Leading diabetes researchers gathered for the annual conference of the International Society for Pediatric and Adolescent Diabetes (ISPAD), which took place from October 18-21 in Rotterdam, The Netherlands, and had more than 1,600 attendees—its largest-ever audience.
More than 45 studies were 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. Here are some of the highlights:
- Presented by Kevan Herold, M.D., and published in the New England Journal of Medicine, the phase III PROTECT clinical trial investigated whether Tzield™ (teplizumab-mzwv) can slow the loss of beta cells and preserve beta cell function in newly diagnosed (stage 3 T1D) children and adolescents ages 8-17. Per the study results, it can. Participants treated with Tzield had:
- Significantly greater stimulated C-peptide levels (a measure for insulin secretion) compared with placebo
- Tended to use lower insulin doses to meet glycemic goals
- Experienced higher rates of predefined clinical remission, defined as participants who achieved HbA1c ≤6.5% and insulin daily dose ≤0.25 U/kg/day
- Conclusion: Tzield has the potential to slow the progression of Stage 3 T1D and improve clinical parameters in newly diagnosed individuals.
Dr. Herold has been supported by Breakthrough T1D since the late 1980s. In his research, he showed that he could prevent autoimmune diabetes with an immune-modifying antibody (which, later, became a humanized version, Tzield) and was the lead on the clinical trial that demonstrated that Tzield could delay the onset of T1D in people almost certain to develop the disease. In November 2022, Tzield was approved by the FDA to delay the onset of the disease (Stage 3) in at-risk (Stage 2) individuals ages 8+.
- In a joint ISPAD-Breakthrough T1D symposium about global pediatric diabetes development, we heard from Tom Robinson, who heads the T1D Index. The Index leverages machine learning models to estimate the incidence of T1D around the globe. According to the Index, in access to care and quality of life most significantly affect low- and middle-income countries. Robinson pointed to four key areas of intervention to address the global T1D crisis, which ISPAD and Breakthrough T1D are working to address:
- Manuela Battaglia, Ph.D., discussed impediments in the T1D therapy research and development pipeline and how INNODIA—an international public-private partnership, with Breakthrough T1D and others support—is addressing the problem. Established in 2015, INNODIA was launched to accelerate the development of new disease-modifying therapies for T1D by fostering the creation of centers of excellence and by building a global network of members and experts. INNODIA now has four intervention clinical trials, paving the way for the development of novel treatments to prevent and find cures for T1D.
- In the complications space, Farid Mahmud, M.D., a Breakthrough T1D grantee since 2017, presented on the need for better blood biomarkers to earlier identify diabetic kidney disease. In his Breakthrough T1D-funded ATTEMPT clinical trial, which examines the impact of SGLT2 inhibitors (such as Jardiance®) on adolescents and young adults with T1D, he is investigating whether decreasing how much glucose is absorbed by the kidney is beneficial in diabetes-related complications. The study has already enrolled 98 out of 100 participants and is set to complete in mid-2024.
The next conferences we’ll be covering are the:
- Network for Pancreatic Organ Donors with Diabetes (nPOD), from February 19-22, 2024, in Long Beach, California
- Advanced Technologies & Treatments for Diabetes (ATTD), from March 6-9, 2024, in Florence, Italy (and online)
Stay tuned for a precap and recap of these terrific meetings!
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 met the study’s primary endpoint, significantly slowing the decline of C-peptide levels, compared to placebo
- C-peptide is a biomarker for beta cell function
- Numerical trends favoring Tzield were seen in key secondary endpoints, whilst statistical significance was not achieved
- On average, people on Tzield required numerically fewer insulin units and had numerically higher time in range, compared to those on placebo
- Tzield has the potential to slow the progression of Stage 3 T1D in newly diagnosed individuals
“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:
- The first findings from the PROTECT clinical trial, which tested the disease-modifying therapy Tzield™ (teplizumab-mzwv) in children with new-onset T1D. The findings are being presented by Kevan Herold, M.D.— who Breakthrough T1D has supported since the late 1980s. In his research, Dr. Herold showed that he could prevent autoimmune diabetes with an immune-modifying antibody (which, later, became a humanized version, Tzield) and was the lead on the clinical trial that demonstrated that Tzield could delay the onset of T1D in people almost certain to develop the disease. In November 2022, Tzield was approved by the FDA to delay the onset of the disease in at-risk individuals.
