 Good evening, everyone, and welcome to another edition of Curiosity on Stage. This presentation is part of a series meant to discuss new and emerging technologies making a difference in Canada and around the world. My name is Michelle Makarski. I am the science advisor at the Canada Science and Technology Museum, and I will be your host this evening. For those of you attending with visual impairment, I'm a woman with shoulder length, brown hair and brown eyes, and I'm joining you this evening from my home office in the city of Ottawa, which is built on the unceded Algonquin Anishinaabe Territory. This presentation is being recorded and will be available on the Canada Science and Technology YouTube channel in the coming weeks. So if you really love what you hear tonight and want to either share it with someone or watch it again yourself, you'll be able to find it there available in both French and in English. I also want to thank the Ingenium Foundation, who is generously co-presenting this Curiosity on Stage speaker series focused on the centennial of the discovery of insulin. We are truly grateful to have the Foundation's support in amplifying the museum's mission, and particularly we are inspired by their mission towards science for all. In addition to the Ingenium Foundation, we're also liking to thank the National Research Council of Canada for their support in making this series accessible through translations, captioning, and transcriptions. Here at Curiosity on Stage, we aim to be a platform for thoughtful, critical, and respectful dialogue around scientific and technological issues that matter. We also want to look into the future of it and how those advances in innovations in science and technology are going to help us to build a better future. Over the next three years, we'll be centering our discussions around artificial intelligence, accessible technology, and medical innovations, which includes the talk that we're going to have right here tonight. So tonight, in conjunction with the Ingenium Foundation, I am delighted to introduce the first of three timely webinars in the thematic series Beyond Injections, 100 Years of Insulin, and the Future of Diabetes. Diabetes is an ancient and widespread disease that is becoming more and more prevalent. It's been around for a long time, and yet it's often poorly understood, especially by those of us who are unaffected, like me. Now, diabetes runs in my family, so I have heard a lot about treatments and foods and exercises that often promise a cure. But of course, a cure is much more complicated than buying a certain product off of your Amazon Prime list. Curiosity on Stage is about inspiring thought by bringing experts together to share relevant, essential, and engaging topics that matter. This particular series is significant as it commemorates the 100th anniversary of the discovery of insulin, a story which is rooted in Canada that has profoundly transformed the lives of so many across the world. The insulin story is impressive, especially the stories of those that have benefited and shared in its progress. Today, therefore, I am delighted and proud to welcome Ron Schlein to our virtual stage. He is the first in a very talented lineup to share stories and insights into their chapter of the insulin story. So what can I tell you about Ron? Well, Ron and I have gotten to know each other quite well over the last couple of weeks, and I can tell you that Ron is an entrepreneur. As a teenager, he co-founded the Mad Science Group, which has grown from humble beginnings into a global franchise organization. Over 30 years of live in-person experiences and imaginative learning has grown Mad Science into the kind of program that has reached 80 million kids, getting them excited about STEM, and also offering career-oriented employment to over 70,000 people. Ron is also a serial investor and collaborator. He has supported and invested in companies in the EV technology, biotech, fintech, renewable energy, data, and cannabis sectors. And who knows, maybe at the end he can offer us a couple juicy stock tips. He also recently joined the Creative Destruction Lab, a nonprofit group that delivers mentorship to massively scalable early-stage science and technology companies. Ron also had the honor of being the Canadian government's first and so far only entrepreneur in residence, a really unique position which was set up to inject entrepreneurial thinking, passion, and creativity into senior government ranks for the benefit of all Canadians. And last but certainly not least, Ron is a diabetes dad. In 2012, Ron's son William was diagnosed with type 1 diabetes. Ron has always held a special place in his heart for kid-related causes, and this particular cause becoming so personal to him has motivated him to get involved in, invest in, and help those especially children living with this chronic conditions. So with that, hold on to your proverbial hats and please join me in welcoming Ron's line to curiosity on stage. Thank you. Wow, that was a great introduction, Michelle. I really appreciate it. So let's begin. Since the dawn of time, we've never seen searching for ways to improve our lives. The modern age has given us unique innovations like the internet, iPhones, refrigerators, cars, and planes. For many, surviving life without easy access to these things sounds rough. However, if you have diabetes, no doubt you're also a big fan of one particular 20th century marvel, insulin. Following its discovery in the early 20s, insulin was wildly hailed as a miracle cure, a gift for humanity, a magical medicine that transformed death into life and whose discovery was considered nothing less than a modern miracle. This year marks a centennial anniversary of insulin, a drug with very humble beginnings produced initially from dogs by completely unknown scientists from within a simple, poorly equipped Ontario lab. And yet it remains to this day, perhaps amongst the most remarkable and vital achievements in medical history. Hi, my name is Ron Schlein and I'm an entrepreneur investor and the former entrepreneur in residence for the Canadian government. More importantly, like so many others, I'm a dad who came into diabetes through a very difficult, painful, and personal family