ARCHIVED - Health Research - Investing in Canada's Future 2003-2004

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Diabetes

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s premier agency for health research.

Through CIHR, the Government of Canada has invested more than $28 million in diabetes.

The Facts

• About 1 million Canadians have been diagnosed with diabetes. It is estimated that another 700,000 Canadians have the disease.
• Diabetes is the seventh-leading cause of death in Canada.
• Type 1 diabetes is usually diagnosed in childhood and involves an abnormal autoimmune response that destroys insulin-producing cells in the pancreas, requiring daily insulin injections.
• Type 2 diabetes typically begins in adulthood, is associated with both lifestyle and genetic factors, and reduces life expectancy by five-to-ten years.
• About 90% of people with diabetes have Type 2; 10% have Type 1.
• Some 60,000 Canadians are diagnosed with diabetes every year.
• Aboriginal people are three-to-five times more likely to develop diabetes than non-Aboriginal people
• Complications of diabetes include heart disease, blindness, and kidney disease.
• The economic burden of diabetes is estimated to be $12.5 billion per year in direct and indirect costs, including physician care, medication, long-term disability and early death.

Research

Improving Health

• More than 30 people with Type 1 diabetes have lived free of insulin for at least a year, thanks to the islet cell transplantation process developed by Drs. Ray Rajotte and James Shapiro and their team at the University of Alberta. The procedure, known around the world as The Edmonton Protocol, was developed with ongoing support from CIHR. Its potential is limited by the availability of healthy pancreatic islet cells. Stem cell research could provide an alternate source of islet cells, making the procedure more widely and easily applied.
• Adult stem cells hold exciting new promise for people with diabetes, thanks to research conducted by Dr. Mickie Bhatia of London, Ontario’s Robarts Research Institute, with support from CIHR. Mice injected with adult bone marrow stem cells experienced a regeneration of pancreatic tissues that were able to produce insulin. Surprisingly, the regeneration was not because the stem cells differentiated into pancreatic cells, but because they induced the recipient’s own cells to regenerate. The ability of stem cells to naturally regenerate the body’s own cells could some day reduce the need for islet cell transplantation, which relies on available donors.
• Type 2 diabetes could become a thing of the past for many people, thanks to a CIHR-supported clinical trial led by Drs. Hertzel Gerstein and Salim Yusuf that is testing the ability of drugs called Ramipril and Rosiglitazone to prevent the disease. The idea for the DREAM trial came about when Dr. Yusuf, of McMaster University was testing Ramipril as a treatment for heart disease and discovered a 34% reduction in self-reported cases of diabetes. The trial, costing $25 million, is the largest ever funded by CIHR.
• Dr. Ji-Won Yoon, at the University of Calgary, has discovered a trigger for diabetes that could lead to the development of a vaccine to protect children from the disease. His work has been supported by CIHR.

Research

Strengthening the Health Care System

Dealing with the epidemic of Type 2 diabetes among Canada’s Aboriginal peoples requires innovative ways of delivering prevention and care that respond to the specific needs of these communities.

• Researchers in Quebec and Manitoba, supported by CIHR, are working with Aboriginal communities to find ways to prevent and control Type 2 diabetes.
• Dr. Ann Macaulay, of McGill University and the Kahnawake Centre for Research and Training in Diabetes Prevention, and Dr. T. Kue Young, from the University of Manitoba, are examining how to mobilize communities and incorporate traditional practices to support healthy lifestyles.

The CIHR Institutes

CIHR’s Institute of Nutrition, Metabolism and Diabetes, under the leadership of Scientific Director Dr. Diane Finegood, is leading the charge in the fight against diabetes. Through its strategic focus on obesity – an investment of $15 million – the Institute is shedding light on one of the key risk factors for Type 2 diabetes. The Institute has also participated in developing a national strategy on diabetes research, as part of the Canadian Diabetes Strategy, which will address the many different factors, from genetics to lifestyle, that can cause diabetes, and how to prevent, treat, and eventually cure this debilitating disease.

In addition, the Institute of Infection and Immunity, under the leadership of Dr. Bhagirath Singh, has identified, as one of its strategic priorities, research into autoimmune diseases, including a focus on Type 1 diabetes.

The Partners

Many CIHR Institutes work in partnership with the Institute of Nutrition, Metabolism and Diabetes (INMD), to tackle the problem of diabetes including the Institute of Circulator Respiratory Health, the Institute of Gender and Health and the Institute of Aboriginal People’s Health. In addition, CIHR works in partnership with major health charities including the Canadian Diabetes Association, the Heart and Stroke Foundation of Canada and the Kidney Foundation of Canada. Together they are investing $6.9 million to better understand the common aspects of diabetes, kidney and cardiovascular disease. INMD has also worked with the Institute of Infection and Immunity, the Institute of Human Development, Child and Youth Health, and the Juvenile Diabetes Research Foundation. With this program, the partners hope to build research capacity and initiate the undertaking of novel and outstanding multidisciplinary research leading to a cure for Type 1 diabetes. Together with Health Canada, INMD is ensuring that data collected through the National Diabetes Surveillance System is fully utilized to understand the prevalence and impact of diabetes on Canada and Canadians.

The People

Bob Teskey had always seen his diabetes as something that was inconvenient, but not terribly limiting.

Since being diagnosed at the age of 14, he had graduated from law school, married and raised a family, become a managing partner in a large law firm – and given himself probably 40,000 insulin injections.

But a few years ago, things started getting worse. The Edmonton resident was getting more cases of low blood sugar and passing out without any warning. Then his wife was killed by a drunk driver, and he sustained serious injuries. While in hospital, doctors discovered a heart blockage that was due to his diabetes.

“Then the miracle happened. I was complaining about my problems to my diabetes specialist and she told me about a research study she was involved with.”

Bob became one of the first people to undergo the Edmonton Protocol. He was injected with the equivalent of a spoonful of islet cells. Now, Bob feels great. He can eat what he wants, and although he has recently been taking small amounts of insulin, that is only a minor inconvenience and he says his life is immeasurably better than before the transplant. He has to take anti-rejection drugs, but says the side effects are benign.

Bob has participated in several research studies – he sees it as his opportunity to contribute to diabetes research. He never thought, though, that one research study could change his life so dramatically.

“I still can’t fathom how I had the immense good fortune to receive this treatment – I was just in the right place at the right time.”

About the Canadian Institutes of Health Research

The Canadian Institutes of Health Research is the Government of Canada’s premier agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.

For more information, visit: www.cihr-irsc.gc.ca