In the past year, we’ve seen a turning point for type 1 diabetes (T1D) treatments and technologies. In improving lives, we have new artificial pancreas systems and continuous glucose monitors (CGMs), which make living with T1D more manageable and convenient. In the area of cures for T1D, we have—in a historic moment for T1D—the first disease-modifying therapy, Tzield (teplizumab-mzwv), for use in delaying the onset of clinical disease in at-risk individuals.*

But what about the approximately 60,000+ people in the United States who are diagnosed each year with new-onset T1D?

Results from a new clinical trial suggest that Tzield has the potential to slow the progression of T1D for them.

Presented by Kevan Herold, M.D., and published in the New England Journal of Medicine, the PROTECT clinical trial investigated whether Tzield can slow the loss of beta cells and preserve beta cell function as measured by C-peptide in newly diagnosed (stage 3 T1D) children and adolescents ages 8-17. Per the study results just announced, it can.

In a press release issued by Sanofi (who acquired Provention Bio in April 2023), the data showed that:

“Tzield demonstrating effectiveness in a study of newly diagnosed children and adolescents is outstanding news,” said Sanjoy Dutta, Ph.D., Breakthrough T1D chief scientific officer. “Preserving beta cell function in individuals diagnosed with type 1 diabetes is a critical step towards cures and, crucially, is helpful in type 1 diabetes management in these people. Breakthrough T1D has believed in this therapy for decades and is continuing to study its potential uses in type 1 diabetes.”

“Thanks to Provention Bio and Sanofi’s ongoing commitment and dedication to individuals with type 1 diabetes, we now know that Tzield can benefit a new subset of the T1D population. Breakthrough T1D applauds all efforts aimed at finding cures and improving therapies for individuals with type 1 diabetes.”

Tzield is not yet FDA approved for individuals with stage 3 T1D. In Sanofi’s press release they say that they look forward to discussing this new data with the scientific community and regulatory authorities around the world.

Breakthrough T1D has supported the development of teplizumab for nearly 30 years, which includes contributions through research grants, federal funding via the Special Diabetes Program, a strategic investment by the Breakthrough T1D T1D Fund that brought Provention Bio into T1D for the first time, and more.

Breakthrough T1D is also currently pursuing multiple therapeutic approaches to cure T1D, and the T1D Fund has over 20 active cures programs in development.

*At-risk, or stage 2 T1D, means that a person exhibited 2+ T1D-related autoantibodies—antibodies against one’s own self—and their blood glucose is starting to be abnormal, but they are not yet insulin dependent. When someone becomes insulin dependent, they are in stage 3 T1D.

Leading researchers from around the world will gather for the annual meeting of the International Society for Pediatric and Adolescent Diabetes (ISPAD). At this year’s meeting, which will take place from October 18-21 in Rotterdam, The Netherlands, more than 45 studies will be presented by Breakthrough T1D researchers, funded now or in the past, working to find cures for type 1 diabetes (T1D) and improve the lives of those living with the condition today. Let’s have a look:

Keep up with the latest updates and exciting news from the ISPAD annual conference on Facebook (@myJDRF), X (formerly Twitter) (@JDRF), and LinkedIn, with the hashtags #JDRFxISPAD and #ISPAD2023.

 

Leading researchers gathered in Hamburg, Germany, for the annual meeting of the European Association for the Study of Diabetes (EASD), which took place from October 2-6. Researchers, clinicians, and other leaders in the diabetes space from more than 120 countries attended—including experts from Breakthrough T1D and the Breakthrough T1D T1D Fund. The meeting featured more than 65 studies presented by Breakthrough T1D-funded researchers, funded now or in the past, working to find cures for type 1 diabetes (T1D) and improve the lives of those living with the disease today.

Research presented at this conference covered all areas of Breakthrough T1D’s research portfolio, from disease-modifying therapies to cell therapies to complications. Here are some of the highlights:

The next conference we’ll be covering is the International Society for Pediatric and Adolescent Diabetes (ISPAD) 49th Annual Conference, from October 18-21 in Rotterdam, The Netherlands. Stay tuned for a precap and recap of this terrific meeting!

Leading researchers from around the world will gather for the annual meeting of the European Association for the Study of Diabetes (EASD). At this year’s meeting, which will take place from October 2-6 in Hamburg, Germany, 65 studies will be presented by Breakthrough T1D researchers, funded now or in the past, working to find cures for type 1 diabetes (T1D) and improve the lives of those living with the disease today.

