Countdown

TheStory of nPOD

J u v e n i l e D i a b e t e s R e s e a r c h F o u n d a t i o n I n t e r n a t i o n a l

S P R I N G 2 0 1 0

2 J D R F C O U N T D O W N S P R I N G 2 0 1 0

Approved By:Date:ClientAEADCopyProofProd

BD, BD Logo and BD Ultra-Fine are trademarks of Becton, Dickinson and Company. ©2008 BD

Millions of tiny nerve endings will be happy you chose BD.

The skin may be the largest organ, but it’s also the most sensitive. So BD engineers every BD Ultra-Fine™ Pen Needle and Syringe to be thinner and smoother for a more comfortable injection. Thanks to technology, like:

Fine Point Technology: a three-step process that shapes the tip of every BD needle as finely as possible for easier penetration.

Electro-polishing: a process that polishes away microscopic burrs. Giving every needle a smooth finish.

Micro-bonded lubrication: a special double-lubrication process that creates more glide and less friction.

For more information, visit www.BDdiabetes.com/us

CLIENT: BD Medical JOB#: BDIN 8021_D DUE DATE: 8/27/2008 SMALLEST TRIM SIZE: 16.25 x 10.875”LARGEST BLEED: 16.5 x 11.125”SMALLEST SAFETY .25 from trim COLORS: 4 color Spread adPUBLICATIONS: Countdown

S P R I N G 2 0 1 0 w w w . j d r f . o r g 1

Approved By:Date:ClientAEADCopyProofProd

BD, BD Logo and BD Ultra-Fine are trademarks of Becton, Dickinson and Company. ©2008 BD

Millions of tiny nerve endings will be happy you chose BD.

The skin may be the largest organ, but it’s also the most sensitive. So BD engineers every BD Ultra-Fine™ Pen Needle and Syringe to be thinner and smoother for a more comfortable injection. Thanks to technology, like:

Fine Point Technology: a three-step process that shapes the tip of every BD needle as finely as possible for easier penetration.

Electro-polishing: a process that polishes away microscopic burrs. Giving every needle a smooth finish.

Micro-bonded lubrication: a special double-lubrication process that creates more glide and less friction.

For more information, visit www.BDdiabetes.com/us

CLIENT: BD Medical JOB#: BDIN 8021_D DUE DATE: 8/27/2008 SMALLEST TRIM SIZE: 16.25 x 10.875”LARGEST BLEED: 16.5 x 11.125”SMALLEST SAFETY .25 from trim COLORS: 4 color Spread adPUBLICATIONS: Countdown

Section Pullout

Kidsfor


international chairmanMary Tyler Moore

chairman of jdrf internationalRobert Wood Johnson IV

chairman of the boardLeo F. Mullin

secretary/chair, nominating & governance

George Nethercutt

chairman, developmentChip Halverson

chairman, researchFrank Ingrassia

treasurer /chairman, financeFernando Aguirre

president & chief executive officer

Alan J. Lewis, Ph.D.

vice president, strategic communications

William Ahearn

chief human resources officerGerri Bostick, SPHR

executive vice president, develop-ment

Mania Boyder

senior vice president, scientific affairs

Robert A. Goldstein, M.D., Ph.D.

senior vice president, strategic alliancesKarin Hehenburger, Ph.D.

chief scientific officerRichard A. Insel, M.D.

vice president, internal auditGil King

vice president, major & planned gifts

Jamie Klobuchar

assistant vice president, glucose control

Aaron Kowalski, Ph.D.

vice president, government relations

Cynthia Rice

senior vice president, marketingClaire Schultz

chief financial officerEdward Sebald

executive vice president, government relations & operations

Lawrence Soler

vice president, chief information officer

James Szmak

SPRING 2010/Vo l . XXX I , No . 1

Newsbriefs .................................................................................................................... .8First-generation artificial pancreas lowers risk of overnight low blood sugar emergencies in kids and teens; JDRF launches new partnership to accelerate autoimmunity treatments; “Yeast shells” used to develop vaccine to stop type 1 diabetes; JDRF creates “toolkit” for adults with type 1 diabetes; Scientists gain insight into why aging beta cells lose ability to regenerate; Beta cell precursors survive when encapsulated in device protecting them from immune attack.

The Little nPOD That Could ............................................................................ .12When it established a network for procuring and distributing pancreatic tissue for research, JDRF took a risk in the face of skepticism about whether it could be done. Three years later, nPOD has already become a success story, providing insights into how type 1 diabetes develops.

A Life-Saving Collaboration .......................................................................... .16In one of the biggest and most comprehensive collaborations in its 40-year history, JDRF has joined forces with the Genomics Institute of the Novartis Research Foundation. The goal: to develop a pipeline of regeneration drugs to be tested in clinical trials.

Calling on Congress to Renew the Special Diabetes Program ................................................. .20The Special Diabetes Program has provided critically needed funds for type 1 diabetes research for 13 years now. JDRF is urging Congress to renew the program and keep type 1 science moving forward toward a cure.

Juvenile DiabetesResearch Foundation

International

14

DEPARTMENTS10…9…8… ............................... 440 Years of Progress

RESEARCH FAST TRACK ................................... 6Driving Toward an Artificial Pancreas

JDRF International News .............. 25

JDRF News .................................. 28

Order your FREE Demo Kit today with a sample

Pod you can wear. Just visit MyOmniPod.com/RequestDemoPod

or call 877.535.3132.

Pump therapy with NO TUBING. Now in full color.Everything about OmniPod is designed to make diabetes a smaller part of your life.And the new PDM (Personal Diabetes

Manager) takes that promise further. New large, color screen keeps information bold and clear. New options show

your information at a glance.New functionality supports enhanced data download—you can even share data with your

healthcare provider. Of course, the handheld PDM still calculates suggested doses and has a convenient, built-in

FreeStyle® blood glucose meter. Above all, it communicates wirelessly with the tubing-free Pod—which you can apply

almost anywhere on your body to deliver your insulin.

The new PDM. Another OmniPod innovation.

Meet your NEWManager.

6

© 2009 Insulet Corporation. All rights reserved.

FreeStyle® is a registered trademark of Abbott Laboratories.

JDRF Countdown_R2:Layout 1 7/17/09 11:57 AM Page 1

This year marks the 40th anniversary of the found-ing of JDRF.

In 1970, a handful of parents of kids with type 1 diabetes got together and made a promise to one another, and to their children. They were going to do all they could to find a cure for type 1 diabetes. Re-search would be the tool they used.

In many ways, JDRF is what it is today because of the passion, commitment, and foresight of those founders.

But we are not celebrating our past 40 years, because we have not yet kept the promise those founding families made to one another and to their children. As you know all too well, we still don’t have a cure.

What we do have, however, is 40 years of astounding progress toward a cure. Over the decades, we have seen tremendous advances on the scientific front, opening new avenues of in-vestigation and moving us faster and faster along various paths that will lead to an ultimate cure. But we have also seen remarkable improvements in how diabetes is treated, improving people’s lives as we work toward a cure.

We helped invent the field of regeneration in diabetes research, to try and coax the body into producing new insulin-producing cells to replace the ones killed off by diabetes. We have pioneered replacement therapies that can reverse diabetes for a time and overcome the dangerous problem of hypoglycemia unawareness. We have led the development of immune therapies that are in the later stages of human clinical trials, including anti-CD3 antibody treatments that slow diabetes in the newly diagnosed. We have helped advance therapies to slow or reverse complications, with particular success in eye disease. We are the clear industry catalyst in developing artificial pancreas systems and glucose-responsive insulins—therapies with a short-term goal of improving glucose control and the long-term goal of keeping people healthy to take advantage of the cures we are pursuing.

While our research progress has been impressive, the improve-ments in how diabetes is treated over JDRF’s 40 years of research leader-ship are amazing.

We have learned more about dia-betes, and more about what it takes to better control the disease. Improve-ments in technologies, in standards of care, and in treatment options have come year after year. As a result, people with type 1 diabetes are living longer, healthier lives.

Consider just two examples.First, when JDRF was founded 40 years ago,

there was no such thing as home blood glucose testing. In fact, even doctors’ offices did not have blood glucose testing. You could test urine, but it was complicated and inaccurate—and besides, there was little you could do about the results. Today, we have multiple ways of measuring blood sugar at home, with meters and continu-ous glucose monitors that are far more accu-rate than even endocrinologists had back then. Moreover, we are light years ahead in our ability to use that information, given today’s multiple insulins and infusion alternatives and intensive insulin therapy guidelines.

Second, if you were a young woman with dia-betes in 1970, your odds of a successful pregnan-cy—for you and your baby—were so low that most doctors recommended against ever having children. In fact, as recently as a few decades ago, many doctors recommended that young women with type 1 seriously consider voluntary steril-ization. As a father and grandfather myself, I find it depressing to think about that. Today, how-ever, women with type 1 get pregnant and have healthy babies and remain healthy themselves.

We see our years of progress as a bridge to a cure—advances that are keeping people alive and in better health so they can benefit from the cure when we find it. And find it we will. After all, the promise to find a cure is not just one we make to our children or ourselves at the time of diagnosis. It’s a promise that goes back 40 years, to the first days of JDRF. That promise is just as important today as it ever was.


Juvenile DiabetesResearch Foundation

International

Board of Directors

Diane AdamsFernando Aguirre

Dick AllenShannon Allen

Richard K. BonnessJohn Brady

Jeffrey BrewerMary Elizabeth Bunzel

Mitchell H. CaplanDayton ColesCynthia Ford

Chip HalversonMichael HendrenRobert R. Hindle

Steve HitchinsJudy M. Hunt

Francis J. IngrassiaRichard Kirkland

Ellen LeakeRichard P. LevyJohn Madden

James F. McDonaldPatrick McFeeley

Leo F. Mullin, ChairmanDavid W. Nelms

George NethercuttNettleton S. Payne II, M.D.

