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‘Lace Up’ funds diabetes research 100 years after Canadians discovered insulin ‘Lace Up’ funds diabetes research 100 years after Canadians discovered insulin

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Diabetes Canada held its first national five-kilometre relay on Sept. 25 as part of the organization’s annual Lace Up fundraiser to generate money for research aimed at curing the disease.

Participants in the activities promoted during September’s month-long Lace Up fundraiser were encouraged to don their track shoes or rollerblades to generate donations.

Those involved were also asked to join Diabetes Canada on Facebook or Instagram at noon in their time zone (12:30 p.m. in Newfoundland) to hear participants’ stories about living with the disease or supporting a family member.

This year’s fundraiser was held 100 years after the discovery of insulin in 1922 by a University of Toronto research team headed by Dr. Fredrick Banting. The Nobel Prize-winning feat, one of the most notable medical discoveries in Canadian history, gave diabetics a way to manage their condition and has saved the lives of millions of people around the world.

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Diabetes Canada’s Lace Up fundraiser ran from Sept. 1 to Sept. 30. Canadians from B.C. to the Atlantic provinces worked together to raise money to advance diabetes research, diabetes education, support services and advocacy. Funds are also used to help children with diabetes attend summer “D-Camps“.

Diabetes Canada promoted the event as “lacing it up” so that Canadians can choose how they would like to do the five-kilometre relay. The fundraising team said participants were invited to walk, run, ride, rollerblade or choose another way to take part.

This year’s fundraiser was held 100 years after the discovery of insulin in 1922 by a University of Toronto research team headed by Dr. Fredrick Banting.

According to Diabetes Canada, nearly 11.7 million Canadians are living with diabetes or prediabetes. The autoimmune disease affects one in three people across Canada, and 1 in 2 young adults are at risk of developing type 2 diabetes in their remaining lifetime.

Diabetes is a disease in which your body cannot produce insulin at all or can’t properly use the insulin it produces. Insulin is a hormone produced by the pancreas, which is located between the stomach and the spine along with the gallbladder, liver and spleen.

Insulin regulates the amount of glucose (sugar) in the body’s bloodstream. Blood glucose levels have to be carefully regulated to ensure that the body functions correctly. Too much sugar in the bloodstream can damage organs, blood vessels and nerves. The body also requires insulin to convert sugar to energy.

There are three major types of diabetes. Type 2 diabetes is the most common diagnosis, accounting for about 90 per cent of cases, and typically develops over time from factors such as body weight and diet. Type 1 diabetes typically develops in childhood as an auto-immune disorder in which the immune-producing cells in the pancreas are damaged.

Gestational diabetes occurs during pregnancy and is usually temporary. Prediabetes is another important diagnosis, which indicates an elevated risk of developing diabetes, typically Type 2.

“When you talk about it in terms of percentages, it’s harder to kind of imagine in your head,” said Diabetes Canada fundraiser Megan Spurrell. “But talking about it (in) terms of one in three” Canadians being affected, is very impactful, she said.

NovoRapid brand rapid-acting insulin aspart solution is commonly prescribed to diabetics. [Photo © Nicole Beswitherick]

But even with the help of insulin, diabetes can still reduce an individual’s lifespan by five to 15 years. Laura Syron, president of Diabetes Canada, said recently: “Diabetes is successful at outrunning us all and with a new diagnosis every three minutes in Canada, it’s not slowing down.”

The Lace Up event was first scheduled to be held in 2020, but the pandemic forced fundraising activities online.

Last year, some 1,000 participants across Canada worked together to raise more than $450,000 for Diabetes Canada. In the summer of 2021, D-Camps provided 95 hours of programming to 218 families, the organization said.

Previously, relay participants didn’t have a way to track the distances they’d covered directly with Diabetes Canada. But this year, there a new Lace Up to End Diabetes app was introduced.

“The app is great because it is the only place through Lace Up where you can track how many kilometres you’ve moved,” Spurrell stated.

Spurrell added that individual or team participants in the Lace Up fundraiser have the opportunity to designate their funds to specific causes if the participants raise $2,500 or more. This would allow them to direct the money they raise to medical research, camps for children living with diabetes or other options.

Diabetes Canada and the Juvenile Diabetes Research Foundation carry out research and conduct clinical trials. Diabetes Canada has been supporting research since 1975 and has provided more than $140 million in grants, awards and partnerships to scientists across the country — funding supported by events such as Lace Up.

Diabetes Canada promotes the Lace Up event as one of its major annual fundraisers. [Courtesy of Diabetes Canada]

Kelly Lang, research and administration specialist for Diabetes Canada, Kelly Lang said the organization holds an annual research funding competition to select the best projects to support each year.

