Diabetes is a stealthy (often invisible) disease that, together with prediabetes, now affects about more than 30 per cent of Canadians.
Upon diagnosis, the burden of diabetes may seem limited to the difficult reality of managing blood glucose (sugar) with various self-management techniques, including medication, careful attention to diet and exercise, and constant vigilance, but its longer-term impact can be devastating: It is the leading cause of vision loss and kidney disease, as well as one of the leading causes of heart disease, stroke, amputations and depression.
In order to help prevent complications by ensuring that people with diabetes get the support they need, the Canadian Diabetes Association’s (CDA’s) new Diabetes Charter for Canada confirms their rights and responsibilities, along with those of governments, service providers, employers, schools, preschools and daycares.
Introduced by the CDA this year, the Charter “provides a set of standards that allow people with diabetes to optimally self-manage and live their lives to their full potential, with dignity and respect,” says Aileen Leo, executive director of government relations and public affairs, CDA.
Having diabetes is a 24-hour, seven-day-a-week job, she points out. “If people living with diabetes are very lucky and very good at self-management, it’s possible to delay complications. But we need support – we need access to education and information, as well as diabetes medications, devices and supplies.”
As most provincial health-care systems don’t cover the costs of medications except for protected groups such as seniors, “if you’re low income, even if you’re middle income, the costs of diabetes medications, devices and supplies may be beyond your reach,” Ms. Leo explains. “I’ve been to many advocate-training days where people have talked about ending up in the hospital because they simply couldn’t afford their medication.”
“When you come right down to it, if you can’t afford healthy food choices, or if you don’t have a health plan that helps to pay for medications, devices and supplies, diabetes is very difficult to manage,” says Rob Beck. The CDA chair of the National Advocacy Council, Mr. Beck was diagnosed with type 2 diabetes about 10 years ago. “I’m very fortunate – my benefit plan pays for 90 per cent of my medications. Yet the last time I refilled my insulins and test strips, my copay was $85.”
Mr. Beck says that he meets many people from Nova Scotia communities with “a very high incidence of diabetes and very low incomes. They have limited access to education, healthy foods, medications and medical advice.”
The Charter is about achieving equal access for them and all of the more than nine million Canadians living with diabetes or prediabetes, he stresses. “We’re not demanding this just for us
– we’re saying that if you want to keep your health-care system intact for everyone who needs it, you have to manage diabetes.”
Emily Johnson, a nurse and diabetes educator who was diag- nosed with type 1 diabetes in her forties, is also a member of the CDA National Advocacy Council. The Charter recognizes that people with diabetes have unique needs because of their diabetes, she says. When the daughter of one of her colleagues wasn’t allowed to keep her diabetes supplies with her in her classroom – a common occurrence as well as a risk for the student involved – the colleague brought the Charter to the school, which then changed its policy.
There is no easy fix for diabetes, Ms. Johnson adds. “But it’s doable – I describe it as a new norm in my life. I tell all my clients about the Charter, and I hope it will encourage them to speak up and advocate for themselves.”
The Charter also addresses inequality of access to care across the country. In Saskatchewan, for example, some diabetes management supplies such as test strips and lancets are publicly covered for anyone who is living with diabetes. “To me, that makes absolute sense, because the key to leading a healthy life with this insidious, chronic, progressive disease is to manage it properly from the onset,” says Phil Bobawsky.
Regrettably, Mr. Bobawsky lives in the province next door, where public coverage for supplies is more limited than in Saskatchewan. As the CDA regional chair for Southern Alberta, he says he hears “all too often” from people diagnosed with diabetes who can’t get the support they need.
The cost of an insulin pump is $7,000, he says. While some may be quick to say there simply isn’t funding available to cover these costs, health-care systems inevitably end up paying much more for hospital visits and treatment of complications, he adds. An insulin pump program was introduced in Alberta in 2013.
Mr. Bobawsky knows too well the cost of less-than-optimal management of diabetes. Diagnosed with type 2 diabetes 17 years ago, he has since lost his sight and his kidney function.
“We have to make management of the disease attainable for everyone. And we have to educate everyone on how to manage the disease. Because if we do that successfully, there won’t be as many complications,” he stresses.
Launched on April 7, the Charter has already been signed by more than more than 17,000 Canadians.
“We’re going to work together to ensure that the Charter is a tangible, robust advocacy tool to make the lives of people with diabetes in Canada better – in two years, five years, 10 years and 20 years,” says Ms. Leo.
If you are over the age of 40, the Canadian Diabetes Association (CDA) recommends you get checked every three years, and more frequently if you have any of these risk factors:
- A parent or sibling with diabetes
- Are a member of an ethnic group at high risk for type 2 diabetes (African, Hispanic, Asian, South Asian and Aboriginal)
- Are overweight
- Have high blood pressure or high cholesterol
- Have been diagnosed with prediabetes
- Have polycystic ovary syndrome
To find out your risk of type 2 diabetes, the Don’t Be Risky campaign asks you to take the Canadian Diabetes Risk (CANRISK) test at www.DontBeRisky.ca and tell your friends and loved ones about it, so they can take it, too.
When you take the Canadian Diabetes Risk (CANRISK) test as part of the CDA’s Don’t Be Risky campaign, Novo Nordisk Canada will donate $1 for every CANRISK test completed through the contest. You also have the opportunity to be entered into a contest to win one of three Money for Life experiences – including a grand prize worth $5,000 and/ or one of two grand prizes worth $2,500 – from Sun Life Financial.
For more details and to enter, visit www.DontBeRisky.ca.