Revolutionizing diabetes treatment: New insulin promises drastic shift in care

Dr. Harpreet Bajaj is an endocrinologist and director of late-phase research at LMC Healthcare, he is also the principal investigator of the Canadian Diabetes Prevention Program; and is the Chair of the Clinical Practice Guidelines at Diabetes Canada (Harpreet Bajaj/submitted via email)

The Public Health Agency of Canada announced on Monday nearly $1 million in funding to support Diabetes Canada’s initiatives across the country.

The funding comes as a global study published last week reported that diabetes cases are expected to soar from 529 million to 1.3 billion worldwide by 2050.

“Unfortunately, we are seeing that kind of progression here in Canada,” Laura Syron, CEO and president of Diabetes Canada, told CTVNews.ca on Tuesday.

Approximately 3.6 million Canadians were living with diabetes from 2019 to 2020 and more than 200,000 new cases are diagnosed each year, according to Health Canada.

Syron explained the $998,450 will be spread out across three years to advance the Framework for Diabetes in Canada by bringing partners from across the country to share best practices in their respective health-care systems – drug coverage, preventative measures, screening.

IS THE HEALTH-CARE SYSTEM READY FOR MORE CASES?

As the number of diabetes cases are projected to skyrocket in Canada and worldwide in the coming years, one question stands out, is the Canadian health-care system ready?

Harpreet Bajaj, endocrinologist and director of late-phase research at LMC Healthcare, told CTVNews.ca the answer is no.

“I don’t think it is ready. Even with the cases that we have, (the system) is being stretched,” he told CTVNews.ca on Tuesday.

“We don’t have the tools or the manpower.”

Bajaj said to address rising diabetes cases and the fragile health-care system, more digital solutions should be implemented to reduce current limitations.

“We got to think outside the box, as well, and have more public education on prevention, of all kinds, on social media,” he said.

WHY ARE CASES RISING?

According to Diabetes Canada, Ontario has the most people in the country diagnosed with diabetes at 4.8 million. British Columbia is the second highest with just over 1.6 million, followed by Alberta with nearly 1.3 million cases.

There are a few factors contributing to the rising number of diabetes cases in Canada, from the country's aging population to lifestyle choices and access to healthy food, said Syron.

“How can we make sure people who have been diagnosed have the best quality of life if they can’t afford healthy food? 'Cause food affordability has changed. Or medication or new technology, if that’s not accessible financially for them,” she said.

Genetics also play a role in diabetes diagnosis. As the country’s population increases, people who have a healthy lifestyle and eat well can also get diagnosed if they have a hereditary factor.

“I think there’s a lot of stigma and misunderstanding about diabetes,” said Syron, who has diabetes and often felt “guilty or judged” as people think it is just a byproduct of eating habits or lack of movement.

Within the coming months, Diabetes Canada says it will be launching a survey to gauge the population’s perspective and experience with the disease and address the stereotypes around it.

Then there’s COVID, added Syron explaining how the pandemic affected both people’s activity level, and delayed their access to a primary health care provider.

“Unfortunately what we are seeing is people who are much further progressed with their diabetes and miss that window of opportunity (for a doctor) to say, ‘Hey you might be pre-diabetic,’” she said.

According to Angus Reid data released in 2022, one-third of Canadians aren’t able to see their doctor within a week, while another 17 per cent have been unable to find a doctor at all despite their efforts. The report also stated more than six million people in Canada don’t have a family doctor.

Bajaj suggests people take a short online test called CANRISK to screen themselves at home if they are unable to get blood tests or see a health practitioner.

DEVELOPMENTS IN THE INDUSTRY

In San Diego, California at the 83rd American Diabetes Association conference, Bajaj presents the clinical developments of ICODEC – an investigational once-weekly basal insulin that could change the status quo of daily doses for diabetic people.

“It’s been over 100 years since insulin was discovered in 1920. We’ve come a long way,” he said.

The development, if approved, would reduce a diabetic person’s scheduled injections from daily to weekly. Bajaj is hoping it will be approved by Health Canada and publicly available by this time next year.

Additionally there has also been a paradigm shift in weight management medicine.

“There was new research that the ADA presented. Newer pharmacotherapy agents may actually lead to about the same amount of weight loss as bariatric surgery,” said Bajaj.

Some people with type 2 diabetes opt for the weight-loss surgery, however many shy away from it “because of its permanent and invasive nature,” he explained.

Diabetes is a complex disease and affects multiple parts of the body leading to heart attacks, strokes, kidney diseases, non-traumatic limb amputation and can even cause blindness, according to Bajaj.

The findings from this research are changing diabetes guidelines' priorities and proving, with the right medication in the right patient, there can be added protection against complications of type 2 diabetes, he said.