experience. To comprehend what insulin represented in 1921, we needed to look at what was happening medically during the early 20s. The previous couple of thousand years had seen no real progress in treating illness and the world had just emerged from the great influenza epidemic of 1918, which killed more than 50 million people. The epidemic, also known as the Spanish flu, was ultimately defeated not by science, but by the immune system adapting to the virus. In other words, we exist today primarily because of survival of the fittest. So I'm saying that doctors in 1921 were mainly unable to treat severe diseases of any kind, including diabetes, as their medical knowledge was still really very early stage. Science relied more on comfort and general best practices instead of the specialized medicines and treatments that we've become so accustomed to and dependent on these days. Remember that penicillin was discovered only in September of 1928 and the polio vaccine in the 1950s. The early days of insulin were very different from what it has become today. Patients relied on glass syringes with thick needles that needed to be hand sharpened and sterilized to determine if insulin was necessary. Patients or caregivers would have to smell or taste their urine to try and tell if there was any sugar in it, a sign of high blood glucose. For context, check out your local museum and look at some of the antique medical devices, like the one you see on the screen. They will most definitely be frightening in the context of daily, indefinite use. So let's talk a bit more about insulin. Insulin has always been produced from living organisms. However, before the advent of biotech, the pancreas from pigs and cows supplied the raw materials needed. More than two tons of them went into extracting a mere eight ounces of purified insulin. I guess we're lucky that both pork and beef-derived insulin are nearly identical and work to convert the carbohydrates we eat into energy in exactly the same way. Insulin was not, however, technically discovered in 1921. Its role in the body was already understood, and its connection to diabetes had become, well, pretty clear. In 1916, the word insulin was coined to describe a pancreatic substance, but the disease was first identified around 1650 BC. And in 250 BC, the disorder was named diabetes from the Greek word siphon. You see, early on it was believed that diabetes was a condition where the body would liquefy itself and escape through urination, since early diabetics were, they'd slowly wither away and eventually die. Researchers' understanding of the disease advanced in 1869 when a German medical student discovered the island of cells in the pancreas. Others eventually realized that they were responsible for regulating glucose. So we know that after more than 30,000 years, there was still no effective treatment for the disease. Researchers did recognize that carbohydrates accelerated decline, so the best medicine developed in the early 1900s was to withhold few food and named it the starvation diet. The problem is that most patients were children, so horrified parents had to watch their kids waste away and die, either from starvation or diabetic ketoacidosis. This severe complication occurs when your body produces high levels of blood acids called ketones. All this made the search for insulin desperate, as investigators, researchers and doctors from around the world sought to discover a pancreatic extract to save these dying children against the ravages of this terrible and ancient disease. The breakthrough happened in Toronto in 1921 led by a researcher who was just out of medical school. Frederick Banting was a doctor, but he couldn't really earn a living. He tried his work as a surgeon, a teacher, and even as an artist painter. His paintings would eventually become quite valuable, drawing prices in line with the famed group of seven. He had little experience and knew little about diabetes aside from reading short paper, as a long shot and in the hopes of making a living, Banting began his work in May at the University of Toronto and was assisted shortly after by a young medical student named Charles Best. They had no idea that they were embarking on a journey that would soon immortalize them as medical geniuses and land them a Nobel Prize for medicine. Their work started immediately and knowing that the pancreas contains insulin, they started removing them from dogs to make them diabetic and then use their own pancreas, the one they had just removed to try and develop an extract that would then lower blood sugars. It was a messy, dirty and cruel work. Many dogs died, but by August, just three months later, one of the extracts worked. It's worth noting that animal experimentation at the time was socially accepted and medical science was trial and error, so we definitely can't fault the Banting team for using them. Incidentally, the dog in this photo, well, he probably didn't make it. Soon after, a biochemist was brought on to purify the ground up Oregon porridge and made it viable for human use. Finally, on January 11th, 1922, a 14-year-old boy, Leonard Thompson, received the first insulin injection. It was described as a smelly, murky, light brown liquid containing lots of sediment and it was given to him over several weeks. Amazingly, it worked and the boy's sugar and ketone levels fell. What's staggering in this photo demonstrate the amazing physical transformation that saved this boy from certain death. The child weighed only 65 pounds, the weight of a mid-sized dog, and was quickly transformed into a healthy looking and strong teenager. The Banting team's researchers, of course, couldn't commercialize insulin, but a pharma company out there called Eli Lilly, well, they sure could, and as a bonus, they were conveniently located close to several slaughterhouses in the Minneapolis region. Lilly jumped at the opportunity and started to mass produce insulin. They stored a couple million pounds of frozen pancreas from pigs and cows just to keep up with demand since there was already an astonishing one million Americans lining up for ongoing daily access. Next slide. Like most median advertisers, the discovery in 1921 spread like wildfire and was heralded and marketed as a cure