Type 1

Join us in finding the cure for type 1 diabetes

Reform and replace

A two-pronged approach to

stopping type 1

NORTONHow type 1 doesn’t

hold him back

FOUR PAGE SPECIAL ON IMMUNOTHERAPY

Two with type 1Mother faces realities of raising two children with a type 1 diagnosis

Issue 84/ November – February 2019/20

JAMES

First oral drug for type 1 diabetes approved for NHSUsed alongside insulin it can improve long-term health conditions

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Managing Editor: Orna Joseph Production Editor: Jayne MulliganContributors: James Norton, Katie Bailey, TJ Halbertsma, Leanne Lochhead, Mark Peakman.

Cover picture: James Norton as pictured on pages 6/7

JDRF does not endorse any of the products or services advertised in Type 1 Discovery. Articles in Type 1 Discovery written by freelance contributors do not necessarily represent the views of JDRF.

A two-pronged approach to stopping type 1

Responding to glucose monitors made easier

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Living a full life with type 1A type 1 diagnosis is life-changing. Whatever age it happens, getting to grips with the condition can take time and effort. It takes strength and resilience.

In this issue we look at how people and families adapt to life with type 1. We have some incredible stories of achievements by families and people with type 1. Whilst living with type 1 can change lives, the message here is clear. It does not hold you back. James Norton shares his type 1 journey with us, and reveals the challenges he’s faced, but how ultimately he doesn’t let type 1 stand in his way to living a full life.

I would like to thank everyone who took part in our first ever Climb 1 for Type 1 fundraising event which saw three teams take on the three highest peaks in the UK.

We saw another successful year of OneWalks. In London we were joined by our celebrity ambassador Jonny Labey, who opened the walk, and lead a dance routine warm up for everybody. Thank you to everyone who has taken part in our OneWalks. Your support brings us closer to a cure for type 1.

A word from Karen

Call for financial support

5

12

for students with type 1

Karen AddingtonChief Executive Join us on

social media

jdrfuk

jdrfukRead this onlineGet the latest edition of Type 1 Discovery at jdrf.org.uk/discovery to find out how

The Steve Morgan FoundationUsing chemically modified insulin in a new test for type 1 diabetes Dr Ahuva Nissim – Queen Mary University of London

Neuroimaging Hypoglycaemia AwarenessDr Pratik Choudhary at King’s College London

Can high-intensity exercise combat hypo-unawareness?Professor Rory McCrimmon – University of Dundee

TrialNetProfessor Polly Bingley – University of Bristol

A generous legacy from the estate of James ElsonOvernight closed loop control in suboptimally controlled type 1 diabetes under free living conditionsProfessor Roman Hovorka – University of Cambridge

The Alan and Babette Sainsbury Charitable Fund Beta cell turnover in patients with long-standing type 1 diabetesDr Richard Oram – University of Exeter and Professor Yuval Dor – The Hebrew University - Hadassah Medical School

The Charles Wolfson Charitable Trust Harnessing vascular stem cells to model and treat diabetic retinopathyDr Reinhold Medina – Queen’s University Belfast

The Cadogan CharityMartin Laing FoundationA new way to measure the risk of developing retinopathy for people living with type 1 diabetesDr Richard Lee - University College London

Garfield Weston FoundationAccelerating the Adoption of Type 1 Diabetes Treatments

The Edward Gostling FoundationType 1 Discovery Days

John Swire 1989 Charitable TrustUsing chemically modified insulin in a new test for type 1 diabetes.Dr Ahuva Nissim - Queen Mary University of London

These foundations and trusts are supporting the following projects:

To find out about all the projects we fund, visit jdrf.org.uk/research

5270 Eversense Ad DiscoveryMag_v3-OLfinal.indd 1 13/09/2019 14:39

jdrf_uk

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NEWS & VIEWSNEWS & VIEWS

Artificial pancreas

Teams of researchers across the US have joined forces to test if a new biological ‘sign’ – or biomarker – of beta cell loss could boost current methods that predict if and when a person will develop type 1 diabetes.

Blood samples from participants in TrialNet’s Pathway to Prevention study, which is part-funded by JDRF, were used by researchers testing the new biomarker. They reported that the new biomarker indicated that people with high levels of beta cell loss developed type 1 an average of five years earlier than those with lower levels. They also found that loss of beta cells was associated with the detection of an autoantibody which is currently used to predict type 1 development.

Henry Slade has been in action during the 2019 Rugby World Cup in Japan, playing for the England team. Henry has lived with type 1 since the age of 18 and has not let it hold back his rugby career. To date, he has over 15 caps.

How have you stepped outside of your comfort zone when it comes to type 1 diabetes management?

Hobbies

Team sports

41%

Family support

The way my son copes with it when I’m flapping and fussing, he’s my absolute hero.

Our survey says

For more information about the latest news go to jdrf.org.uk/news

We asked you...

