History
This is the story of how that breakthrough, known as the Edmonton Protocol, came to be and how it sparked the growth of the Alberta Diabetes Foundation (ADF) to carry its legacy forward.
1979: Dr. Ray Rajotte Begins the Journey
In 1979, Dr. Ray Rajotte joined the University of Alberta with a bold research focus: finding a way to transplant pancreatic islet cells into diabetics. At the time, this idea was daring—isolating fragile insulin-producing cells and getting them to function in a new body was uncharted territory.
Rajotte’s early experiments involved perfecting techniques to isolate and preserve islet cells, even employing cryopreservation methods (freezing cells for later use).
By 1981, he and colleague Dr. Garth Warnock had successfully isolated pure islets from dog pancreases, proving it was possible to extract these cells intact. To translate these advances into a cure, Rajotte founded the Islet Transplantation Group at the University of Alberta in 1982, assembling a team of surgeons, immunologists and scientists dedicated to islet research.
A successful Edmonton businessperson, Donald Oborowsky was a founding member of the local chapter of the Juvenile Diabetes Research Foundation. That early initiative evolved into the Alberta Foundation for Diabetes Research, which would later become the Alberta Diabetes Foundation (ADF).
Throughout the late 1980s and ’90s, the foundation helped fund much of Rajotte’s work in islet isolation and transplantation, paving the way for the medical advances that would change the future of diabetes care.
Before the international recognition, Dr. Ray Rajotte was a young researcher driven by scientific curiosity
1989: First Islet Transplant – A Glimmer of Hope
After years of refining their techniques in the lab, Rajotte’s team achieved a milestone in 1989: they performed Canada’s first transplant of human islet cells into a person with type 1 diabetes.
The islets, infused into the patient’s liver, successfully engrafted and began producing insulin. One patient remained insulin-independent for over two years – a dramatic proof-of-concept that islet transplantation could work.
However, across patients, the procedure’s success rate was only about 8%, and even those who initially went off insulin eventually had to resume injections as the transplanted islets gradually failed. Moreover, powerful anti-rejection drugs were needed, some of which ironically harmed the islets.
Still, 1989 offered a glimmer of hope: it showed that a life without daily insulin injections was not just a fantasy. It motivated Rajotte and his colleagues to push harder, knowing that if they could solve the remaining obstacles, they might truly change the lives of millions with diabetes.
These early years established the scientific foundation – and the community of problem-solvers – that would make the Edmonton Protocol possible.
Photo: Members of the Clinical Islet Transplant Program team. Clockwise from top left: Greg Korbutt, Eddie Ryan, James Shapiro, Ray Rajotte and Jonathan Lakey. - Photo by Richard Siemens
1990s: The Team Behind the Breakthrough
Throughout the 1990s, the Edmonton islet program grew into a multidisciplinary powerhouse. Dr. Rajotte actively recruited talented researchers to Edmonton, expanding the team’s expertise. Notably, Dr. James Shapiro arrived from the UK in 1998 to train under Dr. Norm Kneteman and Rajotte.
Shapiro – a transplant surgeon by training – brought fresh insights into the clinical side of islet transplantation. Working with Rajotte, Dr. Jonathan Lakey (an islet isolation expert), and others, the team zeroed in on a crucial issue: the anti-rejection drug regimen. They discovered that the steroid-based drugs traditionally used to prevent organ rejection were toxic to islet cells, undermining transplant success.
In response, the group explored a new combination of immunosuppressants that eliminated steroids entirely. They also upped the quantity of islets transplanted, using about 11,000 islets per kilogram of the patient’s body weight to ensure a sufficient mass of cells.
By the end of the decade, these refinements dramatically improved outcomes in their experimental protocols. The pieces were in place for a breakthrough: a robust islet isolation method, a healthier anti-rejection drug cocktail, and a team with the right mix of skills.
Dr. James Shapiro, the surgeon who would lead the clinical team that developed and perfected the world-renowned Edmonton Protocol
2000: The Edmonton Protocol Makes History
In the year 2000, the Edmonton research team turned their years of work into a world-changing result. In a clinical trial led by Dr. James Shapiro (with Dr. Rajotte and colleagues), they treated seven patients with type 1 diabetes using their refined islet transplant procedure.
The outcome was unprecedented – all patients became insulin-independent, free from injections, and stayed that way for at least one year. This approach, quickly dubbed the “Edmonton Protocol,” was published in the New England Journal of Medicine and grabbed international attention.
By eliminating corticosteroids and optimizing the transplant technique, the Edmonton Protocol boosted one-year success rates from a dismal 8% in earlier trials to virtually 100%.
