postdoctoral training at such a world-class university known for research excellence as I believe it will have a huge impact on my career advancement.

Then, I really love the natural beauty of coastal areas and the beautiful mountain views in Vancouver. So, I can’t wait to enjoy the adventures of looking and walking through these amazing natural wonders outside my lab/work hours in Vancouver. Finally, I have learnt from my friend that Vancouver is a very diverse and inclusive cosmopolitan city with different ethnic nationalities. Therefore, it will be amazing to meet and work with people from diverse multicultural backgrounds in Vancouver.

***

Breakthrough T1D Canada is grateful to Dr. Awoke for his time and congratulates him on the fellowship award. Thank you, Dr. Awoke for contributing to critical cure-based T1D research and further strengthening Canada as a global leader in this field. 

On October 23, 2025, some of Canada’s top business leaders are trading boardrooms for bright lights—all to help accelerate breakthroughs in type 1 diabetes (T1D) research.   

At Humour Me, they will step out of their comfort zones and take the stage with original stand-up comedy routines vying for the title of “Funniest Amateur”, while raising critical funds to support  Breakthrough T1D’s $100M Campaign to Accelerate.  

Organized by the David Goodman Youth Community Trust and, in 2025, presented by Brookfield, Humour Me applies a twist to the typical stand-up routine by bringing together professional comedians and influential, high-profile amateurs to perform together.  

This year’s headliner is none other than Jeremy Hotz. One of the most unique stand-up comics working today, Canadian-born Jeremy Hotz is a proven international success. With sold-out Canadian tours, as well as performances all over the U.S., Europe and Australia, Jeremy continues to grab audiences with his completely original and confused, yet very astute, observational comedy. He also boasts numerous awards for his comedy, writing, and performances on TV shows like The Newsroom.  

An event with a legacy of giving back, now directed to T1D research 

Humour Me is an iconic comedy fundraiser that has generated over $25 million for worthy causes over the past 15 years, and we’re thrilled to turn the spotlight on T1D research this year on October 23 at the Elgin Theatre in Toronto.   

Lori Pearson, Vice-Chair of presenting sponsor Brookfield and one of the brave amateur comedians, shares her family’s story and why the proceeds from this event are important to them: 

 

“When our daughter Ginny was 7, her life changed forever, as did our family’s. Ginnie was extremely sick, so we took her to SickKids Hospital, where she was diagnosed with type 1 diabetes. About a week later, when we had returned from the hospital, I was sitting with Ginny when she asked, ‘So, when do the needles stop?’ It broke our hearts. Fast-forward over 20 years to today, and Ginny still battles with the daily highs and lows of T1D. Thanks to donor-funded research, she now wears an insulin pump and a continuous glucose monitor, so there are fewer needles and pokes. However, the constant fear of complications, carb-counting, and the mental health impacts of the disease will always live with her until we have a cure. That’s why giving to T1D research is important to us, whether it leads to a cure in the long-term, more short-term ways of improving disease management, or preventing it for those who have not been diagnosed yet.” 

Lori is terrified by the thought of delivering a stand-up routine in front of hundreds, but says she is willing to step WAY out of her comfort zone for the cause – a sentiment shared by most who brave the legendary Elgin stage at Humour Me. Other comedians include Andrew Oliver, whose sister Vanessa and late father Peter famously left their own comfort zones at ground level when they courageously camped atop flagpoles for T1D research.   

The 2025 Humour Me comedians are: 

To see these brave souls rack up the laughs—and dollars—for T1D research, consider sponsoring the event, taking place Thursday, October 23, 2025, at Toronto’s Elgin Theatre at 7 p.m. (doors open at 6:30 p.m.). Learn more at https://humourme.ca/sponsorships/  

Learn where to find resources and information to help support your child with T1D thrive in their new school year.

Receiving a diagnosis of type 1 diabetes (T1D) for your child can be an overwhelming time for parents. Learning to manage the disease and adjusting to the new normal can bring significant stress to a family. And even when a family has adapted to life with T1D, new stages in school can bring with them additional stressors.

T1D is a chronic autoimmune disease where the body attacks the cells in the pancreas that are responsible for insulin. There are approximately 300,000 Canadians living with T1D in Canada. Canada has one of the fastest growing rates of diagnosis in the world, and it’s not known why, and the highest diagnosis demographic are youth aged approximately 11-14 years old, although it can be diagnosed as young as infancy and into adulthood. There is currently no way to prevent the onset of T1D, and there are no cures.

People living with T1D must constantly measure blood glucose levels and administer insulin externally, either via multiple daily injections, smart pens or insulin pumps every single day in order to stay alive. It’s a steep learning curve, and one that can change day-to-day – which can cause additional anxiety when it’s time for a child with T1D to start a new school year.

And even with these tools, the risks of hyper or hypoglycemic episodes (blood glucose going too low or high) are always present. This requires carrying fast-acting sources of sugar everywhere you go and ensuring there are always snacks available. This could mean your child has to eat at times when their fellow students don’t. This feeling of being ‘different’ can make school a scary place for a child with T1D. Talking to their teachers ahead of time and having a few trusted friends in their class can help.

School transitions also come with new challenges. Moving from elementary to middle or high school can mean your child might want to exert more independence over their T1D management, with less parental oversight and involvement. And while this is an important step in any child’s path to autonomy and young adulthood, it doesn’t make the transition any easier for the parents or the worry they feel any easier.

Both Breakthrough T1D Canada, and in particular Diabetes at School are great places to start. On their websites, parents can find a wide range of checklists, training materials to offer educators, and resources to help students feel more prepared and empowered to manage their T1D while at school.

Resources include materials to help parents:

• Prepare for back-to-school when your child has type 1 diabetes 
• Ensure your child’s school is prepared, and where to find resources 
• Educate teachers and administrators about the rights of students with type 1 diabetes at school 
• Advocate for your child or youth with type 1 diabetes 

Breakthrough T1D Canada is the largest non-profit in Canada driving towards cures for T1D while making everyday life better for people affected by T1D. Its advocacy program Access For All connects with all levels of government to ensure that diabetes technologies like advanced glucose monitors and insulin pumps are universally accessible and affordable for all Canadians with T1D. These are life-saving devices that improve disease management and outcomes and can make the transition back to school a little less fraught.

Breakthrough T1D Canada also offers a number of support services to help families through a new type 1 diabetes (T1D) diagnosis, provides resources to better navigate T1D and make personal connections with those who share similar experiences to earn from those who have been there already. Breakthrough T1D Canada wants to make sure that at whatever stage of the T1D journey a family may be on, they never feel alone.

Starting a new school year brings with it a unique set of challenges for any student, and this is only heightened when you add type 1 diabetes. But with the right tools, resources and support, you can send your child off to school with confidence.

To learn more, visit www.breakthroughT1D.ca or www.diabetesatschool.ca.

Breakthrough T1D Canada was proud to have representatives included in this important advocacy event.

The Breakthrough T1D Children’s Congress advocacy program organized by Breakthrough T1D International in the United States, was inspired by a boy from Massachusetts named Tommy Solo (one of the type 1 diabetes (T1D) role models at the event). At age nine, he asked his mother, “Why can’t kids go to Washington and tell their Representatives about what it is like to have type 1 diabetes and let them know that we want scientists to find a cure?” His mom and other volunteers agreed, and in 1999, the first-ever Children’s Congress took place in Washington, D.C.