Researchers find new way to boost predictability of type 1 diagnosis What helps you most with

your emotional wellbeing when managing your or your child’s type 1?

12%

36%

11%

Having a supportive employer to work flexibly when I have bad nights with my type 1 daughter.

Managing type 1 in very young children is particularly challenging for their families as they can have unpredictable outbursts of activity and irregular eating habits.

In a study led by Professor Roman Hovorka, children aged seven and under trialled the artificial pancreas, which continuously monitors glucose and automatically calculates and gives the correct amount of insulin. The children’s parents and caregivers then completed a survey exploring the benefits and limitations of the technology.

More than four in five said that

they spent less time managing their child’s diabetes, and most reported a reduction in stress levels and improved sleep quality. They also said they felt less worried about their child’s glucose management and that the whole family’s wellbeing had improved.

Eleanor Sherwood, Research Communications and Engagement Officer at JDRF, said: “By alleviating some of the anxiety and lack of sleep that can be part and parcel of life with type 1, the artificial pancreas can improve the wellbeing of families of young children with type 1 diabetes.”

Find out moreYou can keep up with our latest news at jdrf.org.uk/news

or follow us

Peer support

A new study has shown that parents and caregivers of very young children with type 1 spent less time managing their child’s diabetes and had better sleep while using the artificial pancreas

CYCLISTS TAKE ON RIDELONDON FOR TYPE

102 cyclists donned their JDRF jerseys and took part in the Prudential RideLondon at the beginning of August to raise funds for vital type 1 research. The course took them through some of London’s most popular landmarks. The cyclists raised an amazing total of £70,000.

improves wellbeing of families

The UK government’s Disabled Students’ Allowance (DSA) provides specialised, personalised support to see students with all disabilities through their studies. But many students with ‘invisible’ health conditions are often under the impression that you can only apply if you have a physical disability.

A grant from DSA can go towards specialist equipment, personal support, non-medical helpers or travel costs. More information is available in the JDRF University Toolkit, created alongside Diabetes UK and NHS England.

Download the toolkit here: jdrf.org.uk/uni

Call for financial support for students with type 1

TACKLING TYPE

Talking to my husband and making joint decisions and plans about management and also about treatment.

In August, JDRF called for universities to do more to help students with long-term health conditions, including type 1 diabetes, access crucial financial support through funding

I didn’t have type 1 when I was growing up and my hero was Jonny Wilkinson, who as a young lad playing fly half, was a big inspiration for me

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Has type 1 stopped you from doing anything you wanted to do?

When I was diagnosed, I was 22 and at drama school – I had a two-day type 1 induction and what I distinctly remember being told was: ‘you control the diabetes, it doesn’t control you.’

I also have a little sister who has lived with type 1 from the age of nine, so I have had an incredible example with her – especially as she was adamant not to let it stop her from doing anything.

There will always be the inevitable times when you have to take more

care, as well as preparation to go anywhere – but I am adamant that it won’t limit what I can do.

The only thing it did once stop me from doing was scuba diving on holiday because I didn’t have the right letter from my GP.

As far as my work is concerned though, it hasn’t stopped me at all – although sometimes I have a hypo and have to take a break and then get my energy back.

I have chosen not to go down the pump route because of the nature of the work I do. With having to get in and out of costume, the pump just

Get support on living with type 1 at jdrf.org.uk/living

REAL LIFE

for me, to make sure that I am relatively balanced. And if there is a kitchen or drawers on the set, I’ll make sure there is a bottle of juice stored in there just in case.

And if it’s a period piece, I’ll ask the costume department to stich me some extra pockets so I can keep Dextrose or Lucozade tablets on me.

Do you know many other actors with type 1?

Jeremy Irvine is one and we always seek each other out at events, we are both on the Dexcom G6 system and its always lovely meeting fellow diabetics.

I was at a dinner once with Jeremy, the model Bambi who also has type 1, as well as my sister and it happened that the first courses were low in carbs. Having given ourselves insulin, we all ended up having hypos together – and had to demand juice be urgently brought to our table.

I love talking to other people with type 1 diabetes and if I see someone giving themselves a jab, I will go over to speak to them, even if they are people I have never met.

For some reason all the people I meet with type 1 seem to be exceptionally cool.

It is reassuring to know there are other people dealing with the same condition as you - it normalises it. Sometimes I forget that other people don’t have it, so I make a point of not ever hiding it, to normalise it for other people – but a lot of people aren’t used to seeing type 1 diabetes.

What are your type 1 management secrets while on location?

My secret is always having fruit juice. I know juice isn’t as easy to know exactly how much you are taking but you soon get used to it and I feel less reluctant to drink it.

For a long time, I used Dextrose but switched about three years ago to juice, so now I always have a bottle in my bag

REAL LIFE For some reason all the people I meet with type 1 seem to be exceptionally cool

I have chosen not to go down the pump

route because of the nature of the work

I do. With having to get in and out of costume, the pump

just isn’t the best option for me

isn’t the best option for me. The great thing is I now have a

Dexcom CGM, which provides peace of mind by allowing you to switch off the part of your brain that thinks about checking your levels every other minute.