David RehrLewis R. RunnionGlen E. TullmanMichael L. White

William T. Young, Jr. Anne Zaring

Ex officio:James C. Tyree

Board of Chancellors

Dr Susan Alberti AO, Hon L.L.D.Don Aron

Robert AuerbachAubrey W. Baillie

Gordon D. Barker, R.Ph.Maureen Barunas Joan BeaubaireCrandall BowlesErskine Bowles

Max C. Chapman, Jr.Sanford Cloud, Jr.

Judi CochranRoss A. Cooley

Don CorraoAnne Domergue

Lee DucatSamuel D. Ewing, Jr.

Gerald Fishbone, M.D.Joseph Gardner, Ph.D.

Eileen GelickRobert D. German, Esq.

David GlusmanKrayna GolfmanMarilyn GommWilliam Graves

Roslyn GreensponEric Harkna

Margaret Conn Himelfarb, M.P.H.Michael J. Hopkins, Esq.

Terry A. JacksonFran Jacoby

Ardy JohnsonDave Johnson

Larry KingRobert N Klein II

Joann Leatherby, Esq.Jan Leeper

Stephen Leeper, D.D.S. S. Robert Levine, M.D.

Carol Lurie James M. Lurie, Esq. John J. McDonoughSteven M. Merdinger

Mollie MillerPenny Moseley

Leah MullinJ. Richard Munro

Katharine S. OverlockWillard J. Overlock, Jr.

Penn Payne, Esq.Margery D. Perry

Gail PressbergSandra Puczynski, Ph.D.Charles J. Queenan III

Kenneth M. RichMark Rubenstein

Steven T. Ruby, M.D.Pam Sagan

Bob SamuelsAlyce SatskyHelaine Shiff

Sandra D. SilvestriAdam Singer

Harold Smethills Roy C. SmithEmily Spitzer

James Stuart Jr.James C. TyreePeter Wilson

Anne Zaring, Chair

JDRF Countdown 10… 9… 8…40 Years of Progress

Alan J. Lewis, Ph.D. President & Chief Executive Officer

We would like your opinion.

JDRF wants to know what you think about Countdown. Please take a moment to fill out our short survey—either the attached print version or online at the link listed below. We want to know if we’re providing the kind of information you want and need about diabetes research. JDRF values your opinions—so please share them with us!

www.jdrf.org/countdownsurvey

Thank you for taking the time to fill out our survey. Your feedback will make a real difference, and we greatly appreciate your participation.

Driving Toward an Artificial Pancreas

JDRF has once again made headlines for our progress toward the development of an artificial pancreas, a system that can reduce the risk of complications and help

to ease the daily burdens of type 1 diabetes as we drive toward a cure.

Earlier this year, JDRF announced two new partnerships in our Artificial Pancreas Project. The first is with Animas Corporation, a leading insulin pump manufacturer that is a Johnson & Johnson company. The partnership’s aim is to create a first-generation artificial pancreas—a partially automated insulin delivery system. The second partnership is with BD (Becton, Dick-inson and Company), a leading global medical technology company, and its aim is to develop new insulin-delivery products to enhance insulin pumps. Advances in pump technology will im-prove glucose control and can potentially be in-corporated into artificial pancreas systems being developed by Animas or other companies.

A Groundbreaking PartnershipJDRF’s non-exclusive partnership with Animas represents a giant step forward on the path to developing an artificial pancreas. The first-gen-eration system being created will be partially au-tomated; people using it will have to manually instruct the pump to deliver insulin at key times (such as around meals). But the device will incor-porate several technological advances that could provide immediate benefits.

The insulin pump will be connected wire-lessly with a continuous glucose monitor, which will continuously read glucose levels through a hair-thin sensor wire inserted just below the user’s skin. The pump will house a sophisticated computer program, or algorithm, that will look to prevent hypoglycemia and extreme hypergly-cemia. The system will slow or stop insulin deliv-ery if it detects blood sugar is going too low, and

it will increase insulin delivery if blood sugar is going too high—functioning as a “hypoglycemia-hyperglycemia minimizer.”

“If successful, the development of this first-generation system will begin the process of au-tomating how people with diabetes manage their blood sugar,” said Alan J. Lewis, Ph.D., JDRF’s President and Chief Executive Officer. “Ultimate-ly, an artificial pancreas will deliver insulin as needed, minute-by-minute, throughout the day to maintain blood sugar levels within a target range. But even this early system could bring dramatic changes in the quality of life for the three million people in the United States with type 1 diabetes.”

Improving Insulin Pump ComponentsJDRF is partnering with BD to support the com-pany’s efforts to develop new products that de-liver insulin from a pump to a patient in either an infusion set or patch-pump configuration. The project includes research on microneedles, tiny needles that deliver insulin just beneath the skin, increasing the speed of insulin uptake; microneedles also may be virtually pain-free.

Research indicates that there are significant opportunities to enhance pump therapy by im-proving convenience as well as minimizing pain, kinking, occlusions, and site infections. These enhancements are intended to improve how peo-ple with diabetes control their insulin therapy, and they are expected to have a positive impact on their overall level of glycemic control.

Landmark StudyAlso recently, a JDRF-funded study at the Uni-versity of Cambridge showed that using an arti-ficial pancreas system overnight in a hospital set-ting can help kids and teenagers better manage their blood sugar while reducing the risk of low blood sugar emergencies (see story on page 8).

More information about these and other devel-opments in JDRF’s Artificial Pancreas Project is available at www.jdrf.org/artificialpancreasproject.

JDRF’s APP PartnershipsPartner JDRF Investment Key Goal

Animas $8 million over three years

To develop a first-generation artificial pancreas and initiate the regulatory review process within about four years

BD $4.3 million over several years

To develop new products, including microneedles, that can improve insulin pumps

FASTFAcTS ll

editorial directorKelly Sobel

creative directorTim Walker

art directorChris Satek

contributing editors

Verna Schwartz Sarah Pollak Sullivan

Research Advisory Group

Barbara Araneo, Ph.D.

Julia Greenstein, Ph.D.

Patricia Kilian, Ph.D.

Aaron Kowalski, Ph.D.

Helen Nickerson, Ph.D.

Concepcion Nierras, Ph.D.

Teodora Staeva Ph.D.

Adrianne L. Wong, Ph.D.

Countdown Editorial Committee

co-chairs Gerald Fishbone, M.D.

Margery Perry

Mark Atkinson, Ph.D.

Fran Carpentier

Andrew Jay Drexler, M.D.

Ben Goldberger

Charry Godwin

Margaret Grey, Ph.D., R.N.

Kevan Herold, M.D.

S. Robert Levine, M.D.

Carol Lurie

Noel MacLaren, M.D.

William Tamborlane, M.D.

Chris Walker

Editorial/World Headquarters

26 Broadway, 14th Floor

New York, NY 10004

212-785-9500/800-533-2873

www.jdrf.org

Annual subscription $25

Acceptance of advertising for products

in Countdown in no way

constitutes endorsement by the Juvenile

Diabetes Research Foundation International.

(ISSN 1070-9282)

Countdown is published biannually, and

Countdown Online is published quarterly,

by the Juvenile Diabetes Research

Foundation International (JDRF),

a not-for-profit, voluntary health agency whose

mission is to find a cure for diabetes and its

complications through the support of research.

ll


JDRF ResearchFASTTRAcK

Millions of people around the globe need a cure for type 1 diabetes. By including a gift to the Juvenile Diabetes Research Foundation in your will, trust or retirement account, you can create a lasting legacy—one that helps ensure research will continue until a cure is found. For more information, please contact:Alan Berkowitz National Director of Planned GivingToll-free – 877-533-4483By e-mail – [email protected] the web – www.jdrf.org/plannedgiving

How Do You Create a Legacy That Can Change the World?


NEWSbriefs NEWSbriefs

In a landmark study in children and teenagers with type 1 diabetes, JDRF-funded researchers at the University

of Cambridge showed that using a first-generation artificial pancreas system overnight can lower the risk of low blood sugar emergencies during sleep, and at the same time improve diabetes control.

The study, published in February in The Lancet, was actually three-in-one; it encompassed three separate trials of a closed-loop system versus standard insu-lin infusion through a pump: overnight control alone, overnight control after rapidly and slowly absorbed meals, and overnight control after exercise.

Conducted in a hospital setting, the tri-als tested the overnight safety and effec-tiveness of a first-generation artificial pan-creas system among young people with type 1 diabetes ages five through 18. The system combined commercially available blood glucose sensors and insulin pumps with a sophisticated computer program called an algorithm. The algorithm deter-mined the insulin dosage to deliver, based

on blood glucose levels while the partici-pants slept. But as a safety precaution, a nurse was present to “okay” the calcu-lated dosage before it was administered.

The study showed that when their dia-betes was regulated with the artificial pan-creas system, the children and teenagers spent twice as much time during the night within targeted blood glucose levels than when they followed conventional “manual” therapy. Low blood sugars were minimized.

The pooled data from the closed-loop studies revealed that blood glucose levels were 61% in target, and even increased to 75% in target after midnight when the closed-loop became fully effective.

“Without a doubt, the biggest worry for parents of kids with type 1 diabetes is that their child will have a low blood sugar emergency during the night, when they’re hard to identify,” said Aaron Kowalski, Ph.D., Director of the JDRF Artificial Pancreas Project. “This study is proof-of-principle that diabetes in kids can be safely managed overnight with an artificial pancreas. We need to redouble

our efforts to move the artificial pan-creas from a concept in the clinic to a reality in the homes of kids and adults with type 1.”

The study comes several months after the publication of two additional JDRF-funded studies on continuous glucose monitors (CGMs), published in the jour-nal Diabetes Care. These investigations revealed that regular CGM use improves blood glucose control in all age groups and enables long-term control while lowering rates of hypoglycemia. There are now four separate publications documenting the benefits of CGM devices—underscor-ing the importance of continued research into a closed-loop artificial pancreas, a system that includes CGM technology as one of its key components.

