Awareness, access key to managing and preventing complications

Amber Mitchell was diagnosed with type 1 diabetes at the age of 12, and for many years she was the only person in her school with the disease. Diabetes was still uncommon in the small Manitoba town in which she was raised, and she estimates that there weren’t more than a handful of people with diabetes in the entire region.

“It can be very isolating,” she says. “There is so much stigma and judgment out there – people don’t really understand what it’s like.” While it is tough for every child to make the transition into adulthood, Ms. Mitchell says it was a lot harder being surrounded by well-meaning but unin- formed people who said things like, “You shouldn’t be eating that!” when they saw her sharing a treat with a friend.

“It just made me feel really alone,” says Ms. Mitchell.

As a result, she rebelled and didn’t take great care of herself, she says, until she had a wakeup call at age 24 after a small scrape on her foot became infected during a whitewater rafting trip. With the nerve and circulatory complications of diabetes, exposing her feet to icy water left her with a dangerous infection that her doctor warned could lead to septicemia – a serious, life-threatening infection – and even a foot amputation without proper care.

Today, Ms. Mitchell is far from alone: the Canadian Diabetes Association (CDA) estimates more than nine million Canadians live with diabetes (type 1 and type 2 diabetes) or prediabetes. But while the disease has reached epidemic proportions, the lack of awareness and understanding Ms. Mitchell experienced growing up continues to be a significant challenge.

Both type 1 diabetes (an auto-immune disease often, but not always, diagnosed in childhood) and type 2 diabetes (a disease that is usually, but not always, diagnosed in adulthood and is influenced by genetic, environmental and lifestyle factors) are serious diseases. But because people die from the complications of the disease rather than the disease itself, it isn’t taken as seriously as it should be, says Dr. Jan Hux, chief science officer at the CDA.

“Canadians need to know that diabetes is serious, it’s important, and it’s manageable,” she stresses.

“It is a leading cause of heart attack, but when somebody has a heart attack they don’t think of it as having a diabetes attack, even though it is a direct consequence of their diabetes. When their kidneys fail because of diabetes – they’re having kidney failure,” Dr. Hux explains.

At the same time, she says, “diabetes is manageable. The treatments available now have dramatically improved the outlook for people with diabetes, in respect to their risk of complications.”

A study published in 2013 in The New England Journal of Medicine showed that for people with diabetes, the risk of having a heart attack fell by two-thirds between 1990 and 2010. During the same period, the risk of stroke and amputation fell by half, and the risk of kidney failure by almost a third. Decades of research have resulted in “better and better treatments leading to better outcomes,” says Dr. Hux.

The risk of complications could be reduced much further if all Canadians had equal access to the medications and care supplies they require. “Medication, taken regularly and appropriately, is a cornerstone of treating this disease,” she notes.

A survey conducted by the CDA found that 57 per cent of people with diabetes report that they can’t afford their prescribed treatment due to a high out-of- pocket cost. Depending on where they live and what supports they use (medications, devices such as insulin pumps, etc.), individuals with diabetes can pay anywhere from zero up to almost $7,000 per year out of their pocket. Almost all Canadians live with catastrophic drug costs, defined as over three per cent of their average annual income, or more than $1,500. These costs are especially prohibitive for low- income Canadians.

“Essential resources are not equally available to all Canadians,” says Dr. Hux. “In particular, a vulnerable group that is of great concern to us are those people who are not covered by either private or public drug benefit coverage.”

For people over 65, those who are disabled or unemployed and qualify for social assistance, and those who are employed by a company that provides a drug benefit plan, drug and care supply costs are covered to some degree. But for the many who fall between the cracks, the medication and support that enables them to manage their disease is simply out of reach.

“It’s penny-wise and pound-foolish,” says Dr. Hux. “The downstream consequences are the increased burden of complications – and those complications account for about 80 per cent of the costs associated with the disease.” 

“Canadians need to know that diabetes is serious, it’s important, and it’s manageable.”
Dr. Jan Hux
is the chief science officer at the Canadian Diabetes Association
> DID YOU KNOW?

If you have any signs or symptoms of diabetes, you should contact your health- care provider right away and get yourself checked. “Getting your blood glucose checked gives you a benchmark, so you can take steps to either reduce your risk or manage your diabetes,” says Dr. Jan Hux, chief science officer of the Canadian Diabetes Association.

To learn more about diabetes, visit www.diabetes.ca or call 1-800-BANTING (226-8464).