So, I can give it to someone on set and when it buzzes, they can come over and tell me what it’s saying. The share feature within the G6 also allows for me to share my data with my colleagues, family and friends off stage, so they can monitor my levels and alert me only if necessary when I’m low or high.

Film sets are intense environments – and so is the stage. I used to sometimes forget about my diabetes and run high, so having CGM technology has provided massive relief.

Are film sets accommodating to your needs with type 1?

I just make sure, without making a big thing of it, that I tell the people who need to know, like the director, and the people who do the running around on the film set. You create little codes, like a quick nod – and they know what you need.

I have contingency plans in place. My pen is always with the make-up bag for example – as you get a make-up refresh every 10 minutes – so while they are doing the powder, I will correct my glucose levels.

I am on two insulins - Novorapid and Lantus, and I choose to do more injections and keep my control within good parameters that way. But having a CGM means I no longer have to stop everything and do finger pricks throughout my day. However, having a phone on set is sometimes an issue. I have heard of directors throwing phones in a bucket of water if they go off.

There are certain important scenes that need total silence, but with Dexcom you can’t override the alarm as people have to know they are going low. While this has caused the odd disturbance, I am really lucky that I can incorporate the condition so easily into my working life.

On stage I can’t check my phone, so I have someone off stage checking

and by my bed, with a straw so I don’t need to get out of bed and brush my teeth again; one of the real irritations with type 1 is the sleep disruption.

What advice or messages of support would you like to pass on?

While I am very lucky to have access to CGM technology, I know lots of people currently don’t. Also, having a mum and sister with the condition has really helped. I also have a great support network and live near my diabetes team in London, which has excellent care.

There does need to be more access to CGM technology, especially for young people. We need the government and NICE to make CGM technology more widely available. It fosters a false economy to not spend money in the earlier stage on life-changing management solutions like CGM technology, and then spend it on care for things like complications later on.

I didn’t talk about my diabetes when I was first diagnosed but when I started to more and more, I felt relief. And once I did, I realised lots of people are dealing with something too.

There is an amazing community, through JDRF and Diabetes UK and other people with diabetes on social media you can talk to now, compare notes and feel a sense of solidarity.

I think one of the weird positives of having type 1 diabetes is it allows you a certain level of empathy – which we talk about a lot in acting – empathy is our currency – so an in-direct silver lining is that my type 1 diabetes really encourages this.

So, my advice is to talk about it, be open and don’t allow yourself to feel embarrassed – as this limits you.

If you go high or low – try not to worry – put precautions in place and do everything you can to give yourself the right attitude and the right approach.

‘You control the diabetes, it doesn’t control youTelevision and film star James Norton, is one of JDRF’s celebrity supporters. He’s joined us through several campaigns, raising awareness and supporting type 1 diabetes research. Here James shares an insight into the way he works to make sure type 1 diabetes doesn’t hold him back

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REAL LIFE LIFESTYLE

My type 1 shopping list

watch

FreeStyle LibreThis flash glucose sensor is the size of a two-pence piece and lasts for 14 days. Readings can be given by scanning the arm with the reader or user’s phone. freestylelibre.co.uk/libre

Guardian Sensor 3 The sensor and transmitter are compatible with the Medtronic 670G and 640G insulin pumps. medtronicdiabetes.com

Dexcom G6 The latest model of Dexcom continuous glucose monitors lasts for 10 days. dexcom.com

Product

If you want to share your shopping list, email us at info@jdrf.org.uk

‘I love gardening and I like to grow my own food!Eight year old Darcy is very independent and when diagnosed at 5 ½, started doing her own injections straight away.

She enjoys everything sporty and knows the type of food that keeps her full of energy but not full of sugar; “My favourite things to eat are fruit and vegetables, and I love to grow them in my garden”.

Carrots • I have always loved carrots and grew them for the first time this

year. They are a great snack that I don’t need to carb count and I love to eat them with hummus. Sometimes I take them to school for my snack.

Tomatoes• I have grown 300 tomatoes this year! They are a very brightly

coloured fruit, which means they are very good for you and they are delicious with cheese. I love to watch them change colour and picking the red ones is the best bit!

Sweetcorn • I love sweetcorn with butter. Corn is really easy to grow and my

mice like to eat it too! Carb counting sweetcorn is easy, as the information is always on the pack. Most vegetables don’t need to be counted so it is important to remember that sweetcorn is a bit different.

Strawberries• I love that strawberries are juicy and

you can put them with cereal, ice cream, yogurt and even cheese! My strawberries are very red and are especially yummy with multigrain muesli. I mix them with nuts to make sure my sugar levels don’t climb too quickly and it helps to make sure I have lots of energy for school.