Since then, 12 successful Children’s Congresses have been held, one every other year, and more than 1,000 kids with T1D have served as Delegates. Breakthrough T1D Children’s Congress has been essential to securing continued government funding of T1D research and to raise awareness of the daily burden of Americans living with this serious autoimmune disease.

The 2025 selected Delegates represented all 50 states and the District of Columbia, as well as Breakthrough T1D’s five International Affiliates (Australia, Canada, Israel, the Netherlands, and the United Kingdom).

Delegates form lifelong friendships, meet T1D role models, develop leadership skills, and leave Children’s Congress empowered to use their voices for the change that will improve their lives and the lives of all people affected by T1D. 

This year, the Children’s Congress took place between July 7-9 and brought over 170 children between the ages of 4-17 to Washington DC to meet face-to-face with US lawmakers and advocate for change.

Advocacy priorities focused primarily on ensuring the renewal of the Special Diabetes Program, a critical program that provides dedicated funding for T1D research at the National Institutes of Health. First created in 1997, $3.5 billion has been provided to date and has yielded at least $50 billion in federal healthcare savings.

Breakthrough T1D Canada’s ambassador representative was Emily Gervais, a 12-year-old from Edmonton, Alberta. Since her diagnosis at age 8, Emily and her family have been active in raising funds for Breakthrough T1D Canada and T1D research, including events like basketball tournaments, raffles, sponsorship events, and fundraisers.

As an advocate, Emily also involved her whole school in raising awareness for T1D by hosting a cotton candy sale. She has also volunteered with her family at the 2024 Edmonton Breakthrough T1D Walk, along with fundraising, has spoken at the Edmonton Breakthrough T1D Ride and has participated in Kids for Cure in the Community, advocating to local leaders for increased T1D awareness and support.

Emily prepared for the Children’s Congress by creating a scrapbook to share her T1D journey including her diagnosis, the devices she uses and the people who support her, her hobbies, and what a cure would mean to her. This scrapbook was left at the Canadian Embassy for the Canadian Ambassador to review.

Once at the Children’s Congress, Emily held a meeting at the Canadian Embassy, participated in meetings at offices of US Senators and Representatives on Capitol Hill, was part of the T1D Role Model Town Hall: https://cc.breakthrought1d.org/t1d-role-models/, a US Senate Hearing: https://www.appropriations.senate.gov/hearings/a-future-without-type-1-diabetes-accelerating-breakthroughs-and-creating-hope and was the Canadian representative for the announcement of the first ever Barbie with type 1 diabetes.

Emily also made sure that Canadian-specific advocacy needs were included, when at the Canadian Embassy she shared how important it was to continue funding research for the approximately 300,000 Canadians living with T1D.

The role models she met with, the relationships she made, and the skills she developed at the Children’s Congress will all stay with her as she continues to advocate for the T1D community in the future.

In her own words: “Meeting new friends, being one of the first kids to get a T1D Barbie and going to the Senate hearing was something I will never forget. One of the best parts was when an alarm (her CGM notifying her of low blood glucose) beeped and it felt normal. No stares from other kids, just people checking if it was them! I really hope the SDP (special diabetes program) is renewed so we can get more money for research and a cure one day soon!!” 

Breakthrough T1D Canada staff member Joey Wong was also in attendance at the Children’s Congress, sharing that by attending Children’s Congress, he saw firsthand how valuable it was for children diagnosed at an early age to find that they belonged to a community.

Delegates saw that they were not alone and there were others their age that had similar experiences as they did living with this disease. Younger delegates felt empowered to participate in event activities, and older delegates were not shy in acting as mentors. For some, the friendships they made will be life-lasting bonds.

They also benefited from hearing from T1D Role Models with backgrounds in journalism, athletics, fashion, and entertainment, who answered questions from delegates. These are inspiring individuals who, despite living with T1D, continued pursuing their passions and excelled in their fields. The Role Models shared their own personal T1D story and how they manage and overcome the disease in their own lives.

He was moved by a T1D community united in using their voices to advocate and drive positive change.  Delegates and parents alike were motivated to share their story with anyone willing to listen and learn more about T1D. They were more than happy to explain the daily challenges of the disease, dispel any misconceptions and/or biases, and bring attention to how Congress can help.

During the same week the Children’s Congress took place, new legislation was introduced with bipartisan support to reauthorize the Special Diabetes Program, which was set to expire in September.

Regardless of age, Breakthrough T1D advocates continue to impress. Some delegates have little to no experience in advocacy and are nervous because of it, but it does not show in their meetings and instead, they put on a brave face when meeting with lawmakers and their staff. During meetings, it was clear that delegates are passionate about creating awareness, articulate in voicing their opinions, and determined to make a difference.

Kids for a Cure

Breakthrough T1D Canada holds our own advocacy event like the Children’s Congress, called Kids for a Cure, where young advocates living with T1D from across Canada to meet federal lawmakers in Ottawa to raise awareness of the disease and advocate for funding research progress towards a cure.

Kids for a Cure advocates are provided training and develop leadership and communication skills all while advocating for federal support of T1D research.

Advocacy remains one of the most important areas of Breakthrough T1D Canada’s work in improving the lives of Canadians living with T1D. Breakthrough T1D advocates are crucial in raising awareness, driving progress, and advancing breakthroughs.

By amplifying the voice of the T1D community, Breakthrough T1D Canada has been successful in bringing positive policy changes in Canada including:

• Breakthrough T1D-CIHR Partnership to Defeat Diabetes
• Disability Tax Credit and Canada Disability Benefit
• Framework for Diabetes in CanadaNational Pharmacare Program
• Improved public access to T1D technologies like insulin pumps and advanced glucose monitors

Kids for a Cure returns in 2026 and while it is still too early to start accepting applications, there will be plenty of opportunities for advocates.

Make your voice heard now:

Breakthrough T1D is engaging with Canada’s federal government, and you can use your voice to let your Member of Parliament know how they can support the T1D community in Canada. Advocates looking to get involved can do so by participating in our Federal Outreach Program Advocacy in Action and meeting with their Member of Parliament. Click here to sign up: BreakthroughT1D.ca/get-involved/advocate/

Breakthrough T1D Canada Board Member Matt Varey rode across Canada in support of type 1 diabetes (T1D) research

On May 3, Matt Varey, a longtime volunteer with Breakthrough T1D Canada (formerly JDRF) and current Co-Chair of the Breakthrough T1D International Board, began a 61 day, 7400km+ journey to cycle across Canada. At 61, Matt had recently retired from a long career with RBC and though he has no personal connection to type 1 diabetes, he has become a passionate advocate over the past 20 years for Canadians living with T1D. Matt’s goal was to raise $500,000 and he surpassed it, raising over $535,000 and counting.

Matt’s journey saw all four seasons of weather as he crossed the country, and he endured excruciatingly long days, injury, and with no rest stops, truly tested his own mental and physical endurance on the road. Travelling with Matt was his wife, Andrea, and their dog, Handel, and they were joined by several of Matt’s lifelong best friends along the way. Matt’s friends Kirk, Stew and Steve had his back from the first day Matt and AJ decided on this journey, and they dropped everything to join him on the road; the mark of true friendship. Their team was small but what they’ve accomplished for the type 1 diabetes community has been extraordinary.

