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The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. Through CIHR, the Government of Canada invested approximately $32.6 million in 2004-05 in research on diabetes.
Dr. Jeffrey A. Johnson of the University of Alberta has spent a career grappling with the implications of type 2 diabetes for the health of individuals and for the health care system. He's found evidence that people with type 2 diabetes at risk of heart disease are not receiving medication that can reduce cardiovascular mortality. Dr. Johnson studied the costs to the health care system of such heart disease, as well as the kidney disease and sight problems that are common complications of diabetes. Now he is focusing on how to reduce the economic burden of diabetes on Canada's health care system through prevention strategies.
Lifestyle modifications, such as diet and exercise, can reduce the onset of type 2 diabetes by nearly 60% in adults at highest risk of developing the condition. Screening programs can identify these people - but they are expensive, and the payoff doesn't come for 20 or 30 years. Dr. Johnson is developing models to predict the number of people who will have type 2 diabetes 30 years from now and the likely costs of care for these people. With these strong projection models for the future, Dr. Johnson and his team will be in a position to estimate the total cost savings of investing now in effective diabetes prevention programs.
Dr. Pere Santamaria: Taking on diabetes
When Dr. Pere Santamaria left his native Spain, he chose Canada as the place to conduct his diabetes research. In doing so, he is building on a long tradition of Canadian achievement, dating from the discovery of insulin by Drs. Banting and Best in 1921.
As a medical doctor, Director of the Julia McFarlane Diabetes Research Centre, and CIHR-funded researcher in the Faculty of Medicine at the University of Calgary, Dr. Santamaria has been trying to understand how certain T-cells (a type of white blood cell) destroy the beta cells of the pancreas. These beta cells are essential for production of insulin.
In 2000, Dr. Santamaria discovered a group of aggressive (highly diabetogenic) T-cells in mice that attacked a beta cell protein called IGRP. This protein had not previously been seen as a target of the immune system in type 1 diabetes.
Since then, with the help of a team that includes mathematicians and molecular biologists, he has developed several animal models to demonstrate how these aggressive T-cells work. Project members have been able to predict, with great accuracy, the development of diabetes in mice by measuring the presence of these T-cells in the blood. He has also developed treatments that eliminate these aggressive T-cells and prevent the development of diabetes in mice.
Because the IGRP protein is also expressed in human beta cells, Dr. Santamaria suspects that the same T-cell attack contributes to the development of human type 1 diabetes.
The next steps for his team will be to confirm that this attack does, in fact, happen in humans, determine why these T-cells strike the IGRP protein in the first place and develop treatments that will help prevent the attack from happening.
Diabetes fascinates Dr. Santamaria because its impact goes so far beyond the physical to affect people's social and emotional functioning.
"When a family member has diabetes," he explains, "it consumes the lives of the entire family."
Dr. Santamaria takes pleasure in teaching graduate students and post-doctoral fellows how to focus and manage their research curiosity so that they can be productive in health research discovery - and contribute to the eradication of diabetes.
"I would like to shape the next generation of researchers," he says, "and show them how to think clearly about their work for the future."
CIHR's Institute of Nutrition, Metabolism and Diabetes, under the leadership of Scientific Director Dr. Diane Finegood, is leading the charge in the fight against diabetes. Through its strategic focus on obesity, the Institute is helping to shed light on one of the key risk factors for type 2 diabetes.
An important partner for the Institute is the Canadian Diabetes Association (CDA). Established more than 50 years ago, the CDA promotes the health of Canadians through diabetes research, education, service and advocacy. Together, the CDA and the Institute are building Canadian capacity to tackle the many challenging problems posed by diabetes including co-funding graduate student scholarships and multi-disciplinary teams. In addition, the Canadian Diabetes Association is working with the Institute on a health research platform for learning more about 'real world' barriers and supports to physical activity and healthy eating called Canada on the Move. They have also been working together to ensure that data generated by the National Diabetes Surveillance System is used to understand the prevalence and impact of diabetes on Canadians.
The Canadian Institutes of Health Research is the Government of Canada's agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to close to 10,000 researchers and trainees in every province of Canada.