Jacket potatoes• I love jacket potatoes. They are my

favourite meal, especially with salad or with baked beans. They are cooked with their skin, which means that my sugar level increases slowly when I eat them. This is much better than a big increase from mashed potato. Next year I am going to grow my own!

Flash glucose and continuous glucose monitoring give greater insights into blood glucose levelsComing to terms with a double diagnosis

As I stood over my sleeping daughter holding the blood glucose monitor that read

28, the floor slipped away from underneath me. This time, I knew what that number meant. This time I knew what was coming. This was the second time this had happened in less than 6 months. I truly questioned whether I had the strength to do this all over again. But from somewhere, that strength has come. It turns out love is stronger than grief.

Last November my four-year-old son was diagnosed with type 1 diabetes and the following April my seven-year -old daughter was also diagnosed. I know from speaking to other parents of kids with type 1 that this is the thing they dread.

And yes, it isn’t easy. We now come as a three while my husband is at work. Playdates, after-school clubs and activities are all done together en masse. It’s all-consuming. There’s the times when one has high blood sugar and the other one is hungry for snacks and the times when one is low and the other wants the

If you’ve got a story to tell, email us at info@jdrf.org.uk

They understand what the other is going though and I hope will be a support for each other in the future

hypo treatment too. It’s two sets of numbers to be watching and managing and double the level of anxiety and worry. And of course it’s not something you want for your child, let alone both of your children.

But there is also a sense of camaraderie. My children’s bond has grown that little bit closer. They understand what the other is going through and I hope they will be a support for each other in the future. My daughter is desperate for me to also join their club: “If you get diabetes too mummy will you have a pump like mine?” I wish with all my heart I could take it from them.

Katie Bailey, mother of two, shares her experiences

And as hard as it is, it’s harder knowing that one day it will be their responsibility and their worry. Although mine will never go away.

But what has helped? A deeper understanding and bond that has also grown between my husband and me despite the sleep deprivation, the tears and the anxiety. I’ve also had to recognise my own shortcomings: I can no longer overthink and over worry about the future. I can’t let myself, as that is a dangerous place. Instead I have learned to live in the moment. Try our best. If it works, celebrate. If it doesn’t, try again tomorrow; but be gentle on ourselves for we are trying our very hardest. It’s also become a family mantra to never say no because of diabetes. So amongst all the grief there’s been joy: camping, music festivals, impromptu swims in the sea, ice creams, candy floss and pizzas. Because that is what childhood is all about. And when I finally have to hand these reins over to my children that’s what I want them to remember: life is full and fun, and nothing is going to take that away. Nothing will stand in their way.

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LIFESTYLE Q&A

Type in 10Leanne Lochhead is mum to Beren, 7, who lives with type 1. She has released a song to fundraise for JDRF

You can read more stories about people living with type 1 diabetes on our blog. Go to jdrf.org.uk/blog to find out more

How did you find out your son had type 1?

A Beren was diagnosed when he was three. He became really thirsty, needed the toilet lots and even started having accidents.

A type 1 diagnosis can be life-changing. How did Beren’s diagnosis affect your life?

A I was a single mum doing gigs and working part time at a nursery whilst Beren was at pre-school. When he started on multiple daily injections, his pre-school were unwilling to administer injections so I gave up work. Now he’s on an insulin pump but I often need to go in to help.

You have been singing all your life and have sung professionally. How did you decide to combine your passion for songwriting and fundraising?

A We already had the song Guardian Angel which is about caring for someone but as I was singing it after Beren was diagnosed the meaning felt different. We changed a few words and decided we would like to try and raise awareness and money for JDRF. If we could make a video showing a little part of life with type 1 it would help people understand more.

Any career highlights you’d like to share?

A I’ve sung and been interviewed live on radio stations which was more nerve- wracking than my performances with a live band! I was recently in a Darkness

video which was loads of fun and had a lovely chat with Dan Hawkins on set whose daughter has type 1!

What has the response to Guardian Angel been like?

A I’ve had a lovely response to Guardian Angel especially from type 1 parents who can relate. Amongst lots of other things I was interviewed on ITV Granada Reports. I’m hoping that people will carry on sharing the video to spread awareness and raise money.

Have you done anything else to raise awareness/money for type 1 diabetes?

A I have had a few companies help me raise money with fundraising events, I had a Type 1 Tea Party and did the 40 day step challenge. We have raised £2,000 so far through my JustGiving Page.

What is an area of type 1 research that you are most excited about?

A I am most excited about smart insulin. Administering one injection a day and not wearing a pump or carb counting would be life-changing.

As a mum of a child with type 1, what would you like others to know about the condition?

A I would really like other parents to realise this is a life-threatening condition that requires 24/7 attention. Many do not understand the condition – even the basics. I had a stranger tell me at an ice cream van that cinnamon would cure Beren in 2 weeks!

What advice would you give to parents of children newly diagnosed with type 1?