EASD Highlights

The Albert Renold Prize has been given out annually since 2007. A total of 15 recipients have received Breakthrough T1D funding prior to winning the prize, including six investigators who received Breakthrough T1D early-career scientist grants. (Dr. Dor was a Breakthrough T1D postdoctoral fellow from 2003-2005 and a Breakthrough T1D Career Development Award from 2005-2010 and has received many more awards since.)

Stay Updated

Keep up with the latest updates and exciting news from the EASD Conference on Facebook (@myJDRF), X (formerly Twitter) (@JDRF), and LinkedIn, with the hashtags #JDRFxEASD and #EASD2023.

Semaglutide, brand names Ozempic®, Rybelsus®, and Wegovy®, is all over the news. It is FDA-approved to help people with type 2 diabetes (T2D) manage their blood glucose levels. It also decreases the risk of cardiovascular events and helps with weight loss. According to study results published in the New England Journal of Medicine [subscription required] by investigators at the State University of New York at Buffalo, it may also help newly diagnosed individuals with type 1 diabetes (T1D) make more insulin.

What Is Semaglutide?

Semaglutide is a glucagon-like peptide, or GLP-1. It helps people with T2D in various ways, including by stimulating insulin production. These drugs have been on the market since the early 2000s.

Thanks to decades of Breakthrough T1D-supported research, we know that people diagnosed with type 1 diabetes (T1D) still have functioning beta cells. They no longer make the amount of insulin needed by the body to function, but they do exist.

Preserving those beta cells, keeping them healthy and alive and, eventually, increasing their number and function through disease-modifying therapies is one of Breakthrough T1D’s key priority areas.

“The preservation of the remaining functional beta cell population is a critical component of developing disease-modifying therapies for patients with new-onset type 1 diabetes,” said Breakthrough T1D Director of Research, Joshua Vieth, Ph.D.

Study Results

The researchers in this study, who currently receive Breakthrough T1D funding to investigate the use of semaglutide later in disease to assist with glycemic control, administered the drug to 10 individuals. These individuals were between the ages of 21 and 39 in stage 3, or new-onset T1D. They began treatment with semaglutide within three months of diagnosis with the goal of preserving beta cell function. Nine individuals tested positive for GAD, an antibody which can indicate the presence of autoimmunity; one tested positive for IA-2, another autoantibody. Over the course of several months, all 1o individuals no longer had to administer insulin at mealtimes and six of the participants no longer needed basal insulin after six months. Additionally, participants saw an increase in c-peptide, which shows that their bodies were making more insulin after being on the therapy.

What Comes Next

These results are exciting, but much more work is needed.

“Overall, these are promising early results, suggesting it may be possible to extend the honeymoon period in early type 1 diabetes, and making it clear that further study is necessary into the mechanisms involved,” said Vieth.

According to Vieth, this study raises additional questions for researchers. In particular, what effect does using semaglutide to increase insulin production by the remaining beta cells have on these cells? It’s possible that this adds further stress on these cells. We need to determine what the effect of this stress will be beyond the length of this study. Will the beta cells continue to produce insulin or will insulin production decline? All of this must be investigated in a larger, follow-up study with a control group.

GLP-1’s Are a Priority for Breakthrough T1D

Breakthrough T1D has been a central player in the discovery and development of GLP-1’s for decades. In fact, a Breakthrough T1D-funded researcher named Pauline Kay Lund, Ph.D., was the first to discover GLP-1 and GLP-2. Since then, Breakthrough T1D has funded many studies to better understand this hormone, how it functions, and how it can be used to help people with T1D. In particular, Breakthrough T1D believes semaglutide has tremendous promise to improve glucose control and mitigate heart and kidney complications for individuals in stage 4, or established T1D.

That work continues today. There are several Breakthrough T1D-funded clinical trials to see how people with established T1D can benefit. This includes research led by Dr. Viral Shah at the Barbara Davis Center at the University of Colorado—and in collaboration with three other leading diabetes centers (Henry Ford Hospital, Iowa Diabetes, and the Oregon Health & Science University)—which is investigating ways semaglutide may benefit people with T1D and obesity who are using artificial pancreas (AP) systems

These drugs are also being explored by the Breakthrough T1D T1D Fund. T1D Fund portfolio company i2O Therapeutics is developing several products leveraging GLP-1s, initially for T2D, including a refillable, implantable GLP-1 device that delivers 6 month’s worth of the hormone, an oral form of long acting GLP-1, as well as a combined oral GLP-1 with Amylin (another important gut hormone).

Additionally, Code Bio, a T1D Fund portfolio company, has explored GLP-1 to target beta cells for targeted drug delivery.  