- In a joint ISPAD-Breakthrough T1D symposium on global pediatric diabetes development, we will hear from Tom Robinson, who heads the T1D Index, the first-of-its-kind tool that provides the most accurate and comprehensive picture of how many people live with T1D in every country in the world. Joining Tom will be Graham Ogle, MBBS, FRACP, who will discuss the Life for a Child Program, an international aid program that provides life-saving support to children and youth with diabetes in developing countries.
- In a presentation by Line Wisting, Ph.D., we will get an update on the Breakthrough T1D-funded clinical trial testing a virtual eating disorder prevention program for young women with type 1. They have recruited approximately three-quarters of their planned 240, and we will get results on the first 6 months of the study. About two-thirds of young women with T1D develop eating disorders in their lifetimes, so this is a very important and timely topic.
- In a symposium sponsored by Sanofi, we will hear from Breakthrough T1D chief scientific officer Sanjoy Dutta, Ph.D., Thomas Danne, M.D.—who were both Breakthrough T1D postdoctoral fellows when they were at the Joslin Diabetes Center—and Kimber Simmons, M.D., M.S., as they discuss general population screening for T1D and how we can work together to help individuals and their families prepare for and potentially delay this chronic health condition.
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:
- Anti-Viral Drugs Against Enteroviruses: The first findings from the Breakthrough T1D-funded clinical trial (DiViD) to test two anti-viral drugs against enteroviruses—common viruses that cause cold-like symptoms and may be linked to the development of T1D—in children with new-onset disease were presented by Knut Dahl-Jorgensen, M.D., Ph.D. Those who received the anti-viral medication maintained a higher level of insulin production after one year than those who did not take the medication, demonstrating that the treatment can slow the progression of T1D. The results were published in Nature Medicine.
- Heart Disease: In an EASD/Breakthrough T1D symposium, co-chaired by our own CEO Aaron Kowalski, Ph.D., presenters shared their insights on cardiovascular risk in youth with diabetes. Janet Snell-Bergeon, Ph.D., MPH, who has received a Breakthrough T1D grant to examine insulin resistance in T1D, spotlighted novel biomarkers for heart disease. The “ABCs” of diabetes risk factor management are HbA1c, blood pressure, and cholesterol levels, however, decreasing HbA1c, for example, is oftentimes not sufficient to reduce heart disease in T1D. To further stratify youth, APOC3 and GDF-15 proteins could be used as heart disease biomarkers. Ongoing research is integrating these into existing prediction models to verify their use as biomarkers for youth with T1D. If we can detect heart disease earlier, we can do earlier interventions, which can lead to the reversal of the early indicators of issues. In short, biomarkers let us see it earlier and act earlier.
- Also presenting on heart disease—which causes approximately three out of every four deaths in people with T1D—were members of the SFDT1 study, a Breakthrough T1D-funded research program that will follow 15,000 people with T1D over 30 years to better understand the factors associated with heart disease complications in T1D. This will offer new opportunities to better advance diabetes management, leading to more personalized prevention and improved quality of life.
- Stem Cell-Derived Therapy: In the summer of 2021, Vertex Pharmaceuticals launched its clinical trial of VX-880, a stem cell-derived islet replacement therapy in T1D for individuals with hypoglycemia unawareness, in combination with immunosuppressive therapy to protect the cells from rejection. To date, six participants have received this therapy, and three are now insulin independent. The phase I/II study is on Part C, where individuals receive a full dose of the therapy, and has opened multiple additional sites around the world.
- Once-Weekly Insulin: Novo Nordisk had results from its phase III ONWARDS 6 clinical trial, the first and only large study to date to investigate once-weekly insulin in people with T1D. There were 582 participants, and Novo Nordisk’s weekly insulin icodec was comparable to degludec (brand name Tresiba®), Novo Nordisk’s ultra-long-acting daily insulin. There was, however, a significantly higher rate of low blood sugar in people receiving icodec. Many participants noted, though, that they preferred once-weekly insulin over once-daily insulin, citing “frequency of injections” (70%) and “ease of use” (52%).
- Pregnancy + T1D: Most women with T1D struggle to reach the recommended blood-sugar targets when they are pregnant. But according to a new study presented by Helen Murphy, M.D., FRACP, an artificial pancreas system helped to substantially reduce maternal blood sugars throughout pregnancy. Published in The New England Journal of Medicine, the study authors say that—as a result of these findings—this technology should now be offered to all pregnant women with T1D to help improve maternal blood sugars.
