Author: Linxi Mytkolli

By Krista Lamb

As Diabetes Action Canada completes its first six years of funding, our Network membership is also shifting. One major change is that Dr. Alex McComber, who has expertly led our Indigenous Patient Circle and co-led our program on Indigenous Peoples’ Health since 2016, will be stepping down from this role.

McComber, a member of the Kanien’kehá:ka community of Kahnawake, came to Diabetes Action Canada with a wealth of experience from his work with the Kahnawake School Diabetes Prevention Program, where he was a Diabetes Prevention Intervention Facilitator, Training Coordinator and Executive Director. He has been an incredible asset in helping Diabetes Action Canada develop research programs that had Indigenous Patient Partners at the forefront, and which supported his message of personal empowerment for healthy lifestyles as a key to healing multigenerational trauma.

“You cannot talk about diabetes in Canada without beginning with Frederick Banting and Charles Best. You cannot talk about Indigenous-led community-based diabetes prevention, care and scholarship without first talking about Dr. Alex McComber,” says Dr. Jon McGavock, who co-leads the Indigenous Peoples’ Health program for Diabetes Action Canada. “Every scientist in my generation references the ground breaking work, guided by Alex’s vision for and respect of Haudenosaunee ways of knowing and doing. From an academic standpoint, this work shaped community-based research and Indigenous Health research in Canada as we know it today. To work alongside Alex, is to work alongside one of Canada’s foremost scholars in our field.”

McComber, who is an Assistant Professor with the Dept of Family Medicine, Faculty of Medicine and Health Sciences at McGill University in Montreal, will continue his research in the areas of diabetes prevention, Indigenous health promotion, community mobilization, mentorship and Indigenous research methodologies.

“Diabetes Action Canada was so fortunate to have Alex lead the Indigenous Peoples Patient Circle and guide the vision for how our network engaged with and honoured Indigenous voices in Canada,” says McGavock. “Alex’s academic accomplishments and generation-shaping vision for Indigenous health research, pales in comparison to his humanity and friendship. The world is a better place because of the gift the creator gave us—Alex McComber. A warrior whose commitment to justice for his people is matched by the size of his heart and love of his friends and the people he works with. Working with Alex was one of the greatest gifts of my career and life thus far. My life is richer, and my world is a better place because of the gift the creator gave me in the form of Alex’s friendship and mentorship. I hope this is the beginning of the next chapter in that relationship. Niá:wen ki’ wáhi, Alex.”

Diabetes Action Canada’s Indigenous Patient Circle is now co-chaired by Tamara Beardy.

By Krista Lamb

On March 3^rd, Brain Canada and JDRF announced the winners of their Addressing Mental Health in Type 1 Diabetes Team Grants competition. Diabetes Action Canada was thrilled that one of our supported projects was selected.

Dr. Peter Selby from the Centre for Addiction and Mental Health (CAMH) will be the lead investigator looking into “Technology-enabled comprehensive care for young adults with type 1 diabetes (T1D) experiencing diabetes distress”. He is joined by co-investigators Drs. David Castle and Gillian Strudwick from CAMH and Dr. Diana Sherifali from McMaster University, who also co-lead the newly established Mental Health and Diabetes research program for DAC, as well as Dr. Bruce Perkins from the Leadership Sinai Centre for Diabetes and Dr. Peter Senior, Director of the Alberta Diabetes Institute, who lead the Innovations in T1D program. Five Diabetes Action Canada Patient Partners helped develop the grant application and they will be at the table throughout the planning for this research proposal.

This project looks specifically at co-developing effective supports to help people between 18 – 29 with T1D manage diabetes distress, a condition which affects more than 40% of those living with the condition. Diabetes distress is the emotional burdens and worries that accompanies the need to constantly self-manage diabetes.

“We have heard from people living with diabetes how important and how real diabetes distress is,” says Perkins. “This team is figuring out how to help people identify distress, and how to help deal with it using virtual care. We are confident that this could change the way the health care system actually helps real people with real issues in an efficient way.”

With an increasing number of people using technology to help them manage their diabetes, this project incorporates proven technologies like video chat and text messages to offer mental health support. The program being developed uses techniques from, The Optimal Health Program, which was designed to explore the origin of wellbeing within every person, and to support those who use it to promote self-agency in the face of life’s challenges. With trained mental health and diabetes experts guiding the process, the hope is to safely reduce barriers to needed resources.

“To improve patient-centred approaches, we will be able to co-design and test technology to bridge the gaps in care delivery between the mental health system and diabetes care and empower people to manage their own mind-body wellbeing,” says Selby.