The current study took place at the Wellcome Trust Clinical Research Facil-ity, at Addenbrooke’s Hospital in Cam-bridge, United Kingdom, and included 17 children and adolescents. Twelve partici-pated in the first study, six in the second, and nine in the third. l

Artificial Pancreas Trials Show Overnight Benefits in Kids, Teens

Working for the first time with researchers representing another autoimmune disease, JDRF

recently joined forces with two new part-ners—Fast Forward, LLC, and Axxam SpA. The goal of this innovative part-nership: to accelerate the development of treatments directed at autoimmunity, the process by which the body mistakenly attacks its own cells and tissues in diabe-tes and multiple sclerosis (MS).

Fast Forward, the drug-development arm of the National Multiple Sclerosis Soci-ety, will work as a patient advocate along-side JDRF. Both type 1 diabetes and MS are autoimmune diseases. Axxam, a com-pany based in Milan, Italy, is a leader in conducting early-stage discovery research.

Under the terms of the agreement, Axxam will screen its extensive chemical library for compounds that can target spe-cific “ion channels” in the immune system. Ion channels are tiny pores on the surface of cells that control the flow of charged parti-cles, allowing the cells to become activated and perform their natural surveillance and protection functions. Recent studies have found that immune cells in both MS and type 1 diabetes contain high levels of a specific ion channel; the hyperactivity of this channel contributes to the dysfunction of the immune system in both disorders. Axxam hopes to identify compounds that can affect the channel—and then further develop them as potential therapies for people with MS and type 1 diabetes.

The agreement with Axxam is the first of its kind between patient advocacy organizations focused on different but similar diseases. It represents a new fron-tier in which groups such as JDRF and Fast Forward ally to advance drug dis-covery and accelerate the development of new therapies that can impact multiple disorders.

“Our partnership with Fast Forward and Axxam opens exciting new avenues for JDRF to speed the translation of basic research into drugs and treatments for type 1 diabetes,” said Alan J. Lewis, Ph.D., JDRF’s President and Chief Executive Officer. “This research has the potential to negate the autoimmune process causing type 1 diabetes and multiple sclerosis.” l

Unique Partnership to Accelerate Immune System Treatments for Diabetes, Multiple Sclerosis

S P R I N G 2 0 1 0 w w w . j d r f . o r g 9


As part of its expanding commit-ment to improving the lives of adults who have type 1 diabetes,

JDRF has created a new resource called the JDRF Adult Type 1 Toolkit.

Developed by people who have type 1 diabetes, the Toolkit is an essential “how-to” guidebook about living with the disease. It offers information and advice on a plethora of topics, such as how to deal with the diagnosis and day-to-day management of diabetes, how to tell friends about the disease, and how to juggle the demands of diabetes at work. It describes how diabetes affects physical and psychological health, relationships, and parenting. It gives tips for approaching things like diet, exercise, travel, and work and explains how to educate others about type 1,

especially on what to do in emergency situations.

JDRF hopes the Toolkit can help to foster a sense of community among type 1 adults, who represent the majority of those living with the disease. Toward that goal, it outlines ways to connect with a network of other type 1 adults and with JDRF’s “expert listeners,” volunteers who give advice and tips for dealing with specific situations that people with diabe-tes encounter.

JDRF developed the Toolkit to address the glaring lack of resources for adults with type 1 diabetes. When children are diagnosed, their parents are often flooded with support and resources. Yet when adults are diagnosed, they usu-ally have far fewer resources and often don’t know where to turn for support.

The resources for children are often not applicable to adults, who have different needs. Making matters more difficult, adult type 1 diabetes is frequently sub-ject to misinformation and misconcep-tions that blur the lines between type 1 and type 2, leaving people with the disease feeling isolated and sometimes confused. The Toolkit is one aspect of JDRF’s response to these issues.

The Adult Type 1 Toolkit is an ini-tial step in JDRF’s plans to develop an extensive program to support the needs of adults who have type 1 diabetes. We will be developing additional resources to ensure that adults have the support they need to live well with the disease.

The Toolkit is free and available at any of JDRF’s 85 chapters nationwide or at www.jdrf.org/adults. l

JDRF-funded researchers are devel-oping an oral vaccine to stop the autoimmune response that causes

type 1 diabetes. Their innovative approach begins

with hollow “yeast shells” derived from baker’s yeast. The researchers use them to ferry proteins and other agents to immune cells, with the goal of retraining the immune system to “tolerate” the insu-lin-producing beta cells that it mistakenly targets and destroys in type 1 diabetes.

The study is using a promising new approach for silencing inflammatory reac-tions associated with autoimmunity. Recog-nizing that the approach could have impli-cations for treating type 1 diabetes, JDRF decided to fund Michael Czech, Ph.D., and a team of researchers at the University of Mas-sachusetts Medical School to develop it for the benefit of people with type 1 diabetes.

Dr. Czech and his team are trying to stop the process that causes diabetes in its tracks—or prevent it from starting in the first place. Their approach targets immune cells that “engulf” particles the size and shape of the yeast shells. When these immune cells come in contact with

the yeast shells and engulf them, the pro-teins and other agents in the shells change how the immune cells present themselves to the immune system. Ultimately, this retrains the immune system’s T cells to tolerate, rather than attack, insulin-pro-ducing beta cells.

In previous studies, the researchers showed that yeast shells loaded with inhibitory agents called short interfering RNA (or siRNA) can minimize immune responses in mouse cells both in vitro (in a test tube) and in vivo (in a living animal). In one set of experiments, the scientists used the yeast shells to orally deliver an siRNA directed specifically against molecules linked to inflamma-tion. By targeting a critical inflammatory

gene found in immune cells, the research-ers were able to suppress the inflamma-tory response.

Using the yeast-shell platform as a start-ing point, JDRF asked the researchers to expand the oral vaccine for type 1 diabe-tes—so that it not only regulates immune system genes but also stops immune system cells from targeting the insulin-producing beta cells. Their approach, ingenious in its simplicity, is to include beta cell proteins along with siRNA in the vaccine shells. By using the vaccine shells to load up immune cells with beta cell proteins, they hope to spur the correct T cell responses—and keep the immune attack from causing dia-betes. The researchers will assess a num-ber of siRNA targets as well as several beta cell proteins to see which combina-tions have the best effect.

With JDRF funding, the researchers have embarked on a two-year study to evaluate and test the vaccine in mice. The first year is focused on finding the best beta cell proteins and siRNA targets and successfully encapsulating them within the yeast shells. In vivo studies will begin at the start of the project’s second year. l

An Oral Vaccine Using “Yeast Shells”

JDRF Launches Adult Type 1 “Toolkit”

The goal is retraining the immune system to “tolerate” the insulin-producing beta cells

1 0 J D R F C O U N T D O W N S P R I N G 2 0 1 0


Two groups of JDRF-funded researchers have identified pro-cesses that explain why insulin-

producing cells lose their ability to regen-erate with age. The findings shed light on the mechanisms that regulate normal expansion and decline of those cells—and could help lead to new therapies for peo-ple with type 1 diabetes.

Scientists believe that insulin-producing beta cells can regenerate within the body either through the replication of existing adult beta cells or from stem cells in the pancreas. However, the capacity of beta cells to regenerate and adapt diminishes as we age. To better understand the molecular events involved, the two groups focused on a specific cluster of genes known to have a “braking” effect on cell growth.

Their choice paid off. The research teams each identified a key protein that stops this inhibitory process. Seung Kim, Ph.D.,

who led the research at Stanford Univer-sity School of Medicine in California, pin-pointed the role of a protein called Ezh2. Anil Bhushan, Ph.D., at the University of California, Los Angeles established the role of a protein known as Bmi-1. Both proteins turn genes on or off by altering gene pack-aging and accessibility within DNA.

Dr. Kim’s group observed that levels of Ezh2 decline with age in the insulin-pro-ducing cells of both people and mice. With this decline, there is an increase in cell cycle braking, and beta cells consequently

have less capacity to proliferate. Ezh2 was found to directly regulate this process.

Dr. Bhushan’s group showed that lev-els of Bmi-1 also decline with age. Work-ing with mouse cells, they demonstrated that the protein regulates the same cell-braking system. They determined that as beta cells age, less of the protein is available, so the cell’s braking genes go unchecked, and the cells’ ability to rep-licate diminishes. Dr. Bhushan’s group also showed that Bmi-1 and Ezh2 work together in a cooperative fashion to reg-ulate this process.

The findings are exciting, said Patricia Kilian, Ph.D., Director of JDRF’s Regen-eration program. They suggest that “con-trolling these pathways might enable us to restore regenerative capacity to treat dia-betes, even in older people.”

Both research groups are following up on the findings with JDRF funding. l

Why Beta Cell Regeneration Slows With Age

Call 1-800-991-4999 for an information package & complimentary DVD

1 As published in the December 2009 USA Today health blog

A division of New England Cryogenic Center

Research on Juvenile Diabetes and the use of stem cells to repair the pancreas are ongoing. Scientists are optimistic about this cell. Recently the NIH approved new stem cells lines for their registry for federal rresearch funding and mandated that they be used for diabetes-related pancreatic cell experiments.1 Your opportunity to cryopreserve these precious cells is now. The choice to bank your child’s stem cells can be made as they start to loose their baby teeth, have teeth extracted for orthodontia and wisdom teeth removed. These are simple non-invasive opportunities for you to harvest these cells and have them preserved for future regenerative medical discoveries.

Saving Your Stem Cells Today Could Bring You Good Health Tomorrow

In 2000, researchers at the National Institutes of Health revealed that there are viable stem cells within the pulp of healthy teeth. A type of cell, called a Mesenchymal stem cell is known to have the potential to become insulin producing.

There Just Might be Magic in the Tooth Fairy’s Wand!

“…controlling these pathways might enable

us to restore regenerative capacity to treat diabetes,

even in older people.”

S P R I N G 2 0 1 0 w w w . j d r f . o r g 1 1


JDRF-funded researchers have made important discoveries in encapsula-tion that could improve the success

of islet replacement.In a study in mice, scientists showed for

the first time that transplanted cells that become insulin-producing cells—beta cell precursors—can survive in the body when they are encapsulated in a durable “device” that protects them against an immune attack. Equally important, the study found that these cells eventually developed into insulin-producing cells that could control rising blood sugar lev-els. By contrast, adult insulin-producing cells that were encapsulated in the same way exhibited poor survival.

