Health Committee on Nov. 27th, 2012

[Matthew Kellway, NDP, Beaches—East York, ON]

Okay. Could you send that video to Ms. Smith, please?

[Some hon. members]

Oh, oh!

[Matthew Kellway, NDP, Beaches—East York, ON]

Michael, on Friday, when we had a chat back home, you seemed a bit nervous about what was coming up this week. How does this compare now to a day at the Roma Youth Academy, trying out for that team?

[Michael Thornton]

Could you explain that again?

[Matthew Kellway, NDP, Beaches—East York, ON]

You said you were nervous coming here. I know you've been in a lot of stressful situations in your young life, trying out for professional clubs in Europe with your soccer. I was wondering how you'd compare the two.

[Michael Thornton]

With soccer, when I went into the change room at first I was really nervous. I could hear everyone talking and laughing, and then I walk in and it goes quiet. So I got nervous there. But once I stepped on the field, I think all my nerves went away, because I was confident and I knew I was there for a reason. It's the same today; I think I'm here for a reason, too.

[Matthew Kellway, NDP, Beaches—East York, ON]

So when you step on the field—let's say last summer at the Youth Academy in Italy—are you thinking about your type 1 diabetes while you're there?

[Michael Thornton]

I'm mainly thinking about soccer. I don't want type 1 diabetes to control me; I want to control it. I have found that if I focus on soccer, my diabetes just takes care of itself kind of.

[Matthew Kellway, NDP, Beaches—East York, ON]

You've been living with this long enough now, since you were six. Is that right?

[Michael Thornton]

Yes.

[Matthew Kellway, NDP, Beaches—East York, ON]

You've kind of grown accustomed to managing the disease through the day.

[Michael Thornton]

Yes. Well, the longer you live with it, the more experience you get and the more you start to understand the disease.

[Matthew Kellway, NDP, Beaches—East York, ON]

Right.

Mr. McKee, we kind of cut you off—well, the chair did actually—on your speech.

[The Chair, Conservative, Joy Smith]

And I'm about to cut you off, Mr. Kellway.

[Matthew Kellway, NDP, Beaches—East York, ON]

You were getting around to the conclusion. I want to have that on the record for us today.

Guys like Michael...he tells us that his life's mission is to find a cure for type 1, but it seems to me he's got another life's mission as well, given his record on the track in his young life and on the soccer pitch. Our concern is to make sure that he gets to realize that life's mission. Can you tell us about how close we're getting to finding a cure and putting out technologies that will assist Michael and all these other guys at the table today in fulfilling their own life missions?

[Andrew McKee]

Absolutely.

Diabetes generally—and type 1 diabetes—has benefited incredibly over the last few years from advances in technologies, some of which you've heard about today from the kids providing their testimony, with both insulin pumps and continuous glucose monitoring. The JDRF Canadian Clinical Trial Network is helping take those technologies a step further.

Our goal here today is to try to garner your support in expanding that trial network across Canada to give access to those technologies to all Canadians, because that is a mechanism that's providing Canadians with the opportunity to see those technologies earlier than others in the world today. In fact, we're a couple of years ahead with the technology that's available here in Canada relative to the United States at the moment. We want to help develop the knowledge economy around...and expand on our history of excellence in diabetes research.

That is a position that Canada holds, and holds very well. We're well regarded in the world. That's our goal here today, to try to expand that human clinical trial network, because that is what's taking those breakthroughs in laboratories and in industry and delivering them to the market.

[Matthew Kellway, NDP, Beaches—East York, ON]

On this issue of delivering these things to the market, how far off are we on delivering new technology? How far off are we on the artificial pancreas technology? And how do we move it forward?

[Andrew McKee]

At present, five of the nine trials in the CCTN are focused on elements of the artificial pancreas. In fact, in a pure laboratory environment at the moment, a closed-loop artificial pancreas is being tested today.

To move that to market will take additional investment in clinical trials to prove the technology in a broader-based community. That timeline would be four to five years, once you can move into phase one and phase two human clinical trials with that technology.

[Matthew Kellway, NDP, Beaches—East York, ON]

Excellent. What are you seeking today? What's the ask for us here around the table?