Each application goes through a rigorous peer-review process and funding decisions are based on the expert recommendations of Diabetes Canada’s National Research Council, said Lang.

Dr. Erin Mulvihill, a researcher with the University of Ottawa and Ottawa Heart Institute, is among the recent funding recipients and is working on a project that is testing the short- and long-term impacts of consuming a low-carbohydrate diet to improve the health of those with diabetes.

Dr. Mulvihill has received the End Diabetes: 100 Award (2021-2024), the Diabetes Canada New Investigator Award, and others.

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Study explores the risk of new-onset diabetes mellitus following SARS-CoV-2 infections – News-Medical.Net

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In a recent study posted to the medRxiv* preprint server, researchers evaluated individuals who had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and were diagnosed with diabetes mellitus within six months of the onset of coronavirus disease 2019 (COVID-19) to understand the temporal relationship between SARS-CoV-2 infections and diabetes mellitus.

Study: Are fewer cases of diabetes mellitus diagnosed in the months after SARS-CoV-2 infection? Image Credit: Africa Studio/Shutterstock

Background

Recent research indicates a potential increase in the new-onset diabetes mellitus diagnoses after SARS-CoV-2 infections. While the causative mechanisms are not clearly understood, various hypotheses suggest the roles of stress-induced hyperglycemia during SARS-CoV-2 infections, changes in the innate immune system, virus-induced damage or changes to the beta cells or vasculature of the pancreas, as well as the side effects of the treatment in the increased incidence of diabetes mellitus diagnoses.

Furthermore, the drastic lifestyle changes brought about by the COVID-19 pandemic have decreased physical activity and increased obesity. The stress induced by the pandemic has also increased endogenous cortisol levels, a known risk factor for diabetes mellitus. Examining the temporal relationship between SARS-CoV-2 infections and new-onset cases of diabetes mellitus will help develop effective screening and therapeutic strategies.

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About the study

In the present study, the team conducted a nationwide analysis using electronic health records aggregated in the National COVID Cohort Collaborative (N3C) database in the United States (U.S.). They analyzed all individuals with SARS-CoV-2 infections and type 2 diabetes mellitus between March 2020 and February 2022. Data from the health records for the six months preceding and following the SARS-CoV-2 infections were included to avoid selection and ascertainment bias.

SARS-CoV-2 infections were confirmed based on the International Classification of Diseases, Tenth Revision (ICD-10) code, or laboratory test results. New-onset diabetes mellitus cases were defined as those that did not have an ICD code for diabetes mellitus in their electronic health records before September 2019. The incidence of diabetes mellitus was then analyzed concerning SARS-CoV-2 infections.

Results

The results reported a sharp increase in new-onset diabetes mellitus diagnoses in the 30 days following SARS-CoV-2 infections, with the incidence of new diagnoses decreasing in the post-acute stage up to approximately a year after the infection. Surprisingly, the number of new-onset diabetes mellitus cases in the months following SARS-CoV-2 infections is lower than in the months preceding the infection.

The authors believe that the increase in healthcare interactions brought about due to the COVID-19 pandemic might explain the notable increase in diabetes mellitus diagnoses in the time surrounding SARS-CoV-2 infections. New patients might have been tested for hemoglobin A1C or glucose levels during their first interaction with the healthcare system, the results of which might have then been used to diagnose diabetes mellitus.

Additionally, SARS-CoV-2 infection-induced physiological stress could have triggered diabetes mellitus in high-risk individuals who might have developed the disease later in life without COVID-19.

According to the authors, the overall risk of developing diabetes mellitus has increased, irrespective of SARS-CoV-2 infections, due to the drastic decrease in physical activity, weight gain, and the stress induced by the COVID-19 pandemic. Furthermore, a longer follow-up period might report an increased incidence in new-onset diabetes mellitus cases, with the SARS-CoV-2 infection precipitating disease development in individuals who might not have otherwise developed diabetes.

Conclusions

To summarize, the researchers conducted a cross-sectional, nationwide analysis of individuals in the U.S. to understand the temporal relationship between diagnoses of new-onset diabetes mellitus and SARS-CoV-2 infections. The results reported a spike in diabetes mellitus diagnoses in the one month following SARS-CoV-2 infections, followed by a marked decrease in the number of diagnoses for up to a year after the infection.

The authors believe that the sudden increase in diabetes diagnoses could be due to increased healthcare interactions brought about by the COVID-19 pandemic. The new-onset diabetes mellitus cases could also be a reaction to the physiological stress induced by SARS-CoV-2 infections.