The results suggest that encapsulat-ing cells before they are differentiated and become beta cells—using stem cells, for example—may be a more successful approach to replacing insulin-producing cells in people with type 1 diabetes, and a new way to take advantage of emerging cell-based therapies.

“Our data suggest that long-term pro-tection of human beta cells in type 1 dia-betic patients without immunosuppression is a realistic goal,” said Pamela Itkin-Ansari, Ph.D., and colleagues from the University of California, San Diego and the Burnham Institute for Medical Research in La Jolla, Calif. Their findings were reported in the journal Transplantation.

Transplants of insulin-producing cells are an especially important option for adults with type 1 diabetes who have hypoglycemia unawareness, a life-threat-ening condition in which people can no longer sense dangerously low blood sugar levels. But the procedure has two main limitations. First, people who get these transplants need to take immunosup-pressive drugs for the rest of their lives to prevent the rejection of the donated islets, even though these drugs can cause health problems and damage the transplanted cells. Second, there are too few donors to make transplantation a widely available option.

A solution to both problems would be to transplant cells from another source and to encapsulate these cells in a material that

protects them from the immune response. Shielding the transplanted cells would mean there is no need for immunosup-pressive drugs—and by using stem cells as the transplant source, people with type 1 diabetes would have access to a potentially unlimited supply of transplantable cells.

With their principal goal to identify a way to safely deliver stem-cell–derived therapies, Dr. Itkin-Ansari and her team set out to test a durable “macroencapsula-tion” device made by TheraCyte, Inc. The device, already shown to be biologically

safe in people, has an inner layer with pores small enough to allow insulin, but not the enclosed cells, to flow out.

To see whether cells within the encap-sulation device would survive and func-tion well, the researchers first tested it in mice that are unable to mount a strong immune response. This allowed them to eliminate the variable of immune rejec-tion. They transplanted the mice with either encapsulated adult human islets or immature cells that would become insulin-producing cells. Other mice were transplanted with unencapsulated islets.

The encapsulated, insulin-producing cell precursors thrived within the device. Ten weeks after transplantation, they were producing insulin, glucagon, and other hormones that indicated normal function. In fact, the fraction of encap-sulated cells producing insulin had nearly tripled since the transplantation. The research suggested that the environment within the device not only allowed the cells to replicate, but may also have pro-moted this process.

In most of the mice, the encapsu-lated cells were able to produce insulin in response to glucose five months after transplantation. In one set of experi-ments, the encapsulated human precur-sor cells produced enough insulin to con-trol the inevitable rise in blood glucose.

Untransplanted mice became diabetic within 48 hours.

The researchers also did mouse-to-mouse transplants to assess how well the encapsulated tissue “took” and to see whether the new encapsulation device would provoke the immune system into an attack. They monitored the encapsu-lated precursor cells over a 50-day period.

What they observed was a dynamic process of cell death followed by regrowth, and ultimately, robust long-term survival of the transplant. Perhaps most noteworthy

was that the encapsulation device did not stimulate a detectable immune response. “In transplanted mice,” they explained, immune cells “were not recruited to the tissue surrounding the device. This was somewhat surprising, given that severe insulitis [inflammation] was readily appar-ent in pancreases from the same mice. The data suggest that the encapsulated beta cells are invisible to the immune system, and this bodes well for long-term clinical translation of the technology.”

Dr. Itkin-Ansari will use funding from the California Institute of Regenerative Medicine to follow up on this work. She will conduct similar tests of the encapsu-lation device using progenitor cells derived from embryonic stem cells, working in collaboration with the biotechnology company Novocell, which recently devel-oped a method for producing pancreatic precursor cells from human stem cells.

The study provides proof-of-concept that insulin-producing cell progenitors can survive, proliferate, and mature in an encapsulation device to the point where they can correct diabetes. “This approach may be an important step in our ability to translate the transplantation of human embryonic stem cell-derived progenitors into clinical testing,” said Julia Green-stein, Ph.D., Director of JDRF’s Beta Cell Therapies research program.l

Beta Cells Survive, Flourish in Encapsulation Device

The data suggest that long-term protection of beta cells without immunosuppression

may be a realistic goal

by Robert S. Dinsmoor

This is a story of perseverance. It’s about believing in something—even when others say it’s impossible—and then working hard to get it done. This is the story of nPOD.

Although it sounds vaguely like something from a science fiction movie or a takeoff on a portable music device, nPOD actually stands for “Network for Pancreatic Organ Donors with Diabetes.” It’s a program JDRF created in 2006 to advance

understanding of how type 1 diabetes develops by promoting the study of pancreases and related tissues from organ donors.

In its short lifetime, nPOD has already become a robust and growing program that has achieved impressive results —providing unexpected insights into diabetes. It’s a JDRF

success story, written by scientists who never doubted it could be done.


The History of nPODBefore the advent of nPOD, not many scientists studied pancreases from organ donors. It was a practice that was largely abandoned back in the 1970s. But among those who remained active in this area was George S. Eisenbarth, M.D., Ph.D., Director of the Barbara Davis Diabetes Center in Denver.

He and his colleagues screened tissues from organ donors for islet autoantibodies – an early sign that a person was on the path to developing type 1 diabetes – even before any outward symptoms occur.

“We knew that most would not have diabetes, but we hypothesized that some subset of these individuals would have islet autoantibodies,” recalls Dr. Eisenbarth, who now serves on the nPOD Executive Committee. What those researchers found was surprising: about one in 300 U.S. organ donors had islet autoantibodies.

JDRF was intrigued by this early work, as well as the work from Daniel Pipeleers, M.D., Ph.D. and Peter in’t Veld, Ph.D. (Belgium), as well as Heikki Hyöty, M.D., Ph.D. (Finland). JDRF thought it deserved to be expanded, because it seemed so highly promising: by studying the biology of the pancreas, scientists could gain unique insights into how type 1 diabetes develops.

However, JDRF met with a large amount of resistance to this idea. Many scientists thought it just wasn’t feasible to establish a nationwide program to provide pancreases for type 1 research. Still, JDRF decided to take a risk and push forward – and knew just who to call to help make nPOD happen.

“JDRF came to me and asked me to form a task force to look at the question,” recalls Mark A. Atkinson, Ph.D., Professor of Pathology and Pediatrics at the University of Florida in Gainesville. “They said, ‘Here are all the reasons people say it can’t be done. Could you find a way to get it to work?’ So, we got together a little group and spent six months communicating by phone and by e-mail, to design a program that would overcome each of the obstacles. And with that, nPOD had its birth.”

Today, Dr. Atkinson is Director of nPOD, which he likens to the protagonist of the “The Little Engine That Could,” the classic children’s book about optimism and determination.

“Mark Atkinson has done a fantastic job of pulling this project together,” says Dr. Eisenbarth.

nPOD’s rapid growth over the past three years – it’s gone from supporting six studies initially to more than 35 today – has affirmed that JDRF was right to take the risk, says Teodora Staeva, Ph.D., JDRF’s Director of Immune Therapies and one of the movers-and-shakers behind nPOD’s establishment. The program is already screening about 12% of the 8000 annual organ donors in the United States for islet autoantibodies, and hopes to boost that to 30% before long.

How it WorksnPOD collects pancreases and other tissues of research interest that were obtained from three groups of organ donors – those who test positive for islet autoantibodies, those with type 1 diabetes of recent onset, and those with longstanding type 1 diabetes. It then sends them to researchers worldwide for studies on how type 1 diabetes develops.

To obtain the pancreases, JDRF has formed partnerships with a number of organ procurement organizations nationwide (see page 15). “When we

come face-to-face with families of people with diabetes, they want to be able to participate in diabetes research, if it’s going to help find a cure for diabetes – and that makes the gift all the more important at the end of someone’s life,” says Howard Nathan, President and CEO of Gift of Life Donor Program, one of the oldest and largest organ procurement organizations in the United States. Nathan, who himself has had diabetes for more than 40 years, serves on the nPOD Executive Committee.

Collecting the pancreases is an extremely time-sensitive process. Once the donor’s family has given consent, teams of surgeons remove various organs, typically for transplantation. If the donor has type 1 diabetes, or if a blood test shows that the donor has islet autoantibodies, the pancreas cannot be transplanted, so the nPOD team is contacted immediately. After the pancreas is removed, it is placed inside a container with preservation fluid. A courier service takes it to the local airport, and it is flown to Florida, either Miami or Jacksonville, where another courier takes it to the nPOD laboratory in Gainesville.

Most of the pancreases arrive completely intact (from a research


Humanizing theMousenPOD is helping to advance research in many ways – including by making mice more “human.”

Two scientists are creating a unique type of mouse into which they can engraft cells from the human immune system, such as spleen cells. The goal is to study the autoimmune response in people without actually putting any people at risk.

“What nPOD is doing is giving us material from type 1 autoantibody-positive individuals and normal controls so that we can engraft human immune cells and study their activity in these novel mice,” says Dale Greiner, Ph.D., Professor of Medicine at the University of Massachusetts School of Medicine. In effect, Dr. Greiner and his colleague, Leonard Shultz, Ph.D., a professor at Jackson Laboratory in Bar Harbor, Maine, are recreating the human autoimmune response in mice. This enables them to “study how the human immune system targets and destroys the beta cells” and to look at potential therapies “to block the process,” Dr. Greiner says.

Next, they hope to take stem cells from the bone marrow of nPOD donors, inject the cells into mice – and then observe the mice as they develop the cells of the human immune system. Says Dr. Greiner, “That would be important in terms of identifying the triggers that cause diabetes during the immune system’s development – and targets that could affect the way these triggers are affecting the immune system in order to prevent diabetes.”

perspective), which has allayed one of the major early concerns about nPOD. “Ninety-nine percent of the pancreas’ function is to make enzymes for digestion,” says Dr. Atkinson. “People thought that by the time the pancreases arrived in Gainesville, the organ would be digested and unusable, essentially a bag of mush. But nPOD has proved that notion wrong.”

