For many, type 1 diabetes comes along with serious and sometimes life-threatening complications, including vision loss, kidney disease, nerve damage, heart disease or amputation. These complications are sometimes caused by poor glucose control, but in other cases there is no known reason for the development. Either way, complications make life much more challenging and can shorten the lifespan of a person living with the condition.
This is why Dr. Bruce Perkins, a clinician-scientist at the Lunenfeld Tanenbaum Research Institute and a Professor at the University of Toronto, has dedicated his career to finding solutions to help lessen the impact of complications. Perkins, who has lived with type 1 diabetes since the age of 18, was surprised to learn that there had been very little research done on ways to treat complications in the early stages. He recognized that, while research into a cure is critical, looking at ways to help people with the conditions they are struggling with right now was equally needed.
Understanding why some people with diabetes develop complications and others do not is important in preventing or treating them. Inspired by similar studies in the U.S., Perkins began the Canadian Study of Longevity in Type 1 Diabetes, which took a deep dive into the physiology of those who had been living with type 1 diabetes for more than 50 years. The study, which is currently moving into Phase III, has led to a wealth of research findings, including looking at kidney function, nerve damage and the risk of heart disease. Numerous other scientists have studied the results to find patterns in the data collected from participants. This work has given great insights into possible treatments and shown how some differences may in fact come down to things like how a woman experiences nerve pain differently than a man, or to improved access to medications such as statins.
Moving forward, Perkins is looking at numerous other options to improve treatments for complications. He is working with Dr. Ahmad Haidar at McGill University on an artificial pancreas that uses Sodium-Glucose Transport Inhibitors (SGLTis), a medication common in the treatment of type 2 diabetes which decreases sugar in the blood and excretes it through the urine, helping the algorithm work better to control blood sugar levels.
He is also looking at the potential of corneal scans for early diagnosis of nerve damage in those with diabetes, which ultimately could help overcome the current problems with screening for nerve damage, and allow eye specialists to efficiently screen for eye and nerve complications at the same time. These projects give him hope that they will lead to improving the lives of those living with diabetes.
This hope is at the core of all the work Perkins does and why the 100th anniversary of insulin has particular significance for him as a clinician-scientist and a person living with diabetes. “When I myself got diabetes as a teenager, I was certain that the world would move ahead without me. I am humbled to say now that I was so wrong,” says Perkins. “I owe so much to this discovery, and it fuels me to make meaningful contributions for future generations of people with diabetes.”
— Written by Krista Lamb