Read more about the potential benefit of these drugs in people with T1D here.

Breakthrough T1D joined thousands within the diabetes community at the American Diabetes Association’s (ADA) 83rd Scientific Sessions, where hundreds of experts presented significant advancements in diabetes research that may prove to be pivotal in improving lives and finding cures for T1D.

Held June 23-26 in San Diego, the ADA Scientific Sessions is one of the most prominent opportunities for researchers, healthcare professionals, and industry members to learn about the latest in diabetes research, treatment, and care. Breakthrough T1D-supported research has been highlighted at the annual event since Breakthrough T1D started funding research nearly 50 years ago. This year, scientists presented 140+ studies—with Breakthrough T1D-funding at present or in the past—to encompass breakthrough clinical trials and significant research studies that are paving the way to novel treatments and technologies for T1D.

The ADA Standards of Care for Diabetes has been updated to include Tzield™ (teplizumab-mzwv) to delay T1D in at-risk individuals. Read more about Breakthrough T1D’s work—funding discovery research to clinical development to work with regulators—that brought Tzield to FDA approval.

There were many fantastic results that came through the ADA’s Scientific Sessions. Here is Aaron J. Kowalski, Ph.D., CEO of Breakthrough T1D, with the key takeaways from the conference, and there is a written summary of Breakthrough T1D highlights below.

Cures

Stem Cell-Derived Islet Replacement Therapy: Update on Vertex’s VX-880

Breakthrough T1D Research Area: Cell Therapies

Cell replacement therapies, including stem cell-derived islet therapy, were on fire, with Vertex Pharmaceuticals leading the way in clinical trials. Vertex launched its clinical trial of VX-880, a stem cell-derived islet therapy in T1D for individuals with hypoglycemia unawareness, in combination with immunosuppressive therapy to protect the cells from rejection, in the summer of 2021. To date, six participants have received this therapy, and two are now insulin independent, have met the primary endpoint of eliminating severe hypoglycemia events, and have exceeded the ADA target time-in-range (>70%). Based on these data, the phase I/II study advanced to Part C in full target dose.

In summary: VX-880 has the potential to achieve insulin independence, as well as eliminate severe low blood-sugar events and significantly improve blood-sugar control.

Breakthrough T1D Leadership

Vertex’s phase I/II clinical trial of VX-880 was pioneered by Doug Melton, Ph.D., whose years of Breakthrough T1D-funded research led to successfully transforming stem cells into beta cells in 2014, and a catalytic investment from the T1D Fund in Semma Therapeutics—a biotech company founded by Melton to develop a stem cell-derived islet therapy for T1D, which was acquired by Vertex Pharmaceuticals.

Islet Replacement Therapy: Update on Sernova “Cell Pouch” Therapy

Breakthrough T1D Research Area: Cell Therapies

Breakthrough T1D also heard from Sernova, who provided an update on the phase I/II clinical trial of their Cell Pouch™—an implantable device designed to form a natural environment and allow the survival and function of insulin-producing (islet) cells. This device uses islets from deceased donors. In the first cohort, six individuals have received the therapy, and five have remained insulin independent, going from 6 months to more than 3 years. Observations from the first cohort led to a higher-capacity Cell Pouch, which provides up to 56% more volume to accommodate more islets, and 5 of the 7 planned participants have been enrolled in the second cohort.

Breakthrough T1D continues to support Sernova to make their Cell Pouch part of the cures portfolio.

TYK2 Inhibitors: Not for Psoriasis Anymore

Breakthrough T1D Research Area: Disease-Modifying Therapies

TYK2 is a crucial signaling pathway that has a role in autoimmune diseases, including psoriasis, Crohn’s disease, and lupus. Moreover, a TYK2 inhibitor—which works by blocking the TYK2 protein and the inflammation that it brings—was FDA-approved in September 2022 for moderate-to-severe psoriasis. But, researchers asked, would a TYK2 inhibitor have similar effects on the development of T1D?

The study showed that a TYK2 inhibitor reduced diabetes incidence by up to 80%, decreasing the immune cells that cause T1D and increasing the immune cells that signal tolerance. Taken together, their findings demonstrate that TYK2 inhibition protects against beta cell stress and T1D development, in multiple preclinical models.

Breakthrough T1D Leadership

The results were presented by Breakthrough T1D-funded researcher Farooq Syed, Ph.D., who was a Breakthrough T1D fellow working with Breakthrough T1D grantee Raghu Mirmira, M.D., Ph.D., the ADA’s 2023 Albert Renold Award recipient. Co-authors on the abstract are Breakthrough T1D-funded researchers Decio Eizirik, M.D., Ph.D. and Carmella Evans-Molina, M.D., Ph.D.—ADA’s 2023 Outstanding Scientific Achievement Award recipient.