On July 2, Matt finished his ride in Halifax by dipping his tire in the Atlantic Ocean, book-ending a similar dip on May 3 in Victoria in the Pacific Ocean at the start of his journey. It was the emotional culmination of an audacious but incredibly meaningful journey.

Breakthrough T1D Canada spoke with Matt following his Ride to discuss his amazing once-in-a-lifetime personal journey and achievement in support of critical T1D research and support for the T1D community.

Breakthrough T1D Canada: How are you feeling today?

Matt: I feel tremendous. And let me tell you that the reason I’m feeling tremendous is because AJ and I were blown away by the absolute kindness, generosity, and sheer humility of society. That’s what I think about every day. The generosity we experienced everywhere we went across this country. We were both just so incredibly touched by how much people truly cared about the mission and the purpose. So, that’s how I feel.

Breakthrough T1D Canada: What surprised you the most?

Matt: Oh wow, several things surprised me, and I will share them in no particular order. Mother Nature surprised me. She thew so many different environments at us, you just had to have this ability to adapt and not get upset. I was continually surprised by how she can change the environment so quickly, and so sharply. This surprised both my wife and me.

Mother Nature can be relentless but at the same time, she can create serenity in the mornings, and at night. Really, the whole natural aspect of the journey, from the birds waking me up in the morning to the birds putting me to bed at night. The noises, the sound of the wind through the trees.

And then as I rode through tougher terrain, and through the areas heavily impacted by forest fires, it seemed to me that the trees were crying, We saw Mother Nature angry with the forest fires. You just saw the forest was sad, tired and dry. And when we saw the smoke, I thought it was Mother Nature crying. And that was unexpected but moving in its own way.

I thought I understood before, but I was in fact still surprised also by the beauty and diversity of Mother Nature, by the sheer beauty of Canada that I had not experienced until this ride. Cycling through just some of the most beautiful places on earth, Northern Lake Superior, the sheer beauty of the Saint John River Valley, the beautiful white churches in southern Quebec, your senses come alive when you’re on the bike, I didn’t have modern day distractions. So, all my senses were on high alert, I could truly smell a farmer’s field, or the scent of fresh cut grass.

And then on the other side of that – I was surprised by how noisy society is. The constant noise of being so close to cars, transport trucks, so close to you all day. You could sense they were coming closer before they did or feel the respect and distance they might give because I was on a bike. You pick up societal noises so much more.

Another thing that AJ and I were surprised and touched by was the sheer trust that human beings give you despite not knowing you. How decent is that? You get a flat tire, there’s no bike shop in a rural community, just a truck stop – and they don’t fix bike tires. Except they do! They see me, a person out on the road needing help, and they jump to give that help.

We were in Lake Louise, Alberta, it was two degrees, and I was cycling through rain and sleet, and my chain broke. And people, they just dropped everything to help. As soon as we mentioned the purposeful journey we were on, people trust you immensely, and want to be a hand on your back, they want to be someone who uplifts and supports you.

I was doing my washing in a laundromat, and a man saw my shirt and asked me what it meant, what I was doing? After telling him, he reached into this pocket to take out $50 and give it to me with the request that I do good things with it. I was so moved by the enormous trust that people give you.

The other surprise was RBC. I always knew it was a purposeful organization; I knew it had a cultural heart and soul, but this was a whole new level. My former colleagues and friends, and the grassroots support they provided, and I’m retired – I don’t work there anymore! But it was just a steamroll of giving from coast to coast.

Nobody said they were too busy for the activation events (pitstops) they came out on in the middle of the day; they came out on weekends. They gave their time and energy in support of this purposeful journey, and that helped drive me. RBC proved to be a deeply human organization, all these folks had a choice, to go about their life, go about their job – they interrupted both to come out and show support.

And of course, we were surprised by the sheer emotions, and how much it impacted us both. Not everyone knows the details of that.

The Breakthrough T1D ambassadors, each one imprinted on me in a different way. AJ and I, we know that if you had T1D, you don’t have a choice but to be courageous. You must be every day. But what surprised us was their quiet determination, their poise, and how they move forward with positivity. How they truly believe that tomorrow is going to be better than today. It took our understanding about living with T1D and what that entails to a whole new level. And that too helped drive both of us every day.

Breakthrough T1D Canada: What did you learn on your journey?

Matt: You learn a tremendous amount about your body, both physically and mentally. It tells you physically, when you can power through, that you have more fuel in your tank. You know before you even get on the road when you are going to have a tough day. Your body gets mad at you. It doesn’t want to do the same thing for 60 straight days. It surprised me that my body gave me two million pedal strokes, but it got mad at me at the same time. It most definitely was angry at me more than once. But I did learn this – you always have more fuel in your tank than you think.

I learned that I needed to just really focus on the positives. When I was so tired and didn’t want to go another kilometre. I would look down at my arm and at the Breakthrough T1D tattoo I got before starting this journey, and I would think to myself ‘I don’t want to do this, but yes I can’. My mind and body taught me so much for so many varied reasons.

Breakthrough T1D Canada: How do you feel about your connection to the T1D community now?

The first word that intuitively comes to mind is that they are even more courageous than I realized over my two decades with this organization. The organizational heart of Breakthrough T1D, I always say that a mind can be convinced, but a heart needs to be won. And when you have both, like Breakthrough T1D does – you can do anything. It became even more apparent what a people-led and purposeful organization this is. And then getting to meet Ambassadors, parents of children with T1D, or even people my age who have been living with this disease for decades. It gave me confidence, and it gave me hope.

Listening to Jessica Diniz (President and CEO of Breakthrough T1D Canada), Aaron Kowalski (President and CEO of Breakthrough T1D International) or board members – it just reinforced for both me and AJ that Breakthrough T1D is a family. It’s not simply an organization, it’s a family and everyone is connected because they are traveling on the same journey. Despite the difficulties of my specific journey, they came together with these family-like bonds. There are very few true bonds left in business. And Breakthrough T1D is a family from coast to coast at every level.

And we want to recognize as well the tremendous support of Katie, Lynne, Dennis and everyone at Breakthrough T1D Canada who worked tirelessly on this journey too. We have never known such a culture of support as the one at Breakthrough T1D.

Breakthrough T1D Canada: Any final thoughts?

Matt: My wife AJ is the most remarkable person that I have ever known. And what she did – for this journey, for me, was the most selfless act that I have ever known or seen or will ever experience. Without her, there was absolutely not a hope that I – but I mean we – could have done this journey. I love her dearly, but this took it to a whole new level.

Out of everything, I will remember what she did more than anything else. Life is about memories, and what I’m going to be left with are memories for life that I will never forget, and that have changed me.

This journey changed me. It made me look at things even more positively. We live in such a remarkable country, which is so kind and so beautiful in its soul. I could only experience that beauty by seeing it replicated over and over – in small towns, in big cities, in bike shops, pastry shops, restaurants, anywhere we went. The circulatory system of this country just pumps decency everywhere. I feel blessed to have experienced it and my gratitude can’t be properly expressed.

It’s also amazing how you can connect with society through social media. I had never used it before this event. But throughout my ride, I would read the comments on LinkedIn, especially when I was tired and didn’t want to get up, didn’t want to get back on my bike. But the humans on the other end would help keep me going. I never knew I could feel humanity that way through a computer. So, thank you to everyone who left me a note and helped fuel my commitment to this purposeful journey. You did more for me than you will ever realize.