The Development of DiabetesResearchers don’t know exactly what causes type 1 diabetes, but they have

gained some important insights over the years. It is known, for example, that certain genes confer susceptibility to type 1 diabetes, and other genes protect against it. It is believed that environmental factors, such as a virus or some dietary component, may trigger the disease (although it is also believed that some environmental factors may actually protect against it).

Whatever the specific cause, type 1 diabetes is the result of an autoimmune reaction – in which the body’s immune system – specifically white blood cells called T-lymphocytes (or “T-cells”) – attack the pancreatic islets, destroying

the insulin-producing beta cells. While scientists used to think that this destruction happened suddenly, they now believe that the process leading up to autoimmune diabetes may occur over several years and may begin early in life. Well before the age of five, and often years before the onset of any obvious signs of diabetes, the immune system begins to destroy the beta cells of the islets in childhood type 1 diabetes. During the time before diabetes is diagnosed, the existing beta cells may be able to secrete more insulin to compensate for the loss of the beta cells being destroyed by the immune attack. Eventually, however,


Attendees at the third annual JDRF nPOD meeting, held this past November in Washington, D.C.

after enough beta cells are lost, the ones remaining are unable to meet the body’s insulin needs, and hyperglycemia (high blood sugar) ensues – leading to a diagnosis of type 1 diabetes.

Virtually all cases of type 1 diabetes were thought to develop exactly the same way. Now, as nPOD has shown, that’s just not true.

A Key FindingAlready, a key finding has come out of nPOD research: Scientists have shown that not all cases of childhood-onset diabetes are exactly alike. A study by Dr. Roberto Gianani and colleagues at the University of Colorado Health Sciences Center in Denver, recently published in the journal Diabetologia, found that childhood-onset diabetes is actually a very diverse disease.

“nPOD has already told us that there is a significant subset of patents with long-term childhood-onset diabetes who appear not to have the typical autoimmune diabetes,” Dr. Eisenbarth explains. “That has occurred in three out of 20 of the initial nPOD pancreases. What’s different about those individuals is that 100 percent of their islets have beta cells, whereas in most patients with type 1 diabetes, they have no beta cells in their islets.”

The findings have changed how Dr. Atkinson sees diabetes.

“I think many researchers had fallen into a trap of thinking that ‘type 1 diabetes’ is ‘type 1 diabetes’ is ‘type 1 diabetes,’” says Dr. Atkinson. “However, as we have looked at the pancreases of individuals who have been diagnosed with type 1, the amount of diversity we’re seeing from patient to patient has been profound. And particularly when we’ve looked at some of the longstanding cases, I’m beginning to think that it’s a very diverse disease, and we have much, much more to learn.”

nPOD offers a number of unique benefits to scientists trying to learn more about type 1 diabetes, Dr. Atkinson says. First of all, it enables cross-disciplinary analysis of the same tissue samples. As he explains: “Normally someone will study genetics. Or someone will perform an immunology-based study. Or someone will look at environmental issues. Or someone

will use a proteomic-based approach. But in nPOD, one of the first things that makes it unique is that, with 35 different researchers asking 35 different questions with 35 different techniques, there could be the potential for cross-disciplinary analyses of the same samples.”

Another unique aspect of nPOD is its pathology website, which now has well over 100 users. According to Dr. Atkinson, research papers about the development of diabetes typically have one or two pictures of the pancreas, along with the researchers’ interpretation. “With our online pathology tool, an outside observer can go in and look at the whole pancreas,” he says. “They can look at dozens and dozens of shots and make their own interpretations.”

The pictures provide a treasure trove of information, says nPOD Coordinator Anastasia Albanese-O’Neill, R.N., B.S.N., who got involved in diabetes research after her daughter, Cassidy, was diagnosed with type 1 diabetes. “People can see the pancreas under attack, and what the islets look like,” she says. “They can go through all the different slides, and they can order various materials based on what they see online. We ask people to look for the current projects we have in place and encourage them to collaborate with other investigators working together from different institutions who are doing the same thing.”

Future Directions There are a number of exciting potential directions nPOD can take. Dr. Eisenbarth’s group wants to better understand the T-cells and T-cell receptors involved in the immune attack that causes diabetes. They believe the best route for gaining insight is to study the pancreases of organ donors who were in the process of developing diabetes.

He also sees the value in studying the pancreases of people who have had diabetes for decades, yet still have islets. nPOD can help answer questions like: Why do some islets survive for 10 or 15 years? Have they “figured out” how to naturally resist the disease?

Another avenue for study would be to look at the pancreases of

people who lived with diabetes for years without major complications. “We understand very little about why these individuals do well,” says Dr. Eisenbarth.

The Dedication Difference

The key to pulling off a feat like nPOD has been the dedication of everyone involved. “This is very complex to run, as it runs 24/7, 365 days a year, including nights and holidays,” Dr. Atkinson says. “We’ve worked almost every Christmas and almost every major holiday in the past two-and-a-half years.”

Ms. Albanese-O’Neill agrees, adding: “Mark often takes calls at two or three in the morning, and all day long on weekends.”

Yet all involved believe it’s well worth it. Thanks to nPOD, some of the mysteries about type 1 diabetes are well on the way to being solved.

For more information on nPOD, visit www.jdrfnpod.org.

3 Gift of Life3 United Network of Organ Sharing (UNOS)

3 Mendez National Institute of Transplantation3 The Organ Procurement and Transplantation Network3 The International Institute for the Advancement of Science (IIAM)

3 The National Diabetes Research Interchange (NDRI)

Where Do the Tissues Come From?


It’s a big challenge: to cure type 1 diabetes by regenerating the insulin-producing beta cells. JDRF believes it can be done, but knows it can’t do it alone. So it has joined forces with a team of innovative scientists that has the skills and expertise to quickly advance research toward this goal.

by Kevin Gault

A Life-Saving collaboration



Recognizing that big challenges call for big responses, JDRF has teamed with the Genomics Institute of the Novartis Research Foundation (GNF) for a four-year,

multi-million-dollar research program that aims

to produce a steady stream of potential regeneration drugs to be

tested in human clinical trials. It’s one of the largest, most comprehensive

collaborations in JDRF’s 40-year history.The collaboration was launched last

fall, powered by mounting scientific evidence that insulin-producing beta cells, which are attacked in the autoimmune response underlying type 1 diabetes, can and do regenerate.

“The old belief was that once beta cells are lost because of type 1 diabetes, there is no way to restore them,” said Patricia Kilian, Ph.D., who directs JDRF’s Regeneration research program. “But now we know that these cells can grow and be restored. There’s also evidence that beta cells exist and multiply even in people with longstanding diabetes.”

JDRF wanted to ensure that these scientific advances were turned into drugs and treatments to benefit people

with type 1 diabetes. It saw the GNF team as an excellent group to help accomplish that aim.

STATE-OF-ThE-ART RESEARCh Founded in 1999, GNF, which is affiliated with Novartis, the global healthcare company, has state-of-the-art expertise and experience in small molecule drug discovery and development. Housed in a 260,000-square-foot research facility in San Diego and staffed by a team of 500 scientists, it boasts the latest technologies in fields like chemistry, biology, automation, and information sciences.

JDRF recognized that GNF has the capabilities to turn scientific advances into potential new treatments.

“JDRF has funded great academic research, but most academic institutions don’t have the resources or expertise to translate basic research findings through the multiple steps to reach clinical trials,” says Dr. Kilian. “That’s where GNF comes in. GNF has considerable expertise in chemistry, cell biology, pharmacology, and disease modeling, as well as the latest databases and experience in informatics technologies. GNF can perform all the safety and toxicity studies that must be done to translate basic research into drugs that reach clinical trials for FDA (Food and Drug Administration) approval.”

FOCUSIng On REgEnERATIOn The main focus of the JDRF-GNF collaboration, beta cell regeneration, is an area of research that is relatively new but uniquely promising. In fact, JDRF has helped to forge this field, launching its first targeted beta cell regeneration program back in 2004.

Regeneration involves triggering the body to grow new insulin-producing beta cells, either by copying existing ones—some beta cells are often still present, even in people who have had diabetes for decades—or by producing new ones from precursors in the pancreas.

In the last five years, type 1 dia-betes research has placed consider-able focus on beta cell regeneration. Researchers funded by JDRF have made significant strides in the field in a short time. For example, ETH Zur-ich scientists identified a protein that regulates cell growth in the pancreas. Researchers at Stanford University discovered a biochemical pathway that promotes beta cell expansion during pregnancy. And at Hebrew University Medical University in Is-rael, a scientist has successfully gen-erated a novel animal model of beta cell regeneration to test the potential of new regenerative therapies.

A Life-Saving collaboration


RESTORIng BETA CELL FUnCTIOnIn focusing on

regeneration, the JDRF-GNF

collaboration aims to find proteins or small

molecules that spark beta cell regeneration, and then develop drugs based on them. GNF has robotics technology that enables it to test millions of potential drug compounds quickly – as well as a library of over two million compounds that it can screen in two weeks.

In searching for these potential drugs, GNF is aiming big.

“The idea is to create a pipeline similar to the type that a pharmaceutical company uses when it takes on a disease,” said GNF’s Ann Herman, Ph.D., who manages the GNF-JDRF collaboration. “We’re not taking just one good idea and putting all of our efforts into that. We’re taking several approaches to ensure that as one promising drug is going toward clinical trials, there are several others coming right after it. We’re putting together a

collection of the best ideas and giving them the opportunity to be translated to clinical trials.”

To ensure the best chance of success, JDRF and GNF are encouraging other scientists around the globe to collaborate in the effort. They are creating a process that will give other scientists a direct path for translating their insights into drugs that reach clinical trials.

Dr. Herman noted that the process will connect those researchers with this JDRF-GNF collaboration. The objective is to create a translational research program around their project and work with them to identify molecules that can be tested to determine whether they have a viable approach toward a drug to regenerate beta cells.

Dr. Herman, who earlier in her career was the recipient of a JDRF postdoctoral award, brings over 16 years of experience to the program. Dr. Herman trained with Mark Davis, Ph.D., at Stanford University and Diane Mathis, Ph.D., and Christophe Benoist, M.D., Ph.D., at the Joslin Diabetes Center. These experiences

inspired Dr. Herman to apply her training and understanding of type 1 diabetes to finding new therapeutic approaches to treating diabetes.