General Population Screening: It’s Time

Breakthrough T1D Research Area: Screening and Monitoring

An ADA/Breakthrough T1D symposium, moderated by Sanjoy Dutta, Ph.D., chief scientific officer at Breakthrough T1D, featured an update on screening and monitoring in Europe (Fr1da, Diabetes Prediction and Prevention (DIPP) Study) and the United States (Autoimmunity Screening for Kids, or ASK), which are now expanding globally. The session highlighted the progress we have made, such as the benefits of screenings, including a decrease in DKA at diagnosis and lower HbA1c levels versus children who had not been screened. The gaps to move general population screening into state and federal guidelines: Cost-effectiveness of screening, at what age(s) do you screen, and how do you monitor when a person has 2+ autoantibodies. Research in all of these is under way.

2+ autoantibodies—antibodies that are directed toward your own body—means you have an almost 100% chance of developing T1D in your lifetime.

Breakthrough T1D Leadership

As a result of decades of Breakthrough T1D-funded research, we can identify those at highest risk for developing T1D—2+ autoantibodies—and we have funded screening programs since they were first introduced in the late 1980s. More recently, Breakthrough T1D launched the T1Detect screening education and monitoring program to broaden screening awareness and access to the general population. The goal: Global universal screening, which is key to developing disease-modifying therapies—like Tzield™ (teplizumab-mzwv), FDA-approved to delay T1D in at-risk individuals—and, ultimately, preventing it entirely.

Improving Lives

Lower Your HbA1c Levels + Reduce Insulin Use ≠ DKA = Success!

Breakthrough T1D Research Area: Glucose Control

SGLT therapies can lower HbA1c levels but increase the risk of diabetic ketoacidosis (DKA). So far, they are only approved for type 2 diabetes. But what if you combined an SGLT therapy with another drug that could improve blood-sugar levels AND potentially reduce ketones? A Breakthrough T1D-funded phase I/II clinical trial wanted to find out if this combo could work for people with T1D. The results? Pretty amazing.

Diabetic ketoacidosis (DKA)—a life-threatening complication, typically resulting from not enough insulin in the body—is an abundance of ketones in the blood, which typically also happens when blood sugar is very high. With SGLT therapy, however, DKA presents with blood-sugar levels at normal or near it. Because of this, there will be a need to counteract the risk if SGLT is going to be approved for T1D.

The combination therapy of an SGLT inhibitor (dapagliflozin) and a glucagon receptor inhibitor (volagidemab) reduced average blood sugars, reduced total insulin use, and increased time-in-range (by >3.8 hours a day!), and there was no DKA or severe low blood sugar. This led Schafer Boeder, M.D., presenter on the clinical trial, to conclude: “This therapeutic combination has the potential to improve glycemic control and reduce insulin use, while mitigating ketogenesis in T1D.”

Breakthrough T1D Leadership

This study involved numerous Breakthrough T1D-funded researchers: Dr. Boeder, as well as Jeremy Pettus, M.D., and Justin Gregory, M.D.—two of his authors on the abstract.

Breakthrough T1D is now funding REMD Biotherapeutics, to run a clinical trial investigating the impact of volagidemab on rescue glucagon to treat severe low blood-sugar events.

“I literally wouldn’t be here doing what I’m doing if I didn’t have funding from Breakthrough T1D. I feel like I’m making a difference, and that’s huge. So having this funding has allowed me to focus on exactly what I want to do and keep doing it thanks to their support.”

– Jeremy Pettus, M.D.
Endocrinologist and Assistant Professor of Medicine
University of California, San Diego

Technology Updates

Breakthrough T1D Research Area: Artificial Pancreas / CGMs

A ton of presentations focused on the artificial pancreas, or automated insulin delivery (AID), systems and continuous glucose monitors (CGMs). Real-world results on two artificial pancreas systems—Omnipod 5 and Medtronic 780G—demonstrated that they significantly improved time-in-range, with averages of 69% and 70% for Omnipod 5 (using the most aggressive target, internationally and in the United States) and 80% and 86% for the Medtronic 780G (for all of the United States users and those with Medtronic’s recommended settings). Time-below-range was 1% for Omnipod 5, and 2.3% for the Medtronic 780G. iLet insulin-only bionic pancreas showed that it improved blood-sugar management independent of how much users interact with the automated insulin delivery (AID) device. And Senseonics presented data from its 365-day implantable CGM, showing that it performed as well as the 180-day sensor.

