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I was recently diagnosed with type 1 diabetes (T1D) at the age of 24. It wasn’t a disease that I knew much about, but it is one that is now going to change my life. T1D is an autoimmune condition where my body’s immune system mistakenly destroys insulin-producing cells in my pancreas. The hormone insulin allows my body to use sugar (glucose) from carbohydrates in the food I eat. Without this function naturally occurring in my body, I cannot properly regulate blood glucose levels. This can lead to me suffering from hypoglycemic or hyperglycemic events that can lead to life threatening complications.

Managing T1D is a 24/7 job without any breaks. I require multiple injections of insulin each day to survive. And it’s not just one type of insulin. I have long-acting insulin which is meant to mimic the body’s natural insulin production, and short-acting insulin which is administered when I eat to correct high blood sugar levels. This means I also need to count the carbs I eat to ensure I can accurately measure how much insulin I need at mealtimes.

Some people are fortunate to be on an insulin pump, which is a small, computerized device often worn on a belt or in a pocket that is attached to the body through a small needle inserted into the skin. The pump delivers a continuous low (basal) dose of insulin. And when a person eats, they push a button on the pump to deliver an extra amount of insulin called a bolus to provide insulin for their food.

But it doesn’t stop there. I also need to check my blood-sugar levels throughout the day with several fingerpicks. However, there are advanced glucose monitors that do this automatically for you. A flash glucose monitor (Flash GM) is a small sensor worn under your skin, which measures your blood glucose levels continuously throughout the day and night. You find out your levels by scanning the sensor whenever you want to.

Similarly, a continuous glucose monitor (CGM) is a sensor just under the skin that measures the tissue-glucose levels in real time. The levels are then relayed to a receiver, smartphone or insulin pump which displays the readings. This also means if my blood sugars go too high or too low when I’m sleeping, an alarm will go off alerting me, or anyone else who received my readings. This means I can sleep throughout the night without worrying that I’ll suffer from my blood sugars going way out of range.

All these devices allow greater flexibility with meals, exercise and daily schedule; improved physical and psychological well-being; smoother control of blood-glucose levels and they enable virtual care, allowing my healthcare providers to see what is happening inside my body without me needing to physically be in an office.

While these devices are life-changing, they also come at a high cost without private or public coverage. That’s why I was anxiously awaiting the 2023 budget out of Nova Scotia, hoping to see T1D devices finally covered – but they weren’t. Disappointment does not come close to how I’m feeling. Without public coverage of these devices, I cannot access them.

Nova Scotia is now falling behind all other Atlantic provinces in this area, failing all Nova Scotians living with T1D. New Brunswick recently announced expanded coverage of devices by removing the existing age cap on the insulin pump program and adding CGMs to coverage. Newfoundland is now piloting a CGM project examining effectiveness and outcomes of this device. Last year, Prince Edward Island announced expanded coverage of Flash GMs and CGMs, now offering the most comprehensive coverage of devices in the Atlantic region and most of Canada.

The most frustrating part is we know that these devices are both cost effective and improve health outcomes. Last year, JDRF Canada commissioned a study to examine glucose monitoring systems, comparing Flash GM, CGM and self-monitoring of blood glucose (finger pricks). Not surprisingly, it noted that use of these devices leads to fewer complications, reduces long-term costs associated with hospitalization, leads to improved mortality rates AND are cost effective when looking at acceptable thresholds.

There was absolutely nothing that I did to become diabetic, but now have no choice but to do my best to survive every day with it. By providing increased public access and coverage for essential medical devices like Flash GMs/CGMs and insulin pumps, it would allow for people with diabetes, like myself, to thrive and manage this lifelong disease day to day with ease, rather than to go through each day without them.

Emma Perry

March 21, 2023 – New Brunswick – The Government of New Brunswick achieved an important milestone today by announcing an investment of $2.1 million to improve access to diabetes devices. The province will be expanding the insulin pump program by removing the existing age cap, updating the family contribution calculation, and including coverage for continuous glucose monitoring. Prior to this announcement, insulin pump coverage in New Brunswick did not extend beyond age 25 and there was no public coverage for advanced glucose monitors. Further details of this expanded coverage, including eligibility, will be known at a later date.