MAnY DIFFICULT ChALLEngESThe search to find treatments to regenerate beta cells has its share of vexing challenges. The most difficult one is tamping down the autoimmune response that causes type 1 diabetes. Even if scientists are able to regenerate beta cells, those cells will be subject to the immune system attack. GNF scientists along with other JDRF-funded scientists are looking at ways to halt the attack to protect the regenerated beta cells.

Another challenge lies in the na-ture of drug development research. In the initial phases, tests are conducted on rodent cells, since human beta cells are difficult to access. Yet the biology of rodents is different from that of humans. Because of this, re-searchers face the possibility that the promising molecules they identify using rodent beta cells may not be translatable to people.

ForgingNew AlliancesSince drug development is a tightly regulated and expensive endeavor, it’s essential for JDRF to team with world-class organizations that have the expertise to help create and market effective new drugs. JDRF is committed to developing more of those productive partnerships.

“To find new therapeutics, we have to go beyond funding basic research, because basic research, while important, will lead to publications, but not to drugs,” says Patricia Kilian, Ph.D., Director of JDRF’s Regeneration program. “If our mission is to cure type 1 diabetes, we have to ultimately market and deliver a drug, which is something we can’t do on our own. Strategic alliances are critically important.”

That concept is the basis for JDRF’s collaboration with GNF. A key step in the progress of this collaboration was the first annual GNF-JDRF Diabetes Research Symposium on regeneration, hosted by the two organizations in San Diego on March 18. Participants included a “who’s who” of investigators involved in regenerative approaches to type 1 diabetes research, including: Anil Bhushan, University of California, Los Angeles; Gerald Crabtree, Stanford University; Marc Donath, University of Zurich; Shimon Efrat, Tel Aviv University; Matthias Hebrok, University of California, San Francisco; Ann Herman, GNF; Christopher Newgard, Duke University; Markus Stoffel, ETH Zurich; and Xu Wu, GNF.


RegenerationTakes Center Stage Regeneration is one of JDRF’s “Strategic Programs,” or priority areas of research. Why was it named as a priority? In setting its research priorities and allocating its resources, JDRF considers several important criteria:

•�Patient�benefit: Will there be a significant quality of improvement in patients and a large percentage of patients who are impacted?

•�Time�to�benefit: How long will it take to deliver the therapy to patients?

•�Scientific�impact: How will this therapeutic strategy affect—and advance—scientific research?

•�Funding�gap: Is this research area in need of JDRF funding?

“Considering these criteria, regeneration scores highly,” says Richard Insel, M.D., JDRF’s Chief Scientific Officer and a driving force behind the Regeneration research program. “The number of individuals with diabetes who could potentially benefit from restoring beta cell function by a drug activating beta cell regeneration will be much larger than the number who will benefit from cell transplantation or replacement because the latter is more cumbersome to deliver and the beta cell source will have limits to scalability. The scientific impact could be profound—by pushing this research forward, we can make a strong impact in the scientific world. And if you look at the funding gap, the NIH (National Institutes of Health) has put more resources into beta cell replacement compared to beta cell regeneration, so funding from JDRF is needed.”

JDRF’s Regeneration research program is directed by Patricia Kilian, Ph.D.; Andrew Rakeman, Ph.D., serves as Scientific Program Manager. Drs. Kilian and Rakeman have created a research plan that includes seeking out partnerships with academic investigators and collaborating with a translational research powerhouse—the Genomics Institute of the Novartis Research Foundation (GNF)—to create a pipeline of potential new drugs.

“Targeting beta cell regeneration is still a relatively new approach for the treatment of type 1 diabetes,” says Dr. Kilian. “We still have a lot to learn, including the answer to the question of how to induce human beta cells to proliferate. It will take time and painstaking effort to answer that question, but it’s fundamentally important to our research.”

According to Dr. Insel, JDRF has catalyzed the field of beta cell regeneration. “In the last three years in particular, a wealth of new information has been garnered, and now we’re funding early stage research to find new therapies,” says Dr. Insel. “This research has great potential, and JDRF has a scientific staff that understands this field and can set priorities. That’s the type of expertise needed to proactively drive this effort forward.”

And that’s exactly what JDRF is doing.

Scientists also face the challenge of selectivity. Specifically, they must identify molecules that regenerate only beta cells and not other types of cells (such as muscle or bone).

To overcome these challenges, scientists must answer many questions about beta cell growth. “At this point, we don’t understand everything about it,” says Dr. Kilian, “so our approach with GNF is to make many different efforts to look for molecules that will affect beta cell regeneration and survival. We’ll find those that seem to be the most effective and focus our efforts on them.”

The collaboration between the two organizations includes a number of familiar faces. In addition to Dr. Herman, other key investigators on GNF’s regeneration research program team include Matthew Tremblay, Ph.D., George Harb, Ph.D., and Christophe Filippi, Ph.D., all of whom received postdoctoral fellowships from JDRF in earlier stages of their careers, and Marco Londei, M.D., who received a JDRF Career Development award.

Dr. Kilian reiterated that collaboration is key to the effort. “We’re not only working on these problems through the JDRF-GNF collaboration, but we’re also putting in place a series of other collaborations around the world,” she says.

The goals are clear. As Dr. Kilian explains: “In the first three or four years of the JDRF-GNF collaboration, we’d like to find molecules that we have enough confidence in that we can begin to test them in clinical trials.”

The bottom line is changing the lives of people with type 1 diabetes. “The hope is that we find approaches that allow us to intervene before the onset of the disease, in the early stage to block further progression of the disease, and in those with established diabetes to restore the original function of the pancreas,” Dr. Kilian says. “If we achieve this goal, children and adults who have type 1 diabetes won’t have to take insulin anymore.”

Patricia Kilian, Ph.D.

Andrew Rakeman, Ph.D.



Calling on Congress to Renew the Special Diabetes Program

jabari birch was diagnosed with type 1 diabetes when he was just a year old. Research shows the disease’s incidence is rising fastest in children under four.

Pho

to p

rovi

ded

by L

aura

Neg

ri P

hoto

grap

hy

Diabetes affects far too many Americans…

Every 30 secondsFrequency of diabetes diagnoses in the U.S.

24 millionNumber of American adults and children with diabetes

More than 1.6 millionNumber of people diagnosed each year

1 in 3Proportion of Americans born in 2000 who are at risk for developing diabetes during their lifetimes

…and carries staggering costs

1 in 5Proportion of U.S. healthcare dollars spent on diabetes

$174 billionAnnual cost of diabetes to the U.S. economy in 2007

2.3 times higherMedical expenses for Americans with diabetes

compared to people without the disease

32%Percentage of Medicare budget spent on diabetes

2 to 4 times higherRisk of heart attack or stroke in Americans

with diabetes compared to people without the disease

Over the next 25 years, the number of Americans with diabetes is

predicted to nearly double; the costof diabetes will almost triple.


JDRF’s Top Legislative Priority for 2010: Renewing the Special Diabetes ProgramFor 13 years now, the federally funded Special Diabetes Program (SDP) has provided critically important support for type 1 diabetes research. JDRF is working to make sure that this vital funding continues.

SDP was launched in 1997 after a working group established by Congress found that type 1 research was not getting enough funding. Congress was urged “to increase significantly the nation’s investment to conquer this disease,” and it responded by creating SDP to support type 1 research and the Special Diabetes Program for Indians to support diabetes treatment and prevention initiatives targeted to American Indian and Alaska Native populations. Since that time, Congress has reauthorized the programs four times (2000, 2002, 2007, and 2008). Today, the SDP provides $150 million a year for type 1 diabetes research, which represents 35% of total federal spending on type 1 science.

Both programs are set to expire after Sept. 30, 2011. JDRF is spearheading a drive to get Congress to reauthorize these critical programs for five years beginning in FY2012 at $200 million each per year. The program must be renewed this year to continue large-scale clinical trials and proactively plan next steps to maximize research opportunities and most effectively allocate research dollars.

Charlotte Cunningham

Soon after she was diagnosed with

type 1 diabetes at age 10 in 2005,

Charlotte enrolled in a clinical trial

testing whether an anti-CD3 antibody

could slow the disease’s advance.

The treatment delayed Charlotte’s

disease from progressing for three

years. While Charlotte now requires

insulin to manage her diabetes, follow

up tests showed that Charlotte was

still producing insulin 3 years after

her diagnosis—helping to protect

her from the complications that can

accompany type 1 diabetes.

Research Uncovering the Causes of Type 1 Diabetes

genetics Forty genetic regions associated with diabetes risk identified.

autoimmunity Biological pathways causing diabe-tes and other autoimmune diseases (multiple sclerosis, celiac disease) uncovered.

epidemiology Higher-than-estimated incidence of type 1 in U.S. children identified, espe-cially in children under four.

environmental determinants Large-scale clinical studies launched to pinpoint environmental triggers.

Preventing, Treating, and Reversing Type 1 Diabetes

delaying progression Antibody therapy developed, delaying progression in the newly diagnosed. FDA-approved drugs for rheumatoid arthritis also shown effective at slow-ing disease progression.

transplantation Transplanting insulin-producing cells shown to improve quality of life, reduce insulin requirements, and greatly re-duce severe hypoglycemic events.

regeneration Growth factors shown to promote expansion and regeneration of insulin-producing beta cells.

glucose monitorsContinuous glucose monitor use proven effective in controlling diabetes and reducing dangerous low blood sugar problems.

Preventing, Treating, and Reversing Complications

eye disease New therapies identified that slow dia-betic retinopathy, the leading cause of adult blindness, with research under-way to reverse damage altogether.

cardiovascular disease risk Intensive glucose control shown to reduce by 50% the risk of cardiovascu-lar events.

hypoglycemia Research has identified how the brain senses glucose in the blood, which could lead to treatments for people who cannot sense low blood sugar.