for diabetes. People from around the world and from all socioeconomic backgrounds were desperate for a magical medicine. The reality, however, was very, very different. Next slide. Insulin did precisely what it was supposed to do, temporary lower blood sugars, but it could also cause hypoglycemia. In this situation, blood sugars become too low, leading to shakiness and confusion or even seizures, loss of consciousness or death. Insulin became a daily self-administered drug, but it could kill just as well as it could save if misused. It's worth noting that no self-administered therapy has ever quite those same properties, before or since. In fact, consider your own experience with medicine, in every case, at least that I can think of, from cancer to heart condition, infection or even cholesterol. A doctor always describes the medicine. That includes a treatment of medicine and a dose. And as a friend of mine, Lane Desborough, when an expert on diabetes automation called it, it take a bunch of insulin and then start eating your way out of hypoglycemia. Incidentally, when you get to the part discussing innovation, I'll offer a sneak peek into an extraordinary innovation led by a couple of good friends and diabetes pioneers. Robert Oringer and Claude Pichet, both living in Canada, one Canadian. They developed a remarkable new delivery method to help counteract the potentially deadly side effect of taking too much insulin. In fact, like Banting and Best, they also work with Eli Lilly, the original insulin pharma, to make and market it. So as you can see, we now know that during the 20s and 30s, insulin curative powers were greatly exaggerated. Despite lowering blood sugars, managing them was still very difficult. And elevated blood glucose over time was dangerous. These days, it's a measurement known as an A1C. As a result, by the mid-1930s, patients who were using insulin began developing some serious high glucose-related complications that included damage to the eyes, kidneys, nerves, and heart. A real problem that remains today. Insulin hadn't cured anything, but what it did was effectively transform diabetes from a death sentence into a chronic, manageable condition. And considering the alternative was sincerely welcome. Remember, the glucose monitoring wasn't developed until the 1940s. So until then, patients unaware of their blood sugar levels, they had to fiddle around with insulin dosage entirely and utterly blind. Next slide. And this is when we get to our story. Like most others, a diabetes diagnosis is a complete surprise. Our family was on holiday in the Bahamas. And I remember noticing that our son was becoming increasingly lethargic, tired, and very thirsty. Also, his breath smelled like chemicals or more specifically like acetone. At first, we assumed he was just under the weather, but we eventually decided to fly home and take him to see his pediatrician. Within minutes, we were warned that he was diabetic or likely diabetic and needed to have him rushed to the ER. His life was in grave risk. The following days in the ICU were focused on getting Williams sugars and ketones under control and then began the work of learning how to help him. The training was short. And we weren't really noted to the life-altering effects that this diagnosis offered. In fact, it wasn't until a couple of friends, Justin Weinberg and Robert Orranger, yes, this same co-creator, Baxini, who separately sat me down and explained it to me in stark, unvarnished detail. But I started to truly understand I was mortified. Will's life would never be the same. Neither would ours. Technology, well, it was still emerging. We practiced fingers dozens of times a day, calculated everything eight, injected him with insulin regularly. We even stuck into his bedroom several times a night to test him, treat him, and even just to make sure he was still breathing. Our best calculations were rarely accurate and the variables to consider were impossible. We treated his highs with insulin, his lows with juice, next. And my wife, Shari, hung around outside his elementary school all day, every day, rain or shine or snow, just so she could be close in case he needed help. You see, his fancy private school had no nurse. Next. On average, a type one deals with therapies at least 250 times a day. And that assumes that nothing went wrong. It's an enormous responsibility that is especially rough on kids, forcing them to mature too quickly. Over the years, technology improved and so did our lives. The burden never left, though, but things got easier. We became early adopters for many of the tools and tech that I'll get into. And we were grateful that people were relentlessly pushing for new ways to keep our boys safe. The world was changing and quickly. People were tired of waiting. Next. Going back to Banting, what's impressive is that following his discovery, when would expect him to sell the patent and find a way to profit from the discovery of history's first modern and hugely needed medicine? Remember that he wasn't an independently wealthy man, yet he did something remarkable and completely unexpected. He chose to sell the patent to the University of Toronto for this grand sum of $1, something amounting to perhaps today's pay. He later declared that this discovery was a gift to humanity and needed to be available for everyone. So I wonder if he understood how diabetes would eventually proliferate the globe and affect hundreds of millions. In my mind, I believe in hope that he did. Next. So I'd like to ask each of you listening to this event to take a moment to reflect on this simple, honest question. Don't worry, there's no right or wrong answer here. But if you were a researcher that just knowingly come up with the discovery of the century and history's very first real medicine, what would you have done? Remember, the discovery of insulin was not an accident. Banting and his team deliberately set out to develop it. This was not a lottery ticket, nor a chance discovery. Would you have sold it and profit massively? Or would you have given it away for nothing? Next. In honesty, I'm ashamed to say that I doubt that I would have or could have done the latter. Next again. On the left is a visual of type 1 diabetes where the body's immune