The Canadian Diabetes Association Invests More than $7 Million in Research
Polly VandenBerg, Manager, Research Knowledge Translation
In 2012–2013, the Canadian Diabetes Association (CDA) will be funding 35 new and 71 ongoing research grants and awards across Canada. This year’s total research investment is $7.2 million, demonstrating the Association’s commitment to investing in excellence in science and innovation. The research being supported will help address important issues relating to the prevention, management, and treatment of diabetes and diabetes-related complications.
The funded research will be carried out over periods of 1 to 3 years for Operating Grants and 1 to 5 years for Personnel Awards. A summary of all grants and awards funded by the Association in 2012–2013 is summarized, by category, below.
Summary of grants and awards 2012–2013
| New and renewed (awarded in 2012 competition) | Ongoing (awarded in previous competitions) | Total | |
| Operating Grants | 20 | 49 | 69 |
| Personnel Awards | 15 | 28 | 43 |
| Clinician Scientist Award | 1 | 4 | 5 |
| Scholar Award | 1 | 5 | 6 |
| Postdoctoral Fellowship Award | 8 | 10 | 18 |
| Doctoral Student Research Award | 5 | 9 | 14 |
| Total grants and awards | 35 | 71 | 106 |
Below are some examples of the projects that were awarded funding in the 2012 competition.
Dr. Daniel A. Winer (Toronto General Hospital Research Institute)
Dr. Daniel Winer was awarded an Operating Grant (funded 2012 to 2015) and a Clinician Scientist Award (funded 2012 to 2017). During the course of his grant and award, Dr. Winer will investigate the role of inflammation in the development of metabolic syndrome and type 2 diabetes. Metabolic syndrome is a common set of conditions, including abdominal obesity, high blood pressure, high cholesterol, insulin resistance, and high blood glucose. People with metabolic syndrome are at significant risk of developing diabetes. Inflammation in the fat surrounding the organs (called visceral adipose tissue, or VAT) is known to be a major cause of insulin resistance. Previously, Dr. Winer investigated how this inflammation occurs. He and his team found that certain immune cells (called T cells and B cells) regulate this inflammation. In particular, B cells produce antibodies (small proteins that are usually produced by the body in response to a harmful substance), and these antibodies contribute to obesity-related inflammation and insulin resistance.
In Dr. Winer’s current Canadian Diabetes Association-funded grant and award, he aims to more clearly define how the immune system contributes to insulin resistance. To do this, Dr. Winer plans to analyze two types of immune cells (B-1 and B-2 cells). He and his team will also investigate how antibodies cause insulin resistance. They will then determine if interfering with these processes could be used to reverse inflammation.
Dr. Winer believes that the results of his research should help uncover new information about how immune cells influence metabolism. He hopes that this research could lead to new diagnostic tools and new treatments for metabolic syndrome, obesity-related inflammation, and type 2 diabetes.
Dr. Douglas W. Zochodne (University of Calgary)
Dr. Douglas Zochodne was awarded an Operating Grant (funded 2012 to 2015). Diabetes-related neuropathy is associated with sensory loss, pain, and poor healing of wounds, and will develop in nearly one-half of people with diabetes within ten years of onset of the disease. The overall goal of Dr. Zochodne’s research is to identify treatments to restore lost sensation in the skin associated with diabetes. Previously, Dr. Zochodne and his team have demonstrated that skin nerve fibres can be made to change in ways that might help wound healing. Dr. Zochodne’s team found that – in both type one and type 2 diabetes – local, low-levels in insulin (too low to affect blood glucose) can act on skin nerve fibres to make them grow.
In Dr. Zochodne’s newly-funded Operating Grant, he is exploring if sensory loss in diabetes is the result of the death of skin nerve fibres. He hopes to show that these nerve fibres can be manipulated to restore sensation. Previously, Dr. Zochodne’s team demonstrated that pathways of growth factors – including insulin – overcome roadblocks to skin healing. Dr. Zochodne will now investigate this pathway and how it is involved in nerve fibre regeneration in diabetes. He hopes to determine how insulin, and other factors in this pathway, cause nerve fibres to grow. He hopes that using this pathway will help regenerate nerves, and will investigate if this regeneration helps wound healing.
