When Michael Riddell was 14 years old, he was diagnosed with type 1 diabetes. Previously known as juvenile diabetes, because the diagnosis often appears in childhood or early adulthood, type 1 diabetes happens when the body attacks the beta cells in the pancreas and prevents them from making insulin. The cells, unable to perform their job, die off or lose function.
Before the discovery of insulin, this diagnosis would have been a death sentence for Riddell. However, by the mid-1980s when he was diagnosed, it instead meant a lifetime of using insulin to manage the job his beta cells were no longer able to perform.
Riddell, who often jokes that he was a less than stellar student prior to developing diabetes, found that learning more about his condition mattered to him, and he has built his career on researching this topic. He studied under Dr. Mladen Vranic, a renowned diabetes researcher who came to Canada to work with insulin co-discoverer Dr. Charles Best and built his own legacy in the field. Riddell considers Vranic one of his greatest mentors, as the esteemed scientist encouraged him to see his diabetes as an asset in the research work he wanted to pursue. Now, a professor at Toronto’s York University, Riddell has become a leading expert on diabetes and exercise.
When his oldest child, Sam, was diagnosed with type 1 diabetes at age 13 it was a family legacy Riddell was not hoping to pass on. However, it galvanized his resolve to improve the lives of those living with diabetes through his research, teaching and volunteer work. As we head toward the 100th anniversary of the discovery of insulin, Riddell is both grateful for this medication and hopeful for the discoveries to come.
“It’s 100 years of keeping people like me and my son and all my friends with type 1 alive. That is such a powerful emotion for me, to think about all the people I’ve met under this type 1 insulin-dependent diabetes. It brings tears to my eyes to think that this discovery has led to our saviour, as far as being life-sustaining,” he says. “Although it wasn’t a cure, it gave us the breath to keep going.”
While many have set their research goals on finding a cure, Riddell has spent his career looking at ways to make diabetes easier and safer for those who are living with it. At diagnosis, he feared that he would no longer be able to take part in the sports that were such an important part of his life. As he grew older and more interested in the topic he was concerned that athletes with type 1 diabetes were an under-studied group.
This was especially concerning because diabetes and exercise brings with it considerable challenges. While Riddell often works with top athletes, some training for the Olympics, others taking on incredible challenges like the long distance cyclists who compete for Team Novo Nordisk, he also knows that exercise management is important for everyone living with diabetes. It is, however, frustratingly complicated.
“Exercise is so tricky to manage if you’re on insulin because on some occasions the exercise acts like insulin and brings the blood sugar down, but then in other situations exercise acts like a stress and brings the blood sugar up,” he explains. In Riddell’s lab they are looking at new options that could help make it easier for someone with diabetes to manage these fluctuations. His team is studying new drugs or insulins that could act more rapidly, or which could help correct doses more effectively, all of it with the hope of making exercise safer for those with diabetes.
The new technologies that have become available over the last decade, like insulin pumps and continuous glucose monitors (CGMs), are making it easier for those who study diabetes and exercise to understand what is happening in the body. CGMs provide constant monitoring of sugar levels in an automated way, helping those with type 1 diabetes to more easily understand if they are going high or low. They are not, however, perfect technologies and Riddell and his team have noticed that there is often a lag time in readings during high-intensity exercise. This presents a challenge for athletes with diabetes and can even lead to hypoglycemia if someone over or under treats because of this delay in their results.
Riddell is an advocate for the technologies that are now available. He himself uses them and they have made reporting to he and his son’s endocrinologists much easier. The data that can be collected and shared in healthcare settings help to ensure that clinicians can better understand patterns and make recommendations to improve blood sugar management based on these. This is also why it’s critical to Riddell that his work in improving them is part of the process. “I think the technology has been life changing for me as a patient, for me as a researcher and for me as a father of someone who’s living type 1,” he says. This is why it’s so important to continue to see it improve.
Looking forward to the next 100 years, Riddell has hopes that many of the potential treatments will come to fruition. Hopefully, in time to have an impact on the life of his child. However, having heard for many years that a cure is just around the corner, he is equally committed to supporting the development of new tools and improved technologies that will make life easier for those with diabetes.
He is proud of the work he is doing and of the impact his students and trainees are starting to have on the research space. Many of those in his lab also live with type 1 diabetes and their passion for this work gives him enormous hope for the future. “It’s been amazing to see that family grow and become so accomplished. And I think that someone coming to my lab for anywhere from two years to seven years, I hope they take something from that about my passion for what I think makes a difference in the people who are living with this diagnosis.”
— Written by Krista Lamb