I’m also so appreciative that Breakthrough T1D gave me and AJ the opportunity to do this, and I feel incredibly blessed and just so grateful to everyone at this organization, to the people I met out on the road, to the volunteers, to the ambassadors and to everyone who supported us along the way. Thank you. From the bottom of my heart – thank you.

***

Breakthrough T1D once again extends its enormous gratitude to Matt and AJ, to the volunteers, staff and everyone at RBC who contributed to the incredible success of Coast to Coast for Cures.

To learn more: https://breakthrought1d.akaraisin.com/ui/CoastToCoastForCures

The American Diabetes Association’s 85^th Scientific Sessions were held from June 21- 24^th, 2025. The research presented at ADA covers all areas of type 1 diabetes (T1D) developments, including devices, adjunct therapies and the latest in cell therapies.

Updates in cell therapies research

Dr. Andrew Pepper (Edmonton) presented on vascularization strategies to increase the survival and functionality of transplanted islets. The implantation of a biomaterial under the skin will trigger the immune system and initiate a foreign body reaction, which results in the formation of blood vessels and structural components around the foreign object. Removal of the object leaves a hollow pre-vascularized core suitable for islet transplantation. This process can be optimized by using a biodegradable material, so no removal is required, and by the addition of “accessory cells” such as stem cells that are programmed to form blood vessels to help maintain a vascularized environment for islets.

Most Pressing Challenge in Cell Therapy: When the panel of experts was asked about the biggest hurdle to bring cell therapies to people, the answer was unanimous – removing immunosuppressants while maintaining efficacy and safety. 

This is a primary area of focus for Breakthrough T1D and the aim of many ongoing projects by Canadian researchers with Breakthrough T1D funding. One example is work led by Dr. Andras Nagy (Toronto) and Dr. Tim Kieffer (Vancouver) presented at ADA:

Dr. Nagy’s lab has identified eight immunomodulatory genes that, when modified, can cause transplanted cells to be ‘cloaked’ and evade immune rejection. The work presented at ADA demonstrates that Dr. Kieffer’s lab successfully incorporated these gene edits into human islets derived from human embryotic stem cells. When the cells were put into a petri dish with other immune cells, they survived the immune response that kills un-modified islets. This approach needs to be tested in an animal model before moving to human trials.

Updates on Vertex’s stem cell therapy, Zimislecel (VX-880)

Dr. Michael Rickels (Pennsylvania) presented on Zimislecel (VX-880) – a stem cell-derived islet therapy that requires immunosuppression, which is infused into a vein in the liver in people with T1D who have impaired hypoglycemic awareness and severe hypoglycemic events.

The phase 1/2 clinical trial, which is part of the ongoing pivotal phase 1/2/3 FORWARD-101 trial, is complete. Twelve participants received a single infusion of a full dose of cells and were followed for at least one year.

All 12 participants achieved the primary endpoint, which was elimination of severe hypoglycemic events and HbA1c levels less than 7%. 10/12 (83%) participants are insulin independent.

All 12 participants demonstrated sustained insulin production as measured by C-peptide, reduced external insulin therapy use, and achieved greater than 70% time in range. Mild to moderate adverse events were consistent with the immunosuppression regimen, infusion procedure, and complications from T1D.

These data were published in the New England Journal of Medicine and represent further evidence of the curative potential of manufactured islet transplantation for T1D. Breakthrough T1D’s support for Doug Melton, Ph.D.—whose proprietary lab-created islets are now being advanced by Vertex—goes back decades, both via research grants and an investment from the T1D Fund: A Breakthrough T1D Venture.

Read more about Vertex updates: https://breakthrought1d.ca/exciting-updates-from-vertex-stem-cell-based-therapy-clinical-trials/

6-month update on Sana Biotechnology’s immune-evasive islets

Dr. Per-Ola Carlsson (Sweden) presented data from Sana’s donor-derived islet therapy engineered with hypoimmune (HIP) technology showing that the cells can evade the immune system without immunosuppression. These cells were implanted intramuscularly in a first-in-human study into a person with T1D with no measurable insulin production.

Six months post-transplant, this person is consistently making their own insulin, as measured by C-peptide levels. A Mixed Meal Tolerance Test (MMTT) confirmed that these cells are not only surviving but also responding to changes in blood glucose levels. The person still requires external insulin therapy because they received a smaller dose of cells than the dose that would be required to achieve insulin independence. They did not experience any serious side effects, so the cells and procedure appear to be safe and well-tolerated.

This is a promising first step toward a functional cure for T1D that does not require immunosuppression. Sana Biotechnology is planning on applying this technology to manufactured islets. Sana has received support from the T1D Fund to advance their HIP technology in islets, and Breakthrough T1D continues to work closely with them.

Read more about Sana here: https://breakthrought1d.ca/cell-therapy-first-transplanted-islets-working-without-immunosuppressives/

Key Takeaways

Cell therapies are making significant headway in clinical trials, and some people receiving stem cell-derived islets become insulin independent. Researchers are tackling the biggest challenges for optimizing islet transplantation, including large-scale manufacturing, ensuring cell survival, and preventing detection by the immune system.

Updates on disease-modifying therapies

Dr. Heather Denroche (Integrated Nanotherapeutics) presented work on their lipid nanoparticle approach that can deliver antigen-specific immune therapy for T1D. This is done with a combination “vaccine-like” product that uses their proprietary multi-cargo lipid nanoparticles platform to co-deliver mRNA expressing certain islet-proteins (to enable antigen-specificity) and small molecule immunomodulators (to switch off the harmful autoimmune attack on islets). They have demonstrated that this therapy prevents and reverses diabetes in mice, which warrants further preclinical development as a promising treatment for T1D.

Laura Sanz Villanueva (Australia), who works in the lab of Breakthrough T1D-funded researcher Dr. Thomas Kay presented on a mechanistic follow-up study to the BANDIT clinical trial. The Breakthrough T1D-funded phase 2 BANDIT study in Australia showed that baricitinib, a JAK1/2 inhibitor that prevents immune cell communication, can increase insulin production as measured by C-peptide in people with recently diagnosed T1D. The present study found that baricitinib can reduce the number of natural killer (NK) cells in the pancreas, which are involved in the autoimmune destruction of beta cells. This data provides valuable insight into the mechanism of baricitinib-mediated protection of beta cells.

Key takeaways

Research that tackles a variety of approaches to disease-modifying therapies is showing true promise and potential to offer medications that will make T1D management easier and safer.

Updates on improving lives research

Adjunct-to-Insulin Therapies

There was significant focus on GLP-1 receptor agonists (GLP-1RAs) and SGLT inhibitors (SGLTi) in reducing long-term complications and improving glycemic control in people with T1D.

GLP-1 receptor agonists

Glucagon-like peptide 1 receptor agonists mimic the hormone GLP-1, which elevates insulin and regulates appetite. Examples include Ozempic® (semaglutide) and Mounjaro® (tirzepatide), which acts on both GLP-1 and a similar target, GIP.

SGLT inhibitors

Sodium-glucose cotransporter inhibitors target kidney cells to prevent them from reabsorbing glucose into the blood so it gets excreted as waste. Examples include Farxiga® (dapagliflozin) and Zynquista® (sotagliflozin).

