Corporate PresentationFebruary 2019

Nasdaq: DMAC

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This presentation contains forward-looking statements, which reflect the Company's current expectation

regarding future events. These forward-looking statements involve risks and uncertainties that may cause actual

results, events, or developments to be materially different from any future results, events, or developments

expressed or implied by such forward-looking statements. Such factors include, but are not limited to, changing

market conditions, the successful and timely completion of clinical studies, the establishment of corporate

alliances, the impact of competitive products and pricing, new product development, uncertainties related to

the regulatory approval process or the ability to obtain drug product in sufficient quantity or at standards

acceptable to health regulatory authorities to complete clinical trial or to meet commercial demand and other

risks detailed from time to time in the Company's ongoing periodic, quarterly and annual reports filed with the

US SEC. Certain of the assumptions made in preparing forward-looking statements include but are not limited to

the following: that DM199 and other programs will generate positive efficacy and safety data in current and

future clinical trials; and that DiaMedica will complete clinical trials within the timelines communicated. Except

as required by applicable securities laws, we undertake no obligation to publicly update or revise any forward-

looking statements, whether as a result of existing or new information, future events, or otherwise.

FORWARD LOOKING STATEMENT

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STROKE & KIDNEY TREATMENT OPTIONS

KLK1 IS A NATURALPROTEIN

URINE AND PORCINE KLK1 USED IN ASIA

DM199: THE 1RST

SYNTHETIC KLK1

DIAMEDICA THERAPEUTICS - OVERVIEW

Millions of patients successfully treated in Japan and China for kidney diseases, stroke, hypertension and retinopathy with KLK1 derived from human urine & porcine (pig) pancreas

Demonstrated DM199 BIOEQUIVALENCE to crude forms of KLK1

Licensed to ‘s neurology subsidiary in China for acute ischemic stroke

KLK1 protein is naturally produced by the bodyLow KLK1 levels is associated with stroke and kidney disease

Clinical stage biotechnology company targeting kidney and stroke markets

Crude forms of KLK1 protein effective in treating patients in Japan & China DM199 is a synthetic form - produced more reliably and economicallyHuman clinical trials of DM199 have shown bioequivalence, superior PK and excellent safety

THE DE-RISKEDDEVELOPMENTPATH

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Developing Treatments for Patients with Limited or No Treatment Options

DM199 CLINICAL DEVELOPMENT

Acute Ischemic Stroke (AIS)

Chronic Kidney Diseases (CKD)

PRE-CLINICAL PHASE I PHASE II PHASE IIIINDICATION

DM199

China Market

PARTNERSHIP

1

2019

1 DM199 licensed to Ahon Pharma, Fosun Pharma subsidiary, for AIS in China

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PRODUCT DM199 KALLIDINOGENASE KAILIKANG®

Company& others

Source Synthetic KLK1 Human Urinary KLK1

Indications Acute ischemic stroke & chronic kidney disease

Chronic kidney disease, retinopathy & hypertension Acute ischemic stroke

Markets Worldwide Japan, China & Korea China

Treated patients Clinical stage Millions patients treated2 500,000+ patients treated2

DM199: FIRST SYNTHETIC KLK1 PROTEIN

2 Estimated using IQVIA, Transl. Stroke Res., March 6 2017 and DiaMedica analysis

SYNTHETIC ADVANTAGES

REDUCE RISK PROFILE OF ENDOTOXINS & IMPURITIES

IMPROVE EFFICACYWITH OPTIMIZED DRUG LEVELS & DOSING & CONVIENCE OF SUBCUTANOUS (SC) DELIVERY

REGULATIONWORLDWIDE USE

1 Shanghai Pharma acquired controlling ownership of

Techpool, May 23 2018 at USD$550M valuation

Porcine KLK1

1

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“Exogenous pancreatic kallikrein (KLK1) both prevented and

ameliorated diabetic nephropathy”

- Dr. Robert Stanton, Harvard, Kidney International

“Evidence has highlighted the importance of the Kallikrein-Kinin

System as a protective system against oxidative stress and organ damage in the heart and kidney. Activation of KKS is likely to be beneficial in… cardiovascular diseases and chronic kidney

disease”

- Dr. Oliver Smithies, Nobel Prize Winner, University of North

Carolina, School of Medicine

“Kallikrein (KLK1) protects against ischemic stroke by inhibiting

apoptosis [cell death] and inflammation and promoting

angiogenesis and neurogenesis”

- Dr. Julie Chao, Medical University of South Carolina

100+ Papers Published Including Top US Institutions on Importance of KLK1 Treatment