JDRF Canada’s #AccessForAll campaign works to improve life for all Canadians living with type 1 diabetes (T1D) by making diabetes technology affordable and accessible. By encouraging greater public coverage, JDRF works with the type 1 diabetes (T1D) community to help reduce the out-of-pocket costs for life-sustaining technology. These devices help ease the financial, physical, and mental health burdens associated with the disease.

It is estimated that 7,900 people live with T1D in New Brunswick and daily management of blood glucose is essential to their survival. Constant monitoring of blood glucose is a reality of this disease and must be balanced with external insulin administered through injections or use of an insulin pump. Even with the most careful management, those living with T1D are at risk of serious diabetes-related complications such as kidney disease, blindness, amputation, and even death.

“JDRF Canada is thrilled with this announcement out of New Brunswick, which is improving the lives of those living with type 1 diabetes. As we all know, type 1 diabetes does not end at age 25 and it is a relentless, lifelong disease that requires continual self-management to survive. We applaud the Government of New Brunswick for recognizing this and the value of innovation in diabetes technology by removing age caps on access to insulin pumps and now providing coverage for advanced glucose monitors. Coverage of this critical technology will enable everyone living with type 1 diabetes, to live healthier, safer and easier lives,” says Dave Prowten, President and CEO of JDRF Canada. 

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Devices like insulin pumps and advanced glucose monitors not only make T1D self-management easier but has led to better health outcomes for its users. Insulin pumps provide greater control in the administration of insulin and continuous glucose monitors can display real-time readings of blood glucose levels including time in target range (TIR). Integrated technology allows them to be used together to form a hybrid-closed loop (HCL) system and acts as an artificial pancreas to allow automatic infusions of insulin based on real-time glucose trends.

Being able to monitor blood glucose in real-time significantly improves self-management and reduces hospitalizations and the risk of long-term complications. Users are also given relief from some of the anxiety associated with the disease as they can better control activities like exercise, meals, and rest.

A JDRF-commissioned cost effectiveness study in 2022 examined population level impact of glucose monitoring techniques on diabetes-related complications, mortality, and cost-effectiveness. It was proven that while introducing these devices under public coverage represents a high short-term investment, it pales in comparison to the significant long-term cost savings from reduced complications, hospitalizations, and medical interventions.

Through the Access for All campaign, JDRF is engaging with passionate T1D advocates across the country to advocate for those who pay out-of-pocket for life-saving technology due to lack of coverage in their provinces. Since its launch in 2019, the campaign has driven significant change in many provinces and territories but until a cure can be found, JDRF will continue to advocate for universal access to and patient choice for diabetes technologies for all those who need it.

“A CGM makes our daughter Mariah’s life with type 1 diabetes be as close to that of someone without T1D. Sleepovers, basketball, and just being with her friends are now possible without worrying about a serious life-threatening event”, say Robert and Louise Inglis, whose daughter Mariah lives with T1D.

“CGMs keep children with T1D safer every day and improve their long-term health. The added bonus is more sleep and less worry for these two working parents. CGM’s are good for kids, families, and our health care system”, they continue.

Read the government release here.

About JDRF Canada 

JDRF Canada is the leading charitable organization funding type 1 diabetes (T1D) research in Canada. Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat T1D and its complications. Since our founding in 1974, JDRF has invested more than $80 million CDN in research funding. We are an organization built on a grassroots model of people connecting in their local communities, collaborating regionally for efficiency and broader fundraising impact, and uniting on a national stage to pool resources, passion, and energy. We collaborate with academic institutions, governments, and corporate and industry partners to develop and deliver a pipeline of innovative therapies to people living with T1D. Our staff and volunteers throughout Canada and five international affiliates are dedicated to advocacy, community engagement and our shared vision of a world without T1D. For more information, please visit breakthrought1d.ca.   

For more information: 

Monica Kocsmaros 
Chief External Relations Officer 
T. 647.354.5598 
E. mkocsmaros@jdrf.ca 
235 Yorkland Blvd., Suite 600, Toronto, ON M2J 4Y8
breakthrought1d.ca 

These training awards will support health researcher training to build capacity in the future of T1D research.  