Dr. David Cherney (Toronto) presented a review of SGLTi and GLP-1RAs in reducing chronic kidney disease (CKD) in T1D:

• In the EMPA-KIDNEY trial, empagliflozin (SGLTi) improved kidney health in people with T1D.
• In the  ATTEMPT trial funded by Breakthrough T1D Canada and CIHR, dapagliflozin (SGLTi) improved time in range (TIR), reduced HbA1c levels, and had positive effects on kidneys in youth with T1D.
• The Breakthrough T1D-funded enrolling phase 3 SUGARNSALT trial is testing whether sotagliflozin (SGLTi) can prevent progression of moderate to severe kidney disease in people with T1D, and it includes careful diabetic ketoacidosis (DKA) risk mitigation strategies.
• The Breakthrough T1D-funded phase 2 REMODEL-T1D trial is testing if semaglutide (GLP-1RA) can improve kidney health in people with T1D.

Key takeaways

Breakthrough T1D is working toward a future where these drugs are an option for people with T1D to better manage their blood glucose levels and reduce the potential of long-term complications.

Canadian data was presented from the Breakthrough T1D-funded BETTER Registry which showed that of nearly 1,400 adults with T1D, approximately 14% (n=192) were using an adjunctive therapy. Amongst this group, the most common was Metformin (39% of the 192 adjunct therapy users), followed by GLP-1RAs (27%), SGLTi (21%), and a combination of these (13%).

While these therapies are not approved for use in adults with T1D in Canada, the Diabetes Canada Clinical Practice Guidelines were updated at the beginning of 2025 and are in the first in the world to recommend considering the (off-label) use of adjunct therapies for selected adults with T1D to help them meet their treatment goals.

Updates on diabetes device research

Dr. Alanna Weisman (Toronto) presented a review of barriers and enablers to diabetes technology in people with T1D. Across over 200 studies, the most common barriers included: racial or ethnic minority status, insurance concerns (e.g., coverage), and clinic- and provider-related factors (e.g., gatekeeping of information and/or prescriptions). The most common enablers included: patient education, patient support, and provider education. Dr. Weisman’s Breakthrough T1D-funded work is looking at barriers to technology use in socially disadvantaged Canadians.

Teams led by Dr. Anne-Sophie Brazeau and Dr. Rémi Rabasa-Lhoret (Montreal), who oversee the BETTER Registry, presented the following data from the Canadian registry on device use:

A comparison of technology use in adults over the age of 50 years of age from the BETTER Registry data (n=674), showed similar rates of insulin pump use in adults with T1D in their 50s (39%) and 60s (38%), but this was slightly lower for adults above the age of 70 (35%). More pronounced was the difference in rates of CGM use in adults in their 50s and 60s (85% for both groups) compared to the much lower rate in adults above the age of 70 (73%).

The BETTER Registry also has a significant wealth of patient-reported outcome measures that inform us of factors such as fear of hypoglycemia. In a sample of 115 adults with T1D, the introduction of automated insulin delivery (AID) reduced the number of hypoglycemia instances reported monthly, the number of nighttime symptomatic hypos, and perhaps most importantly, the average fear of hypoglycemia based on validated survey measurements. These findings support the potential of AID to reduce the burden of hypoglycemia in adults living with T1D.

Key takeaways

Breakthrough T1D-funded research into device access and development of next gen diabetes devices will enable improved daily management and reduce some of the mental and emotional burden of living with T1D.

To watch a video recap: https://www.breakthrought1d.org/news-and-updates/everything-you-need-to-know-about-ada-2025/ 

Guest post:
Mark E. Paull, CME,
Substack: adhd-t1dm.substack.com,
Published Writer | Lived-Experience Advocate | Type 1 diabetes since 1967 |

This is my experience. It may apply to others—perhaps we all share certain aspects of it—or it may not. The connections between ADHD, cognition, and perception need more research. What follows is not a claim, just the reality as I live it.

The Relentless Dance

When I was eleven, a doctor looked me in the eye and said:

“You won’t live past thirty-five.”

He didn’t say it cruelly. It wasn’t meant to be a punishment or a scare tactic. It was clinical, matter-of-fact, as if he were giving me a weather forecast. I remember the sterile smell of his office, the crisp white of his coat, the way my mother gripped my hand just a little tighter.

Type 1 diabetes took over my life—numbers, syringes, and survival became my world. The carefree days of schoolyard games and comic books faded into one relentless focus: control.

But no one saw the real threat: ADHD.

I just didn’t know it yet.

At eleven, I was impulsive, forgetful—constantly losing things, losing track of conversations. My mind bounced from thought to thought, never settling. No one thought much of it. I was the ‘daydreamer,’ the ‘bright but careless’ kid—energetic and scattered. No one thought much of it.

But diabetes doesn’t care if you forget, if you get distracted, or if your brain works differently.

ADHD thrives on chaos, distraction, and forgetting things that could kill you. But diabetes? It demands precision, structure, and unwavering consistency.

And so, my life became a war between two disorders that should never have existed in the same body.

The first time I forgot to take my insulin I was at school.

It was lunchtime. My tray had exactly 60 grams of carbohydrates—a number drilled into my brain through endless diabetes training. Math was now a part of eating. I knew the steps: Take the insulin shot first, then eat. Simple.

Except, before I could inject, someone at the next table cracked a joke.

I turned to laugh.

And in that instant, my attention jumped tracks.

By the time I remembered my insulin, my blood sugar was already climbing. My head felt heavy, my body sluggish, my thoughts wrapped in cotton. I stumbled through the rest of the day, my hands shaky, my brain slow, the numbers on my meter confirming what I already knew—I had lost control. Again.

But the worst moments weren’t when I forgot my insulin.

They were when I wasn’t sure if I had taken it already.

At night, I’d lie in bed, staring at the ceiling.

Did I take my long-acting insulin? Or did I just think about taking it?

If I took it twice, I could die in my sleep.

If I didn’t take it at all, I could wake up in a coma.

I’d get out of bed, check my blood sugar, and stare at the number on the meter—except that wasn’t an answer. It was a riddle. My ADHD brain had no reliable memory for something so repetitive. If I had taken my insulin fifteen minutes ago, would my blood sugar even reflect it yet?

I couldn’t trust my brain. I couldn’t trust my body. And I was completely alone in figuring out how to navigate a world where I was both my own lifeline and my own worst enemy.

Everyone thought diabetes would be my biggest challenge. But the real fight? My mind.

Managing diabetes means following the same steps every day, without fail:

• Check blood sugar before eating.
• Calculate insulin dose with perfect accuracy.
• Eat at the right times—not too early, not too late.
• Carry emergency sugar at all times.
• Double-check. Triple-check. Never miss a step.

No room for error. But ADHD turns routines into chaos.

I created systems—alarms, notes, even tying my insulin pen to my lunchbox—all to help me remember.

But ADHD has its own logic.

I’d hear the alarm and immediately forget why I set it.

I’d see a note and think, I’ll do that in a minute, and then never do it.

I lost count of how many times I ignored the insulin pen, too distracted by whatever was happening in my head.

Some days, I was hyper-focused on managing my blood sugar like a scientist, tracking every fluctuation, analyzing trends, predicting outcomes. I was in control.