> PLEASE DONATE
“I always say to people, “You might not think it’s reaching anybody, but even when you make even a small donation it’s for the future, and for the people living with diabetes. Every dollar that we give to the Canadian Diabetes Association is making a difference in people’s lives in more ways than we may ever understand.”
– Bibianna King

To learn more about Bibianna King, who organizes an annual run with Team Diabetes each June in La Loche, Saskatchewan, to raise funds for the Canadian Diabetes Association, read Bibianna's story. To learn more about the different ways you can donate to the CDA, visit www.diabetes.ca/donate.

Bibianna King organizes an annual run with Team Diabetes each June in La Loche, Saskatchewan, to raise funds for the Canadian Diabetes Association 

Bibianna King organizes an annual run with Team Diabetes each June in La Loche, Saskatchewan, to raise funds for the Canadian Diabetes Association 


Clothesline supports people living with diabetes, reduces waste

The Canadian Diabetes Association’s (CDA’s) Clothesline program is performing “double duty” on the University of Victoria campus.

It is helping the CDA raise funds for diabetes research, advocacy, education and programs, while supporting the university’s goal to increase its landfill diversion rate to 75 per cent.

“Our vision is to be a zero-waste institution, and we are always looking for opportunities to keep more waste away from landfill,” says Nadia Ariff, the university’s coordinator of waste reduction. “I noticed that on residence move-out day every spring, a lot of clothing was being thrown out and I wanted to change that – but we didn’t have the resources to sort through it all.”

After spotting a red Clothesline donation box in her neighbourhood, Ms. Ariff connected with the CDA and learned that the program would provide, maintain and empty the boxes free of charge.

“It was a brilliant solution for our challenge. In 2010, two clothing bins were installed in the family housing complex and two at the regular student residences. We’ve promoted it widely and usage is increasing every year,” she says.

The amount of donated clothing doubled between 2012 and 2014. In April 2014 alone, 2,400 kilograms of clothing were collected from the four drop boxes. “We’re supporting a good cause and achieving our sustainability goals – a great win for both partners,” Ms. Ariff says.

Clothesline is a CDA success story across Canada. Since its launch in 1985, the program has steadily expanded and now has 30 offices from British Columbia to Newfoundland and Labrador (with the exception of Quebec), as well as 2,570 red clothing donation boxes in Canadian communities.

The program collects more than 46 million kilograms of clothing, household and electronic items each year, with the proceeds directly supporting the CDA’s many activities to advance diabetes treatment and management. The CDA also recognizes the environmental benefits – noting that annually, Clothesline saves 840 million kilowatt hours of energy and reduces donors’ carbon footprint by 115 million kilograms of CO2 emissions.

The clothing boxes are just one of the methods for collecting donations. People can also call the toll-free Clothesline number (1-800-505-5525) or go online (www.diabetes.ca/clothesline) to schedule a free pickup of clothing and household items at their home.

Jennifer Shaw of Goderich, Ont., has certainly been a devoted supporter of Clothesline home pickup; she has donated to the program 80 times since 2003.

“It started for me as a way to contribute to the fight against a serious disease that is becoming more prevalent – while also handling all the clothing, shoes and toys that my four children were quickly outgrowing over the years,” she says.

It worked out so well that Ms. Shaw began to make Clothesline a regular part of her household management routine.

“As soon as they collect my donation, I call the toll-free line to get the next pickup date in my area and start filling my next box for pickup. The CDA has made it so convenient to donate – with just a phone call and a box, I can support an important cause,” she says.

“Clothesline also allows people who want to support a charity – but don’t have the financial means – to contribute without out-of-pocket expenses,” she adds. 

Clothesline saves 840 million kilowatt hours of energy and reduces donors’ carbon footprint by 115 million kilograms of CO2 emissions each year.   SUPPLIED 

Clothesline saves 840 million kilowatt hours of energy and reduces donors’ carbon footprint by 115 million kilograms of CO2 emissions each year. SUPPLIED 

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To donate to Clothesline or for more information, visit www.diabetes.ca/clothesline.

New tools give people with diabetes a greater sense of control

Harry Flint says a diagnosis of type 2 diabetes 13 years ago was the wakeup call he needed to make some dramatic changes in his life. The 63-year-old Calgary trucking sales manager weighed almost 300 pounds, smoked a pack-and- a-half of cigarettes a day and routinely ate take-out in front of the tube. “If it weren’t for that diagnosis, I’d be dead by now because I probably wouldn’t have changed my lifestyle.”

