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Improving Outcomes

A new inter-provincial research study led by Memorial is looking at ways to improve the well-being of young people living with type 1 diabetes.

Researchers have just received a $75,000 grant from the Canadian Institutes of Health Research (CIHR) which is allowing them to examine the experiences of adolescents and young adults with the disease transitioning into the adult care system in two provinces: Newfoundland and Labrador and Ontario. This CIHR grant is being matched by additional funds from the Janeway Children’s Hospital Foundation, Memorial’s Faculty of Medicine, and the University of Toronto.

“The project will look at any changes in health-care usage and directly talk to patients who have recently transitioned into adult care to get their perspective,” said Dr. Roger Chafe, principal director of the project, director of the Janeway Pediatric Research Unit, an associate professor in the Division of Pediatrics in the Faculty of Medicine and a Memorial alumnus.

“An additional focus of our work is on the role that family physicians can play in better supporting these patients, so we will be interviewing family physicians to get their perspective on how they could play a greater role in improving the care of these patients.”

Inter-provincial research team
The new research team includes Drs. Leigh Anne Newhook, Tracey Bridger, John Knight and Kris Aubrey-Bassler from Memorial; as well as Drs. Astrid Guttmann, Rayzel Shulman and Alene Toulany, researchers at the University of Toronto who also work at SickKids hospital; Aryn Gatto from the Ontario Pediatric Diabetes Network; and Dr. Baiju Shah from the Sunnybrook Health Sciences Centre and University of Toronto.

“Proper control of type 1 diabetes relies to a large extent on continuous self-management by patients.” — Dr. Roger Chafe
Dr. Chafe says the research team will compare the results from both provinces, identify strategies for improving primary care involvement in the care of young adults with type 1 diabetes and study the overall experiences of these patients during the transition period.

Type 1 diabetes on the rise
Globally, type 1 diabetes has increased dramatically over the past 50 years and is now one of the most prevalent childhood chronic diseases.

Newfoundland and Labrador has some of the highest reported rates of type 1 diabetes in the world. Currently, there are about 1,000 people in the province with the disease; roughly half are under the age of 18.

Type 1 diabetes requires lifelong insulin treatment. It can also lead to blindness, kidney dysfunction, heart disease and nerve damage.

‘Tumultuous period’
Dr. Chafe says those transitioning from teenagers to young adults are at vulnerable stages in their lives, making the team’s research important.

“Proper control of type 1 diabetes relies to a large extent on continuous self-management by patients,” he noted in an interview with the Gazette, “so changes in life circumstances, like the changes in lifestyle people go through in early adulthood, can impact health outcomes.

“Late adolescence can be a tumultuous period for people, yet it is during this period that patients transition from the pediatric to the adult health care environment and take more responsibility for managing their own care,” he added. “Sadly, some patients do not have a smooth transition to adult care and have experienced potentially serious negative outcomes related to this period in their care.”

Direct impacts
Dr. Chafe says the CIHR funding is critical to the goals of the research project. He says the outcomes of their work could have direct impacts on the lives of young adults with type 1 diabetes.

“This is an important work and an excellent opportunity to build a new research team. None of this would have been possible without the funding from CIHR. It is also good to have national recognition for our work.”