A I would tell them to get help and do their own research. I have had a lot of support from other parents in the same position. I’ve still got things to learn.

Now you have released Guardian Angel, what have you got planned for the future?

A I started writing blogs and sharing our highs and lows (literally) on social media. I also sing soprano in eight- piece pop a cappella group called Shades of Blue. I take every opportunity I perform to spread awareness if I can!

Find out more about Leanne and her music, including Guardian Angel, at www.tinyurl.com/leannelochhead

TJ Halbertsma has always loved challenge and adventures but when his nephew, Felix, was diagnosed with type 1, they took on a whole new meaning

Thoughts of a type 1…

Uncle

If you’ve got a story to tell, email us at info@jdrf.org.uk

I decided that my adventures should mean something and started using them as a way of raising money for type 1 research. In 2015, I took 20 young people with type 1 up Ben Nevis

I love to push myself out of my comfort zone and this usually involves the great outdoors. I’m not a trained mountaineer or famed explorer. I’m just an ordinary guy who likes to do extraordinary things. So what has this got to do with type 1 diabetes? In 2012 at the age of two, my nephew Felix was diagnosed with the condition. Now nine, he has dealt with years of constant fingerpricks, injections and pump infusions with strength and resilience. I want to see medical developments advance so that he doesn’t have to do this anymore.

I decided that my adventures should mean something and started using them as a way of raising money for type 1 research. I also wanted to get young people with the condition involved. In 2015, I took 20 young people with type 1 up Ben Nevis. I wanted them to see that having type 1 should not hold them back from achieving great things. It was

inspiring to see the participants’ confidence levels soar as they completed the trek.

People who live with type 1 are an inspiration to me. The first time I had to babysit Felix, I was extremely nervous. Even though I had been shown how to use a glucometer I still faltered. However, Felix, aged five at the time, took over and showed me how to do it. His acceptance and determination at such a young age was wonderful to witness.

I think it’s extremely important for people to believe in themselves and know that they can achieve amazing things if they want to. This is why I have written a book called Many Worlds to Conquer: Dare to Dream and Make it Happen! Each chapter covers an adventure that I have had

and how I overcame obstacles while doing them.

Having type 1 diabetes should not stop you having these experiences. One of my partners in these expeditions has type 1 and I have seen him achieve amazing things. It has not held him back. I have seen the countless blood glucose tests and insulin injections needed to manage his blood glucose but he has always done it without complaint.

I want to see a cure for Felix and everyone else with type 1 diabetes. That’s why proceeds from the sale of my book will be donated to JDRF to continue to fund world-class type 1 diabetes research. Until that day comes, people with type 1 should know that they can achieve anything.

TJ with his nephew Felix

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With a two-pronged approach aiming to replace lost beta cells and stop the immune attack through immunotherapy, we believe that a cure is possible

inflammatories and immunotherapy, to immune cells in the pancreas and the gut.

Tolerisation projects such as these seek to stop type 1 at the very core. However, upon diagnosis, it’s estimated that people have just 10-30% of their beta cells left and so a functional cure would also need to involve replenishment of the lost beta cells.

Replacement and regenerationA team of scientists led by Dr Francesca Spagnoli at King’s College London is trying to reprogramme skin cells so that they turn into bona fide pancreatic beta cells. Skin cells have previously been transformed into heart muscle, liver and nerve cells using a similar technique and so Dr Spagnoli is optimistic about the results.

If successful, a person with type 1 could simply donate a small sample of their own skin cells to a lab before having them turned into functional beta cells and reintroduced into the body to restore insulin production. As the beta cells would essentially be ‘home-grown’, there should be no risk of rejection, removing the need for immunosuppressant drugs.

In the US, researchers are trying a different approach. Professor Gregory Ku at the University of California, San Francisco, is leading a team who hope to kick-start beta cell growth in people with type 1. In the past, this has been problematic as beta cells do not naturally divide and grow very quickly.

However, his team has found a molecular pathway that stimulates beta cell growth and insulin production in mice. The ‘switch’ which turns this pathway on is

RESEARCH FOCUS RESEARCH FOCUS

12

Immunotherapies have been successful in other autoimmune conditions such as rheumatoid arthritis and psoriasis.

JDRF is currently funding over 80 immunotherapy research projects.

Know your facts on Hypo activity

Know your facts

A two-pronged approach to stopping type 1

Type 1 diabetes is an autoimmune condition driven by an attack on insulin-producing beta cells in the pancreas. As a result, the beta cells are destroyed and people with type 1 can no longer make their own insulinType 1 is therefore a complex condition that may need a complex solution – and JDRF scientists are investigating ways to stop the attack by using a two-pronged approach.

Tolerisation – reforming rogue immune cellsIn Cardiff, a team led by Professor Susan Wong has successfully prevented type 1 development in mice by genetically engineering a team of ‘good’ immune cells to find and destroy the ‘rogue’ T cells, stopping the attack behind the development of type 1.