Breakthrough T1D Leadership

The iLet presentation involved research from several former Breakthrough T1D-funded scientists: Ed Damiano, Ph.D., CEO of Beta Bionics; Firas El-Khatib, Ph.D., co-founder and vice president, research & innovation, at Beta Bionics; and Steven Russell, M.D., Ph.D.

The First Study to Show Correlation Between Time-in-Range and Complications

Breakthrough T1D Research Area: Complications

Continuous glucose monitoring (CGM) metrics, such as time-in-range, have been proposed as new metrics to assess diabetes management. No longitudinal studies, however, have placed time-in-range and diabetic eye disease…until now.

Viral N. Shah, M.D., in a study funded by Breakthrough T1D, analyzed up to 7 years of retrospective CGM data; 92 of people were without a diagnosis of diabetic eye disease and 71 of them were. HbA1c of the diabetic eye disease was significantly higher than those without a diagnosis. But people with diabetic eye disease had an average time-in-range of 52%, while the control group had a time-in-range of 62%—meaning that every 5% point decrease in time-in-range was associated with a 16% risk increase in diabetic eye disease. Time-in-tight target range (70-140 mg/dL) and time above range (>180 mg/dL) were also associated with the disease.

What does this mean? 1. It’s the first longitudinal study to demonstrate the association between CGM metrics and complications. 2: Time-in-range could become closer to realizing its potential application in T1D management and clinical trials.

Breakthrough T1D Leadership

Dr. Shah is an important part of the University of Colorado-Breakthrough T1D-scientist atmosphere, which goes back to the 1980s. From George Eisenbarth, M.D., Ph.D., who came up with the staging system in 1986, and Kevin Lafferty, Ph.D., who had demonstrated that a second signal is required to activate immune cells, to the next generation of researchers. Co-authors of the abstract include Gregory Forlenza, M.D., who is an expert on artificial pancreas systems in youth, Sarit Polsky, M.D., MPH, a specialist in T1D and pregnancy, and Halis Akturk, M.D., an authority on checkpoint—the “brakes” of the immune system—inhibitor-induced T1D.

We also had the opportunity to hear about the Mary Tyler Moore Vision Initiative (MTM Vision), with S. Robert Levine, M.D., the husband of the late Mary Tyler Moore and creator of MTM Vision, Jennifer Sun, M.D., MPH, and Patrice Fort, M.S., Ph.D. The first part of this initiative is a new Diabetic Retinal Disease Staging System, to update the grading system that has not been changed for 50 years, despite the advancement of our understanding the disease and its presentation.

Dr. Fort is collecting and characterizing different stages of the disease, to do in-depth analysis of those tissues to identify new potential targets to be developed. Dr. Sun presented work to identify new clinical endpoints and biomarkers for better characterization of the progression of the disease. She is spearheading clinical trials that will take place at the beginning of next year.

Breakthrough T1D Leadership

Breakthrough T1D has supported eye disease research since its beginning, and has driven discoveries that have reduced the risk of blindness by 95%, including laser therapy and anti-VEGF treatments. In 2018, Breakthrough T1D and the Mary Tyler Moore and S. Robert Levine, MD, Foundation launched MTM Vision, an ambitious initiative to reverse diabetes-related blindness and vision-threatening eye disease, which afflicts millions of individuals worldwide, held in honor of Mary Tyler Moore’s contributions to diabetes awareness and research.

Novel Interventions for the Most Vulnerable

Breakthrough T1D Research Area: Psychosocial

Many Breakthrough T1D-funded researchers presented on psychosocial issues, including the stigma associated with diabetes, telehealth and diabetes distress, depression, and anxiety, and social inequities—economically vulnerable, minorities, food insecurity—in diabetes care, including Michael Harris, Ph.D., whose Novel Interventions in Children’s Healthcare (NICH) was among the winners of the Innovation Challenge.

The inaugural ADA Innovation Challenge was designed to connect diabetes leaders with investors to move the field forward.

Funded by the Helmsley Trust, Breakthrough T1D, and other like-minded organizations, NICH is an innovative program designed to integrate medical care with behavioral therapy to support at-risk youth and their families. It deploys interventionists to address social determinants of health for the most vulnerable, highest need youth with T1D—the 1% who are responsible for 25% of cost. They had fantastic results over the past years, significantly reducing DKA and diabetes-related admissions to the hospital and a drop in HbA1c.

You can view all of the oral and poster presentations on the Diabetes journal website.

