Reversing the Tide on Diabetes
With over one million Canadians suffering from Type 2 diabetes
and a further two million who are considered to be at high risk of developing the disease, the urgency to learn more about how to prevent and effectively treat diabetes is greater than ever.
Scientists at Mount Sinai Hospital’s Leadership Sinai Centre for Diabetes—which has been ranked #1 in the world for its comprehensive approach to Type 1, Type 2 and gestational diabetes research— have taken a leading role in advancing the understanding and treatment of diabetes at the local, provincial, national and international levels.Their work will transform care for patients like Susan, who face daily challenges in living with the disease.
"Diabetes has changed
my food choices
my life choices
in a way
I didn't really expect."
DIABETES GLOSSARY: What does it mean?
Diabetes: A disease resulting from impaired insulin metabolism: either not enough insulin is produced or the body’s cells do not properly respond to insulin (or both)
- Type 1 diabetes occurs when the insulin-producing cells in the pancreas break down, likely due to attack by the body’s immune system. People with Type 1 diabetes require life-long insulin replacement therapy.
- In Type 2 diabetes, the insulin-producing cells in the pancreas become overworked trying to keep up with rising blood sugar levels and eventually break down. Though often associated with diet and lifestyle, Type 2 diabetes has a genetic component as well.
Gestational Diabetes: A temporary condition that can affect expectant mothers as a result of metabolic stresses associated with pregnancy. The condition typically resolves after giving birth, but women who experience gestational diabetes are at increased risk for developing Type 2 diabetes within five years after pregnancy.
Glucose: A breakdown product of food and the main source of energy for body cells.
Insulin: A hormone produced by the pancreas that allows body cells to absorb glucose. When people with diabetes have low insulin levels or their cells do not properly respond to insulin, it results in too much glucose in the bloodstream.
Insulin-resistance: A condition in which the body produces insulin but uses it ineffectively, causing glucose to build up in the blood rather than be absorbed by the cells. Insulin-resistance is a risk factor for developing diabetes later in life.
Hypoglycemia: A potentially serious condition characterized by low levels of sugar (glucose) in the bloodstream. Hypoglycemia (the “lows” Susan describes) is a common side effect of diabetes treatment.
Pre-diabetes: A condition in which blood glucose levels are higher than normal but not high enough to diagnose diabetes. At this stage, it is sometimes possible to reverse the trend toward diabetes through changes to diet and exercise.
DR. DANIEL DRUCKER: A pioneer in Type 2 diabetes research
Dr. Drucker is an endocrinologist and a Professor of Medicine at the University of Toronto. He is also a member of the Royal Society of Canada and holds the Canada Research Chair in Regulatory Peptides.
Dr. Daniel Drucker, a Senior Investigator at Mount Sinai’s Lunenfeld-Tanenbaum Research Institute, is a game-changer in the field of diabetes research. Dr. Drucker began his career as a clinical endocrinologist, but left clinical practice when he recognized an opportunity to improve the lives of many more patients through his pioneering research. To date, his work has resulted in more than 230 original research papers and 30 issued U.S. patents.
Discoveries in Dr. Drucker’s lab have contributed to the development of two new classes of drug therapies for Type 2 diabetes, glucagon-like peptide-1 receptor (GLP-1R) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors, which have transformed care for millions of patients around the world. These drugs harness the action of hormones called incretins (a family of gut hormones produced in the gastrointestinal tract and brain that increase insulin) to control blood glucose and insulin secretion without weight gain or hypoglycemia, common side effects of previous diabetes treatments.
Incretin hormones help the pancreas produce more insulin to assimilate the energy (glucose) from food, thereby controlling blood glucose and insulin secretion, regulating appetite and controlling the absorption of nutrients from the food and the conversion of those nutrients to energy. In his lab, Dr. Drucker identified substances that mimic and enhance the ability of these naturally occurring hormones for use in treating diseases such as diabetes, obesity and inflammatory bowel disorders. Moreover, Dr. Drucker recently demonstrated that incretin therapies—specifically GLP-1R agonists—can also lower blood pressure and modify the risk for developing heart attacks and strokes, two of the most dangerous complications associated with Type 2 diabetes. These breakthroughs have the potential to lead to new and better treatments for millions of people worldwide.
RESET IT and PREVAIL: Transforming care for diabetes patients through clinical trials
Patients like Susan who must constantly be vigilant about her Type 2 diabetes management are profoundly grateful for the work by researchers like Dr. Drucker and for the opportunity to participate in cutting-edge clinical trials, such as RESET IT, that are catalyzing shifts in the treatment of diabetes that could stop the disease in its tracks, preventing the worsening of the condition and making life—and treatment—more manageable for diabetes patients.
Led by Dr. Ravi Retnakaran, RESET IT—the trial Susan is participating in— aims to put diabetes into remission by introducing short-term insulin therapy for two to three weeks early in the course of the disease, when it is still possible to preserve the function of beta cells in the pancreas (which produce insulin). Typically, insulin therapy is the treatment of last resort, prescribed to patients at a point in the disease when the beta cells have worsened beyond repair.
Another new clinical trial at Mount Sinai, PREVAIL, led by Dr. Drucker’s colleagues Drs. Ravi Retnakaran, Bernard Zinman, Caroline Kramer, and Bruce Perkins, may help early Type 2 diabetes patients maintain blood sugar control without increased risk of low sugars or weight gain – adverse effects caused by current drug treatments. Participants involved in the PREVAIL study receive insulin injections and a new medication called exenatide in an effort to preserve the function of beta cells in patients with Type 2 diabetes.
For more information about ongoing clinical trials for diabetes or to enroll in the PREVAIL trial, please call the Leadership Sinai Centre for Diabetes at 416-586-4800 ext. 8775.
Your Donor Dollars at Work
Mount Sinai’s groundbreaking work in diabetes is sustained by the generosity of our donors, who help fuel our innovative research programs and enable us to offer our patients first access to the most cutting-edge therapies available. In 2014, Stephen and Suzie Pustil, long-time supporters of Mount Sinai and our diabetes research, committed to a generous gift to support the pivotal work of Dr. Bernard Zinman, Director of the Leadership Sinai Centre for Diabetes, whose frequent collaborations with Dr. Daniel Drucker have enhanced treatment for millions of diabetics worldwide. A portion of the Pustils’ gift also supports the RESET IT clinical trial that is changing the lives of patients like Susan.