CIRTN was established in 2020 as a world-class training and research network with joint contributions from the University of Alberta, University of British Columbia, University of Manitoba, Université de Montréal, Institut de Recherches Cliniques de Montréal, and the University of Toronto and now includes 12 institutions from across Canada.   

Now, in 2023, JDRF Canada has partnered with CIRTN to leverage funding to this network from the National Science and Engineering Research Council – Collaborative Research and Training Experience (NSERC-CREATE) program. Through this partnership, JDRF Canada is pleased to fund 6 PhD trainee scholarships and 1 postdoctoral fellowship to trainees working on pancreatic islet research. This support is part of JDRF’s goal to expand its support of the next generation of T1D researchers in 2023 and beyond. 

Angeles Olvera, Zuraya Elisa
PhD Student
Vincent Poitout, Université de Montréal

Mechanisms controlling beta cell proliferation by nutrients

Beta cells located within the pancreas are responsible for the production and secretion of insulin. T1D is caused by the destruction of beta cells by the body’s own immune response, whereas type 2 diabetes involves eventual loss of beta cell function. This research will examine how oleate (a fatty acid naturally occurring in animal and vegetable fats and oils) contributes to increasing the growth of beta cells. Specifically, the relationship between reactive oxidative species and antioxidant enzymes produced by the beta cells will be examined to determine its role in beta cell proliferation.

Wang, Yufeng 
PhD Student 
Jonathan Rocheleau, University of Toronto

Design of an islet-on-a-chip device to dynamically measure 1st-phase oxygen consumption rate and insulin secretion from individual islets 

The measurement of insulin secretion and oxygen consumption rate by islets is important for characterizing glucose metabolism in people with diabetes. This research project will design an “islet-on-a-chip” – that is, a living islet stabilized inside a microfluidic chip – for the purpose of measuring insulin secretion and oxygen consumption from individual islets simultaneously. These devices will then be used to evaluate the impact of metabolic stresses on islets during glucose metabolism, providing new information about islet cell molecular function. 

Kar, Saumadritaa 
PhD Student 
Bruce Verchere, University of British Columbia 

Mitigating amyloid associated islet transplant failure with pramlintide-expressing human embryonic stem cell derived beta cells 

Transplantation of insulin-producing beta cells is a potential curative therapy for T1D; however, limited organ donors, the need for lifelong immune suppression, and the eventual failure of transplanted cells hinder widespread clinical implementation. One cause of islet transplant failure is the formation of toxic protein aggregates called amyloid. Therefore, this research will examine the use of beta cells from genetically engineered embryonic stem cells. Specifically, these cells will be engineered to produce Pramlintide, which does not form amyloid, and assessed to determine whether the inhibition of amyloid formation could enhance transplant survival and function. 

Velghe, Jane
PhD Student
Bruce Verchere, University of British Columbia

Characterizing human islet-resident macrophages in health and disease

Macrophages are innate immune cells that can alter their function based on their surrounding environment. In mice pancreas, islet macrophages play an important role in development and proliferation of insulin-producing beta cells, and thus are a potential target for diabetes therapy. This research project will analyze human islet macrophages to provide new insight into their function in T1D as well as the communication between macrophages and beta cells. 

He, Siyi 
PhD Student 
Gareth Lim, University of Montreal/CRCHUM

Development of a screening approach to repurpose previously approved drugs to ameliorate Type I Diabetes

Autoreactive CD8+ T cells are the cells responsible for the selective destruction of insulin-producing beta cells in T1D. The survival of CD8+ T cells is controlled through specific protein-protein interactions. This research will identify compounds that can disrupt these protein-protein interactions – leading to destruction of the harmful CD8+ T cells. Small molecules that have destructive effects on CD8+ T cells may be a promising therapy for the delay or prevention of T1D with the additional benefits from small molecule drugs such as oral administration and lower cost as compared to existing therapies that target T cells. 