The American Diabetes Association’s 83rd Scientific Sessions is here! Scientists will present the latest type 1 diabetes (T1D) research, from beta cell replacement to regeneration, and glucose and complications trials, all with the goal of improving lives for the T1D community.

Here are Breakthrough T1D-funded researchers Drs. Sarit Polsky, Riitta Veijola, Maria Golson, and Patrice Fort to share their key takeaways from day 3, with their commentary in the video and below:


Sarit Polsky, M.D., MPH
Director, Pregnancy and Women’s Health Clinic, Barbara Davis Center for Diabetes, University of Colorado
Area: Automated Insulin Delivery Use among Pregnant Women with Type 1 Diabetes—Past, Present, and Future

Managing T1D with pregnancy is difficult, and artificial pancreas, or automated insulin delivery (AID), systems—for the most part—are not tailored to pregnancy. There are significant changes to insulin requirements over the course of pregnancy, making it difficult for pregnant women to achieve blood-sugar targets. Continuous glucose monitors (CGMs) help women increase their time spent in the optimal, pregnancy-specific time-in-range, but even with CGM some pregnant individuals do not reach their targets until the last few weeks of pregnancy.

Presenting on AID systems in pregnancy were Helen Murphy, M.D., FRACP, Carol Levy, M.D., CDCES, Sarit Polsky, M.D., MPH, and Denise Feig, M.D., M.Sc., FRCPC. They discussed the commercially available system for pregnancy (CAM APS, the only available system for pregnant women), “off-label” AID systems (like Medtronic, Tandem, Insulet, and iLet—which are not approved for pregnancy), and those in clinical trials, including one that has a special pregnancy-specific algorithm, developed by Harvard researcher (and Breakthrough T1D-funded) Eyal Dassau, Ph.D.

There are still a lot of things in the future we have to figure out—What is the optimal time-in-range? Should it be different overnight or during the day? What are the barriers to automation, such as cost and skin issues? There are currently five studies underway, with results that will be published in the next year or two.

“We’ve made a lot of progress and it’s all very exciting,” says Dr. Polsky, “so we all have a lot to look forward to.”

Riitta Veijola, M.D., Ph.D.
University of Oulu
Area: Joint ADA/Breakthrough T1D Symposium—Global Perspective on Population Level Type 1 Diabetes Screening and Monitoring

Anette-Gabriele Ziegler, M.D., Cristy Geno Rasmussen, MPH, Ph.D., and Riitta Veijola, M.D., Ph.D., presented on global screening in Europe and the United States, in a session run by Breakthrough T1D’s own Sanjoy Dutta, Ph.D., chief scientific officer at Breakthrough T1D. Dr. Veijola, who has been working on the development of T1D in children for almost 30 years, summarized the screening process. In Finland—the country with the highest rate of T1D—the most common age when islet autoantibodies appear is around 1 year, for reasons that are being explored in current studies.

2+ autoantibodies—antibodies that are directed toward your own body—means you have an almost 100 percent chance of developing T1D in your lifetime.

A screening test can tell you if you have 2+ autoantibodies. If you do, blood-sugar levels need to be monitored for the onset of type 1. You can do this in multiple ways. The traditional way is a glucometer with strips. A more modern way is continuous glucose monitoring (CGM) technology, which gives you your blood-sugar levels every 5 minutes. Another measure is to test HbA1c, which can tell you about blood-sugar levels over the past 12 weeks.

Monitoring can help you avoid diabetic ketoacidosis (DKA)—a complication of T1D when there is too much blood sugar, that can lead to death if not caught early. Monitoring also gives you time to learn about T1D and an opportunity to take part in preventive treatment, like Tzield™ (teplizumab-mzwv), or a clinical trial. To learn more about screening and monitoring, go to our T1Detect program.

Maria L. Golson, Ph.D.
Assistant Professor, Johns Hopkins School of Medicine
Area: The Islet-Cell Interactome

Alpha cells! Beta cells! Delta cells! Oh my! Maria Golson, Ph.D., and the presenters in her session, Manami Hara, DDS, Ph.D., Danielle Dean, Ph.D., and Abdelfattah El Ouaamari, Ph.D., talked about the other cells and blood vessel architecture in T1D, and how they contribute to beta cell failure.

Dr. Golson presented on delta cells, which produce somatostatin, a hormone that inhibits insulin secretion and is also released in response to high glucose as the hormone helps regulate the gastrointestinal tract. Next up was Dr. Hara, who talked about the blood vessel system in the islets, who demonstrated that there’s more interaction than previously thought between the blood vessel tissue and islet tissue. Dr. Dean spoke about glucagon, which is secreted by the alpha cell, which is also important for regulating insulin secretion. Finally, Dr. El Ouaamari found that islets have different sensory neurons, which might explain some of the differences in diabetes incidence in males and females.

