Treatment for diabetes has rapidly advanced over the past several years and a recent study showed that people with type 1 diabetes are living longer, healthier lives. While the number of people with type 2 diabetes has dramatically increased, new medications, some of which were developed by researchers at the Lunenfeld-Tanenbaum Research Institute, has allowed for more effective blood glucose control and a reduction in complications of diabetes such as heart and kidney disease, blindness and amputation. We sat down with Dr. Bruce Perkins, the new Director of the Leadership Sinai Centre for Diabetes, and the newly named Sam and Judy and Family Pencer Chair to get a picture of where we are in caring for patients with this serious chronic condition.
What excites you most about taking on the Directorship of Leadership Sinai Centre for Diabetes?
The first thing is that I don’t think that there has been a more exciting time to be in the field, because there are so many advances in diabetes management that we can offer our patients today. And that’s even advancing month to month. So, from a perspective of our team’s ability to offer outstanding care to the over 20,000 patients who come to us as complex referrals, it is very fulfilling.
The other thing that I’ve always loved about this clinic is how its foundational principles have permeated our culture and how we engage with patients. The Centre was founded by a group of philanthropists who each gave a modest amount, but together, made such an incredibly impactful gift. Led by the extraordinary Dr. Bernard Zinman, a legend in the area of diabetes research, our centre was formed from a very grassroots perspective. The grassroots feeling still informs the way we deliver care- we engage our patients in providing feedback about how we provide care, how we develop education materials and how we can make our clinic even more responsive to their needs. But while we may think of ourselves as a small, grassroots team, I would say that we are punching well above our weight. We are the leading centre for complex cases in Ontario, including for diabetes in pregnancy. Our researchers are regularly published in the highest impact journals and transforming the way care is delivered globally – I can’t underemphasize this last point.
What is your most important priority?
We are always working to achieve a clinic that is highly-specialized for the most complex diabetes cases, that puts patients at the centre of care. As a team, we really have to think about how we can design and individually tailor care. Every one of our patients has unique requirements and we have to ensure that they are deeply engaged, and if they are open to it, to help shape the future of care. For example, I want every one of our patients to have the opportunity to participate in research.
What do you think is the greatest challenge in diabetes care?
Well, my research area focuses on complications in diabetes and I think that there is good reason to be concerned. With rising rates of diabetes and an aging population, we really have to have better ways to first of all diagnose the complication at an early stage, but also to protect patients before that occurs.
One of my priorities will be to open a Complications Assessment Unit on site. This is important because we are seeing inconsistent reporting around eye damage, vascular function and nerve damage. There is an exciting opportunity to create a “one-stop” shop as part of clinic to get a clearer picture of how diabetes is affecting our patients.
As in any disease, the challenges lie in what we don’t yet know, for example the exact mechanism of the disease. While at times, it can feel like a daunting challenge, great progress is being made. For example, I still find it extraordinary that I get to work down the hall from a world-renowned researcher like Dr. Dan Drucker who has literally transformed the field of diabetes medications. And all of our team at the clinic is deeply committed to our academic mandate and furthering research.
As a leading diabetes clinician and researcher, and as someone who lives with type 1 diabetes, what is your most important message to others living with the condition?
I would say that it’s important to recognize that you can live a fulsome, good life with diabetes. Now, more than ever, we can more effectively regulate blood sugar and reduce risks of complications. And when complications do happen, we can provide responsive care. Diabetes has not stopped me from pursuing my personal and professional goals. Like any health condition, there are ups and there are downs, but I would say that there is every reason to feel optimistic about managing the disease.