The team is now trying to use these ‘good’ immune cells to find and retrain (rather than kill) rogue T cells to tolerate beta cells. These newly ‘tolerised’ T cells can then also find and retrain other rogue T cells, potentially resulting in a much more effective and long-lasting therapy.

Also in Cardiff, Professor Colin Dayan and his team are trying a different approach by developing patches of microneedles, similar to velcro, that can be placed painlessly onto the skin by the user. The microneedles are coated with small fragments of beta cells and anti-inflammatory molecules and the researchers hope that when the immune system ‘sees’ the beta cell fragments while being dampened down by the anti-inflammatories, it will learn to tolerate the beta cells, preventing any further attack.

In the US, a team led by Professor Giorgio Raimondi at Johns Hopkins University in Maryland is aiming to retrain the immune system in a similar way. Instead of microneedles, they are using microscopic parcels to deliver fragments of beta cells, along with anti-

Your support made this possibleTo fund more research

like this, visit jdrf.org.uk/fundresearch

Immunotherapy

Know your facts

Immunotherapy

also found in humans and so the researchers are aiming to make a drug to trigger beta cell growth in those with depleted beta cells.

In Ontario, Canada, Professor Gerald Prud’homme and his team at St. Michael’s Hospital are also aiming to boost beta cell regeneration – but by using drugs which are already on the shelves.

His team hope that two drugs combined together – sitagliptin, which is currently used in type 2 diabetes to increase insulin production, and the nutritional supplement GABA – will trigger beta cell regeneration and increase levels of a protein called Klotho, which is important for beta cell health and survival.

Type 1 diabetes is complex, but with a two-pronged approach aiming to replace lost beta cells and stop the immune attack through immunotherapy, we believe that a cure is possible. With your support, JDRF scientists around the world are working to make this happen.

Professor Colin Dayan and his team are trying a different approach by developing patches of microneedles, similar to velcro, that can be placed painlessly onto the skin by the user

1514

RESEARCH FOCUS

Mark Peakman is a Professor of Clinical Immunology at King’s College London. With a research career spanning more than 30 years, Professor Peakman is a leading figure in the field of immunotherapy for type 1 diabetes and JDRF is proud to have supported his research throughout this time. Here he discusses his career and shares his thoughts on the future of type 1 research

What got you into type 1 diabetes research?It started after my medical training, when I had a conversation with my

mentor about what I could do for my postgraduate research. He gave me the latest research in immunology to take home and read, some of it on type 1 diabetes. At the time, not much was known about type 1, and reading through the literature, something about it just grabbed me. Some of the earliest findings were starting to come out around the genetics of the condition, as well as early descriptions of the cells that attack beta cells in type 1.

So when I came back to the UK, I started speaking with JDRF about how to turn these peptides into a drug and got some funding to explore that. Since then, we’ve done a number of clinical trials and our approach has shown some promise. In fact, this is the area of research that I’m going to take forward in the future.

How do you see type 1 research developing in the years ahead?

I think we’ll see more developments in prevention. We already have the tools to estimate your risk before you’re diagnosed, so we need to get to the point where whatever stage you’re at, pre-diagnosis, we can prevent you from getting type 1. And we’re just starting to see the first drugs that can do that – teplizumab is a really good example. It was found to delay the development of type 1 by an average of two years in people at high risk.

What would you change about the way research is done?

The way research is structured today, everybody has their own field – whether it’s technology, beta cell encapsulation, or immunotherapy. And they’re all adding a piece of the puzzle. But I wonder if we could advance more quickly by combining our approaches, and tackling type 1 on more than one front.

More broadly, I think it depends what people affected by type 1 want to see from research, as ultimately they’re the ones who will benefit. A lot of people I see want to know if there’s any way to make their life with type 1 easier, right now. There is work

By the time I came to do my PhD in immunology, I’d

got the bug. Even though I still had

to finish my clinical training, I knew that

I wanted to be a clinical researcher

So by the time I came to do my PhD in immunology, I’d got the bug. Even though I still had to finish my clinical training, I knew that I wanted to be a clinical researcher.

What happened next?After I finished my clinical training, I

went to the United States to continue my research into type 1. There I made a number of discoveries about the role of a group of genes that help regulate the immune system, and this led us to a set of molecules called peptides that we thought could potentially be used as part of a treatment.

going on in this area – but it is tough. Because we have insulin and it is very safe to use, there’s a resistance to developing new drugs with the potential for side effects. So it needs more people with type 1 to speak out and push for this research.

You mention researchers working together more – what do you think about Connect Immune Research, where JDRF is working with the MS Society and Versus Arthritis on the links between autoimmune conditions?

I think that if we can better understand the common pathways, as well as why particular tissues are affected in different conditions, then that would be a major step forward. We don’t have that insight yet but we’re only going to get it through an initiative such as Connect Immune Research.

How has working with JDRF helped your research?