Islets were previously thought to be made up of different cells, each responsible for a singular function. Now, we see that these different cells communicate with and among each other. Additional study of these interactions could help illuminate a path to new research and therapies that act upon these intercellular actions.

Patrice Fort, M.S., Ph.D.
Associate Professor and Director, Biorepository and Resource Center, University of Michigan
Area: Creating a World without Visual Loss from Diabetes

Patrice Fort, M.S., Ph.D., presented on the Mary Tyler Moore Vision Initiative (MTM Vision), with S. Robert Levine, M.D., the husband of the late Mary Tyler Moore and creator of MTM Vision, and Jennifer Sun, M.D., MPH. The first part of this initiative, due to a workshop hosted by Breakthrough T1D in 2018, is a new Diabetic Retinal Disease Staging System, to update the grading system that has not been changed for 50 years, despite the advancement of our understanding the disease and its presentation. An article outlining the new Diabetic Retinal Disease Staging System is set for publication in the coming months.

The workshop also detailed the state of the science, and outlined scientific needs and opportunities, which helped establish a “roadmap” for next steps.

One of these, presented by Dr. Fort, is collecting and characterizing different stages of the disease, to do a very in-depth analysis of those tissues to identify new potential targets to be developed with pharma companies or other academic centers. Another one, presented by Dr. Sun, is new clinical endpoints and biomarkers for better characterization of the progression of the disease. She is spearheading clinical trials that will take place at the beginning of next year.

MTM Vision’s goal is to lead to the development of therapies that will reduce or reverse vision-threatening diabetic eye disease development and progression. Ultimately, it aims to create a world without visual loss from diabetes, honoring Mary Tyler Moore’s commitment to diabetes awareness and research.

The American Diabetes Association’s 83rd Scientific Sessions is here! Until June 26, scientists will present the latest type 1 diabetes (T1D) research, from beta cell replacement to regeneration, and glucose and complications trials, all with the goal of improving lives for the T1D community.

Here are Breakthrough T1D-funded researchers Drs. Martin Thelin and Robert Eckel to share their key takeaways from day 2, with their commentary in the video and below:


Martin Thelin, M.D., Ph.D.
Clinical Fellow–Pediatrics, University of California, San Francisco
Area: Type 1 Diabetes Through Another Lens—Lessons from Other Disease Settings

It has been known for some time that T1D is associated with increased risk of developing other autoimmune diseases, such as celiac disease, multiple sclerosis, and lupus. But cancer? It turns out that some patients on cancer immunotherapy go on to develop T1D. And there is a monogenic—meaning something that involves or is controlled by one gene—form of diabetes. It’s different from T1D or T2D, and while rare and requires a genetic test for accurate diagnosis, it can be studied for its relationship to T1D.

First up was Breakthrough T1D-funded Halis Akturk, M.D., who presented on checkpoint inhibitors—drugs that take the brakes off the immune system—in cancer and how they may lead to T1D. Next up was Martin Thelin, M.D., Ph.D., who has a Breakthrough T1D advanced postdoctoral fellowship in the laboratory of Dr. Mark Anderson, presenting on monogenic diabetes and how it can teach us about T1D. Lastly, there was Edwin Liu, M.D., who presented on celiac disease and how it correlates with T1D.

This session shone a light on how other diseases can be a resource for better understanding and managing T1D.

Robert H. Eckel, M.D.
Professor Emeritus, University of Colorado Anschutz Medical Campus
Area: Implementation of Guideline-Directed Medical Therapy for Cardiometabolic Disease—Emerging Multidisciplinary Initiatives

While he was at the University of Washington in Seattle from 1977 to 1979, Robert Eckel, M.D., was one of the first Breakthrough T1D-funded postdoctoral fellows. Now at the University of Colorado, he has been president of both the American Diabetes Association and the American Heart Association and has gone on to be an expert in cardiometabolic disorders. Cardiometabolic disorders are a cluster of interrelated factors, including high blood pressure, elevated blood-sugar levels, and high cholesterol, that put someone at high risk for having a heart attack or a stroke. Dr. Eckel also has type 1 diabetes and has had it for more than 70 years.

