$2.7 million for unique
U of A diabetes research

The research teams

Every day, Richard Siemens follows the same routine: he gets up, does a blood test, measures his glucose levels and gives himself an insulin shot. It's a three-times-a-day schedule the 46-year-old campus photographer has been keeping since he was five.

"I never talked about it when I was growing up. It was always something I was embarrassed about," he said.

As an insulin-dependent diabetic, Siemens recently had more than a professional interest when taking photos of Dr. Alex Rabinovitch's top research team.

That's because these University of Alberta researchers received a $2.7 million funding boost June 9 to move their work one step closer to achieving an insulin-free treatment for Type 1 diabetics, such as Siemens.

The U of A is one of only two 1999 Juvenile Diabetes Foundation/Medical Research Council Diabetes Research Network Partnerships awarded in Canada. (Simon Fraser University's Dr. Diane Finegood received the second.)

In addition to Rabinovitch, an Alberta Heritage Foundation for Medical Research Scholar, team leaders include Drs. Ray Rajotte and John Elliott. Researchers such as Drs. Chris Bleakley, Norm Kneteman, Greg Korbutt, Jonathan Lakey, Allan Murray, Eddie Ryan, James Shapiro and Garth Warnock are also on board, along with hundreds of post-doctoral fellows, research associates, laboratory staff and grad students.

Diabetes affects more than 2.25 million Canadians, many of them children and young adults. In people with Type 1 diabetes, insulin-producing islet beta cells in the pancreas are destroyed by the body's own immune system. These diabetics are then forced to receive insulin injections to replace the function of lost islet beta cells. The problem is maintaining and controlling the body's glucose levels. It's an imprecise routine and could eventually lead to blindness, renal failure, nerve damage or life-threatening cardiovascular and circulatory complications.

"Either people are very good at taking care of themselves, or they're very bad," said Siemens, "particularly if they're diagnosed later in life, because it's harder to adapt to the lifestyle change. I'm somewhere in the middle."

But U of A research in islet transplantation, currently the most effective means of controlling glucose levels in diabetics, could one day do away with these daily injection routines and significantly improve the quality of life for one in 20 Canadians. "The impact would be huge," said Siemens.

Islet cells work as the body's thermostat, telling it when to start producing insulin in order to move glucose and other nutrients from the blood stream into cells and tissue. Researchers at the U of A's Muttart Diabetes Research and Training Centre were the first in Canada to successfully transplant islet cells in patients in the early '90s. But only a small fraction of diabetics who received islet transplants went without insulin injections for up to a year.

Rabinovitch said researchers are investigating techniques to keep islet cells alive and productive "by using new ways to protect these cells after transplantation." The focus of the U of A's Diabetes Research Network is two-fold, he says: "How to obtain more islets from donor pancreas, which is a very complicated procedure, and how to prevent rejection with therapies such as anti-rejection drugs and immuno-suppressants." Researchers are also developing procedures to transplant islet beta cells in Type 1 diabetics before the physical complications set in.

"Hopefully, by improving the growth of these beta cells, we'll have a treatment to block the molecules these cells express which accelerate rejection," said Wilma Suarez-Pinzon, research associate and lab supervisor.

The studies target diabetics at the chronic stage-people who vascillate from high and low levels of glucose-"simply because they cannot control insulin levels," said Suarez-Pinzon. "It's really tough for them." Younger people still have some beta cells, and the diabetes tends to be under better control, she said.

While the research is groundbreaking, an excited Rabinovitch cautions this is not a breakthrough for Type 1 diabetics, nor a cure.

"Ultimately it means diabetics should continue to follow the insulin-injection therapy and all other aspects of their insulin management, awaiting the day when islet transplantation could eventually improve their situation." It will happen in the future-but not the near future, Rabinovitch added. Still, the potential impact provides "great motivation to keep working in the lab," said Suarez-Pinzon with a smile.

Meanwhile, U of A's photographer-at-large Richard Siemens awaits the day he'll have one less thing to schedule in his busy daytimer.