Hoffman, Emily 
PhD Student 
Michael Riddell, York University 

The role of somatostatin in the deficient glucagon response to acute and recurrent hypoglycemia  

Glucagon is a pancreatic hormone that stimulates the liver to release stored glucose in response to low blood glucose levels as a counter-regulator to insulin, meaning that these two hormones work together to balance blood sugar. Somatostatin inhibits the release of insulin and glucagon, thus, blocking the action of somatostatin may help to prevent hypoglycemia in people with diabetes. ZT-01 is one such drug that acts in this way (i.e., a somatostatin receptor antagonist) and is now being tested in clinical trials for its ability to prevent lows in people with T1D by Canadian company Zucara Therapeutics. This project will delve further into the pathways affected by ZT-01 by studying somatostatin at low glucose levels in rodent models of type 2 diabetes, which will in turn help to inform and advance the ZT-01 development program.

Huang, Hui 
Postdoctoral Fellow 
Jean Buteau, University of Alberta 

A novel small-molecule activator of Lyn kinase for the treatment of type 1 diabetes

Although people living with T1D have a substantial >80% loss of insulin-producing beta cell mass, there is evidence that most people with long-duration T1D still have surviving beta cells and secrete small amounts of insulin. Therefore, approaches that preserve residual beta cells and stimulate beta cell expansion may be a promising therapy for T1D. This research will examine a small molecule activator of Lyn – a novel regulator of beta cell “health”. Through pharmacological activation of Lyn, it is hypothesized that surviving beta cells will be preserved, and beta cell mass expansion will be promoted. This research will have significant implications for clinical therapies to harness existing insulin-producing beta cells in T1D. 

This is a significant milestone for the type 1 diabetes community as teplizumab is the first drug that can delay the onset of type 1 diabetes in at-risk individuals

Toronto, November 17, 2022 — JDRF, the leading global type 1 diabetes (T1D) research and advocacy organization, applauds today’s decision from the U.S Food and Drug Administration (FDA) to approve Provention Bio’s teplizumab. Teplizumab is the first therapy available to delay the onset of clinical T1D in people at-risk of developing the disease.

“Today’s decision by the US FDA represents the first disease-modifying therapy to be approved for T1D in any country,” said Dr. Sarah Linklater, Chief Scientific Officer for JDRF Canada. “Teplizumab can change the course and slow the development of T1D. This is a huge win for the T1D community and the latest example of how JDRF’s research and advocacy contributes to improving the lives of people and families affected by the disease. We will continue to prioritize research into T1D risk screening and prevention. Weare so proud of JDRF’s role in bringing this therapy to the T1D community, and we look forward to working to ensure teplizumab now becomes available to those who need it in Canada.”

There are many responsible for this accomplishment, and JDRF extends our deepest gratitude to all involved – many brilliant researchers including Jeffrey Bluestone, Ph.D., Lucienne Chatenoud, M.D., Ph.D., and Kevan Herold, M.D., the National Institutes of Health (NIH), the clinical trial participants, and Provention Bio for making today a reality.”

By delaying the onset of T1D, teplizumab will allow those at high risk of developing the disease to postpone the disease burden and reduce the risks of eye, kidney, nerve and heart disease–complications frequently associated with T1D. Teplizumab’s approval can mean additional years without the burden of blood glucose monitoring and insulin administration. It also gives families time to prepare for a future diagnosis.

“November is National Diabetes Awareness Month, so the timing of this approval is incredible,” said Dave Prowten, President and CEO of JDRF Canada. “JDRF’s theme for the month is sharing the realities of what living with T1D means on a daily basis – the time lost to managing blood glucose, recovering from a hypoglycemic episode, hours of lost sleep. By now having a drug that can delay the onset of this disease, potentially by several years, people can get some of that time back.”

Dr. Cory Wirt enrolled her daughter, Claire, who had biomarkers and was at-risk for developing T1D, in a clinical trial for teplizumab 7 years ago. Today, she has yet to progress into clinical T1D.

“As a mom, I appreciate 83 months of not checking blood-sugars multiple times per day, worrying about life threatening lows, and balancing my child/teen’s independence with the importance of tight medical control,” said Dr. Cory Wirt. “Not to mention the significant cost of supplies, office visits, and emotional stress.  We don’t know how long the effects of the treatment will last, but every day without insulin has been a gift!”