First Mr. Flint tossed his smokes. Then he cut out thefast food, took up running and watched the pounds peel off. Since then he’s lost 100 pounds. In 2005, he also joined Team Diabetes, the national, physical activity fundraising program of the Canadian Diabetes Association (CDA), and credits that decision as being instrumental in his journey to good health.

Not only has he completed 25 marathons and half-marathons in exotic destinations such as Barcelona and Hawaii with Team Diabetes, but he has benefited from the camaraderie of being alongside the many others who are running for the cause. Mr. Flint says being part of Team Diabetes has given him a renewed sense of purpose (he’s raised more than $100,000 in donations) and also given him friends for life. “All of us bond together during these Team Diabetes events – it’s a real family atmosphere.”

One of the keys to successful diabetes management is being in charge of your health, says Joanne Lewis, manager of diabetes education for the CDA. “People with diabetes who are involved in the decision-making around their health feel a greater sense of control over how things are being managed. Knowledge builds power, so the more you know about managing diabetes, the better.”

To help people with diabetes feel more in control, the CDA has developed a new set of user- friendly customized online tools that encourage patients to play a leading role in managing their diabetes. Available in one easy-to-access online space at www.diabetes.ca/takecharge, these resources are based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (Guidelines).

The new diabetes tools include:

  • an interactive tool to determine optimal blood glucose (sugar) testing patterns,
  • blood glucose log pages,
  • an action plan to help set goals and targets,
  • advice on building a diabetes care team,
  • guidelines for preparing for diabetes health-care visits,
  • a progress form to document information from various members of the diabetes healthcare team (which can be shared among health professionals), and
  • a self-assessment tool to determine the risk of heart disease and stroke.

Ms. Lewis says the personal care plan is an especially handy tool since it tracks whether required tests and screenings, such as eye care visits and cholesterol checks, are done at the right time. And the “My Team’s Notes” tool offers a convenient way to document all of the input from the various health-care professionals a person with diabetes encounters, she adds.

Sometimes, as in Mr. Flint’s case, simply being diagnosed with diabetes is all the motivation needed to kick-start new food and fitness routines. But it isn’t always easy.

Most of us are well aware of what we need to do to stay healthy: eat our greens, get moving, and limit fat, sugar and salt – everything in moderation. The trick lies in actually doing all of this. It’s especially daunting when living with a chronic disease, like diabetes, that is dependent on how careful you are about your self-management and food intake or how committed you are to an exercise regimen.

“Most people with diabetes will eventually end up on medication, and they shouldn’t feel guilty about this,” says Dr. Catherine Yu, an endocrinologist at St. Michael’s Hospital in Toronto and chair of the committee responsible for dissemination and implementation of the CDA’s internationally recognized Guidelines. “But it’s important to remember that activity and nutrition – in combination with good medication management – is the cornerstone by which we manage diabetes and its complications,” she stresses.

Key recommendations in the Guidelines include getting at least 150 minutes of aerobic exercise each week as well as two (preferably three) sessions of resistance exercise weekly, and consuming carbohydrates with a low glycemic index (GI), such as whole grains and legumes, which helps control blood glucose levels.

Dr. Yu advises using an eight- to nine-inch dinner plate and filling half of it with veggies, a quarter with low GI carbohydrates and a quarter with protein. (Visit www.diabetes.ca/plate for an example.) “It’s important to rethink how we load our plates,” she says. 

After being diagnosed with type 2 diabetes, Harry Flint quit smoking, lost 100 pounds and completed 25 marathons and half-marathons with Team Diabetes.   SUPPLIED 

After being diagnosed with type 2 diabetes, Harry Flint quit smoking, lost 100 pounds and completed 25 marathons and half-marathons with Team Diabetes. SUPPLIED 

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To join Team Diabetes or for more information, visit www.teamdiabetes.ca. For more information on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada, visit www.guidelines.diabetes.ca.

Initiative aims to improve diabetes care in Aboriginal communities

As Canada continues its fight against diabetes, a group of scientists and health-care professionals are focusing their efforts on communities that bear a greater burden of this disease than the rest of the country: First Nations, Inuit and Métis communities.

Through a five-year program called FORGE AHEAD – short for TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery – these scientists and health-care workers are working with Aboriginal groups across the country to identify local health challenges and improve the delivery of health care through better coordination of clinical and community services.

“The gaps in health care in Aboriginal communities are much greater than what we see in the general population,” says Dr. Stewart Harris, the program leader and a professor at Western University’s Schulich School of Medicine and Dentistry. “At the same time, they face greater health challenges.”