The Gould Family

Patrick, diagnosed at age 12 in 2004

Sam, diagnosed at age 10 in 2007

Sarah, diagnosed at age 6 in 2005

Oliver, diagnosed at age 3 in 2008

When Sarah became the second

of the eight Gould children to be

diagnosed with type 1, the rest of

the family enrolled in the TrialNet study

and learned Sam and Oliver were at

risk for developing diabetes. Oliver

enrolled in a study to try to prevent its

onset. While these studies were not able

to prevent type 1 in the Gould family,

they are helping identify causes of the

disease and ways to prevent it in others.

The Huntley Family

After Ryan Huntley’s diagnosis

in 2002 at the age of 8, his

father, Scott, enrolled in a

study for relatives of people

with type 1. Scott learned

that he had antibodies to

type 1 diabetes and enrolled

in a clinical trial of a drug

called rituximab to slow the

disease’s progression. “This

research benefits me, ben-

efits my son, and benefits

the millions of those with

this disease,” Scott says.

How the Special Diabetes Program Has Forged the Path to a CureSpecial Diabetes Program-funded research has led to new and better treatments, improved technologies, and a greater understanding of diabetes—all of which mean better lives for people with diabetes. Below are a few of the top research findings that demonstrate a strong return on the federal investment.


Type 1 Diabetes Genetics Consortium (TIDGC) & The Environmental Determinants of Diabetes in Youth (TEDDY) Study

percent supported by the sdp: 100% Large clinical studies that are answering the fundamental question of what causes type 1 diabetes. The answers will help point the way to new treatments to prevent the disease.

Type 1 Diabetes TrialNet

percent supported by the sdp: 50% A national network conducting clinical trials of therapies to prevent type 1 diabetes in people who are at risk of developing diabetes and to stop the disease from progressing in those who are newly diagnosed.

Clinical Islet Transplantation Consortium (CITC)

percent supported by the sdp: 100% Multi-center Phase III trials that will lead to FDA approval of insulin-producing cell transplant therapy to reverse diabetes.

Beta Cell Biology Consortium

percent supported by the sdp: 65% An international collaboration focusing on the function of insulin-producing beta cells and on developing cell-based therapies to treat type 1.

Diabetes Research in Children Network (DirecNet)

percent supported by the sdp: 80% A network of U.S. clinical centers testing and validating new diabetes management technologies in children.

Animal Models of Diabetes Complications Consortium (AMDCC)

percent supported by the sdp: 65% An interdisciplinary consortium advancing the development of diabetes cures and treatments by creating animal models (60 to date) that closely mimic the human complications of diabetes.

The Steps AheadThe renewal of the Special Diabetes Program will allow us to build on the program’s advances in its initial years by translating those discoveries into treatments and cures for people with diabetes. Continued SDP funding is critical to ensure that the following highly promising major clinical trials now underway can continue.

We’re on This Path TogetherThe combination of federal diabetes research funding and JDRF’s own investment has become one of the world’s most effective public-private partnerships focused on disease research. This partnership has yielded impressive research advances much faster than anyone believed pos-sible a decade ago. We must build upon this momentum in research and continue leveraging this success, which is bringing us closer to a cure for type 1 diabetes and its complications.

How You Can Help• Meet with your Members of Congress and let them know how important it is to renew

the Special Diabetes Program and expand type 1 research funding. You can do this through JDRF’s Promise to Remember Me campaign. We’re in the final months of the campaign, which is the most powerful way for type 1 families to interact with their Members of Congress. To learn more and sign up for a Promise meeting, visit http://promise.jdrf.org. You can also register by texting PROMISE to 56333.

• Become a JDRF advocate. Sign up at advocacy.jdrf.org, text ACTION to 56533, or visit our Facebook fan page at www.facebook.com/jdrfadvocacy.

$156 million

JDRF $150 million

Special Diabetes Program


*FY08

For more information on the JDRF Ride to Cure Diabetes, visit ride.jdrf.org or contact your local JDRF Chapter at 888-533-9255.

Ride to Cure Diabetes

Join us in 2010 at one of our amazing destinations!

Burlington, VermontJuly 15-18, 2010

La Crosse, WisconsinAugust 12-15, 2010

Lake Tahoe, NevadaTour de Tahoe, September 10-13, 2010

Death Valley, CaliforniaOctober 14-17, 2010

Tucson, Arizonael Tour de Tucson, November 18-21, 2010

“Crossing the fi nish line I hadan overwhelming sense of accomplishment. You test yourself physically, mentally, and emotionally, and you make a real difference in fi nding a cure for diabetes. I walked away a changed person.”

WilliamPort Washington, NY

“Crossing the fi nish line I hadan overwhelming sense of accomplishment. You test yourself physically, mentally, and emotionally, and you make a real difference in fi nding a cure for diabetes. I walked away a changed person.”

WilliamPort Washington, NY


1. Talking Type 1 on World Diabetes DayAs part of World Diabetes Day 2010, a group of T1 Youth Ambassadors from JDRF UK delivered thousands of messages to Prime Minister Gordon Brown about type 1 diabetes. Carrying the messages to Downing Street in a giant syringe, they transferred them to a budget-style blue briefcase for delivery to the Prime Minister’s residence. The Ambassadors then met with their respective Members of Parliament to tell them what having type 1 diabetes means to them and to explain the importance of continued funding for medical research. Nine-year-old Emily Norris summed up the experience this way: “I really enjoyed going to Downing Street with JDRF. I want them to find the cure so that no one has type 1 diabetes anymore, and JDRF needs more money to do this.”

2. Riding for ResearchJDRF Canada’s Ride for Diabetes Research saw phenomenal results in 2009, raising more than $6.1 million for research toward a cure.

The Ride for Diabetes Research is a stationary bike-a-thon with teams of five alternating riding for eight minutes each over the course of 40 minutes. It’s an unparalleled experience for par-ticipants and a great team-building event. Held in 16 cities across Canada each year, the Ride attracts thousands of exuberant riders in colorful, creative costumes. To a backdrop of high-energy

music, the participants pedal as colleagues and company mascots cheer them on in support.

Thanks to the riders’ intense determination to clock the most kilometers, show the most spir-it, and raise the most money, the Ride chalked up an increase of $800,000 raised over the previous year. This growth was also the result of the tremendous support and participation of corporate partners in the financial, account-ing, insurance, legal, and real estate sectors from across the country.

3. Friends in High PlacesJDRF Australia’s Youth Ambassador Brendan Rose is making the rounds of world leaders, do-ing his part to communicate the need for a cure. This past summer, he got to meet U.S. President Barack Obama at a White House visit during Children’s Congress 2009. Brendan followed that up recently by having dinner with Australian Prime Minister Kevin Rudd (pictured).

In addition to “swapping White House stories,” they spoke mainly about how type 1 diabe-tes affects Brendan’s life and how the insulin pump has changed his life. The Prime Minister understands a lot about the disease, including the importance of developing better treat-ments and preventing complications, Brendan said, adding “The great thing is that he also appreciates how much extra work having type 1 diabetes is for a kid like me.”

Next on the list of luminaries he hopes to meet? The Queen of England.

4. Denmark Rocks for a CureJDRF Denmark’s Rock the Cure gala on Dec. 2 was a rousing success. The first-time event featured an outstanding lineup: magnificent décor, brilliant artists like Sanne Salomonsen, a gifted emcee, a Michelin stars-worthy din-ner, and a highly enthusiastic crowd. Thanks to sponsors’ and participants’ contributions, the gala raised about half a million Danish krones (approximately $94,000), an achievement JDRF Denmark is especially proud of in these tough economic times.

5. A Decade of SuccessIn December 2009, JDRF Israel marked the 10th anniversary of its Walk to Cure Diabetes—and raised $119,000 to support the program in a fund-raising campaign with partner Super-Pharm. During the three-week campaign, Super-Pharm shoppers were asked to donate $2 in return for a keychain with a mini “Croc” shoe attached.

A group of children helped launch the campaign in a Super-Pharm store near Tel Aviv. With them are, from left, Lior Reitblat, Super-Pharm CEO and a member of the JDRF Israel Board of Trust-ees; and Raz Meirman, a model, TV presenter, and lawyer who has type 1 diabetes.

JDRF INTERNATIONAL NEWS

1 3

4

22

5



Get the whole picture with continuous glucose monitoring

©2008 Abbott. ART16674 Rev. A 10/08

Glu

cose

Con

cent

ratio

n (m

g/d

L)

Time

300

400

350

250

200

150

100

50

09 11 1 3 5 7 9 11 1 3 5 7 9

am ampm

HYPERGLYCEMIA

HYPOGLYCEMIA

“The FreeStyle Navigator® system gives you the whole picture over a 24 hour period, showing you what different types of food, activity, and stress can do to your blood sugar.

Seeing that information in advance, you can make better decisions for your diabetes management.”*

Matthew V. / Cyclist, 18 years with type 1 diabetes* Individual results may vary.

Glu

cose

Con

cent

ratio

n (m

g/d

L)

Time

300

400

350

250

200

150

100

50

09 11 1 3 5 7 9 11 1 3 5 7 9

am ampm

HYPERGLYCEMIA

HYPOGLYCEMIA

Illustrative depiction of a 24 hour period. A target range of 80-180 mg/dL is used in the above examples.

For information about the FreeStyle Navigator® system, please visit www.FreeStyleNavigator.com or call ADC Customer Care 24/7 at 1-800-358-9960

Virtual FreeStyle Navigator™ Product Tour — Don’t Miss It! www.FreeStyleNavigator.com

For Reimbursement Support and Purchase Information,please call 1-877-423-2463

Connect the dots with continuous monitoring, which shows you the glucose levels you might otherwise miss.

The FreeStyle Navigator® Continuous Glucose Monitoring System shows you where your glucose levels are now, and more importantly, where your glucose levels are headed — so you can act instead of react. With continuous glucose readings every minute and customizable early warning alarms, you can identify trends quickly, predict glucose levels in advance and reduce glucose fl uctuations.

Safety Information: Users should read all of the instructions in the User’s Guide before using FreeStyle Navigator® Continuous Glucose Monitoring System. Adjustments to treatment should be done under the guidance of the user’s healthcare team.