Today’s decision would not have been possible without decades of JDRF support, beginning with funding of basic research in the 1980s. JDRF’s involvement culminated in a strategic investment by the JDRF T1D Fund in 2017 that brought Provention Bio into T1D for the first time.  

Currently, teplizumab has only been approved by the FDA for use in the United States. It is our hope that it will be reviewed by Health Canada in the near future for use in Canada.

About JDRF Canada

JDRF Canada is the leading charitable organization funding type 1 diabetes (T1D) research in Canada. Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat T1D and its complications. Since our founding in 1974, JDRF has invested more than $80 million CDN in research funding. We are an organization built on a grassroots model of people connecting in their local communities, collaborating regionally for efficiency and broader fundraising impact, and uniting on a national stage to pool resources, passion, and energy. We collaborate with academic institutions, governments, and corporate and industry partners to develop and deliver a pipeline of innovative therapies to people living with T1D. Our staff and volunteers throughout Canada and five international affiliates are dedicated to advocacy, community engagement and our shared vision of a world without T1D. For more information, please visit breakthrought1d.ca.  

About Type 1 Diabetes (T1D)

T1D is an autoimmune condition that causes the pancreas to make very little insulin or none at all, leading to long-term complications which can include highs and lows in blood-sugar; damage to the kidneys, eyes, nerves and heart; and even death if left untreated. It is one of the fastest-growing chronic health conditions. Many believe T1D is only diagnosed in childhood and early puberty, but diagnosis in adulthood is on the rise, and accounts for nearly 50% of all T1D diagnoses. The onset is sudden and nothing can be done to prevent it yet—it is not related to diet or lifestyle. While its causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers are involved. There is currently no cure for T1D.

We want to thank everyone who led this incredible effort from Diabetes Canada in their unwavering pursuit of getting the Framework to where it is today, to MP Sidhu for taking this on as a private members bill. 

Thank you to Minister Duclos and the Government of Canada for recognizing the tremendous need for such a Framework and getting the right stakeholders in place to create it.

JDRF is thrilled to see a clear path forward to improve health outcomes for the 300,000 Canadians living with type 1 diabetes. 

As the Framework outlines, we need to continue building Canada’s research momentum. We are seeing incredible results of clinical trials that are testing stem cell solutions that replace daily insulin injections, but we need to support the right infrastructure and talent to launch these life-changing trials. 

The Framework’s holistic approach is also essential as people living with type 1 diabetes are more likely to experience mental health challenges such as depression and can benefit from interventions that prevent or treat mental health disorders.

We are very excited by the tabling of this Framework and look forward to our continued journey in its implementation to ensure those living with type 1 diabetes can live safer, healthier and easier lives until cures are found.

Framework for diabetes in Canada

Government of Canada Announces New Framework for Diabetes in Canada

Release of the Framework for Diabetes in Canada

Canada’s Stem Cell Network and JDRF Canada are pleased to announce Dr. Karoliina Tuomela as the inaugural J. Andrew McKee Fellow in Type 1 Diabetes (T1D). The announcement was made today in Vancouver at the Till & McCulloch Meetings, Canada’s premier stem cell and regenerative medicine conference.

The J. Andrew McKee Fellowship in Type 1 Diabetes, aims to help accelerate Canadian research, develop talent and enhance 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 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. Tuomela, who is currently completing post-doctoral research at the BC Children’s Hospital Research Institute, will be joining the JDRF Centre of Excellence at the University of British Columbia for a yearlong Fellowship valued at $60,000 to pursue research focused on treating and curing type 1 diabetes. During her PhD studies at University of Manchester, UK, Dr. Tuomela researched the effects of radiotherapy on immune-cancer cell interactions. Now, under the supervision of Dr. Megan Levings, her research project will focus on the metabolism of regulatory T cells (Tregs) and engineering Tregs to respond better in the pancreatic microenvironment. The goal of Dr. Tuomela’s research is to use Tregs to suppress the autoimmune response in type 1 diabetes, including in the context of stem cell-based therapies as a cure for the condition.

