JDRF CEO Aaron Kowalski, PhD, on Joining StartUp Health’s T1D Moonshot: ‘Entrepreneurship Is the…

JDRF CEO Aaron Kowalski, PhD, on Joining StartUp Health’s T1D Moonshot: ‘Entrepreneurship Is the Bedrock of Innovation’

StartUp Health introduces Aaron Kowalski, PhD, CEO of JDRF International, as the latest member of our Type 1 Diabetes Moonshot Impact Board. As the world’s largest nonprofit funder of T1D research, Kowalski’s work with JDRF throughout his career — along with his personal experience with diabetes — give him an incredibly unique and passionate approach to helping others.

Anyone orbiting in the universe of Type 1 diabetes will know that JDRF is the world’s largest nonprofit funder of T1D research. In his role atop the organization, Kowalski has combined his professional experience as a molecular biologist and executive with his personal passion to fight Type 1 diabetes in order to impact patients like himself and his brother.

Kowalski is a recent addition to StartUp Health’s Type 1 Diabetes Moonshot Impact Board. This board is a cross-disciplinary team of T1D experts spanning the gamut from research to funding to commercialization. We are thrilled that Kowalski is bringing his vast experience to this cohort in order to speed up innovation and support a generation of health entrepreneurs.

We sat down with Kowalski and learned about his journey, as well as his goals for working with our Health Transformers.

Can you give us a quick summary of your career thus far?

I’m a molecular biologist by training, and I spent a lot of years in the lab working on molecular biology and protein biochemistry. I came to JDRF as a scientist and I kind of grew up here. I focused a lot in my early career on artificial pancreas or automated insulin delivery systems, and then broadened to oversee our entire research portfolio and policy work. About three and a half years ago, I took on the role of CEO. My background beyond that is that my brother and I, two of six kids in our family, have Type 1 diabetes. That was a big motivator. My brother, Steve, has hypoglycemia unawareness, which is a big challenge, and hence kind of my passion for the device side of the equation. Having continuous glucose monitors (CGMs) that could alert for impending lows, and starting to automate insulin delivery, which we’re both benefiting from now, are both passions of mine. Now, as CEO, I try to shepherd more research to solve those problems and keep my finger on the pulse of science. I want to engage more people and partners to move the field along.

You’ve recently been working on a project called the Type 1 Diabetes Index Data Project, which highlights the increasing number of people with T1D on a global scale. Can you elaborate on this problem and what it means for the world of healthcare?

The Index is a categorization of the impact of T1D around the world, looking from a country-by-country lens. Many people see T1D as a Caucasian, North American, or Western European disease. That’s not true. T1D affects people wherever they live. And a lot of that misconception comes from the fact that though 100 years have passed since the advent of insulin, people still die from lack of treatment. In places like America, if you have great care, you’re going to live a long and healthy life with T1D, but if you don’t have access to that care, you will have challenges. Many kids still die, which is totally unacceptable. The Index has provided the foundation for a platform for change to drive better treatments for more people to ensure that they can live and thrive. Increasing incidence is something we are concerned about because part of the story is that we are seeing that with delivery of insulin and care, you can help people survive. But part of this is we are truly seeing more T1D and auto-immunity emerging. Why is that? That’s a big area of focus for JDRF and NIH and other research organizations. I think the answer is likely an environmental issue. Is it viral, is it a chemical? The bottom line is a lot of people have diabetes, and we need new therapies to help them do better.

As someone with T1D yourself, what are some life-changing breakthroughs you’ve seen over the course of your life?

My definition of a life-changing breakthrough is moving from where we are to somewhere better. So, when my brother was first diagnosed with diabetes, they used urine testing. It was a huge breakthrough, the blood glucose testing. I fought a lot at JDRF for continuous glucose monitor (CGM) access. That was another life-changing breakthrough. Automated insulin, life-changing breakthrough. Ultimately, I would love to take off my pump and have cells make insulin for me. I’d love to have drugs that could delay the onset of diabetes. What occurred to me over the last few years is life-changing breakthroughs depend on where you live and your circumstances.

In your work with JDRF, how do you portion funds between supporting access to existing discoveries and increasing innovation that move progress forward?

Care in diabetes is a continuum. I’m fortunate to be on the front line of that continuum. My insurance pays for my diabetes supplies; I have an amazing doctor; I have the best technology. But I look across the river here in Manhattan, and there are kids who don’t have easy access to these advancements. At JDRF, we see that if your life is going to be changed, access is an essential part of that.