Indications for Use: The FreeStyle Navigator® Continuous Glucose Monitoring System is indicated for continually recording interstitial fl uid glucose levels in people (ages 18 and older) with diabetes mellitus for the purpose of improving diabetes management. Readings and alarms about glucose levels from the FreeStyle Navigator® Continuous Glucose Monitoring System are not intended to replace traditional blood glucose monitoring. Before adjusting therapy for diabetes management based on results and alarms from the FreeStyle Navigator® Continuous Glucose Monitoring System, traditional blood glucose tests must be performed. The FreeStyle Navigator® Continuous Glucose Monitoring System provides a built-in blood glucose meter to confi rm the continuous glucose result.

The FreeStyle Navigator® Continuous Glucose Monitoring System provides real-time readings, graphs, trends, and glucose alarms directly to the user. The FreeStyle Navigator® Continuous Glucose Monitoring System is intended to be used in home settings to aid people with diabetes in predicting and detecting episodes of hypoglycemia and hyperglycemia and in clinical settings to aid healthcare professionals in evaluating glucose control. The FreeStyle Navigator® Continuous Glucose Monitoring System is available only by prescription.

Contraindications: The FreeStyle Navigator® Continuous Glucose Monitoring System must be removed prior to Magnetic Resonance Imaging (MRI).

Prescription Device: Federal law restricts this device to sale by or on the order of a physician.

Warnings/Precautions: Infection, infl ammation, or bleeding at the glucose sensor insertion site are possible risks of inserting a sensor into your skin. If you believe your results are not reliable, or are inconsistent with how you feel, perform a blood glucose mode test to measure your glucose. If the problem continues, discard the old sensor and insert a new sensor. Performance of the system under conditions of fl uctuating hydration levels such as during renal dialysis has not been evaluated. Unintended dislodging of the sensor due to excessive perspiration, exercise, or bumping, may cause unreliable or no results without warning. A portion of the membrane polymer will remain in the skin each time the sensor is removed. Although no health effects were observed or reported in clinical studies, the long term effects of the sensor membrane fragments remaining in the skin have not been determined. Performance of the FreeStyle Navigator® system has not been evaluated in pregnant women.

Traditional blood glucose testing Real-time continuous glucose fl uctuations

Built-in FreeStyle® meter for convenient calibration and confi rmatory fi nger stick tests.


Get the whole picture with continuous glucose monitoring

©2008 Abbott. ART16674 Rev. A 10/08

Glu

cose

Con

cent

ratio

n (m

g/d

L)

Time

300

400

350

250

200

150

100

50

09 11 1 3 5 7 9 11 1 3 5 7 9

am ampm

HYPERGLYCEMIA

HYPOGLYCEMIA

“The FreeStyle Navigator® system gives you the whole picture over a 24 hour period, showing you what different types of food, activity, and stress can do to your blood sugar.

Seeing that information in advance, you can make better decisions for your diabetes management.”*

Matthew V. / Cyclist, 18 years with type 1 diabetes* Individual results may vary.

Glu

cose

Con

cent

ratio

n (m

g/d

L)

Time

300

400

350

250

200

150

100

50

09 11 1 3 5 7 9 11 1 3 5 7 9

am ampm

HYPERGLYCEMIA

HYPOGLYCEMIA

Illustrative depiction of a 24 hour period. A target range of 80-180 mg/dL is used in the above examples.

For information about the FreeStyle Navigator® system, please visit www.FreeStyleNavigator.com or call ADC Customer Care 24/7 at 1-800-358-9960

Virtual FreeStyle Navigator™ Product Tour — Don’t Miss It! www.FreeStyleNavigator.com

For Reimbursement Support and Purchase Information,please call 1-877-423-2463

Connect the dots with continuous monitoring, which shows you the glucose levels you might otherwise miss.

The FreeStyle Navigator® Continuous Glucose Monitoring System shows you where your glucose levels are now, and more importantly, where your glucose levels are headed — so you can act instead of react. With continuous glucose readings every minute and customizable early warning alarms, you can identify trends quickly, predict glucose levels in advance and reduce glucose fl uctuations.

Safety Information: Users should read all of the instructions in the User’s Guide before using FreeStyle Navigator® Continuous Glucose Monitoring System. Adjustments to treatment should be done under the guidance of the user’s healthcare team.

Indications for Use: The FreeStyle Navigator® Continuous Glucose Monitoring System is indicated for continually recording interstitial fl uid glucose levels in people (ages 18 and older) with diabetes mellitus for the purpose of improving diabetes management. Readings and alarms about glucose levels from the FreeStyle Navigator® Continuous Glucose Monitoring System are not intended to replace traditional blood glucose monitoring. Before adjusting therapy for diabetes management based on results and alarms from the FreeStyle Navigator® Continuous Glucose Monitoring System, traditional blood glucose tests must be performed. The FreeStyle Navigator® Continuous Glucose Monitoring System provides a built-in blood glucose meter to confi rm the continuous glucose result.

The FreeStyle Navigator® Continuous Glucose Monitoring System provides real-time readings, graphs, trends, and glucose alarms directly to the user. The FreeStyle Navigator® Continuous Glucose Monitoring System is intended to be used in home settings to aid people with diabetes in predicting and detecting episodes of hypoglycemia and hyperglycemia and in clinical settings to aid healthcare professionals in evaluating glucose control. The FreeStyle Navigator® Continuous Glucose Monitoring System is available only by prescription.

Contraindications: The FreeStyle Navigator® Continuous Glucose Monitoring System must be removed prior to Magnetic Resonance Imaging (MRI).

Prescription Device: Federal law restricts this device to sale by or on the order of a physician.

Warnings/Precautions: Infection, infl ammation, or bleeding at the glucose sensor insertion site are possible risks of inserting a sensor into your skin. If you believe your results are not reliable, or are inconsistent with how you feel, perform a blood glucose mode test to measure your glucose. If the problem continues, discard the old sensor and insert a new sensor. Performance of the system under conditions of fl uctuating hydration levels such as during renal dialysis has not been evaluated. Unintended dislodging of the sensor due to excessive perspiration, exercise, or bumping, may cause unreliable or no results without warning. A portion of the membrane polymer will remain in the skin each time the sensor is removed. Although no health effects were observed or reported in clinical studies, the long term effects of the sensor membrane fragments remaining in the skin have not been determined. Performance of the FreeStyle Navigator® system has not been evaluated in pregnant women.

Traditional blood glucose testing Real-time continuous glucose fl uctuations

Built-in FreeStyle® meter for convenient calibration and confi rmatory fi nger stick tests.


1. “Team Kowalski” and Others Run for Research in NYC Marathon The 2009 New York City Marathon was a great test of endurance for thousands of runners—and a big boost for research toward a cure. “Team Kowalski,” pictured, which included Dr. Aaron Kowalski, director of JDRF’s Artificial Pancreas Program, and his family members, tested their mettle in the race and used the event to raise funds for JDRF, netting $20,000 for research. Says Dr. Kowalski, “We all fin-ished...It was an amazing experience!” They weren’t alone: altogether JDRF volunteers ran and raised more than $130,000 as well.

2. “PJs for the Cure” Program LaunchedWhen long-time JDRF supporter Charlie Komar wanted to help raise more funds for research toward a cure, he decided to stick with what he knows best. Charlie, the CEO of Komar, the nation’s largest sleepwear and intimate apparel manufacturer, created a line of pajamas for women and children and is donating 100% of every sale to JDRF. The “PJ’s for the Cure”

campaign had already raised more than $100,000 in just its first three months. The goal: $1 million for research toward a cure for Charlie’s wife, Liz, and the millions of others worldwide with type 1 diabetes. To learn more, visit www.pjsforthecure.org.

3. Golf FORE A Cure A Growing SuccessMore than 160 golfers participated in the JDRF Illinois Chapter’s Golf FORE A Cure in 2009, raising $15,000 for type 1 diabetes research. This July, the event will be even bigger—with 320 golfers playing on two courses at St. Andrews Golf and Country Club in West Chicago. Golf FORE A Cure honors the memory of the son of Len and Willean Mahoney, Joseph, who passed away as a young man due to complications of type 1 diabetes.

4. Sugar-Free Halloween Party A Howling Good TimeA light rain added to the eerie mood on Oct. 25 as the St. Louis College of Pharmacy hosted its annual Boo Fest at Pumpkin Park on the Campus

Quad. This “spooktacular” sugar-free Halloween party for JDRF’s Metro Saint Louis/Greater Mis-souri Chapter is always a spirited event.

Young people with type 1 diabetes, their fami-lies, and friends were entertained with games, clowns, a stilt walker, prizes, and more. A spe-cial low-carb lunch and treats were served.

In this photo, from left to right: Rebecca Jones, Marcus Long, D-Lori Pitts, Bryan Daniels, Nicole Lombardo, and JDRF Special Events Coordinator Ally Klein, who called the event “truly fa-BOO-lous!”

5. American Idol Supports JDRFAndy Williams, an American musical idol for nearly 40 years, is a major supporter of JDRF’s Metro Saint Louis/Greater Missouri Chapter. This past holiday season, he wowed audiences at his Branson, Mo. theater with an over-the-top show—and still took time to shine the spotlight on JDRF during Diabetes Awareness Month. This picture was taken in Andy’s dressing room on World Diabetes Day.

JDRF NEWS


1

5

6

21

3 4

2

5

Lose the sugar,not the fun.

When it comes to making smart choices to build a healthier you, Healthy Balance from Old Orchard is on your team. With 75% less sugar, carbs, and calories than regular juice, it’s the juice that’s fit for your lifestyle. Visit healthybalance.com. Old Orchard is a proud sponsor of the JDRF.

Client: Old Orchard / Healthy BalancePublication: JDRF Spring 2010 Agency: Grey Matter Group Contact: 616-458-8750 www.greymattergroup.com

NERF00141_R1_Dex4AD_Rls.indd 1 1/29/10 3:56 PM

Juvenile Diabetes Research Foundation International26 Broadway, 14th FloorNew York, NY 10004

Change Service Requested

Documents

Countdown