February 26, 2021 Putting the brakes on kidney damage

Who:

Dr. Andrew Advani, staff endocrinologist and Keenan Chair in Medicine at the Keenan Research Centre for Biomedical Science, St. Michael’s Hospital and Department of Medicine at the University of Toronto

Research highlights/discoveries:

• Exploring the cell processes that lead to kidney disease in people with diabetes in order to develop treatments to stop the disease from getting worse

Dr. Andrew Advani at a glance:

• Appointed to the Keenan Chair in Medicine at St. Michael’s Hospital and University of Toronto (2020)
• Awarded the Diabetes Investigator Award, Diabetes Canada (2017)
• Recipient of the Charles Hollenberg Young Investigator Award, Canadian Society of Endocrinology and Metabolism (2015)
• Received the Clinician Scientist Award, Diabetes Canada (2009)

You completed your medical training in the United Kingdom. Why did you settle in Toronto to pursue a career in diabetes research?

I was interested in coming to Toronto because it is the home of the discovery of insulin, which is a very big deal. I also knew there was already a big community of diabetes researchers and clinicians here to collaborate with. I’ve been at St. Mike’s Hospital since 2008.

What does your current practice at the hospital look like?

I primarily look after people with type 1 diabetes, although not exclusively. My main focus is the care of young adults who are transferring from pediatric to adult diabetes care. This is a challenging time in the life of a person living with diabetes as it competes with other demands like school, new jobs, and recreational activities. I try and help young people with diabetes navigate through this time in their lives while keeping on top of their diabetes management.

Why the interest in kidney disease specifically?

Some of my young patients may go on to develop kidney disease later in life, which could require dialysis treatment or even a kidney transplant. I am focusing on helping develop future treatments to prevent kidney disease or slow down the progression of it in people with diabetes.

What have you discovered so far in your research?

My team and I are studying epigenetics: processes that go on in cells that turn certain genes either on or off as they’re needed. In diabetes, we’ve discovered that there can be epigenetic mistakes where the ‘stop’ signals turn wrongly to ‘go’ and vice versa. This results in damage to kidney cells. In the lab we were able to stop these cell processing mistakes, which, in turn, slowed the development of kidney disease.

What are next steps?

Now that we’ve made this discovery, the goal is to develop medications that will correct epigenetic mistakes and give people with diabetes longer lives that are free from kidney damage. But there is still more research to do in the lab before we can start developing treatments for humans.

What else are you working on?

We’re always very interested in working with patient partners—people who work alongside scientists to represent the voices of people living with diabetes. They help ensure the research we are doing matches the priorities of people living with diabetes. We’re also using social media to connect with people in ways that they are familiar with away from the health-care setting. We have a series of animated videos called ‘DiaBiteSize’ on YouTube that we hope will help people living with diabetes, including one about diabetes and your kidneys. We recently set up an Instagram account (@stmikesdiabetes), too, to help us connect virtually during the pandemic.

To hear Dr. Advani talk about his work, tune into the Diabetes Canada Podcast.

The last word

“Diabetes is the leading cause of kidney disease in Canada. That sobering reality is one of the reasons why we are proud to support the work of Dr. Advani, who is looking at ways to prevent or delay this complication of diabetes.” — Dr. Seema Nagpal, vice president, Science & Policy, Diabetes Canada

Did you know?

2021 marks the 100th anniversary of the discovery of insulin. Today, more Canadians have diabetes than ever before. Diabetes or prediabetes affects one in three Canadians. One in two young adults will develop diabetes in their remaining lifetime. We cannot wait another 100 years to End Diabetes. #LetsEndDiabetes Visit 100 Years of Insulin to learn more, including how you can support those living with or at risk for the disease.