system destroys beta cells in the pancreas and as a result can no longer produce insulin. Type 1 is also an autoimmune disease that to this day still cannot be prevented. It represents about 5 to 10% of all diabetes worldwide. On the right, we have type 2 diabetes. It sounds the same, but it isn't. With type 2s, the pancreas does produce insulin, but it isn't used correctly. This is known as insulin resistance. Often, insulin produced in the pancreas also decreases, causing insulin deficiency. Type 2 diabetes can be prevented or delayed as two of the major risk factors can be modified. Overweight and inactivity. What's quite incredible is that type 2 diabetes accounts for a staggering 90% of all diabetes cases globally, many of which can be delayed or most certainly better managed. Next. Over the years, insulin, it's improved. There are long acting, fast acting, many brands each with unique and essential attributes. Other important medicines to help manage blood sugars have been developed. Glucose testing has improved. We've come a long way from tasting urine to test strips that are instant, small and accurate. We have CGMs. These are devices that offer nearly real-time blood glucose readings. We can leverage smartphones to process data instantly, anticipate blood glucose, provide recommendations, and even deliver insulin all instantly. We can also connect endocrinologist and caregivers with real-time blood glucose to better manage and treat diabetes. Knowledge on diabetes has also greatly improved, and the unicorn known as a closed loop has finally become a reality. Next. To better understand a closed loop system, it combines a CGM, an insulin pump, and a control algorithm to adjust insulin delivery based on real-time blood glucose. So if your blood sugar is high or trending high, your insulin dose will be increased to bring your blood sugar levels back into range, or inversely decreased if you're low or trending low. The goal of the system is, of course, better insulin management, and perhaps more importantly, is to reduce the burden that people with type 1 bear every day by helping with control around the clock. Next. Even the basic insulin pens are becoming smarter by connecting to CGMs and leveraging AI to incorporate easy dosing recommendations. A big shout out to Bigfoot Biomedical. They developed the first-of-its-kind smart pen cap that combines the CGM data with AI to provide real-time insulin dosing recommendations that just receive FDA clearance. Like so many others, Bigfoot emerged from people having a deep connection to diabetes and choosing to risk, well, everything to make a difference. Next slide. Every company and organization on this screen, along with many others, have given so much to drag diabetes out of the cave and create an opportunity for our children to have better, less complicated, more independent, and longer life. Because of each of them working, failing, succeeding, trying, and pushing the boundaries of the art of the possible, we move ever closer to a world and a life without insulin. Next. But for now, diabetes remains an epidemic of unprecedented biblical proportion. And it's getting worse. According to the CDC, 34.2 million Americans, just over one in 10, have diabetes. 88 million American adults, approximately one in three, have pre-diabetes, and about 95% of them are type 2. Unlike type 1, these patients often have other options other than insulin, although many will eventually require insulin as a better glucose-lowering choice. Some of the other medicines in new classes of drugs, like churlicity and Lantus, are already generating billions in annual sales, which is an obvious indicator of demand. So let's look at some mind-numbing statistics. And I hope you're all sitting down for this. Here in Canada, nearly 11.5 million Canadians live with diabetes or pre-diabetes. In North America and the Caribbean together, one in six adults are at risk of type 2, which will increase 33%. In South and Central America, two in five people with diabetes were undiagnosed, which will rise 55% to 49 million. In Africa, three in five people with diabetes are undiagnosed, and three in four diabetes deaths are from people under 60, which will increase 143% by 2045. In the Middle East, one in eight have diabetes, which will rise 96%. And in Southeast Asia, one in five adults have diabetes, and this will increase 74% to get this, 153 million by 2045. Incidentally, Europe has the highest type 1 kids population, a mountain to 300,000, and one in six live births are affected by hyperglycemia or high blood sugars in pregnancy. Despite a century of advancements in treatment, education, and prevention, we as a global society remain in the wake of these awful statistics. One in 10 adults on this planet today, some 537 million people are currently living with diabetes, and the numbers are only getting worse. That doesn't count the lives lost to COVID-19, which has been particularly deadly for people living with diabetes. A study published in February found that having either type 1 or type 2 diabetes tripled the risk of severe illness and death from COVID-19. Moreover, as many as 40% of the people who died in the U.S. from COVID-19 had type 1 or type 2. Even worse, experts are concerned that more people may develop diabetes due to COVID, and the debate over a specific COVID-induced diabetes begins. It's been discovered that as many as 14% of people hospitalized with severe COVID later developed diabetes. There have also been new onset type 1 or type 2 in babies, children, and adults infected with COVID-19. This data will no doubt be studied for years, but the news is not encouraging next. What then is the next chapter for insulin? Well, it will undoubtedly include continued improvements in everything. Next again. Innovators and entrepreneurs are developing a once a week insulin to replace the current once a day option. Research also continues on glucose-sensitive insulin, which would only take effect when your blood sugar rises. But progress remains slow, and like everything else, always seems to be, you guessed it, 5 to 10 years out. Next. Insulin has saved the lives and families, including my son, and we owe so much to this extraordinary discovery. However, the most significant contribution