In Dr. Eckel’s video, he talks about a clinical trial for type 2 diabetes, in which participants had bariatric surgery (surgery intended to help a person lose weight) and were followed for 12 years to see how many people went into remission. In the beginning, the participants lost weight and there was also some remission of type 2 diabetes, which is defined by an HbA1c of under 6.5% and being off diabetes-related medicines. At one year, 50% of participants had a remission of type 2 diabetes. At 12 years, however, most of them—80%—had type 2 diabetes again.

“What are the predictors of poor outcomes?” Dr. Eckel posed. “I turned to the historical literature here. It’s people who have longer durations of diabetes and also people who are on more medications to treat their diabetes.”

This has relevance for type 1 diabetes, as longer durations of diabetes often lead to an HbA1c that is 7% or higher and may lead to complications that require diabetes-related medicines, similar to type 2. Research on these metabolic measures will ultimately benefit all of those in the diabetes space, whether it’s type 2 or type 1.

The American Diabetes Association’s 83rd Scientific Sessions is here! Until June 26, scientists will present the latest type 1 diabetes (T1D) research, from beta cell replacement to regeneration, and glucose and complications trials, all with the goal of improving lives for the T1D community.

Here are Breakthrough T1D-funded researchers Drs. Cristina Nostro and Tricia Tang to share their key takeaways from day 1:

Cristina Nostro, Ph.D.
Senior Scientist, McEwen Stem Cell Institute, University Health Network
Associate Professor, University of Toronto
Toronto, Ontario, Canada
Area: Designer Beta Cells

In an all-star line-up, Cristina Nostro, Ph.D., Audrey Parent, Ph.D., Heiko Lickert, Ph.D., and Trevor Reichman, M.D., Ph.D., presented on the state-of-the-art advancements in stem cell-derived beta cells. There were talks on the use of immune-modulated cells to promote tolerance and the use of stem cell-derived receptor to produce higher levels of insulin and be sustained longer when transplanted. But the real highlight of the session was an update on Vertex’s clinical trial to test VX-880, a stem cell-derived replacement therapy for diabetes, presented by Dr. Reichman.

At the ADA’s conference last year, 3 people had been dosed with VX-880, and one of them achieved insulin independence. Now, there are 6 people treated, all of whom produced endogenous insulin and had improved blood-sugar control, while reducing or eliminating insulin use. On the latter, both participants with 1+ year of follow-up achieved insulin independence and exceeded the ADA target time-in-range, while also meeting the primary endpoint of eliminating severe low blood-sugar events.

In other words, both participants with 1+ year of follow-up no longer need to administer insulin through injections or pump therapy and have exceeded the recommended time-in-range.

Vertex’s phase I/II clinical trial of VX-880 was made possible by Doug Melton’s years of JDRF-funded research and a catalytic investment from the T1D Fund in Semma Therapeutics—a biotech company founded by Melton to develop a stem cell-derived islet therapy for T1D—which was acquired by Vertex Pharmaceuticals.

Dr. Nostro, in her video, says, “In the last 20 years, we’ve learned how to differentiate these cells, and now we’re moving them to the clinic and they’re giving us the results that we want. The future is bright. I’m super excited, and I hope you are, too.”

Yes, we are!

Tricia S. Tang, Ph.D., R.Psych.
Associate Professor, Division of Endocrinology, University of British Columbia, Vancouver, Canada
Area: Translating Psychosocial Care into Real-World Practice Settings

The presence of T1D—whether for your child, yourself, or a family member—often affects people’s social, behavioral, and emotional well-being, known collectively as psychosocial health. Psychosocial issues—such as diabetes distress, depression, and anxiety—can put people with T1D at-risk for serious complications.

The session on psychosocial care, reported by Tricia Tang, Ph.D., R.Psych., wanted to know what worked—and didn’t work—in diabetes care to reduce the psychosocial concerns in the real-world practice settings. It featured sessions on psychosocial and behavioral screening, presented by Sarah Corathers, M.D., diabetes distress in type 2 diabetes, presented by Lawrence Fisher, Ph.D., family-based intervention, presented by Jill Weissberg-Benchell, Ph.D., and peer-support models for diabetes management, presented by Dr. Tang.

The American Diabetes Association’s (ADA) 83rd Scientific Sessions is almost here! From June 23-26, scientists and healthcare professionals will gather at one of the largest diabetes conference in the world. Breakthrough T1D-funded researchers will also be there to present new study results that will improve outcomes for people with diabetes (T1D). Read what’s happening below.

ADA’s 83rd Scientific Sessions

Curing T1D

Improving Lives

Throughout the Scientific Sessions, Breakthrough T1D will be sharing updates to keep people apprised of the day-to-day happenings: