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50-Year Medalists to be Studied in Canada at the University of Toronto

Wednesday, January 22, 2014

One unique aspect of the Joslin Diabetes Center research division is the 50-Year Medalist study, which recognizes and examines people who have been living with insulin dependent type 1 diabetes for 50 years and often without any major complications. This study aims to determine the genetic, environmental, psychological and physiological factors that enable Medalists to evade diabetes complications over an extended period of time. Following its success at Joslin, a Canadian Medalist Study is now being conducted at the University of Toronto, called the Diabetes Longevity Study.

This study focuses on the characteristics of the 50-Year Medalists in Canada in addition to generating a database capable of comparing the similarities and differences between the Canadian and American medalists. In addition to this cross-border comparison, the study will focus on investigations of kidney and nerve complications associated with type 1 diabetes.

Bruce Perkins, M.D., MPH, FRCP(C), Associate Professor at the University of Toronto and a former Joslin fellow, oversees the Diabetes Longevity study. The study is designed as a cross-sectional survey expected to evaluate a cohort of 300 Canadians with a minimum of 50 years with type 1 diabetes. The comprehensive mail-based survey takes two hours to complete. The survey informs Dr. Perkins and his team about how the Medalists have managed their diabetes over an extended period of time. The survey also updates Dr. Perkins about the participants’ medical history and daily lifestyle habits.

“The inspiration for the Canadian study came from Joslin’s Medalist study,” explained Dr. Perkins. “We recognize that a large number of people with type 1 diabetes in Canada and abroad are living longer and without major complications. Furthermore, we are focusing on some different aspects of diabetes complications – for example, we are planning to perform advanced kidney function studies and in-depth exploration of nerve injury.”

Aside from serving as an inspiration for the Diabetes Longevity Study, Joslin assists with their recruitment process.

“As the people who award the 50-year medals, we are able to provide details of Dr. Perkin’s study to individuals in Canada who have been awarded this medal,” commented Hillary Keenan, Ph.D., co-Principal Investigator for the 50-Year Medalist Study at Joslin and liaison for the Diabetes Longevity Study. “Therefore, we are able to facilitate Canadian involvement in Dr. Perkins’ study.”

Dr. Perkins and his team are grateful for the connection with Joslin, which helps to boost the respectability and recognition of their study.

“Joslin’s world-renowned reputation has helped in our recruitment of Canadian participants. We are grateful for the cooperation between Joslin and our study team – this partnership is essential for the future success of our study,” he said.

In the data analysis phase of the study, Joslin and the University of Toronto will team up to examine data from both sets of study participants.

“We are interested in comparing the different patterns of lifestyle and care behavior of the Canadian population with of what we are seeing in the U.S. population,” explained Dr. Keenan. “In the end we will be collaborating on analyses comparing data and biomarkers and to see if there are behaviors different between the two countries.”

Through the Diabetes Longevity Study, Dr. Perkins initiated a national registry of Canadians with 50 years or more of type 1 diabetes. Using the registry collected during the first year of the study, his team will be able to perform advanced phenotyping of Ontario participants at the Toronto center of the JDRF Canadian Clinical Trial Network (CCTN).

“The first phase of our study, the questionnaire phase, will help us to understand if there are deficiencies in diabetes care in Canada – for example, are Canadians less likely to have care through an endocrinologist? Are Canadians less likely to use insulin pumps?” commented Dr. Perkins.

The answers to these questions will inform policy makers about the quality of diabetes care and help them to identify solutions for Canadians with diabetes.

The second phase of the study – which involves detailed studies in the lab – will enable Dr. Perkins to better understand if specific therapies used to prevent diabetes complications, like intensive blood sugar control and renin-angiotensin blockers, are effective in protecting people with longstanding diabetes from advanced complications.

By drawing on data from two separate Medalist studies, Joslin and the University of Toronto will enhance their knowledge and capabilities for treating type 1 diabetes and its complications.

Page last updated: May 24, 2018