Diabetes researchers at Memorial’s Faculty of Medicine have joined a global network of experts and specialized laboratories to understand and hopefully prevent type 1 diabetes, also known as juvenile diabetes. Newfoundland and Labrador has one of the highest incidence of type 1 diabetes in the world, making it a particularly valuable population to study.
There are 18 diabetes research centres in the type 1 Diabetes TrialNet consortium, located in the U.S., Canada, the U.K., Finland, Italy, Germany, Australia and New Zealand. At Memorial, Dr. Leigh Anne Newhook is the principal investigator for TrialNet, working with colleagues Drs. Joseph Curtis and Tracey Bridger, faculty members and clinicians at the Janeway Child Health Centre. Endocrinologist Dr. Vikram Chandurkar, Discipline of Medicine, has recently added his expertise in adult diabetes to the group. Research nurse co-ordinator Marie Grant is an invaluable member of the team, working with diabetes educators and physicians throughout the province to recruit families.
Dr. Newhook said TrialNet has already initiated a number of studies and the Newfoundland team is participating by recruiting relatives of people with type 1 diabetes to determine if they have a high risk of developing the disease,” she said. “If they do they are offered the opportunity to participate in other studies looking at preventing the disease. Or if they are diagnosed very early on it is possible they can start on medications that might prolong their health. For example, one study is testing oral insulin to see if it can prevent of delay type 1 diabetes in people at risk.”
The goal of TrialNet is to perform intervention studies to preserve insulin-producing cells in individuals at risk for type 1 diabetes and in those with new onset type 1 diabetes, and focus on identifying individuals who are at risk for developing the disease. Screening relatives to see if they are at risk involves a simple blood test to look for diabetes-related autoantibodies that may appear years before the disease develops.
Ms. Grant said there is an “incredible interest” among type 1 diabetes families in participating in research. She began recruiting families in 2001 when the Juvenile Diabetes Research Foundation (JDRF) International began major funding for genetic studies of type 1 diabetes in Newfoundland and Labrador. The money is shared between the Memorial University team and a research team based at Toronto’s Hospital for Sick Children, where the genetic studies are done. The goal was to recruit 1,000 families, and 900 have already been recruited.
“At first I was cautious about approaching the families but I quickly learned that they are very happy to be doing something,” said Ms. Grant. “The message I get is that we should do more, we can’t just sit back while this disease appears in generation after generation.”
Dr. Curtis began researching the incidence of diabetes in the province in 1987. “Years ago research was very scattered. With groups like TrialNet it’s become much more co-ordinated and focused on prevention and slowing the progression of the disease. Diabetes research has come a long, long way,” he said.
Although type 2 diabetes represents a larger portion of diabetes cases, Dr. Curtis said type 1 is very common, usually starts in childhood and immediately requires insulin injection from the time of diagnosis. Dr. Bridger also works with obese children and is an investigator on a childhood obesity study with geneticist Dr. Guang Sun.
Dr. Newhook expects that the TrialNet consortium will grow. “Every year there are more centres grouping together to look at diseases globally. It’s fascinating to watch all the co-operation that’s taking place,” she added.