“ “ “KLK1 IN SCIENTIFIC LITERATURE

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DM199 (KLK1): INCREASING BLOOD FLOW IN BRAIN & KIDNEYS

Capillary (small) Blood Vessel

DM199

KLK1

DM199 to restore KLK1 levels and release NO & PGI2 to where and when needed§ Improves blood flow (regulates)§ Reduces inflammation, fibrosis and oxidative stress§ Improves insulin sensitivity§ Regulates neurogenesis

Promoting Cardiovascular Homeostasis (“Stability”)

§ KLK1 plays critical role in cardiovascular, renal and neuro physiology§ Deficits in KLK1, NO & PGI2 linked to kidney diseases & stroke

Nitric Oxide (NO) & Prostacyclin (PGI2)

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DM199 Boosts KLK1 Levels to Release Physiological Levels of BK When and Where Needed,Generating Beneficial Nitric Oxide, Prostacyclin and Related

DM199 MECHANISM OF ACTION

ACEi block normal breakdown of BK,

• Low KLK1 ➜ Low BK• ACEi ➜ limited efficacy

& side effects

Tissue Kallikrein (KLK1)

Low molecular weight kininogen

Bradykinin (BK)

NITRIC OXIDE & PROSTACYCLIN

- Improves blood flow (regulates)- Reduces inflammation, fibrosis and oxidative stress- Improves insulin sensitivity- Regulates neurogenesis

↓ VEGF

↑ TREGS

ANTI-INFLAMMATION

RETINOPATHY

BK2Receptors

BK1Receptors

Plasma Kallikrein (PK)

High molecular weight kininogen

Bradykinin (BK)

Extremely High Bradykinin (BK) Levels

Firazyre*

Kalbitor*

AngioedemaRetinopathy

DM199RECOMBINANT KLK1

ACEi

ARB

ACE

ATI

ATII

AT1 & AT2 Receptors

Aldosterone K, Na Hyperkalemia

Kininases(Inactivate BK)

Cleaves VEGF in eyes

Suppresses autoimmune

response

BK2Receptors

BK1Receptors

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§ Well-tolerated in five clinical studies with 120+ subjects§ Treatment-dependent stabilization of blood pressure§ Dose limiting tolerability was orthostatic hypotension at 50 µg/kg

(10-20x higher than expected treatment levels)

DM199 15/25 µg/kg vs. placeboDM199 3 µg/kg vs. placebo

Syst

olic

blo

od p

ress

ure

chan

ge -

mm

/hg

Syst

olic

blo

od p

ress

ure

chan

ge -

mm

/hg

Time (hours) Time (hours)

* p < 0.01* p < 0.01

PlaceboDM199

PlaceboDM199

DM199 STUDIES SHOWS EXPECTED PHYSIOLOGICAL & THERAPEUTIC ACTIVITY

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~30M Chronic Kidney

Disease Patients in the

U.S. Alone

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Chronic Kidney Disease (CKD)

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CHRONIC KIDNEY DISEASE (CKD)

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§ CKD is the progressive loss of kidney function leading to dialysis, transplantation and ultimately death

§ Current standard of care – managing blood pressureØ ACEi (i.e. Ramipril) and ARB (i.e. Valsartan, Losartan)

§ Less than 30% patients on required dose due to adverse side effect risks

§ KLK1 (DM199) treatment option to improve kidney function:Ø Regulate blood flow, reduce inflammation, reduce damage to small blood vessels to

prevent structural damageØ KLK1 (porcine) approved in Japan and China to treat CKD & retinopathy

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LOW KLK1 LEVELS ASSOCIATED WITH KIDNEY DISEASE

1 Immunopharmacology 44 1999. 183–192

Lower KLK1 Levels Found in Patients with Kidney Disease

KIDNEY DISEASE

KLK1 LEVELS

High

LowNormal SevereMild

Severe Kidney Disease,Lower KLK1 Levels1

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KLK1 (PORCINE) USED TO TREAT KIDNEY DISEASE IN ASIA

Human published trials in 20+ papers demonstrating KLK1 efficacy & mechanism

1 Hainan Medical Journal, 2014-012 Chin J Diabetes, August 2011, Vol 19, No 8

“Kallidinogenase [KLK1] has Significant Curative Effect in the Treatment of Diabetic Nephropathy” - meta analysis1

0

50

100

150

Baseline 6 MonthsUrin

ary

Albu

min

Exc

retio

n (U

AER

) Rat

e (m

g/24

h)

at

6 m

onth

s

Upper limit of normal kidney function

PlaceboARB KLK1+ARB

KLK1 (porcine) + ARB over 6 Months Reduced UAER by 84% and Restored Kidney Function in 90 Patient CKD Study2