I feel very lucky to have had the support of JDRF throughout my career. It’s not just funding, but advice and knowledge. So I’ll definitely continue to seek advice and support from JDRF in my future endeavours.

I’ve also appreciated the opportunity JDRF has given me to meet people who are affected by type 1 – it reminds me of why the work we do is so important.

If you weren’t an immunologist what would you be doing?

I’d like to be in the peloton actually – I’d like to experience the Tour de France!

An interview with Professor Mark Peakman

To date, more than £115 million has been invested by JDRF into immunotherapy research.

Know your facts

Immunotherapy

RESEARCH FOCUS I think that if we can better understand the common pathways, as well as why particular tissues are affected in different conditions, then that would be a major step forward

1716

PUBLIC AFFAIRS

Progress in type 1 diabetes research means we are entering an era in which we see significant changes in the landscape of treatment options for the condition

Dapagliflozin, originally used in the treatment of type 2 diabetes, has been recommended for use on the NHS in certain groups of people with type 1. Alice Palombo looks at what this announcement might mean for people with type 1

The once-a-day pill is the first of its kind in type 1 diabetes treatments. Dapagliflozin can

be used alongside standard insulin therapy to improve long-term health outcomes for many people with the condition. It’s estimated that up to a third of people with type 1 in England and Wales could be eligible for the drug.

Previously, insulin, which has to be injected or infused through a pump, was the only treatment for type 1 diabetes.

Dapagliflozin helps to reduce blood glucose levels by stopping the kidneys absorbing glucose into the body. Instead, the glucose is passed out in urine. Previous clinical trials showed that, when used alongside insulin, the drug helped people lower their HbA1c levels without increasing the incidence of hypos.

Following these results, in 2018 JDRF advised the National Institute for Health and Care Excellence (NICE) that Dapagliflozin could offer substantial benefits for people

To find out more about our public affairs work, visit jdrf.org.uk/campaigns

First oral drug for type 1 recommended for use on the NHS

with type 1 diabetes by submitting evidence to its Technical Appraisal consultation and subsequently giving evidence to its committee. In July the appraisal committee approved the use of the drug on the NHS, to those who met certain criteria.

Some side effects of the drug include weight loss and increased risk of diabetic ketoacidosis (DKA). The drug will therefore only be offered as an option to those who find managing

blood glucose levels challenging, but who also have a BMI over 27 and – amongst other criteria – are aware of how to spot and treat DKA.

Karen Addington, Chief Executive for JDRF in the UK, said: “Progress in type 1 diabetes research means we are entering an era in which we see significant changes in the landscape of treatment options for the condition. JDRF will continue its work to support people to gain access to the treatments they need.”

Christian and his son Ethan with T1D

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19

GET INVOLVED

Find out more about how to get involved at jdrf.org.uk/get-involved

Come along to a free Discovery Day and find out how you are helping to change the type 1 research landscape

When you come to a Discovery Day you can:

• Listen to presentations about the latest cure, treatment and prevention research from leading scientists and diabetes specialists

• Hear from inspirational people who live with type 1

• Meet others who are affected by the condition

DISCOVERY DAYS TAKE PLACE UP AND DOWN THE COUNTRY

Find out more on page 22 or at jdrf.org.uk/discover

DISCOVERY DAYS

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If you're looking for a break this year, JDRF has teamed up with Golf Escapes and Signature Safaris to allow you to enjoy a great holiday while supporting life-changing type 1 research. For every golf holiday booked, JDRF will receive 3% of the overall cost and 5% for every safari booked. Quote 'JDRF' when booking to ensure the funds are attributed.

Enjoy a Signature Safari or Golf Escape for JDRF Back for 2020, the hugely popular JDRF

Make a Splash returns for another year in January. Whether you want to increase your fitness, improve your swimming, or work towards your New Year’s resolution.

Join our sponsored swim challenge and ‘Make a Splash’ for type 1 diabetes research.

To get involved head to jdrf.org.uk/events

21

SCOTLAND – Staff at Kinross-shire based Giacopazzi’s raised £6,700 for JDRF through a 120-mile cycle, a sponsored walk and a variety of in-store events. The store owner’s

daughter Anita has type 1 diabetes.

WALES – Thank you to APM Customs in Flintshire, whose staff and

customers raised £1,800 by holding an open day and raffle in May, with

lots of supercars!

SOUTH – Joshua Buck, who has type 1, cycled 90 miles in the hot weather

of August bank holiday weekend, from Theale in Berkshire to Bristol with his

Dad. He has raised nearly £900 to date.

SOUTH WEST – Thank you to the amazing Jack Badge and his family,

who held an Open Garden Event at his grandparents’ house and raised an

incredible £1,116.

THANK YOU

20

NORTH – Six mums from Manchester who have seven

children between them with type 1, hosted a family fun day out at

Wythenshawe Cricket Club in August and raised over £6,000 for JDRF. Rufus made an appearance too!