For the Patient Partners involved in the research planning phase, access to appropriate support systems and education about how to find these resources were key priorities. Currently, diabetes-focused mental health interventions are limited, especially outside major city centres. It is also difficult to find health care providers with experience diagnosing or treating diabetes distress. Technology may be able to help by leveraging the available resources and reducing barriers to access, but it can only help if it is designed with the unique needs of people living with diabetes at the forefront.

“I think everyone with T1D struggles at some point with diabetes distress and mental health, but rarely is this raised with health care providers,” says Senior. “It would be easy for researchers to propose a solution based on assumptions or their narrow perspective. However, unless we take the time to hear from people living with diabetes about how they experience the problem and have them direct the design of a solution, there is a huge risk that we will miss the mark.”

The research team also includes Diabetes Action Canada researcher Dr. Joe Cafazzo and the Connect1d Canada team. The project will begin the initial phase of the project this spring.

By Krista Lamb

In February, BMJ Open Ophthalmology published a paper by Diabetes Action Canada researchers: Diagnostic accuracy of teleretinal screening for detection of diabetic retinopathy and age-related macular degeneration: a systematic review and meta-analysis

The paper, which looks at the diagnostic accuracy of teleretinal screening for the detection of diabetic retinopathy and age-related macular degeneration (two of the most common retinal diseases seen in most North American clinical practice), was part of a research project led by Dr. Tina Felfeli. Dr. Felfeli is a resident physician in the Department of Ophthalmology and Vision Sciences at the University of Toronto, and a PhD student in Clinical Epidemiology at the Institute of Health Policy, Management and Evaluation, University of Toronto as a part of the Integrated Physician-Scientist program.

The research team found that teleretinal screening is highly accurate for detecting diabetic retinopathy, while this type of screening for age-related macular degeneration is promising but needs more research.

This project was a systematic review of the published research on this topic and a meta-analysis, which means the team comprehensively examined of all the relevant literature available to see if there were overall messages and conclusions that could be drawn. They also evaluated the quality of the studies and looked at the ways in which the research should be interpreted. These types of studies, Felfeli explains, “serve as an overarching guide and summary of all the evidence we have available to date, and they can really inform decisions and guide future research by identifying gaps in the literature, or gaps in the research that is available so that future studies can be conducted in a better manner.”

Teleretinal screening has been a focus for Diabetes Action Canada’s research teams, as it offers a cost-effective way to increase access to eye screening for those with diabetes. Traditionally, eye screening is done in the office of an eye care provider, but access remains a barrier for many—especially those in remote communities or from marginalized groups. Teleretinal screening uses technology to check the eyes of patients remotely, and then those who show signs of diabetic retinopathy can be referred to a specialist.

Felfeli’s team looked at 28 articles published between 2010 to 2021, which showed great promise for teleretinal screening for diabetic retinopathy in particular. This was encouraging, as was the ability to share this information with more people in an open access journal. “We really wanted patients, clinicians and scientists to have zero barriers to being able to benefit from this data. Having Diabetes Action Canada as our collaborator really opened up the opportunity for us to have the funding to be able to make this data and this really important information available publicly.”

Read the full paper on the BMJ Open website.

In February, myhealthdatapath.ca launched. With support and information from Diabetes Action Canada staff and researchers, this new resource aims to help people feel more confident about the ways in which their health data is shared to support research.

When it comes to health data, many people don’t understand how it is collected and the many ways in can be used (completely anonymously) to support better health outcomes for everyone.

My Health Data Path explains what data is, how it is generated, how it is anonymized, and some of the responsible uses for this data. It walks users through the journey or their data using easy-to-follow dialogue and patient-experience examples from our healthcare system.

“The goal is to show patients that there are meaningful connections in data,” says Conrad Pow, Diabetes Action Canada’s Senior Project Manager, who has been supporting this project. “We want to show how data can save lives.”

Visit myhealthdatapath.ca to learn more!

Join us on Thursday February 10, 2022 at 12 pm – 1 pm ET

Having a social media presence has never been more important for those working in health care and science. Whether it’s helping to educate and inform the public, developing a sense of community, or networking with peers from around the globe, social channels can open doors and help you build your personal brand.

Diabetes Action Canada’s Communications Lead, Krista Lamb, is an author and science communicator who has a deep love for #ScienceTwitter and doctors who TikTok. In this webinar she will go over some of the tips and tricks to help you communicate authentically and appropriately.

You will learn:
• Why we need scientists in these spaces
• How to select the right platform(s) for you
• The best ways to build community and your personal brand
• How to avoid the pitfalls and perils of social networking

This webinar will not be recorded and is only available live. Be sure to join us!

Register now!

About the speaker

Krista Lamb is a writer, communications professional and podcast producer and host.