*

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Phase II, multi-center, US, Randomized, Single Dose§ Rare disease focused § 30 patients per rare disease (targeting multiple diseases) § Patients to act as their own control

Study endpoints at week 12:§ Safety, Tolerability of KLK1 and DM199 Levels§ PK levels of KLK1 and DM199 § Change in KLK1 levels based on dose § Albumin to creatinine ratio, eGFR, BP & Glucose

DM199 dose 1 (dosed 1 or 2 times week depending on Phase Ib results)

Day 1 Week 12

DM199 dose 2 (option depending on Phase Ib results)

Targeting Multiple Rare Chronic Kidney Diseases

DM199 dose 1 - (2 cohorts)

Day 1 Day 12

Phase Ib, Multi-Center US, Randomized, multi Dose § 32 CKD patients (Cohort 1 N=24, Cohort 2 N=8) § 3 dose levels§ 4 Cohorts (3 moderate & 1 severe CKD patients)

Study endpoints over 12 days:§ Safety, Tolerability of KLK1 and DM199 levels§ PK levels of KLKI and DM199§ Change in KLK1 levels based on dose§ Albumin to creatinine ratio, Kidney Biomarkers, BP & others

DM199 dose 2 – (1 cohort)

DM199 dose 3 – (1 cohort)

EndpointEndpoint

Phase Ib to select dose for phase II

DM199 PHASE IB & II CKD STUDY DESIGN

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>15M Strokes Per Year

Worldwide

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Stroke is a Devastating Condition in Great Need of Treatment Options

Acute Ischemic Stroke (AIS)

§ Blockage of blood flow in brainØ ~87% of all stroke cases are AIS

Ø 2nd leading cause of death in developed countries

Ø Affects 1 in 6 people in their lifetime

Ø Average age of first stroke 65 years(Risk doubles each decade after 55)

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SIGNIFICANT UNMET NEED IN STROKE

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1 tPA (Tissue Plasminogen Activator)

tPA1

(Activase®)

ONSET

3 – 4.5 hours

24 HOURS

Most stroke patients should reach hospital by 24 hours

MechanicalThrombectomy

DM199

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Less than 10% of stroke patients treated

up to 24 hours

Stroke Treatment Window

Recent extension limited to specific types of patients6+ hours

DM199 has Potential to Provide Treatment Option for Almost all Stroke Patients

Potential frontlinetherapy if DM199 proven

safe in hemorrhagic stroke patients

ACUTE ISCHEMIC STROKE (AIS)

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Lower KLK1 Levels are Independently Associated With First Time Stroke and Predictor of Recurrent Stroke1

Study of 2,000+ Stroke Patients and Event Free Survival Over 5 YearsRed line represents patients in lowest KLK1 quartile who are at highest risk of stroke

1 Annals of Neurology (2011) 70:265-73, Five year Event Free Survival by quartile, Kaplan-Meier Survival Curves.

LOW KLK1 LEVELS ASSOCIATED WITH STROKE PATIENTS

Quartiles:

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KLK1 (Urinary) Reduces Neurological Impairment After Acute Ischemic Stroke and Improves Long-Term Outcomes - 2,433 patient meta analysis4

Human trials published in 50+ papers, covering 4,000+ stroke patients, demonstrate KLK1 efficacy

on standard stroke scores, blood flow, inflammation and other measurements5

25

50

75

Baseline 3 Months

Bart

hel I

ndex

(BI)

at 3

mon

ths3

PlaceboKLK1

*

1 Chin J Neurol, May 2007, Vol 40, No 52 IMS Health and Transl. Stroke Res. March 06 20173 Measure of activities of daily living4Journal of Evidence-Based Medicine (2012) 5: 31-39 5 Modified Rankin Scale, Barthel Index, NIHSS, inflammation (CRP), MMP9, Aβ levels and others

KLK1 (Urinary) Phase III in 446 Patients Treatment Initiated Within 48 hours of Stroke Significantly Improved Post Stroke Function Compared to Placebo1

KLK1 (URINARY) STROKE USE IN ASIA

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DM199 REPLENISHES KLK1 LEVELS

DM199 Dose Level Identified for Stroke Patients

Normal humanKLK1 range

Pharmacokinetic Profile (Drug Levels in Blood) In Subjects Dosed Every 3 Days

KLK1 levels (ng / mL)

DM199 SC maintains target KLK1 levels better than approved Kailikang® (urinary KLK1) Potential to substantially improve efficacy, safety and tolerability

Days

Last Dose

First Dose

Target range for stroke patients

0 7 14 21 28

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Study endpoints at 90 days:• Safety, KLK1 levels

• Stroke function - Modified Rankin

score, Barthel Index and NIHSS

• Biomarkers - inflammation, MMP-9

and others

DM199 IV

administration

≤24 hours from

symptom onset

DM199 IV, followed by SC

Placebo

Randomization 1:1

Double blinded

DM199 subcutaneous (SC) admin.