Through this research, Dr. Zochodne hopes to find new ways to stop or reverse diabetes-related neuropathy.
Dr. Gary D. Lopaschuk (University of Alberta)
Dr. Gary Lopaschuk was awarded an Operating Grant (funded 2012 to 2015). Obesity is a major risk factor for diabetes. The hypothalamus is a small part of the brain (about the size of a pearl) that acts as a control centre for several processes in the body, including hormone control, energy balance, food and water intake, and the sleep-wake cycle. The arcuate nucleus is a small collection of nerve cells in the hypothalamus. Some of the nerve cells in the arcuate nucleus regulate feelings of hunger.
During Dr. Lopaschuk’s previous Canadian Diabetes Association-funded grant, Dr. Lopaschuk and his team found that a molecule (called malonyl-CoA), that is produced when fats are metabolised, plays an important role in how the arcuate nucleus regulates food intake and energy use in the body, and he identified how it plays this role. He showed that increasing this particular molecule in the brain and in the whole body results in weight loss and improves insulin resistance. Dr. Lopaschuk also showed that a hormone called leptin (which acts to control food intake and energy use in the body) acts in the brain to increase malonyl-CoA, which helps muscles use glucose better, to decrease body weight, and to decrease food intake.
During the course of Dr. Lopaschuk’s current grant, he aims to focus on malonyl-CoA to determine exactly how it works to control eating and energy use. Specifically, how it works on a molecular level, and how the process of food and energy control works in response to, and in the absence of, the hormone lepin and a hormone called ghrelin.
Through the course of these studies, Dr. Lopaschuk aims to better understand how eating and body energy use are controlled. He believes this knowledge will be useful in developing new therapies that can treat obesity and, therefore, decrease the incidence of diabetes.
Dr. Rémi Rabasa-Lhoret (Clinical Research Institute of Montreal)
Dr. Rabasa-Lhoret was awarded an Operating Grant (funded 2012 to 2014). Type 1 diabetes represents about ten per cent of all cases of diabetes. Current standard treatment for people with type 1 diabetes is with multiple daily injections or continuous subcutaneous insulin infusion pump. Despite these treatments, it has been reported that many people with type 1 diabetes have difficulty maintaining good control of their blood glucose (an HbA1c of below 7 per cent) and can also face large swings in blood glucose: “highs” (hyperglycemia), “lows” (hypoglycemia). Poor glucose control and glucose swings can lead to long-term health complications and reduce quality of life.
Dr. Rabasa-Lhoret and his team are testing closed-loop system (CLS) strategies to regulate glucose levels in adults with type 1 diabetes. Closed-loop systems (also called external artificial pancreas) have three components: a continuous glucose sensor that measures glucose levels constantly using a small piece of equipment on the belly skin; infusion pumps to infuse insulin (single-hormone configuration) or insulin and glucagon (dual-hormone configuration); and a program that controls insulin and glucagon delivery. The single-hormone system is less complex to program and use, and the dual-hormone system could better improve blood glucose control and reduce “lows”, because glucagon is an essential hormone to prevent hypoglycemia.
With a previous funding from the Canadian Diabetes Association, Dr. Rabasa-Lhoret and his team have completed their first CLS study comparing their dual-hormone CLS to traditional continuous subcutaneous insulin infusion therapy. The study showed promising results in a small sample size of 15 adults with type 1 diabetes. The CLS reduced the risk of low blood glucose emergencies by up to 8-fold, while increasing the time for which glucose levels were in the target range by 17 per cent (nearly four hours per day).
In his newly-funded application, Dr. Rabasa-Lhoret and his team aim to compare single-hormone CLS (insulin), dual-hormone CLS (insulin and glucagon), and conventional continuous subcutaneous insulin infusion therapy. This comparison will monitor glucose levels for 24 hours in 12 adults with type 1 diabetes. The study will include an exercise session, three meals, and overnight glycemic control (three challenging situations for many people with type 1 diabetes). This study will allow for multiple comparisons to evaluate the benefits of each of the two CLS systems.
The closed-loop system has the potential to improve the quality of life for people with type 1 diabetes by reducing complications, preventing low blood glucose emergencies, allowing for easier management of meals and physical activities, and alleviating the burden of diabetes management from the people with diabetes and their support networks.