As the Director of Krista Lamb Communications, she specializes in helping translate complex medical, scientific and health-related topics into interesting and understandable stories for diverse mediums.

In addition, Krista is the producer and host of the Diabetes Canada Podcast, which won the Canadian Podcast Award for Outstanding Health and Fitness Series in 2020. She also hosts the From Beta Cells to Bicycles podcast for the BC Diabetes Research Network and the Actions on Diabetes Podcast with Diabetes Action Canada. Throughout her career, she has written extensively about health and research topics and she currently provides communications support for a wealth of Canadian not-for-profit organizations.

Her first book, Beyond Banting: From Insulin to Islet Transplants, Decoding Canada’s Diabetes Research Superstars, will be released by Rock’s Mills Press in early 2021.

Follow her updates on Twitter @kristalambcomms.

In December, Diabetes Action Canada member Dr. Bruce Perkins and his collaborators were awarded a Diabetes Canada End Diabetes: 100 Award.

Their project, which will incorporate Patient Partners at all levels, looks at ways to reduce and prevent diabetic ketoacidosis (DKA) in type 1 diabetes. The research team will work to identify factors that may increase the risk of DKA, define ways that people with diabetes can mitigate DKA and then create an educational tool to help increase awareness around factors that can reduce risk. The team will then test the tool to ensure it is effective and helpful.

Because DKA is a common and potentially deadly complication in type 1 diabetes, this project is particularly important to those living with diabetes and to their caregivers and health care providers. For Perkins, it also offers the opportunity to continue his work looking at the potential for using a newer form of drug therapy called sodium glucose transport inhibitors (SGLTis) in those with type 1 diabetes. Currently, the therapy is being used with much success in those with type 2 diabetes, but the risk of DKA has meant it is not available for those with type 1 in North America.

“Despite improvements in monitoring and treatment over the last 100 years, DKA continues to be an ongoing and very frightening issue for people living with type 1 diabetes,” says Perkins. “This means that new therapies and medications, like SGLTis, which have shown the potential for positive outcomes are not currently available for those with type 1. Our study will look at ways to help everyone with diabetes reduce the risk of developing DKA and potentially open the door for new drug therapies in the future.”

In addition to the Perkins lab, a Diabetes Action Patient Partner, Doug Mumford, will be a co-lead on the project. Diabetes Action Canada researcher, Dr. Noah Ivers, will also be a collaborator, helping to support the development of the educational tool and its implementation. It is anticipated that a large number of patient co-researchers will be involved throughout the project to ensure the outcome meets the needs of the type 1 diabetes community.

By Krista Lamb

In 2022, we are celebrating big changes at Diabetes Action Canada. In January, Dr. Catharine Whiteside, who has led the organization in her role of Executive Director since its inception, has stepped into a part-time role as Diabetes Action Canada’s Director of Strategic Partnerships. Tracy McQuire, will transition into the role of Executive Director, steering the organization forward as we plan for the next phase of development.

“We are incredibly grateful to Cathy Whiteside for the work she has done as Executive Director,” says Dr. Gary Lewis, Scientific Co-Lead at Diabetes Action Canada. “Her tireless dedication to supporting the research community and the needs of those living with and affected by diabetes has helped build a solid foundation for the organization’s future growth. We are lucky that she will be continuing in a new, part-time, role to further the many collaborations and partnerships she has fostered during her time as ED.”Dr. Whiteside, who was previously the Dean of Medicine and Vice Provost Relations with Health Care Institutions at the University of Toronto, will continue to serve in multiple roles in the research community. She is the Board Chair for the Banting Research Foundation and a Director and Vice Chair of The Scarborough Health Network Foundation.

McQuire has held the role of Manager, Research Operations, since Diabetes Action Canada launched in 2016. She has led the organization’s administrative processes through multiple rounds of funding and been a co-lead on the Innovations in Type 1 Diabetes program. She is a passionate advocate for the diabetes research community whose dedication to patient-oriented research has made her invaluable to the organization.

“We are thrilled to be able to promote Tracy McQuire into the role of Executive Director,” says Lewis. “Tracy has been a driving force behind Diabetes Action Canada’s success and I know she is the perfect person to lead us into the next stage of our development.”

This month, Dr. Charles de Mestral and his team have a new paper in the JAMA Network Open journal. The paper, A Population-Based Analysis of Diabetes-Related Care Measures, Foot Complications, and Amputation During the COVID-19 Pandemic in Ontario, Canada, looks at the care of 1.4 million Ontarians living with diabetes during the pandemic versus before. The team hoped to clarify the impact of the pandemic on rates of diabetic foot ulceration and amputation, as well as diabetes care measures that influence amputation risk.