We have a model that we call the right and left side of the pipeline, the pipeline being moving from discovery research all the way to the hands of a person. To me, the left side of the pipeline is the bleeding edge — research, and commercial development, and ultimately regulatory approval. That takes where we are today and moves us to somewhere better. The right side defines who gets access to those new advancements, and that’s something that we’ve really increased our focus on because we want everybody to do better. I’ve been on a continuous glucose monitor for 16 years, and CGMs have become much better over that time period, but imagine if every kid and person with T1D in India, China, and Brazil had access to CGMs right now. There would actually be a much better business model and things would move faster. So we believe that access drives a more virtuous cycle of better health outcomes, which is our ultimate goal.

What is a success story where your work has opened up treatment access for those with Type 1 diabetes?

In the United States, one of my proudest achievements at JDRF is that we fought really hard for access to continuous glucose monitors (CGM) for the Medicare population. The Medicare population has a lot of people with T1D, and as you age with diabetes, you become more susceptible to hypoglycemia. JDRF published a very important paper back in 2008 that I co-authored on the benefits of CGMs in the New England Journal, and it actually opened up private insurance quite a bit for coverage, but not Medicare. And that to me is a perfect example. All of those people who are sitting there at high risk for hypoglycemia didn’t have access to CGMs. And we spent a lot of money, and lobbied and worked to actually get over the hump and open up coverage for more than 150,000 people with T1D. And now we are seeing coverage open for T2D as well. Another example is that at JDRF international, we represent folks all over the world. We just got the Australian government to commit $250M to opening access for adults to have CGMs. That is life changing for those people. Advocacy and access to me are hugely important because without them, people don’t see these advancements.

Is there something that you’re particularly excited about just around the corner in diabetes innovation?

One really interesting area is SGLT2 inhibition drugs; new drugs being widely used in T2D with such a huge impact on quality of life. They’ve been amazing, but they’ve been dangerous for people with T1D because of a surprise side effect of what is called euglycemic diabetic ketoacidosis, which is when someone gets ketosis, but has a normal blood sugar level. That’s been tricky in the T1D community because most people associate ketosis with high blood sugar, when it’s actually driven by low insulin. These drugs are so good, and they have the incredible effect of reducing kidney and heart disease progression as well. We want to see them get into T1D, and one area we have focused on is combining continuous glucose monitoring with continuous ketosis monitoring. This would minimize the risk of that side effect. Abbott is exploring this idea, along with a number of innovative companies. It has weight benefits, complication benefits, glycemic benefits, they’re easy to use, they just need extra help in the T1D world.

What words of wisdom do you have for Health Transformers working in the world of T1D?

My advice is always look at impact. There are a lot of good ideas out there, but ultimately, what is the impact? Another important factor is understanding that T1D is about more than A1C. I’ve seen so many things fail because they only focus on changing someone’s A1C and forget people with diabetes live a whole life. You have to incorporate these advancements into a more holistic lens of diabetes. A very specific example is in these closed-loop systems that I worked on for a long time at JDRF, everyone in the industry focused on the A1C side. In the diabetes world, the number one benefit people talk about is sleep. It’s a completely different lens for what’s important, and that’s the secret sauce of advancing new treatment options. Of course we are trying to fix the glycemic problem, but life is more than glycemia, and that would be my advice: think bigger.

What value do you see in supporting entrepreneurs at scale within the T1D market?

Entrepreneurship is the bedrock of innovation and driving us to a better place. I love that we have folks like StartUp Health coming into the world of Type 1 diabetes because it takes a village. JDRF funds a lot of research, but by no means do we think we can take on this problem ourselves. We work with the Helmsley Trust, now StartUp Health, many governments, all in finding those niches where you can drive more smart people to get involved. Think outside the box, combine different skill sets. This is only going to move us to better solutions faster. When David [Weingard] and the team reached out to me to be involved in this initiative, I was thrilled because there’s more energy, more smarts, more money, more capital moving into T1D, and that means people benefit faster.

Passionate about Type 1 diabetes?

If you’re an entrepreneur or investor, contact us to learn how you can join our T1D Moonshot.

Listen to the full interview on the StartUp Health NOW podcast

Aaron Kowalski, PhD, CEO of JDRF, Brings His Professional & Personal Experience to StartUp Health’s T1D Moonshot Impact Board

Watch on StartUp Health TV

https://medium.com/media/86afdd12fa841c8a91efab270168ea52/href

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JDRF CEO Aaron Kowalski, PhD, on Joining StartUp Health’s T1D Moonshot: ‘Entrepreneurship Is the… was originally published in StartUp Health on Medium, where people are continuing the conversation by highlighting and responding to this story.

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