Dedication, diligence, and determination - amazing work!

LONDON – A massive thank you to Jack, Joe and their loved ones for

hosting their second hockey match for JDRF and raising an amazing £1,000!

EAST – 50 ‘Striders’ took on a three-day Mont Blanc challenge

last month to raise money for JDRF. The Leigh-On-Sea-Striders raised an

incredible £30,000!

TAKE PART

16 to 20 July 2020 Join this beautiful long weekend challenge from London to Paris, covering 300km in three days. This event is an action-packed weekend with a beautiful route through historic towns and villages. You also get to see the finale of the Tour de France 2020. Apply today!

Sign up at jdrf.org.uk/event/cycle-london-to-paris/

JDRF & Ford Cycle for a Cure 16 May 2020Back by popular demand JDRF and Ford are bringing you the second Cycle for a Cure. Take part in this unique event and cycle around the Ford Dunton Test Track and beautiful surrounding Essex countryside. We offer a 50km, 100km and a child-friendly route that all start and finish at the JDRF Ride Village. Head to the website today and sign up to this truly inclusive family event.

Sign up at jdrf.org.uk/event/jdrf-cycle-for-a-cure-supported-by-ford

29 March 2020 The event is not your average half marathon. From cultural landmarks and heritage, to the city’s quirky and hidden secrets, runners will get to explore the capital on a route like no other! Join over 10,000 runners starting on Pall Mall, as they take in fabulous views of London’s most iconic landmarks including Big Ben, St Paul’s Cathedral, Nelson’s Column, the Gherkin, the Shard, the Tower of London and the London Eye – finishing by Downing Street. Registration is free and there is a minimum sponsorship of £350.

Sign up at jdrf.org.uk/event/london-landmarks-half-marathon-2020

London Landmarks

London to Paris Bike Ride

MIDLANDS – Mia Patel, who was diagnosed with type 1 in 2018, took part in a Mini Military Mud Run with her family, raising a fantastic £760.

We are so grateful for

everything you do for us

For more information please visit jdrf.org.uk

22

TAKE PART

To sign up to any of our events, go to jdrf.org.uk/events

What’s onWherever you live, you will not be far from an exciting challenge. So visit jdrf.org.uk/events and do your bit to create a world without type 1

Bath Half Marathon 15 March 2020

Manchester Marathon 5 April 2020

Leeds Half Marathon 10 May 2020

Edinburgh Marathon Festival 23 /24 May 2020

Abersoch 10k Land & Sea 30 May 2020

Swansea Half Marathon 14 June 2020

Keep on running

Climb 1 for Type 1, across all three 2 May 2020 peaks, Snowdon, Ben Nevis and Scafell

One Fun Run Leicester 16 May 2020

One Fun Run Peterborough 27 June 2020

One Fun Run Southampton 28 June 2020

One Fun Run Chippenham 25 April 2020

Community events

Glitz and glamour

The Sheffield One Ball 9 November

Roaring Twenties, Aberdeen, 25 April 2020 Marcliffe Hotel

Roaring Twenties Gala Ball, Edinburgh, 6 June 2020 Prestonfield House

Type 1 Discovery Day, Redhill 9 November

Type 1 Discovery Day, Glasgow 9 November

Type 1 Discovery Day, Birmingham 13 November

Type 1 Sports Day, Cardiff 16 November

Type 1 Discovery Day, Leeds 23 November

Type 1 Discovery Day, Hull 30 November

Type 1 Discovery Day, Northampton 15 Feb 2020

Type 1 Discovery Day, Belfast 29 Feb 2020

Type 1 Discovery Day, Liverpool 7 March 2020

Type 1 Discovery Days

The CARTEN100 2 May 2020

Tour de Yorkshire 3 May 2020

Cycle for a Cure supported by Ford 16 May 2020

London Ride to Cure 5 June 2020

On your bikes

jdrf.org.uk/runningevents

jdrf.org.uk/cyclingevents

jdrf.org.uk/discover

jdrf.org.uk/glitz

jdrf.org.uk/communityevents

JDRF is a registered charity in England and Wales (no. 295716) and in Scotland (no. SC040123). A company limited by guarantee (England no. 2071638). Registered office: 17/18 Angel Gate, City Road, London EC1V 2PT.

JOIN A GLOBAL MOVEMENTTO CREATE A WORLD WITHOUT TYPE 1 DIABETES

SIGN UP TODAY Type 1 Discovery Day, Boston 8 March 2020

Type 1 Discovery Day, Bristol 14 March 2020

Type 1 Discovery Day, Reading 14 March 2020

Type 1 Discovery Day, London 26 March 2020

Type 1 Discovery Day, Newcastle 28 March 2020

Type 1 Discovery Day, Oxford 15-18 April 2020

Type 1 Discovery Day, Manchester 18 April 2020

Type 1 Discovery Day, Aberdeen 16 May 2020

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