Other days, I’d get so absorbed in writing, reading, or just daydreaming that I wouldn’t eat until I was shaking and drenched in sweat. I was out of control.

There was no in-between.

And the worst part? My brain played tricks on me.

On a school field trip, I packed my insulin in a zippered pouch, zipped it into my backpack, and congratulated myself.

Halfway through the trip, I realized I had no memory of actually taking the shot.

I froze on the bus, trying to replay the morning in my mind.

Had I unzipped the pouch?

Had I pulled out the pen?

Had I done the injection?

My brain said I had. My gut said I hadn’t. I had to guess.

That was ADHD and diabetes in a nutshell. A daily roulette of whether my own memory could be trusted.

And the world—my doctors, my teachers, even my parents—didn’t understand.

They saw a kid who “just needed to be more responsible.”

I saw a kid fighting a battle that no one had prepared him for.

No one warned me that ADHD and diabetes played by opposite rules.

No one had told me I would have to figure this out alone.

The Systems That Failed Me

Diabetes is a disease of routines. ADHD is a disorder of breaking them.

That’s the contradiction I lived with every single day.

Diabetes means doing the same steps, in the same order, every single time:

• Check blood sugar.
• Calculate insulin dose.
• Inject insulin.
• Eat at the right time.
• Adjust for exercise, stress, or anything unpredictable.
• Carry emergency sugar.

If you mess up, you don’t just feel off—you crash. Your blood sugar spikes too high or drops too low, and both can kill you.

ADHD means you can know all of this and still forget in the moment. It means routines don’t feel natural. It means every time you try to build a habit, it crumbles under the weight of distraction, impulsivity, forgetfulness, or just your own unpredictable brain.

So I tried to outsmart myself.

I followed all the advice, experimented, and adjusted. Nothing worked.

The Alarm System That Never Worked

Doctors said: ‘Set alarms.’ So, I did—alarms for insulin, meals, blood sugar checks. They didn’t work.

ADHD made my brain filter alarms as background noise. I would hear it, register that it was important, and then—just as quickly—forget about it. Or worse, I would turn it off thinking, I’ll do it in a second, and then never do it.

Sometimes, I would snooze the alarm so many times that by the time I actually paid attention, it was hours too late to take my insulin.

Other times, I would check my blood sugar, see a number in range, and think, I must have already done it. But had I? I had no way of knowing. One of the worst times was during an exam in high school. I had set a quiet vibration alarm on my watch to remind me to take my insulin at lunchtime.

But I was so deep in concentration that I just ignored it.

Two hours late. Blood sugar climbing. My brain drowning in syrup. The test became a blur.

My body was sluggish, my mind dull, my focus shot.

I stumbled through the rest of the test, barely able to think straight.

That was the moment I realized: even alarms don’t work if your brain doesn’t register them as urgent.

The Notebook That Disappeared

Since alarms didn’t work, I switched to writing things down. A doctor suggested a logbook, so I bought one that made me feel responsible.

Every entry was supposed to be neatly recorded—time, dose, blood sugar, carbs eaten.

It was a foolproof system.

Except ADHD means nothing stays where you put it.

I lost that notebook within the week. The next one disappeared too.

Eventually, my room became a graveyard of half-filled diabetes logs, scattered across drawers and bookshelves, each one abandoned because I had forgotten where I left it.

One time, I found an old logbook and thought, Great, I’ll start using this one again!

Only to realize all the entries were from two months earlier.

The worst part? Even when I did manage to write things down, I’d forget to check what I had written.

I had all the information—I just never looked at it.

The Trick That Didn’t Work

Next strategy: leaving things in obvious places.

• I put my insulin pen next to my toothbrush so I’d see it every morning.
• I left glucose tablets by my bed for nighttime lows.
• I even put sticky notes on my laptop saying, CHECK BLOOD SUGAR NOW.

But ADHD doesn’t work like that.

I saw those things so often that my brain stopped noticing them.

The sticky notes became part of the scenery.

The insulin pen next to my toothbrush? I brushed my teeth, stepped over it, and walked away.

The glucose tablets? Completely ignored until I needed them in a panic.

Nothing worked. No matter how hard I tried, no matter how many systems I built, my brain refused to cooperate.

The System That Finally Helped (Sort of)

“It took years, but I realized I had to work with my brain, not against it.”

Instead of trying to force myself into a rigid structure, I worked with my brain’s natural tendencies.

• Blood sugar checks happened when I took off my shoes.
• Habit stacking – I tied diabetes tasks to things I already did without thinking.
• Morning insulin was paired with coffee.
• Timers, not alarms – Instead of setting a one-time alarm, I used countdown timers.
• “Take insulin in 10 minutes” became a more immediate task than a random beep.

 Tech helped – When continuous glucose monitors (CGMs) became available, they changed everything.

Now, my phone told me when I was high or low, rather than relying on me to remember.

It wasn’t perfect, but it was better than anything else I had tried.

Still, the frustration remained:

Why did I have to work twice as hard just to stay alive?

Every missed dose, every forgotten blood sugar check, every time I had to scramble to correct a mistake—it wasn’t carelessness.

It wasn’t irresponsibility.

It was ADHD.

And no one had ever told me how much harder that would make managing diabetes.

For years, I thought ADHD only made my diabetes worse. That it was just another obstacle, another failure waiting to happen. But I was wrong.

ADHD and Hyperfocus: The Unexpected Lifesaver

For years, I thought ADHD made me bad at diabetes. I was wrong. It made me survive it.

The same brain that forgot insulin could also hyperfocus on it.

On good days, I tracked my blood sugar with an obsessive precision that rivaled medical professionals. I could see patterns before my doctor did.

I would run my own experiments—how different foods affected my glucose, how stress changed my numbers, how exercise played into everything. When my brain locked in, I became my own best endocrinologist.

One time, my doctor raised an eyebrow at my self-made spreadsheet, color-coded and filled with notes about insulin absorption times.

“You track this better than half my patients,” he said.

I smirked. Of course I did. It was an ADHD deep-dive.

Pattern Recognition and Instincts

I began to trust something most people didn’t even think about—my gut.

ADHD made me notice tiny details, subtle shifts. I could feel a low blood sugar coming before the numbers confirmed it. I sensed when something was “off” before I could logically explain why.

It wasn’t magic—it was pattern recognition, honed from years of analyzing every mistake, every reaction, every small variable.

Doctors told me, “You can’t feel a blood sugar drop before your CGM does.”

But I could. And I did. Repeatedly.

Crisis Mode: When ADHD Became a Superpower

ADHD brains are wired for high-pressure situations. When everything was going wrong, when my blood sugar was crashing, when I had seconds to act, my brain flipped into hyperfocus survival mode.

There was no hesitation. No distraction. Just clear, sharp action.

One night, I double-dosed insulin—again. I felt the symptoms creeping in fast. My heart was racing. My hands were shaking. The room tilted. I knew what was coming.

But instead of panicking, my brain locked in.

I lined up exactly what I needed: juice, glucose tablets, honey. I ran calculations in my head. I spaced out my carb intake strategically. I set timers to check my glucose every five minutes. I executed it like a pilot handling an emergency landing.

An hour later, I was stable.

This wasn’t luck. It was ADHD’s ability to hyperfocus under stress, to rapidly problem-solve, to process chaos in real time.

