Over two million Canadians are diabetic, and around 10 percent of these individuals suffer from type 1 diabetes. Given these high numbers, the McGill University Health Centre (MUHC) joined forces at the end of the 1990s with TrialNet, an international network of health centres. This partnership has allowed the MUHC to provide free type 1 diabetes screening tests to relatives of diabetic patients. Those found to be "at risk" can now enroll in a prevention study. Starting in October 2007, the study will be headed by Dr. Constantin Polychronakos, Director of the MUHC's Pediatric Endocrinology and Metabolism Division at the Montreal Children's Hospital, and coordinated by Ms. Diane Laforte, Medical Research Administrator of the PRUDENT Clinical Research Unit.
The TrialNet screening test performed at the MUHC is mainly geared to immediate family members (siblings, parents and children) of type 1 diabetes patients. These individuals have an approximate 5% risk of developing the disease, which is fifteen times higher than the risk for the general population. The test consists of a simple blood sample that will initially be used to make an assay of antibodies that are typical of type 1 diabetes. This will determine the risk-level of the person.
"For those who are detected at high risk for type 1 diabetes, the next step is a genetic study to find out if their immune system mistakes insulin for a foreign body", explains Ms Laforte. This second question is particularly important, as type 1 diabetes is an autoimmune disease that leads immune cells called T lymphocytes to destroy the insulin-producing cells of the pancreas. In 50% of cases, a genetic error expressed through the T lymphocytes leads to this destruction by causing the cells to identify insulin as an alien substance. This error is what the test is designed to detect.
Researchers hypothesize that having people with this genetic error take oral insulin prior to the on-set of type 1 diabetes symptoms may allow their immune systems to develop a tolerance to the hormone and may decrease the destruction rate of insulin-producing cells. The upcoming prevention study will put this hypothesis to the test with the help of "at risk" volunteers. The study will last approximately seven years.
"Combining the screening test with the prevention study is an evolution towards personalized medicine that treats patients based on their own characteristics and not according to general symptoms," said Dr Polychronakos. "This is a major development, and anyone at risk may want to take advantage of this opportunity."
More information on TrialNet and its programs can be found on-line at www.diabetestrialnet.org. To contact the TrialNet team in Montreal, contact Diane Laforte via e-mail at: dianel.laforte [at] muhc.mcgill.ca ( ).
The McGill University Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at McGill University--the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge. www.muhc.ca
The Montreal Children's Hospital is the pediatric teaching hospital of the McGill University Health Centre (MUHC). The institution is a leader in the care and treatment of sick infants, children, and adolescents from across Quebec. The Montreal Children's Hospital provides a high level and broad scope of health care services, and provides ultra specialized care in many fields including: cardiology and cardiac surgery; neurology and neurosurgery, traumatology; genetic research; psychiatry and child development and musculoskeletal conditions, including orthopedics and rheumatology. Fully bilingual and multicultural, the institution respectfully serves an increasingly diverse community in more than 50 languages. www.thechildren.com