from this miracle drug would be for it to simply disappear, which would mean diabetes has been cured. It will undoubtedly take more time, but I believe that until then other therapies, cell-based therapies, will someday provide a better, safer, and more curative option. SEM cell treatment for a long time has been the anticipated future for diabetes, specifically making insulin-producing beta cells, which the body would either tolerate through cell encapsulation or some kind of mild immune suppressant. A couple of great companies are on the verge of precisely this. Virtex has become a clinical trial on a stem cell-derived, fully differentiated pancreatic islet cell therapy. It's a fancy way of saying that they found a way to transform stem cells into insulin-producing beta cells. And via site, based on Canadian technology, known as the Edmonton Protocol, has begun a phase two clinical trial using encapsulated cells that transform into insulin-producing beta cells. Lisa Hepner, also Canadian, will speak about this game-changing innovation that has already helped La Lucky few become temporarily insulin-free in an upcoming ingenium talk as part of the series. Something I promise that I'll be tuning into and learning from. Insulin forever changed what's meant to be diagnosed with diabetes. It transformed death into a future and gave people a chance to live along in productive lives. Insulin was discovered right here in Canada in a Canadian lab by Canadians. Next slide. And their discovery showed the world for the first time that Canadian innovation mattered. The Banting team didn't receive government funding, participate in a supercluster, or deliver the next great IPO. But they did have Canadian training, Canadian talent, Canadian grit, and Canadian curiosity. Next. Banting lived from 1891 to 1941 before his untimely death, a mere 49 years. And during this short time on earth left an indelible mark that'll be remembered throughout the ages. We now know that there isn't a country or town anywhere on this planet that doesn't share our gratitude for their achievements. They've saved so many, so much sadness and been credited for saving more lives than any other Canadian and perhaps even any other person in history. For Canada, this means that we need to celebrate and remember Banting's life. It requires that we encourage others to follow in similar footsteps so that we as proud Canadians can cultivate the next great invention. Next. So I asked, how do we encourage more Canadians to create medicines, technology, and advancements, not just for themselves, but for the benefit of humanity at large? Next slide. How do we clone this philanthropic recipe so that those Nobel Prize winners replicate their humanitarian DNA for public good? How can Canada as a government participate in creating advantage and value for the benefit of a global society? How do we transform economic motivation into social potential in essence and to coin a Canadian charity? How do we transform me into we? Well, I've had the opportunity of thinking about this for a while. So first, I think we need to encourage the government to attract and retain internal top talent and equip them to explore solutions that matter. They already have the best equipment and tremendous skill, but what they may lack is the permission, culture, and perhaps some of the connective tissue to innovate. That's not to say that Canada doesn't deliver. On the contrary, magic does happen here. For example, the Ebola vaccine was an incredible achievement along with other vital innovations developed right here in Canada. Second, government should invest alongside in innovators, not as a financial backstop, but as motivated investors alongside other expert incubators looking to identify, accelerate, and commercialize opportunities that generate returns and pride for Canada. Third, and perhaps the most important of all, we must invest strategically, but I'm not referring this time to stocks and bonds, but in our greatest assets are children. All kids are unique and they all have talents. However, not each child has the same talent. Identifying aptitudes and capabilities early on during elementary habit forming years is extremely important, then providing the specialized education that will better equip kids to help identify and grow their skills as they learn, surround them with the specialized technology and training so that they become the leading edge as early as possible. Remember, skills are a perishable and evolving resource. Our system is geared to deliver homogeneous education, but our kids are not the same and we shouldn't always learn the same way, so we need to embrace their individuality and help them figure out their super skills early. The sooner they discover and develop their talent, the more time they will have to excel and contribute before they get too old and need to retire. My thoughts are not novel and other nations like Israel have done this with stunning success, so we already have a working model to consider and evolve. Next slide. For our family, diabetes is personal. Suppose I could speak with Frederick Banting, Charles Best, JJ McLeod, and James Collough. I want to say thank you and offer father's most profound gratitude. Thank you for giving my son a shot at an everyday life. Thank you for letting me watch him grow up and do such amazing things every day. Thank you for every birthday, graduation, and for each special moment, big and small. Next slide. Diabetes is no longer a death sentence, and we are grateful for all the love and potential that you've made possible. Know that your efforts have saved the lives of our son, and the children of so many that can celebrate, live, love, and laugh. Because of you and for us. Next slide. Life goes on. Finally, I'd like to thank the Canadian government for allowing me to work alongside our senior leadership to explore unique pathways, priorities, and opportunities to bring innovation, including novel diabetes technologies to Canada. Believe me, it took real courage to unleash an entrepreneur into the enormous and complex government machine, and I remain grateful for theirs. Thank you. Next slide. So, Michelle, we turn it back to the Q&A now. Wow, Ron. Thank you so, so much for sharing the story