Furthermore, the drastic lifestyle changes brought about by the COVID-19 pandemic might be responsible for the high incidence of diabetes mellitus, irrespective of SARS-CoV-2 infections. However, extensive research is required to understand the epidemiology and mechanisms connecting SARS-CoV-2 infections with new-onset diabetes mellitus.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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Toronto-based infectious disease expert seeing more older patients with flu in hospital

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An infectious diseases physician in Toronto is reporting an increase in the number of older patients he is seeing with seasonal influenza.

Dr. Isaac Bogoch at Toronto General Hospital noted this year’s flu season started early and escalated quickly.

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According to the Public Health Agency of Canada, children under five are still making up the largest age bracket of flu patients in hospital. However, rates among seniors (aged 65 and up) are on the rise.

Bogoch expects the number of flu cases to keep increasing. The season usually peaks in January.

To track the number of flu cases in Durham Region this season, click here.

 

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Breakthrough Infections More Likely in Infliximab Treated IBD Patients Than Those Treated With Vedolizumab

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Patients with inflammatory bowel disease (IBD) treated with infliximab who were vaccinated against SARS-CoV-2 were more likely to have a breakthrough infection than patients treated with vedolizumab, but the benefits of the vaccine are still superior.

A team, led by Zhigang Liu, PhD, Department of Metabolism, Digestion and Reproduction, Imperial College London, determined how infliximab and vedolizumab affect vaccine-induced neutralizing antibodies against highly transmissible omicron (B.1.1.529) BA.1, and BA.4 and BA.5 (hereafter BA.4/5) SARS-CoV-2 variants.

The Treatments

Anti-TNF drugs, including infliximab, are linked to attenuated antibody responses following SARS-CoV-2 vaccination. The variants included in the analysis have the ability to evade host immunity and with emerging sublineages are currently the dominating variants causing the current waves of infection.

In the prospective, multicenter, observation, CLARITY IBD cohort study, the investigators looked at the effect of infliximab and vedolizumab on SARS-CoV-2 infections and vaccinations in patients with IBD.

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The study included patients aged 5 years or older with an IBD diagnosis that were treated with infliximab or vedolizumab for 6 weeks or longer in infusion units at 92 hospitals in the UK. Each participant had uninterrupted biological therapy since recruitment and were not previously diagnosed with a SARS-CoV-2 infection.

Outcomes

The investigators sought primary outcomes of neutralizing antibody responses against SARS-CoV-2 wild-type and omicron subvariants BA.1 and BA.4/5 following 3 doses of a SARS-CoV-2 vaccine.

The team also investigated the risk of breakthrough infections in relation to neutralizing antibody titers using Cox proportional hazard models.

There were 7224 patients with IBD recruited to the study between September 22 and December 23, 2020. Of this group, 1288 had no previous SARS-CoV-2 infections after 3 doses of the vaccine that were established on either infliximab (n = 871) or vedolizumab (n = 417). The median age of the patient population was 46.1 years.

Following 3 doses of SARS-CoV-2 vaccine, 50% neutralizing titers were significantly lower in the infliximab group compared to patients treated with vedolizumab against wild-type (geometric mean, 2062; 95% CI, 1720–2473 vs geometric mean, 3440; 95% CI, 2939–4026; P <0.0001), BA.1 (geographic mean, 107.3; 95% CI, 86.40–133.2 vs geographic mean, 648.9; 95% CI, 523.5–804.5; P <0.0001), and BA.4/5 (geographic mean, 40.63; 95% CI, 31.99–51.60] vs geographic mean, 223.0; 95% CI, 183.1–271.4; P <0.0001) variants.

Breakthrough infections more frequently occurred in patients treated with infliximab (n = 119; 13.7%; 95% CI, 11.5–16.2) than in those treated with vedolizumab (n = 29; 7.0%; 95% CI, 4.8–10.0; P = 0.00040).

The Cox proportional hazard models show time to breakthrough infection after the third vaccine dose in the infliximab group was associated with a higher hazard risk than treatment with vedolizumab (HR, 1.71; 95% CI, 1.08-2.71; P = 0.022).

There was also higher neutralizing antibody titers against BA.4/5 with a lower hazard risk in the group with a breakthrough infection and a longer time to breakthrough infection (HR, 0.87; 95% CI, 0.79-0.95; P = 0.0028).

“Our findings underline the importance of continued SARS-CoV-2 vaccination programs, including second-generation bivalent vaccines, especially in patient subgroups where vaccine immunogenicity and efficacy might be reduced, such as those on anti-TNF therapies,” the authors wrote.

The study, “Neutralizing antibody potency against SARS-CoV-2 wild-type and omicron BA.1 and BA.4/5 variants in patients with inflammatory bowel disease treated with infliximab and vedolizumab after three doses of COVID-19 vaccine (CLARITY IBD): an analysis of a prospective multicenter cohort study,” was published online in The Lancet Gastroenterology & Hepatology.

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