Day 1 & every 3rd day over 21 days

Day 22 Day 90

Endpoint

Phase II – first dose IV within 24 hours of stroke followed by 21-days SC treatment§ Up to 100 patients

§ Mild-moderate stoke severity (NIHSS score >6) at treatment

§ Endpoints - standard stroke endpoints and anticipate same protocol design for phase III

24 hours

Dosing complete

DM199 REMEDY TRIAL: PHASE 2 ACUTE ISCHEMIC STROKE STUDY

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§ Issued composition of matter (2033) and delivery (2033) patents

§ Worldwide dose, route of delivery, formulation & indication patent pending (2038)

§ 12 years biologics exclusivity in US, 10 years in EU

§ Manufacturing know-how expertise and trade secrets (5+ companies unsuccessfully attempted a synthetic KLK1)

Patents & Trade Secrets

§ Exclusivity with manufacturer on patented expression system

§ Proprietary cell line, expression system, composition & know-how

License Agreement

Manufacturing Exclusivity

§ DM199 for acute ischemic stroke in China with Fosun Pharma’s neuro subsidiary Ahon Pharma

§ Terms§ $32+ million upfront and milestone payments§ Sales based royalties § Excludes other indications

§ DiaMedica retains control of technology, manufacturing process & cell line

At least five other Companies have been unsuccessful developing synthetic KLK1

MULTI-LAYERED IP POSITION & FOSUN PHARMA LICENSE AGREEMENT

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BOARD

RICK PAULS, MBA

PRESIDENT & CEO

Former venture capitalist with two early stage funds, including co-founder & Managing Director of life sciences venture capital fund

TODD VERDOORN, PHD

CHIEF SCIENTIFIC OFFICER

28+ years experience with several neurological companies including Fidelity Biosciences, and with Bristol Myer Squibb’s stroke group

LEADERSHIPSCOTT KELLEN, CPA (INACTIVE)

CFO & VP FINANCE

25+ years in life sciences industry. Held senior leadership roles including CFO and COO for several private and pubic (Nasdaq) companies

RICHARD PILNIK, MBA

CHAIRMAN

Former VP & Chief Marketing Officer at Eli Lilly, former President, Innovex (a Quintiles Company). Former board member of Elan Pharma & Chiltern (acquired)

MICHAEL GIUFFRE, MD, MBA

DIRECTOR

Clinical Professor of Cardiac Sciences at University of Calgary, BOD FoodChek Inc, BOD Canadian Medical Association; BOD SCS Inc.

RICK PAULS, MBA

PRESIDENT & CEO

Former venture capitalist with two early stage funds, including co-founder & Managing Director of life sciences venture capital fund

ZHENYU XIAO, PHD

DIRECTOR

Managing Director of Hermed Capital, previously Associate General Manager of Fosun Pharmaceutical - deputy chief of Fosun Pharmaceutical IPO

JAMES PARSONS, CPA-CA

DIRECTOR

CFO at Trillium, a Nasdaq listed biotech company. Has been CFO of life sciences companies for last 15 years

PAUL PAPI

VP BUSINESS DEVELOPMENT

38+ years life sciences experience, 28 years Mylan, 10 years investment banking, business dev., capital markets & M&A transactions

HARRY ALCORN JR., PHARM.D

CHIEF MEDICAL OFFICER

30+ years biopharma experience. Principle Investigator of over 150 clinical studies, mainly kidney disease. Former Chief Scientific Officer at DaVita

PHILIP BATH, MD, DSC

Chair and head of clinical neuroscience, University of Nottingham

PAOLO MADEDDU, MD

Chair of experimental cardiovascular medicine, University of Bristol

JOHN VOLPI, MD

Co-director of the Eddy Scurlock Stroke Center, Houston Methodist

BRUCE CAMPBELL, MD

Head of Hyperacute Stroke in the Department of Neurology, Royal Melbourne Hospital

SCIENTIFIC ADVISORS/COLLABORATORSROBERT STANTON, MD

Chief of Kidney and Hypertension and principal investigator of vascular cell biology at Joslin Diabetes Center, Harvard Medical School

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Highly Experienced Leadership Team

DM199 licensed in China for Stroke

DM199 De-Risked Product Profile

Crude form of KLK1 approved and used in Asia

Significant markets with large unmet needs

Nasdaq: DMAC