Category: Uncategorized

November 20, 2020

During the week of November 2^nd, delegates joined JDRF for its annual Kids for a Cure Program. This year, due to COVID the event was held virtually.

Hear from some of this year’s participants:

Senator Nancy Hartling, Moncton, New Brunswick:

“Kids for a Cure was the highlight of my week. Talking to the kids and their parents and hearing their positivity gave me hope for the future and stirs me forward to keep the momentum going.

I have a personal connection to type 1 diabetes, my 8-year-old grandson who lives in BC has T1D. When I hear from the kids – I use the conversation in my speeches – it’s their voice that I want to bring forward to the government because hearing it in their words is so important.

JDRF has my commitment to write a letter to the government to support CIHR funding – our office will be doing that, and I intend to continue speaking about it.

Across the country, access to the devices that help people manage T1D is not equal and consistent. And when all families can’t access it equally – it can be a challenge to get what they need to manage their illness. It’s even more important during COVID, as this equipment can help to keep people out of the hospital.

I want to tell all the kids and JDRF to please keep up the good work. Thank you for connecting me, I have great respect for JDRF.

Youth Ambassador Co-Chair Anne Pettigrew

Age: 15

Age at Diagnosis: 11

Lives in: Etobicoke, ON

I’m a very strong-minded, take-action kind of person, and I’m used to working towards solutions to my problems in my everyday life and being able to handle most things independently. But I can’t solve the problem of having diabetes by myself. No amount of hard work or dreaming big will make that happen if it’s just me. I can’t cure type one diabetes myself, as much as I want to. But Kids for a Cure is my chance to work towards a cure with dozens of other advocates living with type one diabetes who want to get rid of type one just as much as I do. And in addition to working with the other delegates, we’re also all supported and propelled forward by JDRF. JDRF gives us the platform we need in order to have our voices heard by the right people – the people who control how much funding goes into type one diabetes research. Working with JDRF and the other delegates through Kids for a Cure gives me a chance to fight for a solution to one of the biggest, most dangerous, and most heartbreaking problems in my life. Kids for a Cure to me means a fighting chance at a better future, in a way that can actually yield results.

Doing Kids for a Cure virtually had pros and cons. It was organized flawlessly and gave us (the delegates and our families) many chances to connect and plan and prepare for our MP and Senator meetings. Additionally, doing it online meant we didn’t have to go all the way to Ottawa, so it kept our schedules freer and allowed each team of delegates to have more opportunities to meet with government officials. The only con for me was that I didn’t get to meet any of the other delegates in person.

During Kids for a Cure 2018, when we all stayed in the same hotel in Ottawa, we had an incredible opportunity to be surrounded by other type one diabetics – people who understand everything it takes to manage type one diabetes in a way that only other type one diabetes can really understand. It was very special and meaningful for me, especially because I don’t have any type one diabetics in my family or my immediate circle of friends. I don’t often get the opportunity to talk to other type ones, which is isolating for me. Doing Kids for a Cure virtually still gave delegates opportunities to connect, but there was something special about all of us being in the same room, talking and laughing and being physically all together, united by our experiences and our fight for a cure.

I hope that the JDRF-CIHR Partnership to Defeat Diabetes is renewed so that we can continue to have the funding that we so desperately need if we want to move closer to a cure to type one. I also hope that the government officials with whom we met will remember us, remember our stories, and remember type one diabetes. I hope they remember our dedication, our passion, and our drive, and how hard we’ve worked to get to where we are today. Type one diabetes takes so much – mentally, physically, and emotionally – to manage and live with. We work so hard every day just to keep ourselves going, at this point without even an end to look forward to. I hope they remember us. However, they decide to show their support for us, I want us to be remembered.”

Marie-France Lalonde, M.P. , Juvenile Diabetes Caucus Co-chair

“I would like to congratulate the JDRF and its delegates for their awareness campaign, Kids for a Cure, on juvenile diabetes. Not only was this campaign a great success with participants, it was also an opportunity for the JDRF to share its hard work in research to improve the quality of life for those living with juvenile diabetes.

The two main events of this campaign, November 2nd and 3rd, also provided an opportunity for youth delegates to engage us in meaningful interactive activities to share the reality of their condition.

This reminded me and my elected colleagues of the importance of the partnership between the government and JDRF in the fight to eradicate type 1 diabetes. I applaud the impact of such awareness campaigns. As Co-Chair of the All-Party Caucus on Juvenile Diabetes, it was a great pleasure and honor for me to participate and deliver a speech. JDRF and Canadians with juvenile diabetes can always count me to be an ally.”

Terri and Colby Ryan – Mother and son living with T1D

Age: 13

Age at diagnosis: 6

Lives in: St. Philips, NL

Terri: “This being my third time doing Kids for a Cure, it was sure different than the past.