This happened again when I was traveling. I was in a new city, out of my usual routine, and my blood sugar started dropping rapidly. I had no glucose on me.

But instead of panicking, my brain did what it always does in a crisis—it calculated.

I spotted a small café down the street and sprinted in, gasping out, “Juice—fast.” The cashier blinked at me, confused. I didn’t have time to explain. I grabbed the nearest bottle of orange juice and chugged it at the counter, shaking hands gripping the plastic like a lifeline.

That’s what ADHD does.

It makes normal life hard—but when things go wrong? I thrive.

Reframing ADHD: A Strength, not a Weakness

For so long, ADHD felt like an enemy. It made diabetes harder. It made me fail. It made me feel reckless and irresponsible.

But then I saw the full picture: ADHD didn’t just create problems—it helped me solve them.

It made me notice details others missed.

It made me experiment and adapt faster than most people.

It let me hyperfocus on solutions when I needed them most.

It forced me to find creative workarounds when standard systems failed.

I was never going to be the patient who followed perfect routines. My brain wasn’t built for that. But I could be the patient who out-thought diabetes.

Who adapted faster.

Who found new ways to manage when the textbook ones didn’t work.

I stopped trying to fight my brain and started working with it.

That shift changed everything.

One of the biggest lessons I learned was that success didn’t have to look like “normal” success.”

For me, a “perfect” diabetes day wasn’t about hitting every number exactly right—it was about catching mistakes before they spiraled out of control.

It was about realizing my brain wasn’t broken—it was different.

Instead of beating myself up for not being consistent, I leaned into my strengths:

• I used hyperfocus to analyze patterns and spot mistakes.
• I stopped fighting alarms and started linking insulin to physical habits I already had.
• I trusted my instincts when my body told me something was wrong.

For years, I thought I was just bad at diabetes.

That I was irresponsible, careless, lazy.

I wasn’t.

I was managing two conditions that fundamentally clashed with each other.

And I was doing it without any guidance, without understanding why my brain worked the way it did.

The First Time I Gave myself Grace

I remember the exact moment I stopped being angry at myself.

It was late at night.

My blood sugar was dropping, and I was sitting on my bed, glucose tabs in one hand, phone in the other, staring at an article about ADHD and diabetes.

It described everything I had been through—forgetting insulin, missing doses, panicking over double-dosing, the exhaustion of trying to be “good” at diabetes but never quite getting there.

I’d been told I was bad at diabetes. For so long, I believed it.

Now I see—it was never a fair fight.

And I had never been failing.

I felt like I was reading my own life story.

For the first time, I didn’t feel like a failure.

I felt seen.

I was never alone.

It was my brain.

And my brain wasn’t broken.

It was just different.

What I Wish Someone Had Told Me Sooner

If I could go back and talk to my eleven-year-old self sitting in that doctor’s office, I would tell him this:

“Dear 11-year-old me: You are not failing. The world just doesn’t understand how your brain works—yet. You are not lazy. Your brain works differently, and that’s okay. Diabetes will be harder for you than it is for some people, but that doesn’t mean you’re failing. You will find ways to adapt. They won’t always be conventional, but they will work for you. You will mess up. It’s not your fault. It’s part of learning how to manage two conditions that weren’t designed to play nicely together. You will survive this.”

No one told me those things when I was younger.

So I’m telling them to myself now.

What Success Looks Like for Me Now

For years, I measured success by how well I could imitate neurotypical diabetes management.

Now, I measure success differently:

1. Did I catch a mistake before it became dangerous? That’s a win.

2. Did I problem-solve creatively when my brain wouldn’t cooperate? That’s a win.

3. Did I show myself patience instead of self-hatred? That’s a win.

Success isn’t perfection. It’s about figuring out how to live.

Speaking to Others Like Me

I know I’m not alone in this.

There are others out there—kids, teens, adults—trying to manage diabetes with a brain that doesn’t follow the rules.

To them, I say this:

Your ADHD isn’t a curse. It isn’t a weakness. It’s a challenge, yes, but it’s also a tool.

You can survive this. You can thrive. You can find ways to make it work.

For years, I thought I was fighting myself.

Now, I see I was fighting a battle I was never meant to fight alone.

ADHD and diabetes together are hard.

But I am not failing.

I was never failing.

I was surviving.

The doctor was wrong. He didn’t know my fight. I didn’t just survive—I thrived. And that? That’s everything.

Throughout June, thousands of supporters in nearly 50 communities gathered across the country to raise funds for type 1 diabetes (T1D) research.

Breakthrough T1D Walk (formerly the JDRF Walk to Cure Diabetes) is the largest fundraising event in Canada that unites the T1D community who are dedicated to making every day better for the estimated 300,000 Canadians living with type 1 diabetes (T1D), as we drive toward curing this disease. Breakthrough T1D Walk has raised more than $143 million to date in its over 30-year history, making it one of the longest running and most successful fundraising events in the country.

The collective fundraising goal is $3.2 million that will help support Breakthrough T1D Canada’s mission to find cures for T1D, and to date more than $2.5 M has already been raised through 1312 teams, 9112 participants and 17807 donations!

Additional Walks took place in May with several communities still planning Walks in the Fall, including schools participating as part of our Breakthrough T1D School Walk Program, where schools across the country can host Walks supported by their students and teachers throughout the year.

This year has truly been a national effort with Walks taking place in every province, from Newfoundland to Vancouver Island, and even with Walk Your Way events happening in Yukon and Nunavut.

The Walk is so much more than just a fundraiser. It’s a chance for families living with T1D to meet, share their stories, and gain support from each other. Many Walks had a tent for newly-diagnosed families, manned by volunteers who have lived through a T1D diagnosis and were available to offer support, resources, and encouragement. 

There were exciting kids’ games, activities from our corporate sponsors, Star Wars characters, amazing custom-made Team t-shirts, face-painting, and so much more! Each Walk location had their own unique offerings to make the day one to remember for all the participants.

At the Breakthrough T1D Walk in Toronto, we were once again joined by Breakthrough T1D ambassador Max Domi. Max met with families, took hundreds of selfies with fans, signed countless autographs and shared a bit of his T1D story from the stage, especially noting the role his parents played (who were both in attendance) in helping him learn to manage his T1D and help smooth his path to the NHL. As always, Max was generous, welcoming and brought hope and inspiration to attendees, particularly our newly-diagnosed families.

We want to thank our Walk Ambassadors who are helping to break the stigma of living with T1D, paving the way for a new generation of younger people living with T1D who are fiercely proud and committed to making life better today while we work towards a tomorrow free from T1D. They are so inspiring, and we thank each of them for their efforts and enthusiasm.

Thank you as well to our corporate partners, whose support helps us to build a special day of community spirit, along with important resources for T1D families, particularly those new to T1D.

Thank you to our amazing and tireless Breakthrough T1D Volunteer Committees and our staff who spend months working to ensure that the Walks run smoothly and that our participants have the best possible experience.

Our Breakthrough T1D Walks simply couldn’t happen without our incredible Walkers, volunteers, donors, vendors, and our local, regional, and national partners. Truly, we can’t do it without you.

Together we walked, knowing that with each step we got closer to the finish line – a world free from T1D. And we won’t stop until we cross it.

