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Diabetes is the leading cause of kidney failure in Canada. The Kidney Foundation of Canada is excited to announce details of a $1-million investment it is making to research that will address the prevention of kidney failure for people with Type 1 diabetes. Funds are matched by the Canadian Institutes of Health Research (CIHR) through a ground-breaking initiative: 100 Years of Insulin: Accelerating Canadian Discoveries to Defeat Diabetes.

The Kidney Foundation joins JDRF Canada, Diabetes Canada and Fonds de recherche du Québec - Santé, which collectively will provide a total of $6 million towards the 100 Years of Insulin $20 million research funding envelope.

The Sodium Glucose Co-Transport-2 Inhibition Diabetes and Kidney Function Loss in Type 1 Diabetes (SUGARNSALT) research project will study the kidney effects of sodium glucose co-transport-2 (SGLT2) inhibition in people with type 1 diabetes. 

SUGARNSALT, one of eight diabetes-related research projects that were unveiled on November 25, is a major research investment for the prevention of kidney failure and other serious complications of type 1 diabetes.

“The Kidney Foundation is proud to be part of this significant investment and partnership. We are supporting talented researchers and allied health care professionals who will address the complex kidney disease-diabetes relationship,” said Elizabeth Myles, National Executive Director, The Kidney Foundation of Canada. “Through improved intervention strategies and treatment options, diabetes does not have to be the leading cause of kidney failure.”

New therapies called SGLT2 inhibitors have been discovered that reduce the risk of kidney failure and cardiovascular diseases in people with type 2 diabetes. These drugs may delay the need for dialysis by as much as 15 years or prevent it entirely. Unfortunately, it is not known if these medicines are also beneficial for people with type 1 diabetes. 

So far, there is very little data related to the use of SGLT2 inhibitors for patients with type 1 diabetes and reduced kidney function explains SUGARNSALT principal investigator Dr. David Cherney, University Health Network. “Trials for type 1 diabetes have been focused on blood sugar control and have excluded patients with kidney disease. Conversely, kidney disease trials have excluded anyone with type 1 diabetes, so these patients have been hit from both sides.”

The research project will include a pilot study to understand the risks and benefits associated with SGLT2 inhibitors for people with type 1 diabetes in clinical trials. A patient preference study will serve to understand how patients themselves view the risks and benefits. Another key component of the project will be the use of mathematical modeling analysis using real-world data to predict how this could reduce the risk of kidney failure, the need for dialysis or transplant, as well as the risk of heart failure in the future, thus establishing the potential benefits for Canadians at a societal level.

“There is a huge unmet need for people with type 1 diabetes,” says Dr. Cherney. “These patients have roughly a decade shorter lifespan and their risk of developing kidney disease during their lifetime is something in the order of 30 to 40%. Yet, the treatment regimen we provide today is the same as it has been for well over 20 years: insulin and control of blood pressure. None of the innovations available to those with type 2 diabetes have been approved for patients with type 1 diabetes.”