Mount Sinai Hospital

Mount Sinai's Samuel Lunenfeld Research Institute Redefining Treatment and Quality of Life for People with Diabetes Redefining Treatment and Quality of Life for People with Diabetes More than 2 million Canadians and 250 million people worldwide suffer from diabetes. Bayview Village resident Debbi Ross has been living with type 1 diabetes for 60 years. Over the years, the mother of two and grandmother of four has developed complications that impact her eyes and her kidneys. She takes four injections of insulin a day, constantly monitors her blood sugar, plans what she can eat, how much exercise she can do and must be prepared to respond quickly to low or high blood sugar if she doesn't get it right. Debbi is one of more than two million Canadians and 250 million people worldwide who suffer from diabetes. what is scary. We're going to see more complications in people decades earlier than we used to. It's a looming public health crisis. They work in what I call a smart manner, meaning they lower your blood sugar when it is high, but the moment it comes back to normal, they stop working. What brought you into this field of study? What does that mean to patients with diabetes? I had the opportunity to do some fundamental basic science research at Harvard in 1984 in an area very few people worked on at the time. It was an area that I'll call gut hormones, which may not sound very glamorous, but these hormones have an important link to diabetes. As an international leader in both diabetes research and patient care, Mount Sinai Hospital's top scientists and physicians work closely together to make cutting-edge discoveries that are translated into improved treatments for patients. One of those scientists is Dr. Daniel Drucker, whose work was critical in developing new, effective drug treatments for type 2 diabetes. In 2011 he was awarded the Canadian Institutes of Health Research – Canadian Medical Association Journal Award for top achievements in health research and in 2012, he received the Claude Bernard Lecture/ Award of the European Association for the Study of Diabetes. People with diabetes taking traditional medications must constantly monitor their blood sugar levels and adjust their dosage. The number one side effect of these medications is low blood sugar– hypoglycemia, because the medications continue to work even when the blood sugar levels drop. When you have a smart medication, you don't have this side effect. What breakthrough discovery did you make in linking gut hormones and Are these new smart drugs currently available? the control of diabetes? Here Dr. Drucker shares his thoughts about the impact of research on the treatment of diabetes. In 1987, I pinpointed the action of a digestive hormone – glucagon-like peptide 1 or GLP 1 – which regulates the production of insulin. By studying this hormone over the last 25 years, my lab was able to identify its role in regulating food intake, digestion and body weight. Our research here at The Lunenfeld, along with the work of other leading scientists, also identified an enzyme that can inhibit the proper functioning of the GLP 1 hormone. New diabetes drug therapies that better regulate insulin production and discourage overeating have been developed as a result of this research. What is the scope of diabetes as a health issue? Are these drugs a game changer for diabetics? We are facing a worldwide epidemic of diabetes. We're seeing type 2 diabetes that we used to see in elderly people, but now the disease is being detected in kids as young as 15. That's really The two approved drug therapies based on our work represent the first medications for diabetes that not only control blood sugar, but also tell people when they're not hungry anymore. Mount Sinai's Samuel Lunenfeld Research Institute involving patients with diabetes – several are being carried out here at the Leadership Sinai Centre for Diabetes – that we call cardiovascular outcome studies. It may well turn out that these smart medications not only lower blood sugar, but may also reduce the number of heart attacks and strokes in diabetic patients. That's the thing about basic medical discovery – it's all connected. A single breakthrough can have enormous impact in areas that you never imagined. Several options are currently available and a monthly and annual dosage are in development. Imagine the lifestyle impact if a person with diabetes only had to get a single annual injection to keep their blood sugar under control! How does the urgency around diabetes as a global health issue affect your work? It's immensely satisfying to collaborate with Mount Sinai's physicians who are prescribing medications based on discoveries that originated in our lab. Since Mount Sinai is a leader in diabetes, our patients are among the first to benefit from clinical trials based on new advances developed here. What future hopes do you have for these smart drugs? There are about eight huge studies Dr. Daniel Drucker Senior Investigator, Samuel Lunenfeld Research Institute of Mount Sinai Hospital Redefining Treatment and Quality of Life for People with Diabetes

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