of insulin, and especially for sharing your story. Hang on. We'll wait for you to reconnect. Well, Ron's reconnecting. I'd like to invite you. I need to just fix a small technical glitch. Not a problem. Well, Ron is fixing his technical glitch. I'd invite everyone to explore the Q&A function at the bottom of the screen. And if you have any questions for Ron, write them in, and we'll see how many we can get to. Michelle, I'm ready for your questions. Fabulous. Okay. Sorry. No problems. This is the era we live in. So the first question I'm going to start with is actually one that came in earlier from, I think, someone that's here tonight. And they're asking, is there a profile for Canadians who are most likely to get type 2 diabetes? Yeah, great question. Yes, you are in fact, there are in fact more likely to develop type 2 diabetes if you're over 45, have a family history of diabetes, are obese or overweight. Diabetes is more common in African Americans, Hispanics, Latinos, Indigenous people, or Asian Americans. Although not everyone with type 2 diabetes is overweight, obesity and an inactive lifestyle are two of the most common causes. These factors are responsible for the majority of type 2 diabetes cases in North America. As a follow up, what about low income communities? I've heard that they're at risk as well. Yup, they are. So unfortunately, yes, people with less money, less education, and lower social status usually have less access to good food. They also have more barriers to exercise, more stress, and often more exposure to chemicals. So people who have had hard lives like a history of trauma or a difficult childhood also have more of these risk factors. Thank you. So what about type 1 then? You said there were certain things we could do in our lives to help prevent or at least push off type 2 diabetes. What about type 1 diabetes? Yeah, so if the question is, can type 1 diabetes prevent it, the answer is unfortunately not. There are however new tests that can be performed to determine if you have the genetic markers that place you at a higher risk. Great. So there's a question coming in from Anouk and she's, I'm going to kind of change her wording a little bit, but she's, what can people do to prevent like a type 2 diabetes or slow the chances of it developing into full blown diabetes from just pre-diabetes? Anouk, that's a great question. Thank you. There are several ways to try and prevent type 2 diabetes, and it's a list. So cut sugar and refined carbs from your diet, work out regularly, drink water as your primary beverage instead of soft drinks and sugary drinks, lose weight if you're overweight or obese, quit smoking, follow a very low carb diet, watch your portion sizes, avoid a sedentary behavior, eat a high fiber diet, even things like optimizing vitamin D levels or minimizing your intake of processed foods. And surprisingly drinking coffee or tea, along with other foods or drinks that are high in antioxidants will absolutely help. I'm going to ask a follow up question from that too. So do you think then that some of these factors are the reason that type 2 diabetes is increasing in the world, like more people eating fast food, more coffee being drank, that kind of thing? In a word, yes. Yeah. I think type 2 diabetes to a large degree, not for everyone, is simply caused by this intake of all of these things and a lack of a sedentary life and doing all the things I had just mentioned. Another question that came in from before, what is the average age to get diagnosed with type 1? So type 1 is usually diagnosed before the age of 40, although sometimes people have been diagnosed later on after an illness causes an immune response that triggers it. Most type 1 diagnoses occur in children between the ages of 4 and 14. So that's really young, my goodness. Yeah, my son was diagnosed at 5. Yeah. Oh my goodness. I mean it sucks for everyone, but for a kid and their parents, it's heartbreaking. It is, but for children that are diagnosed very early on, the only thing I can really say is they don't really know another way. So once they get used to where they are and they get a little older, they don't remember a life without diabetes. So their routine, although they may not like it, it becomes part of their life. Another question that we got several mail-in questions, is insulin the most expensive liquid in the world? Yeah, that's a good question. It's good that I started doing some research before this. So insulin in the U.S. costs about $9,600 a gallon. And that makes it, believe it or not, the sixth most expensive liquid in the world behind Chanel number five, which is $26,000 a gallon. Horseshoe crab blood, which is being used in research. It's a blue blood that's apparently incredible for research. And that costs $60,000 a gallon, poor horseshoe crabs. Lysergic acid or LSD, the drug, comes in number three at $123,000 a gallon. King cobra venom is a whopping $153,000 a gallon. And the number one most expensive liquid in the world. You want to take a shot at Michelle at what this might be? I'm all that I can imagine is like melted gold or something. No, no, no. Scorpion venom at $39 million a gallon. Wow. I suddenly feel like I'm in the wrong field. Well, kind of fun. And you got to milk a lot of scorpions. I'm not sure there's a lot of job security in that work. So why are the prices so high? Like it's in demand. The patent got sold for a dollar. How is the cost so ridiculously high? So an economics question, I love it. I shout out to my friend, Stephen, in the audience. In a single word, greed. Generally, basic economic principles would dictate that prices for goods and medicines should fall over time. And as competition enters the market, prices are driven down. It's the rule of supply and demand. So despite insulin being price regulated, it's sad to say that it's gone up about 8x over the past 20 years. I personally believe that manufacturers charge so much for one really simple reason. Because they can't. For example, if a video game system was too expensive, consumers would hold off buying it. But with insulin, consumers can't walk away because they just they can't live without it. And what's particularly sad for me is that, you know, there are a lot of people out there that don't