The Islet Transplantation Team that went on to create the Edmonton Protocol. Top, from left: Greg Korbutt, Ray Rajotte, Norm Kneteman, Eddie Ryan; bottom, from left: Jonathan Lakey, James Shapiro, Garth Warnock
Media around the globe reported on the “Edmonton miracle,” and people with diabetes and their families suddenly had new hope. Importantly, beyond freeing patients from insulin shots, the Protocol also improved long-term health – recipients avoided the severe complications of diabetes during the years their grafts functioned.
Almost overnight, Edmonton became the epicenter of diabetes research, as clinics worldwide raced to adopt the Protocol. In fact, by 2001–2006, over 550 patients in some 50 centers internationally had received islet transplants following the Edmonton method.
This achievement was more than a medical breakthrough; it was proof that curing diabetes was not science fiction. And it underscored the value of research funding and collaboration
2002: Birth of the Alberta Diabetes Foundation
In 2002, the Alberta Foundation for Diabetes Research made a bold move. It committed $10 million toward building a dedicated diabetes research facility at the University of Alberta and, in the process, renamed itself the Alberta Diabetes Foundation (ADF). In essence, the foundation was reborn after the Edmonton Protocol breakthrough, with a strengthened mission to ensure that this was “just the beginning” and that future breakthroughs would follow. The newly christened ADF became a driving force for raising funds and awareness, uniting donors, patients, and researchers under a common goal: to cure diabetes.
2007: A World-Class Home for Diabetes Research
The vision that ADF and the University of Alberta shared in the early 2000s came to fruition in 2007. That year saw the grand opening of the Li Ka Shing Centre for Health Research Innovation, a state-of-the-art research facility on campus – and the new home of the Alberta Diabetes Institute (ADI).
The Alberta Diabetes Foundation played a pivotal role in making this happen: ADF spearheaded a capital campaign to help fund the centre’s construction, recognizing that world-class science needs world-class infrastructure. Inside the gleaming new building, researchers gained access to cutting-edge laboratories and clinical research space, all dedicated to advancing diabetes knowledge. The Alberta Diabetes Institute became a hub where experts in immunology, cell biology, nutrition, and endocrinology could collaborate under one roof.
For ADF, this was a proud moment: the foundation’s fundraising leadership helped establish a world-class institute in Edmonton, cementing the city’s reputation as a global leader in diabetes research.
University leaders recognized ADF’s critical contribution by committing space for the foundation’s offices in the planned research center.
From Breakthrough to Global Impact: Continuing the Legacy Toward a Cure
Hundreds of patients have received islet transplants thanks to the protocol, and Edmonton’s contribution is routinely cited as the “gold standard” for this procedure. At the University of Alberta, Dr. Ray Rajotte continued to mentor and inspire the next generation of scientists, even serving as ADI’s first Scientific Director and later staying involved as a professor emeritus and ADF board member.
In 2024, to recognize a lifetime of vision, innovation, and service to the diabetes community, the Alberta Diabetes Foundation honoured Dr. Ray Rajotte with its highest distinction at the Hummingbird Awards Gala: the inaugural Dr. Raymond Rajotte Lifetime Achievement Award.
The award now bears his name and is presented to an individual who has devoted many years—often a lifetime—to improving the lives of those affected by diabetes. It stands as a permanent tribute to Dr. Rajotte’s pioneering spirit and his enduring impact on the field.
Throughout the years, the Alberta Diabetes Foundation continued to rapidly fund research in both type 1 and type 2 diabetes, targeting projects that could overcome the remaining challenges.
From immune tolerance studies to prevention of type 1 diabetes, and even technology like artificial pancreas development, ADF sought out high-impact research and provided grants to keep that work moving. The foundation’s flexible funding approach (support for early-stage ideas) meant that promising young researchers and innovative concepts in Alberta got a chance to prove themselves
Reflecting on how far we’ve come, it’s clear that the Edmonton Protocol was not just a one-time triumph, but the start of a journey. It sparked the creation of the Alberta Diabetes Foundation, which in turn has ensured that the momentum toward a cure continues to build. What began as Dr. Rajotte’s bold experiment has grown into a global movement
Today, the foundation carries on that legacy of hope and perseverance.
Researchers, clinicians, and donors are all working together, inspired by the Edmonton Protocol’s success, to achieve the ultimate goal: a world where diabetes is cured for everyone.
Whether it’s fundraising, volunteering, or donating—there’s a way for you to make a difference.
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We gratefully acknowledge the University of Alberta and NAIT for their detailed reporting and archival materials, which helped us respectfully share the history and impact of the Edmonton Protocol.
Alberta Diabetes Institute – Our History Timeline (University of Alberta) ualberta.caualberta.ca
TechLife Today (NAIT) – “The NAIT grad who brought the world closer to a cure for diabetes” (Story of Dr. Ray Rajotte, 2023)
University of Alberta News – Edmonton Protocol 10th Anniversary ualberta.ca and 25th Anniversary Reflections