- And, finally, congratulations to Breakthrough T1D-funded investigators:
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- Åke Lernmark, M.D., Ph.D., received the 55th Claude Bernhard Medal, the highest award in recognition of contributions to the advancement of knowledge in the field of diabetes, for his role in dissecting the genetic and environmental causes of T1D;
- Yuval Dor, Ph.D., received the 17th Albert Renold Prize, given for a member’s outstanding achievement in research on the islets and their relationship to diabetes; and
- Roman Hovorka, Ph.D., received the EASD-Novo Nordisk Foundation Diabetes Prize for Excellence, which awards an internationally recognized researcher who has contributed significantly to advances in the understanding, prevention, and treatment of diabetes and its complications. Dr. Hovorka has been at the forefront of artificial pancreas research, developing the algorithm in CamAPS® FX, which is now available in 16 countries and is used by over 16,000 people.
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 first findings from the JDRF-funded clinical trial to test two anti-viral drugs against enteroviruses—a common virus that causes cold-like symptoms and may be linked to the development of T1D—in children with new-onset disease, presented by Knut Dahl-Jorgensen, M.D., Ph.D.
- Vertex Pharmaceuticals will present an update on the cell replacement therapy VX-880. We learned at the American Diabetes Association conference in June that six people had been treated, with two achieving insulin independence. We’re excited to hear more information on this groundbreaking trial!
- Chairing a session is our own CEO Aaron Kowalski, Ph.D., on a very important topic—heart disease in T1D youth and how to best detect it before children reach adulthood.
- And, finally, congratulations to Breakthrough T1D-funded investigators:
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- Åke Lernmark, M.D., Ph.D., who will receive the 55th Claude Bernhard Medal, the highest award in recognition of contributions to the advancement of knowledge in the field of diabetes, for his role in dissecting the genetic and environmental causes of T1D;
- Yuval Dor, Ph.D., who will receive the 17th Albert Renold Prize, given for a member’s outstanding achievement in research on the islets and their relationship to diabetes; and
- Roman Hovorka, Ph.D., who will receive the EASD-Novo Nordisk Foundation Diabetes Prize for Excellence, which awards an internationally recognized researcher who has contributed significantly to advances in the understanding, prevention, and treatment of diabetes and its complications.
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.
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
- The Scientific Sessions is one of the largest gatherings of diabetes researchers in the world. Scientists and healthcare professionals share and learn about new diabetes conference advances with top experts.
- JDRF-supported research has been highlighted at this annual event since Breakthrough T1D started funding research. This showcases new breakthroughs and therapies for people with T1D.
- This year, researchers will present 140+ studies—with Breakthrough T1D-funding at present or in the past. This will encompass breakthrough clinical trials and significant research studies that are paving the way to novel treatments for T1D.
- JDRF-funded researchers will outline new advances such as:
Curing T1D
- Cell Therapies
- How do we design a cell source—beyond stem cells—for future replacement approaches?
- Disease-Modifying Therapies
- What are the results of recent immunotherapy clinical trials?
- How do you stop the beta cells from being stressed out, furthering their destruction?
- Screening and Monitoring
- Global universal screening and monitoring: How far have we come and what’s next?
Improving Lives
- Treatments
- How close are we to time-in-range being used for diabetes management?
- How do we create a world without visual loss from diabetes?
- Technologies
- Do-it-yourself (DIY) vs. commercial artificial pancreas systems: Which one is the best for you?
- Psychosocial Health
- What are the gaps in using telehealth for behavioral and psychological diabetes care?
Throughout the Scientific Sessions, Breakthrough T1D will be sharing updates to keep people apprised of the day-to-day happenings:
- Blog posts before, during, and after the ADA meeting
- A Facebook Live event (@myJDRF) for each day, taking place the following day, with Breakthrough T1D-funded scientists talking about the takeaways
- A “happy hour” with CEO Aaron J. Kowalski, Ph.D., from 7-8 p.m. ET on Thursday, June 29, speaking about the takeaways from the ADA Scientific Sessions and a Q&A period to answer questions from you, via Facebook Live (@myJDRF)
- Interviews with Breakthrough T1D-funded scientists, who will go over their research and what it means to the T1D community, to be pushed out on social media
- To stay updated, follow us on Facebook (@myJDRF), Twitter (@JDRF), and LinkedIn, with the hashtags #JDRFxADA and #ADA2023