have these medicines paid for by Medicare or Medicaid or provincial subsidy programs. And often they have to make decisions, especially in an inflationary market between medicine and food. And what's so rotten is that as, you know, as a diabetic, if you're a type one diabetic, food is medicine. And having to decide between insulin and food is just terrible. And if you're a type two diabetic, well, you need higher quality food to be able to try and keep your diabetes in check. And the last expensive food are always the inexpensive carbs, which then these people would then be forced to eat more and more of. So this becomes this horrible self fulfilling prophecy of their their diabetes becoming out of control because they can't afford their medicines, or they can't afford the food to take care of themselves. So it's it's a horrible situation that really at some point needs to really get looked at perhaps through the different food services and food agencies within the Canadian the Canadian government and other governments around the world because this problem is it's not going to go away on its own. Another question and hear about cost while we're on the subject. And it's about insulin pumps. So this question is from someone living in Quebec and insulin pumps are not covered by provincial health care. Do you know are pumps covered in other provinces and territories? Well, actually, I would like to correct that. Insulin pumps in Quebec absolutely are as an example. My son is diabetic and in Quebec, he's on an omnipod. This is an example of a small omnipod, which is an insulin pump. If you're under 18 in Quebec, and you sign up for the insulin pump program, and you go through their process from zero to 18, you're fully covered for insulin for pumps for pump supplies, even things like MLA are covered. But if you're over 18, and you weren't underage when you were first diagnosed, therein lies the problem. But yes, other provinces are starting to get into this. And incidentally, this is this bag full of insulin pumps. It's a horrible environmental waste, but it keeps my son alive. And there's a few months of pumps in here. If you can, if you can see inside this package, there's, I don't know, 50, 60, and he goes through this every, every couple of days, he needs a completely different pump. So the good news is if the, if the caller is asking questions and they happen to be under 18, absolutely, they're covered. No problems there. It's part of RamQ. If they were diagnosed when they're under 18, they are still covered as part of RamQ as long as they fill out that form every year and send it through their endocrinologist back to RamQ or shoot a Quebec. And if they're over 18, I don't know what to say. It's not covered. It's too bad. A question coming in from, from Laura here, and she's asking you to expand on the stem cell treatment. Her daughter was unfortunately recently diagnosed with type 1 diabetes. So stem cell treatments are nothing that's available now. Viaside, Vertex, other companies are trying to find ways to get the, the, to get stem cells to become an insulin producing beta cells. And they're trying to find ways to inject them into the liver, to inject them into the pancreas, to encapsulate them into these special teabags that are, that are inserted underneath the skin where interstitial fluids that contain blood, glucose levels can go in, and then they can produce insulin on their own. And then you're, you're technically insulin free because your body is producing it. These are things that are currently in testing. Lisa Hepner with the Human Trial will be talking about that on hers, I think in February, Michelle, and stay, stay tuned because they had a film crew follow a bunch of these diabetics around. Some of them have been insulin free for a long time now. And it's, it is the future of this technology. Another question asking, what about pancreas transplants? Yep, you can have a pancreas transplant and conceivably you would be diabetes free. The problem is the immunosuppressant drugs required to keep you healthy. So your, your body or your white blood cells don't go after your own pancreas is arguably more dangerous or similarly as dangerous to insulin therapy. So that's why, unless you have real chronic insulin issues where you really can't tell your lows and you can't really treat it and you run into serious hypoglycemia situations, it's not something that is typically explored medically. Question here from Lisa asking some of these innovations you've been talking about, which ones have you and your son personally used? Well, my son started off with an insulin pen. So this is an example here of an insulin pen. It's a pen, it's loaded with insulin in the front. This is a rapid acting insulin from called Novorepid. You attach your pen, your insulin tip, you dial in the amount of insulin that you want. You're the one that calculates it and you inject it. And this is how you lower blood glucose. Since then, my son has evolved onto a pump, which was one of these things. This pump is connected to a PDM. The PDM is like a brain. It doesn't talk to anything, but you program it and you figure, you figure out things like insulin sensitivity and carb ratios and all kinds of other stuff. And it injects insulin that's part of something called a basal rate. In other words, a certain minimum amount of insulin that you need to stay alive, the minimum. And then every time you eat, you have to calculate your bowl as insulin, the insulin that you use to eat your way out of hypoglycemia, if you will. So my son went on to that. And after the insulin pump with Omnipod, he actually went on to a fully closed loop technology, which was part of a product called Loop, which really isn't part of anything here in Canada just yet. It's part of a we're not waiting movement. And that is the future of closed loop technology. So he's kind of been through the full gamut. That's incredible. Such a crazy story. So Ron, there's a bit of a special guest who's popped up in our audience and wants to say hi to you and has a bit of a story to tell. So I'd like to introduce, as a bit of a surprise, Bob Banting, who can correct me if I'm wrong, is the great nephew of the Banting that we've just been talking about. And I think he