Quick Facts:

• T1D is an autoimmune disease that affects the daily lives of approximately 300,000 Canadians. It occurs when the body’s immune system attacks and destroys the cells in the pancreas that make insulin.
• Stem cell therapy holds immense promise for the treatment of people with diabetes, by offering the potential for the body to one day start producing its own insulin again.
• The J. Andrew McKee Fellowship in Type 1 Diabetes, supported by JDRF and SCN will award one yearlong fellowship per year through 2026, with a value of $60,000 CAD per year, for a fellow working at the JDRF Centre of Excellence at UBC. Applications for the 2023 Fellowship is set to open on November 1, 2022.
• The JDRF Centre of Excellence at UBC was established in December 2021 and is exclusively focused on research to cure T1D. 

“We are honoured to partner with JDRF on this unique, national fellowship opportunity. We are equally pleased to name this fellowship program after an important leader and visionary for both the stem cell and JDRF communities. Andrew McKee understood the power and potential of stem cell technologies in the fight against chronic diseases, such as type 1 diabetes. He also knew that cutting-edge advances would come from next generation talent. As such, naming our joint fellowship after Andrew could not be more appropriate and I am thrilled we can do this as part of his legacy.” – Cate Murray, President and CEO, Stem Cell Network

“We are pleased to partner with SCN to provide new opportunities for trainees at the JDRF Centre of Excellence at UBC, which alongside its exciting research goals has an outstanding multidisciplinary training program. Andrew was an impactful leader for JDRF, and we are honoured to remember his legacy in naming this award program for him. It is fitting since this will continue to accelerate progress in Canada in regenerative medicine, and help people today and tomorrow living with type 1 diabetes.” – Dave Prowten, President and CEO, JDRF Canada

“Andrew held both SCN and JDRF very close to his heart. He would be chuffed by this lovely tribute in his name, however he would say the true honour of this fellowship is the opportunity to encourage and support Postdocs in sharing their expertise. He believed in the power of people. People create change. The recipients of the J. Andrew McKee Fellowship will move Type 1 Diabetes research forward. They will give us hope for the future. That would make him smile.” – Shelagh Allen, Partner of the late J. Andrew McKee

“JDRF and SCN are huge networks of researchers, of scientists across the country, across the continent and across the world. Whenever you start bringing scientists together, particularly from different areas of research, there’s so much opportunity for learning and for creating networks that really support research. It’s just fantastic to be working in an area where there’s so much potential to see my research actually make a clinical impact and make an impact that could really change someone’s life from very early years onwards.” – Dr. Karoliina Tuomela, inaugural J. Andrew McKee Fellow in Type 1 Diabetes

About the Stem Cell Network: 

The Stem Cell Network (SCN) is a Canadian not-for-profit that supports stem cell and regenerative medicine research; training the next generation of highly qualified personnel; and knowledge mobilization and transfer of stem cell and regenerative medicine research. From the lab to the clinic, SCN’s goal is to power life-saving therapies and technologies through regenerative medicine research for the benefit of all. Created in 2001, with support from the Government of Canada, the Network has grown from a few dozen labs to more than 230 world-class research groups, supporting over 225 research projects and more than 25 clinical trials. Since its inception, over 20 biotech companies have been catalyzed or enhanced and more than 5,000 highly qualified personnel have been trained. In 2021, the Government of Canada demonstrated its continuing trust and support in SCN with an investment of $45 million for the 2022–2025 period.

About JDRF:

JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our goal is to raise funds to support the most advanced international T1D research and progressively remove the impact of this disease from people’s lives – until we achieve a world without it. JDRF collaborates with a wide spectrum of partners and is the only organization with the scientific resources, regulatory influence, and a working plan to better treat, prevent, and eventually cure T1D. For more information, please visit jdrf.ca.

Media contact SCN:
Samantha Rae Ayoub
Vice President, Communications & Knowledge Mobilization
Stem Cell Network
srae@stemcellnetwork.ca  

Media contact JDRF:

Michelle van Vliet
National Director Communications and Marketing
Cell: 514-803-0877
mvanvliet@jdrf.ca