Compared to the general population, the rate of diabetes is between two to three times higher in First Nations communities and one-and-a-half times higher among Métis, according to Statistics Canada.

In Inuit communities, where type 2 diabetes used to be rare, the disease now affects residents at rates that are comparable to those among non-Aboriginal groups.

Dr. Harris hopes that by changing the current models of healthcare delivery in Aboriginal communities, the upward trend of type 2 diabetes can be halted and reversed. He notes that most First Nations communities have a federally funded diabetes prevention program as well as health-care clinics. But what’s often lacking is co-ordination between the two.

“One of our goals is to facilitate the integration of community and clinical programs to create, in essence, a cohesive healthcare team,” he says. “So if I’m a doctor in a clinic seeing a patient who has diabetes, I could easily set up my patient with a walking program in the community or send him to a particular person for diabetes education. And we would all communicate with each other and co-ordinate what we’re doing for this particular patient.”

This would lead to better outcomes for patients, says Dr. Harris, and help Aboriginal communities optimize limited resources. So far, he says, 12 communities from various provinces have expressed interest in FORGE AHEAD, which is funded by a $2.5-million grant from the Canadian Institutes of  Health Research and a $500,000 donation from pharmaceutical firm AstraZeneca Canada. In September, Dr. Harris and his team held their first workshop with representatives from six communities. This was the first of multiple training and quality improvement workshops that will be conducted with representatives from partnering Aboriginal communities over the life of the program.

During five years of FORGE AHEAD, the research team will create a diabetes registry and assess clinical measures to see if the program’s efforts are yielding clinical improvements, says Dr. Harris.

“At the end of five years, we will be developing a tool as part of a knowledge translation strategy to ensure we have a package that other communities can utilize,” he says. “If we get it right with diabetes, then the lessons learned can be expanded across the whole chronic disease profile.”

   

"The gaps in health care in Aboriginal communities are much greater than what we see in the general population.”
Dr. Stewart Harris
is the FORGE AHEAD program leader and a professor at Western University’s Schulich School of Medicine and Dentistry
 
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For more information, visit www.tndms.ca/
forgeahead
.

Researchers take aim at complications

Diabetes research is continually advancing, resulting in new knowledge and treatments. With the support of the Canadian Diabetes Association (CDA), a number of initiatives currently underway are targeting the devastating complications caused by the disease.

Dr. Subrata Chakrabarti, professor and chair of the department of pathology and laboratory medicine at the University of Western Ontario in London, Ont., is researching the mechanisms that damage the retina in people with diabetes, one of the major causes of blindness in Canada. One promising focus is the recently discovered microRNA molecules, which regulate the production of some proteins in the cells lining the blood vessels. Diabetes reduces the number of microRNA molecules, allowing the proteins to make more of the same proteins, causing cells to proliferate and wreak havoc.

“These proteins are like foot soldiers,” says Dr. Chakrabarti, “and they attack the retina by sending messages to the blood vessels to make new vessels that bleed, causing blindness.” His team is looking at ways to stop the protein production by using these microRNAs and by finding substances that could block the cell receptors for these proteins.

Dr. Allison Dart, a kidney specialist at The Children’s Hospital in Winnipeg, is studying the  high rates of kidney disease in children diagnosed with type 2 diabetes.

“Children exhibit kidney injury at diagnosis,” says Dr. Dart, “whereas adults don’t usually show signs until five years later.” The result is that up to 50 per cent of children with type 2 diabetes in Manitoba may go on to experience kidney failure by the time they reach their mid-30s.

Dr. Dart and her team are currently following 130 diabetes patients between the ages of 10 and 25 who live in Winnipeg and northern communities in Manitoba and Ontario. About 95 per cent of the patients are Aboriginal and are genetically at higher risk. Many are also obese and have been diagnosed with high blood pressure as a result of behavioural and environmental factors.

“Telling them to eat healthy, take their insulin or giving them pills doesn’t work,” Dr. Dart says. “We have to find other approaches, such as hiring more psychologists in the clinical care setting to help them with their mental health issues, increasing education in schools regarding diet and physical activity, and making fresh foods more affordable.”

Dr. Ravi Retnakaran, an endocrinologist at the Leadership Centre for Diabetes at Mount Sinai Hospital in Toronto, is studying new treatments for type 2 diabetes to prevent weight gain and low blood glucose levels, complications of the medications now used to manage the disease.