wants to say a couple of words on what drove Banting to come up with this idea and press on with the research when he wasn't even paid. So Ron, with your permission, I'd like to introduce you to Bob Banting. Yes, Mr. Banting, thank you. How are you today? Wonderful. Thank you for tuning into this. Hope we're not bouncing around here too much. There we go. Trying to do this with an iPad. Yes, I thought maybe viewers would be interested in hearing a bit of a bit of a story about how Fred Banting, that's great uncle Fred Banting, ended up being driven. His idea came to him in the middle of the night in London. But it really was driven by the fact that as he was growing up, one of his chums, a gal, her name is now known, known to us fairly recently, as Jenny Victoria Jordan. Jenny was a childhood friend that lived on an adjacent farm. And little by little, she exhibited all the classic symptoms of diabetes. And when Fred was away at the first few years at the university, she came down with diabetes and Fred would visit her on her porch. He ultimately was a bearer at her funeral. So Fred ended up being driven by this. He talked about this idea many times long before the idea came forth by discussing it with one of his cousins, also a doctor and a person who helped out with the original insulin injections. That was a good friend, Fred Hipple. They grew up together on the farm. And Fred and he talked about the need for this solution in 1920, sorry 1919, when they were both looking for a ride, a boat ride back to Canada after serving in the war. So really the driver and the idea for the insulin was in fact, I guess cultured in his mind with a childhood friend that he didn't talk about at all, largely because the family, her family died at the time with a lot of kids at the same time. They all died one after the other of infectious diseases. And her sister died as well as a diabetic. So he never talked about it, never mentioned it. And out of respect for the neighbors, he never focused on this at all. So I thought maybe he'd be interested in that tidbit. That's an incredible story. And while I have you here, I want to thank you because of what your relative has done. He saved my son's life. My son's alive. And the lives of so many others have been saved because of this incredible medicine. And it's incredible sitting here and speaking with you knowing that a couple generations back was a close family member that made this all possible. Yeah, I was close to it. My father talked about Fred a lot. He was old enough soon enough to have met him alive. So he talked about it. My aunts and uncles all talked about it. And Fred would come back home to his birthplace home in Alliston. And they would all meet there. So it was great background. I hear this story and the thank yous. It wasn't me or any of the relatives that did this at all. But the thank yous keep coming up. And I like to take and consider the need to take the history and the thanks and the thankfulness and turn that somehow into a way to have Fred Banting come back and finish the job. Wouldn't that be something? Sorry about the video. That would truly be something. Well, listen, you bear his name and you bear his blood and I'm grateful for that. So thank you. You're welcome. Thanks to both of you. There's thank yous flying in on the question and answers right now, both to you, Bob, and also to you, Ron. Unfortunately, I think that's all the time we have for questions. There are a couple more that we didn't get to answer. And Ron has agreed that any unanswered questions, he will do a bit of a kind of a written interview, which we'll have posted on the ingenium website after the fact. So if your question didn't get answered, look for Ron's article or tune in for our next topic, which is going to be on December 8th, where we're going to be exploring some of the future innovations in diabetes. So I can tell you that Rob and Claude are two really interesting guys, and their innovation is incredible. That's made a huge difference in our lives as well, because, you know, the antidote of too much insulin requires glucagon, which raises your blood sugar. And if you can't drink anything because you're unconscious because you've accidentally taken too much insulin, you're in a situation where you need help. And their story is remarkable. Their innovation is fantastic. And, you know, we have it in our go bag all the time. I've got a couple of bottles right here with me of what they invented. So I strongly think anyone that's interested in diabetes should check it out. They're two really dynamic guys. And, of course, after that, the session with Lisa Heppner is going to be fantastic. But Michelle, I just want to thank you for doing this. It's been a pleasure working with you. And I'm so glad that the Ingenium Foundation and, you know, the Science Museums of Canada found that this was an important enough topic on the centennial to talk about. Absolutely. And I want to thank you, our guest speaker this evening, and also our surprise guest speaker, Mr. Poppy. Yes. Wasn't that great? It was so cool. I want to thank you so much for your generosity, for sharing your passion with us and in this story that's very personal for you. I'd also like to thank our audience, of course, for coming and for participating and for sharing all of those questions. And one special request, Michelle, if you could just reach out to Bob Banting and find out if I can get in touch with him directly, that would be fantastic. I will send him a message. For the rest of our audience members, there's going to be a link dropped in the chat any second now to a survey in case you want to share your thoughts with us. We'd really love to know how we can keep improving this series. And you will also be receiving an automated message tomorrow through the email that you use to register, which will also have a link to this survey if you don't manage to click it in time. So please check the museum's website for upcoming topics. If you want to know more, check out our info line. And on behalf of myself and Ron and the Canada Science and Technology Museum and the Ingenium Foundation, I want to say a sincere thank you and good night. I hope you all stay healthy and stay well. Right now. Good night. Thank you.