Focus on Diabetes Research
"I've met kids with diabetes who have never gone on a play date or sleepover, because of parental worries about diabetes complications. If that’s not motivation to do something about this disease, I don’t know what is!"
Diabetes strikes a chord emotionally as much as it takes a toll on the body physically. The onset of type 1 diabetes (T1D) impacts children suddenly, leaving them dependent on injected or pumped insulin for life, all the while with a constant threat of devastating short-term and long-term complications. Children with diabetes have so many layers to their story, but the researchers at CHEO collectively strive to make their lives better - we want kids with diabetes to have healthy and normal lives now and in the future.
From the Bench
People produce insulin to reduce glucose in their blood after eating. The insulin moves throughout body and basically tells any insulin-sensitive tissue (fat, muscle, brain, liver) to store glucose for future use (when we need energy). Children with T1D have cell death of their pancreatic beta cells, so they’re not able to produce sufficient insulin to regulate blood glucose. Since impaired beta cell function and survival are the critical hallmarks of Type I and Type 2 diabetes, the two central questions that Dr. Robert Screaton lab wants to answer are: (1) how can we make beta cells in patients with T1D grow (they don’t, and no one knows why!) and (2) why don’t these cells respond to glucose anymore? In his earlier work, Dr. Screaton discovered that removing or ‘knocking out’ the Liver Kinase B1 (LKB1) gene in a mouse model enhances pancreatic beta cell growth and insulin secretion. Today, he is working with human beta cells from islet organ donation to investigate and establish the relevance of his original findings in humans, as well as to identify novel genes that will help make beta cells grow better in people with type 1 diabetes. His team is regularly published in high-profile scientific journals such as Cell Metabolism and Proceedings of the National Academy of Sciences (PNAS).
Last year, Dr. Screaton renewed his Canada Research Chair in Apoptotic Signaling for the next five years. We’re certain that his focus and determination will yield new treatments for diabetes and a crossover to clinical trials in the near future.
From the Bedside
In March 2011, Dr. Margaret Lawson received significant funding from the Juvenile Diabetes Research Foundation Canadian Clinical Trials Network (JDRF-CCTN) to establish a centre for T1D clinical research. A multidisciplinary research team was established with responsibility for a number of large multicentre studies including the CGM TIME Trial and TRIGR Canada. CHEO is leading the CGM TIME Trial (Timing of Initiation of Continuous Glucose Monitoring in Established Pediatric Diabetes), which will involve 128 children and youth at five pediatric diabetes centres who are starting insulin pump therapy and considering use of Continuous Glucose Monitoring (CGM). The objective of the CGM TIME Trial is to determine the best time to introduce CGM to improve diabetes control in children and youth.
TRIGR (Trial to Reduce IDDM (Insulin dependent diabetes mellitus) in the Genetically at Risk) is a multi-national 15 year prospective study involving 2160 children followed through 77 local sites across 15 countries and 3 continents. This randomized controlled trial will determine whether delayed exposure to intact food proteins (i.e., cow’s milk proteins) will reduce the likelihood of developing T1D in genetically susceptible children. This is the largest and most ambitious primary prevention T1D trial to date, and CHEO is leading the Canadian initiative under Dr. Lawson’s direction.
Congrats to all for doing what you do best - making discoveries for healthier kids tomorrow.