Using data for the whole province of Ontario, available from ICES, De Mestral’s team found that the outcomes did not look as stark as data from other countries had suggested. “Despite limited ambulatory in-person assessment by physicians, hospital avoidance and restrictions to scheduled hospital-based procedures, excess leg amputations were not observed among people living with diabetes during the first 11 months of the COVID-19 pandemic in Ontario, Canada,” De Mestral says.

While this is encouraging, the team also made clear that as the pandemic wraps up, improved prevention and treatment of diabetic foot complications will be necessary to maintain these results.

By Krista Lamb

In late November, the Canadian Institutes for Health Research (CIHR) announced new funding for its Team Grant: Diabetes Mechanisms and Translational Solutions as part of the organization’s 100 Years of Insulin program. Alongside CIHR co-funders Diabetes Canada, JDRF Canada and Kidney Foundation of Canada, exciting new research programs were announced. Among them, were several with a clear focus on patient-oriented research and where the teams worked with Diabetes Action Canada Patient Partners on their grant applications.

The SUGARNSALT Team Grant looks at “Sodium glucose co-transport-2 inhibition diabetes and kidney function loss in type 1 diabetes”. The team is being led by Dr. David Cherney from UHN Research and includes co-investigators Dr. Bruce Perkins, Dr. David Campbell and Dr. Anita Layton – all of whom are Diabetes Action Canada researchers.
“Patient partners have been involved from the beginning to include trial components that are relevant to their experiences,” explains Cherney. “We have included components of the trial that are meaningful to them, including measures of kidney function, and also included an entire aim related to patient preferences and reported outcomes. We will also be meeting on a regular basis to make sure out methods and approaches remain patient focused.”

Led by Dr. Patrick MacDonald from the Alberta Diabetes Institute, a second funded project looks at “A deep phenotyping network for understanding human islet variation in health and diabetes”. For their application, the team brought together members of the Diabetes Action Canada Collective Patient Circle to ensure the work met the needs of those living with diabetes.

“We appreciate this funding from CIHR-INMD and JDRF, and the support we received from Diabetes Action Canada and their Collective Patient Circle for input and guidance as we developed this program,” says MacDonald. “Our project seeks to build a cellular and molecular atlas describing pancreatic islets in both health and disease, with a goal of making this resource available to answer many questions from the broader scientific and health communities. Interaction with Diabetes Action Canada, and engagement through a patient focus group, taught us much about the kinds of questions and the sources of data that are important and also about how we can better integrate patient feedback with our program going forward. We will continue to develop these important interactions to help bridge gaps between cellular work on islets and the needs of the community.”

Having received ongoing support from Diabetes Action Canada, Project OPEN, led by Dr. Valeria Rac from UHN Research, has a new infusion of funding for its project “Preventing vision loss from diabetic retinopathy: Guiding primary care diabetic retinopathy screening in Canada through the use of provincial healthcare administrative data.”

The only team to have a Patient Partner listed as a PI, the group has benefitted greatly from the inclusion of Debbie Sissmore, who lives with vision loss due to diabetic retinopathy, and her husband, Malcolm. During the application process, this team also had focus groups facilitated by Diabetes Action Canada. During this consultation, participants emphasized the need for a more systemic approach to the prevention of diabetic retinopathy.

“Our Team Grant application had a very holistic approach to engaging Patient Partners,” says Dr. Valeria Rac. “The insights gained from Debbie and Malcolm Sissmore and our focus group fully guided our application. In line with the Diabetes Action Canada approach, we wanted to make sure that patients’ perspectives and needs were at the forefront, and we will continue to do that throughout our diabetic retinopathy screening project.”

Led by Dr. Bruce Verchere at the University of British Columbia, the fourth funded team is looking at “Immunometabolism in diabetes: harnessing metabolic crosstalk between islets and immune cells for therapy”. They drew on the input from the Collective Patient Circle, and Diabetes Action Canada facilitated focus groups as they designed their application, and found the experience extremely valuable.

“One hundred years since the discovery of insulin by Canadian researchers, there is no cure. And just what is a “cure”? In a patient engagement session in partnership with Diabetes Action Canada, our team learned from T1D patients and caregivers what a cure meant to them,” says Verchere. “For most, they wanted to be free of the constant disease burden; one patient described, ‘to live a life that looks like anyone without diabetes; no devices, no insulin, no complications, no anxiety.’ Our team learned the urgency to move research forward and the importance of communication findings to all.”

Diabetes Action Canada is thrilled to see patient-oriented research at the core of so many of these funded projects and looks forward to working with each team as they move forward to ensure the needs of those living with diabetes are front and centre.