In just the last decade, genetic studies have led researchers to discover the central role that beta cells play in preserving the ability of the pancreas to make insulin. Currently, doctors typically recommend weight loss for their newly diagnosed patients. When that eventually fails to control blood glucose levels, doctors prescribe medication. In the last stages, insulin is administered because the beta cells have deteriorated.

Dr. Retnakaran, on the other hand, believes that every effort should be taken to preserve the body’s beta cells at the beginning of treatment rather than at the end. He is doing so by using combination therapies.

Three clinical trials at Mount Sinai and other centres are recruiting type 2 diabetes patients in the first five years after diagnosis to test the use of short-term insulin alone, and then together with liraglutide and similar drugs that mimic GLP-1, a naturally occurring hormone produced in the small intestine that helps the body balance the ratio of insulin to blood glucose.

“I believe the results of these clinical trials will make us look at diabetes in a completely different light,” says Dr. Retnakaran. “We’ll be treating it intensely upfront to improve and preserve beta cell function and then maintain that function for the rest of a patient’s life.”

Dr. Subrata Chakrabarti’s research targets retina damage that is currently one of the major causes of blindness in Canada.   SUPPLIED 

Dr. Subrata Chakrabarti’s research targets retina damage that is currently one of the major causes of blindness in Canada. SUPPLIED 

“I believe the results of these clinical trials will make us look at diabetes in a completely different light. We’ll be treating it intensely upfront to improve and preserve beta cell function and then maintain that function for the rest of a patient’s life.”
Dr. Ravi Retnakaran
is an endocrinologist at the Leadership Centre for Diabetes at Mount Sinai Hospital
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To learn more about CDA-funded researchers, such as Dr. Chakrabarti, Dr. Dart and Dr. Retnakaran, or how you can support groundbreaking diabetes research in Canada, visit www.diabetes.ca/research or call 1-800-BANTING (226-8464).

> PLEASE DONATE
As a family living with diabetes, we need a lot of support. We have hope for a cure – our long-term goal is that one day kids like Sarah won’t have to deal with having diabetes. But in the meantime – just to live a healthy life, emotionally as well as physically – she needs a lot of support in the community, and that’s what the Canadian Diabetes Association does for us.”
– Jack Minacs

To learn more about Jack Minacs and his daughter Sarah, a dancer and competitive cheerleader who lives with type 1 diabetes, read their story. To learn more about the different ways you can donate to the CDA, visit www.diabetes.ca/donate.

Jack Minacs and his daughter Sarah, a dancer and competitive cheerleader who lives with type 1 diabetes

Jack Minacs and his daughter Sarah, a dancer and competitive cheerleader who lives with type 1 diabetes


D-Camps help equip children and teens to meet the challenges of life with diabetes

In less than a year's time, Maya Krowiak will leave the familiar routine, spaces and faces of high school – and perhaps even move away from her family home in Mississauga, Ont. – to start life as a university student.

Wherever her studies take her, Ms. Krowiak, who was diagnosed with type 1 diabetes when she was eight years old, says she's ready to take the transitional step from teenage years to adulthood.

“I'm super comfortable with my diabetes,” says the 17-year- old, who plans to become a nurse. “I've been basically doing everything to manage my diabetes – like testing my blood sugar and carb counting – on my own for some time now.”

Ms. Krowiak attributes her confidence and independence largely to the summer camps she's been attending since she was 10 years old. Launched by the Canadian Diabetes Association (CDA) in 1953, D-Camps help children and teens gain confidence in their ability to manage their type 1 diabetes. Offered at 12 sites across the country, D-Camps combine an authentic camp experience – with activities such as canoeing, hiking and singing around the campfire – with type 1 diabetes education. Kids learn, for example, why they need to take a certain dose of insulin before a particular activity. They are also taught to administer their own insulin, a vital skill in diabetes management.

Andrew Young, the CDA’s executive director of programs, services and partnerships, points to another important benefit of D-Camps: meeting other young people with type 1 diabetes.

“Often kids with type 1 diabetes are the only ones in their school or community living with this disease,” says Mr. Young. “At camp, they meet other kids who are in similar situations and form friendships that carry over when they're back in their own communities.”

Ms. Krowiak agrees. She says meeting other kids with type 1 diabetes helped her grow up without feeling self-conscious or embarrassed about her disease. This confidence was especially helpful as she moved from childhood to her teenage years.

“While supporting the transition from child to teen is important, it’s also critical to ensure that teens with type 1 diabetes are well equipped to enter adulthood,” says Mr. Young. With this in mind, the CDA also began offering two streams of leadership options for teens – Leadership Development Programs in the summer, and D-Tour, a weekend youth retreat.