[Andrew McKee]

Today is to seek your continued support of CCTN here in Ontario, where appropriate, but also to expand it across Canada, to broaden the patient cohort and the patient base who'd have access to the technologies, and give our researchers out there in the Canadian community the opportunity to take their technologies from the lab to the bedside.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Kellway.

We'll now go to Mr. Strahl and Mr. Brown.

Do you want to start, Mr. Brown?

[Patrick Brown, Conservative, Barrie, ON]

Yes. Thank you, Madam Chair.

First of all, I just want to say to all the JDRF youth advocates what an excellent job you've done today as representatives for young people living with juvenile diabetes across Canada.

Particularly, I want to recognize Noah Stock, who comes from Barrie, Ontario. Noah has been an inspiration in our community. Whether it's speaking and talking to people in Barrie at the walk or the skate, to have an eight-year-old who is so eloquent...you really are moving mountains. I feel very proud to have someone like you hailing from the city of Barrie and coming all the way here today to speak before our committee. You did an excellent job.

To Andrew McKee, I think one issue that would be important to raise and highlight is the cost that diabetes has on the health care system, and particularly the portion that is type 1 diabetes. Could you touch upon that to start with?

[Andrew McKee]

Certainly. Some of this is derived from estimates, but it is estimated that diabetes costs the Canadian health care system at present in excess of $12 billion a year. As you know, as the health committee, that's a significant portion of the budget.

Type 1 diabetes presents an extra challenge in terms of cost to the system in the sense that type 1 diabetes is typically diagnosed much earlier in life, as we've seen here with youth, and you're immediately insulin-dependent. So there's the maintenance challenge associated with insulin, with continuous testing and continuous insulin dosing, but because of that earlier diagnosis, it also raises the risk of developing complications much earlier in life, and complications associated with diabetes are very expensive for the health care system to manage.

Diabetes is currently the leading cause of working-age blindness in Canada. It ranks very highly in the cause of heart attacks and stroke. It represents a progenitor disease to many other conditions we face. When you consider the quantum of dollars that diabetes is costing the Canadian health care system now, and the advances that are being made that allow us to mitigate some of those expenses by good management and good controls, there's a real opportunity here for us to realize some health care savings in the long run.

[Patrick Brown, Conservative, Barrie, ON]

I certainly noticed that with Noah's family, or beforehand, with Sydney Grace and Rebecca Morrison, the previous youth advocates. If you look at the cost to the families, whether it's lost time at work for his father, Jay, whether it's the nurses involved, or the huge family obligation that's involved with managing this.... I'm glad we've raised that figure because I think it highlights that investments into juvenile diabetes research in the long run could actually save the taxpayer.

I know I'm sharing my time with Mark Strahl, but there's another thing I wanted to ask. Could you just update us briefly on the clinical trials that we're undertaking in Waterloo and Hamilton and that historic $20 million federal contribution? What is the progress from that, the success from that?

[Andrew McKee]

Of the nine clinical trials that were launched against the target of three—so we're very pleased that we could over-deliver on that front—the first trial, which I spoke to briefly, Bruce Perkins' trial at the University Health Network in Toronto, has finished enrollment and is just finalizing its collection of data. The first reports on that will be out. Clinical trials by their very nature take time, so the data will be coming out from each of these trial networks over the next three to four years. The shortest trial is Bruce Perkins', which, as I say, is wrapping up now, and three years out from now we should see data from the pregnancy, or CONCEPTT, trial.

Thus far, I'll say we've had unparalleled success in recruitment. One of the great measures of how you're doing within clinical trials is how well you're recruiting. Canada, which certainly hasn't had as many clinical trials available to the diabetic population as we've seen, say, in the United States, is over-recruiting. In fact, one of the trials, the AdDIT trial, which is being done in conjunction with the United Kingdom, has completed the Canadian portion of recruitment and is now over-recruiting and picking up some of the U.K.'s portion. So thus far, we're seeing really great success, great strides forward.

Then there's somebody like Maksim, who testified here before you today, who is participating in the CGM TIME trial. That trial, which is being run here out of the Children's Hospital of Eastern Ontario, but at four sites across Ontario, has actually over-delivered on its recruitment targets as well. As you can see, it's having a direct impact on the lives of Canadians as we sit here today.