Dapagliflozin, an SGLT2i medication often used for people with type 2 diabetes, showed improved kidney function and glycemic management in teens with type 1 diabetes. This trial supports a growing body of evidence that supports the use of adjunctive therapies (drugs beyond insulin) for T1D.

Adolescence can be a challenging time to manage type 1 diabetes (T1D). Life (and hormones!) change in all sorts of ways, and many teenagers experience higher than recommended blood glucose levels as a result, which can mean an increased risk of complications later in life. The study of novel therapies that can improve glycemic control in teens with T1D and reduce the risk of diabetes complications is critical to improving the lives of youth living with diabetes.

Adjunct-to-insulin therapy – i.e., taking another drug alongside usual insulin treatment – is one approach that could help on both fronts. For example, sodium-glucose cotransporter-2 (SGLT2) inhibitors are a class of oral medications approved for type 2 diabetes that reduce glucose from the blood from being absorbed by the kidneys, instead encouraging glucose to be released in urine. Dr. Farid Mahmud and his team at the Hospital for Sick Children (SickKids) in Toronto conducted a clinical trial that tested the safety and efficacy of an SGLT2 inhibitor called dapagliflozin in teens with T1D. The ATTEMPT trial (Adolescent Type 1 Diabetes Treatment with SGLT2i for Hyperglycemia & Hyperfiltration) was funded as part of the Breakthrough T1D – CIHR Partnership to Defeat Diabetes.

The ATTEMPT study

The ATTEMPT trial aimed to determine the safety and effectiveness of an SGLT2 inhibitor called dapagliflozin on managing blood glucose and on improving kidney function in adolescents aged 12 to 18 with T1D. The study had two main goals:

1. To determine how effective dapagliflozin would be at improving kidney function and glycemic management; and
2. To determine if the drug increased the risk of diabetic ketoacidosis (DKA) and if additional safety measures could mitigate any increased risk  

ATTEMPT was led by Dr. Farid Mahmud, an endocrinologist and researcher at The Hospital for Sick Children in Toronto.

A total of 98 participants and their families attended 5 in-person visits over 22 weeks and were given a random assignment to the dapagliflozin group, or the placebo group (a small pill that contains no active medicine). During the study, participants kept taking insulin, wore a continuous glucose monitor (CGM), tested for blood ketones, and were to report any adverse events. Over 850 potential participants were approached over the course of 2-years to take part in the study.

Results:

ATTEMPT is the first of its kind, landmark trial designed to evaluate the effectiveness of SGLT2 inhibitors to optimize diabetes control and prevent early subclinical kidney complications in an at-risk pediatric population with T1D.

Efficacy:

The study showed that a low dose of SGLT2 inhibitor could safely be given to youths and adolescents to improve kidney function as well as improve glycemic management. There was a clinically significant decline in HbA1c of 0.47% in the treatment group as well as a 9% increase in average time in range from CGM metrics. There was no change in the total daily insulin dose.

Safety:

The trial was designed with strict safety protocols to mitigate the risk of diabetic ketoacidosis. In collaboration with patient-partners (those living with and caregivers of individuals with T1D) a DKA Risk Mitigation Strategy was employed due to the increased risk of DKA during euglycemia (normal range glucose levels). The protocol included routine ketone monitoring with guidance for action above the threshold of 0.6 mmol/L.

Dapagliflozin was well tolerated with no study-related serious adverse events. There were no significant differences in the proportion of participants who experienced elevated ketone levels, hypoglycemia and genitourinary tract infections in the Dapagliflozin vs Placebo groups. A single case (N=1) of mild DKA was seen in the Dapagliflozin group. While rates of DKA were low, a greater number of elevated blood ketone events ≥0.6mmol/L were seen in the Dapagliflozin group (n=106) vs Placebo group (n=62) (P<0.001), demonstrating the importance of the patient-centered DKA Risk Mitigation Education strategy operationalized during the study.

The results from ATTEMPT will hopefully pave the way for further research and longer studies on the potential benefits of using adjunctive therapies to help manage type 1 diabetes.

Please note that dapagliflozin, or any SGLT2 inhibitors are not approved for individuals with T1D by Health Canada.

Mahmud, F.H., Bjornstad, P., Clarson, C. et al. Adjunct-to-insulin therapy using SGLT2 inhibitors in youth with type 1 diabetes: a randomized controlled trial. Nat Med (2025). https://doi.org/10.1038/s41591-025-03723-6

Clinical trial participation is crucial for moving forward vital T1D research from the lab to the people who need it most. To find T1D trials that are recruiting participants, and if you qualify, please visit: clinicaltrials.breakthroughT1D.ca.

On Jan 7, 2025 (Sweden), Sana Biotechnology released significant clinical data: the first person with type 1 diabetes (T1D) who received deceased donor islets engineered to evade the immune system is producing insulin without immunosuppression.

UPDATE: June 23, 2025
Sana Biotechnology presented updated data on June 23, 2025 at the six-month follow up timepoint. The single patient dosed with hypoimmune donor islets continues to produce insulin in response to a mixed meal tolerance test (MMTT) without the use of immunosuppressants. 

The details

This is a big step for cell-based therapies for potentially curing T1D. Sana’s first-in-human study consists of allogeneic islets, meaning they are derived from an external source, which in this case is the pancreases of deceased donors. These islets were engineered to avoid recognition by the immune system (hypoimmune) and were implanted intramuscularly into a person with T1D. After four weeks, circulating C-peptide increased, meaning that the beta cells are alive, healthy, and producing insulin—all without the need for immunosuppression and no safety issue. This is the first evidence of engineered islets successfully avoiding immune destruction.

What this means for the T1D community

While this is an incredibly promising step forward for the T1D community, to have allogenic cells survive without the use of immunosuppressants, this trial relied on deceased donor cells, of which there will never be enough to provide to everyone living with T1D.  The trial was done in a single participant and is reporting only 4-weeks of data – this is a proof-of-concept study that is promising but very preliminary.

What’s next: lots to look forward to

Breakthrough T1D believes that the best chance for T1D cures lies in stem cell-based therapies since deceased donor islets are in short supply, while stem cell-derived islets can be produced at scale. Engineering cells to evade immune attack is a new path forward to protect the insulin-producing beta cells and avoid the use of immunosuppressants. Most importantly, this technology is being studied to apply to stem cell-based therapies, which is a scalable solution for many more people with T1D. This hypoimmune technology moves us closer to the possibility of having enough immune-evading cells for everyone with T1D.

Another trial is in progress testing a similar approach (CRISPR) in Canada – https://clinicaltrials.breakthrought1d.ca/clinical-trial/NCT05565248

While this approach will take significant time, effort, and money, every day we take another step toward a possible life-changing T1D cure. 

Breakthrough T1D’s Role

The primary objective of Breakthrough T1D’s beta cell replacement efforts is to place insulin-producing cells into people with T1D without the use of immunosuppressants. Breakthrough T1D strongly supports the development of stem cell-based therapies that do not require broad immunosuppression and Breakthrough T1D International based out of the US recently launched an initiative to accelerate this faster than ever (Project ACT – Accelerate Cell Therapies). To contribute to the advancement of these game-changing therapies, the T1D Fund: A Breakthrough T1D Venture invested in Sana recognizing that their hypoimmune engineering technology held significant promise for T1D cell therapies. We look forward to seeing how the trial progresses.