“Any teen who transitions into adulthood goes through a whole series of life changes, and when you overlay type 1 diabetes on those life changes, it just adds to the normal pressures of becoming an adult,” says Mr. Young. “With our leadership programs, teens develop life and leadership skills, which may help them to make good decisions in life, especially the ones pertaining to their health.” 

Sailing is a popular activity at Camp Kakhamela, located on picturesque Howe Sound in Gibsons, B.C.   SUPPLIED 

Sailing is a popular activity at Camp Kakhamela, located on picturesque Howe Sound in Gibsons, B.C. SUPPLIED 

 Camper James smiles with counsellor Claire during a theme-day competition at Camp Banting in Ontario.   SUPPLIED 

 Camper James smiles with counsellor Claire during a theme-day competition at Camp Banting in Ontario. SUPPLIED 

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The CDA would like to thank CN for its generous support of D-Camps. To learn more about how the CDA is helping provide a life-changing camp experience for children with type 1 diabetes, visit www.dcamps.ca.

Fighting to keep children safe at school

All parents feel some anxiety when they send their child to school for the first time. But the worry is compounded when they must also ask the school to provide individualized support for their child living with diabetes.

For parents of children with type 1 diabetes, the responses to this question are inconsistent across the country and even from school to school within a province. It’s a situation the Canadian Diabetes Association (CDA) and parent advocacy groups are working to change.

“Our goal is to ensure that school boards in all parts of Canada support kids to manage their diabetes in school the way they do at home,” says Joan King, manager of outreach and individual advocacy in the CDA’s government relations and public affairs department.  In response, the CDA launched a national advocacy campaign to draw greater attention to the issue.

With support from school personnel, most students can manage their diabetes while in school. However, young children often require a trained adult to help monitor their blood sugar levels and administer their insulin, she explains. “Many boards and schools provide strong supports for daily diabetes management, but others do not, putting many parents under tremendous stress while their children’s health and safety are at risk.”

The CDA has developed guidelines for the care of students living with diabetes at school that help clarify the essential roles of the student with diabetes, his or her parents/guardians, school personnel and healthcare providers. Provincial education ministries are key players, with the authority to require school boards to implement a comprehensive diabetes policy. Provincial policies currently exist in New Brunswick, Nova Scotia, Quebec and most recently in British Columbia.

Shirley-Anne Parsons spent years advocating for the policy in B.C. after her life changed dramatically when her son Nicholas started Grade 1 in 2008. She was shocked to learn that managing his diabetes in school fell to her.

Ms. Parsons quit her job and went to the school two or three times each day to operate her son’s insulin pump and ensure his safety.

She was among a handful of parents in B.C. who were eventually able to negotiate individual care plans for their children with their district school boards, and is part of Unsafe at School, a parent group that advocated for a provincial policy.

“We saw this as a human rights issue,” she says. “Why should where you live or what school your child attends determine the kind of health care they get?”

A significant component of the new B.C. policy is the requirement for schools to have a supply of glucagon and personnel trained to administer it, says Ms. Parsons. “Glucagon is given when someone has a severe hypoglycemic (low blood sugar) reaction, which can be life-threatening. We’re so pleased that it is now available in B.C. for every child at public school through to the end of high school.”

Change may also soon be coming in Ontario, where the province has commissioned a needs assessment to determine how school boards can best support students with diabetes and other chronic conditions, such as epilepsy and asthma.

Toronto-area parent Shana Betz is a member of the Ontario advocacy group SOS Diabetes, which is seeking a provincial diabetes policy for schools.

She is grateful that her daughter Emma, now in Grade 1, is in a school region set up to provide practical support. “We’ve always had a nurse or an educational assistant who performed the tasks needed to keep Emma safe in school. But in many parts of Ontario, community health nurses don’t go into schools, leaving parents scrambling to piece together a solution,” says Ms. Betz.

In addition to being a safety issue, “this also goes to the heart of a child’s right to be healthy enough to learn,” she adds.

“When a child’s blood sugar is high or low, they have cognitive impairment, and there is often no allowance in the school system for that fact.”

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For more information on the CDA’s new guidelines, please visit www.diabetes.ca/kidsatschool.

    

Shana Betz feels fortunate that her daughter Emma has practical diabe- tes support in school, and wants the same for other families.   SUPPLIED 

Shana Betz feels fortunate that her daughter Emma has practical diabe- tes support in school, and wants the same for other families. SUPPLIED