I feel the whole atmosphere doing this in Ottawa was always amazing, and the interactions between the candidates were the best part, they got to be with so many others from all across Canada, this is where Colby and I both made amazing friends.

As for this years’ virtual Kids for a Cure, it was amazing in different ways, I believe that we had way more meetings than if we were in Ottawa, and we had great success with all our attendees making it to the meetings and I feel that we had their undivided attention. I love them interacting with the kids and asking them questions. It was a little tougher as for the internet and technology aspect but it always worked out.

While I loved all experiences we have had, I feel the better experience was the personal one in Ottawa, but as for the aspect of the MP and Senators I think they took more away from the meetings this year.

I would love to be able to do this again, it is both Colby and I passion to raise awareness.”

Colby: “First off, I have to thank everyone at JDRF for all the hard work that they do, especially to make things like kids for a cure possible. This is my third year and my favourite of all the JDRF events because we get to share our story with the people who can make a huge impact on Type1 and help us we hope find a cure.

I love chatting with the Members and I love how every time we meet with them they are always so amazed and they always seem to realize that this is a disease that affects all ages and that it is something they can get behind to make a real difference.

This year was a little different while I did seem to have a lot more meetings than before, it was kind of sad that it wasn’t that personal one on one meeting, face to face that I feel was a better impact and as well to be in the room with so many others and to meet all the delegates from across Canada is way better, sadly these times and the new way of life didn’t allow this. In the meetings virtually I do believe that there may have been more attention to the important topics and less off topic subjects, to have the scrapbooks online for them to follow as well was a huge help.

I am happy to have gotten the chance to speak to so many members and to hear them all say they will support us and they believe that it is something they will move forward with was good, and to know that by us doing this can make a lot of needed changes is also the part I like. I hope that I will get to do more things for JDRF and I want to be able to say I was a part of finding the cure.

I have been a Type1 for 7 years and from my first JDRF event I knew it was where I wanted to put my support, to know that there is a organization determined to help me and so many others living with Type1 and giving me so much hope for a cure, it was where I belonged.

It is fun to meet so many others through JDRF that live with Type1 and to know that all across Canada and the world there is so many like me struggling everyday with the same issues is a comfort.

I will always support JDRF in any capacity that will allow, and I will always encourage others to do the same. I believe that with all of us fighting the fight and JDRF on our side we will find a cure.”

Jo and Tilly Stimpson – mother and daughter living with T1D

Age: 12

Age at diagnosis: 2

Lives in: Peterborough, ON

Tilly would like to say: “I LOVE ‘Kids for a Cure’. It’s such an amazing experience to be part of. Meeting and connecting with other kids with Type 1 who also want to make a difference is my highlight. Advocating is a passion of mine and being able to be in front of MPs, Senators and other key decision makers is a privileged situation to be in. I’m thankful to JDRF for giving me this opportunity and for their ongoing support to the Type 1 community.”

Aly and Hartley Halvorson – Mother and daughter living with T1D

Age: 4

Age at diagnosis: 2

Lives in: Regina, SK

I really felt that it was so important for each MP to hear the stories of these amazing T1D’s warriors but also the stories of the parents who care for them. The MPs that we spoke with were all very much in support of what we were asking and again it gave us hope that soon there will be a cure for this disease, hopefully in Hartley’s lifetime.

The virtual event was a huge success in my opinion. There was very little technical issues and everything was laid out on how we wanted each meeting to unfold. The only change I would have made is to be with all of the wonderful delegates in Ottawa. Fingers crossed it will happen next year.

Thank you again for all you do and if there’s anything else you need we are an open door for you.”

October 28, 2020

October 26, 2020

Yukon gets #AccessForAll

Thanks to the advocacy efforts of adults, parents and others touched by type 1 diabetes (T1D), the Yukon government has moved to fully reimburse continuous glucose monitoring (CGM) and flash glucose monitoring (Flash GM).

This past September, the government announced it would begin covering CGM and Flash GM for youth up to 18 years old, and Flash GM for adults, however advocates with the Yukon T1D Support Group demanded the coverage of both devices for all – regardless of age.

The group’s campaign, backed by local businesses, convinced the government to move forward with its original commitment – making Yukon the first jurisdiction in Canada to embrace #AccessForAll

Saskatchewan parties agree on more coverage

Meanwhile in Saskatchewan, the governing Saskatchewan Party who’ve just be re-elected have promised to reimburse CGM for those under age 25 and expand insulin pump coverage to all ages. The Opposition NDP made a similar promise, and we’ll be following up in the coming weeks to make sure it’s been fulfilled. This is great news for those with type 1 diabetes in the province. These commitments follow advocacy efforts by parent and adult advocates including the Halvorson family, who were on hand for the announcement. Hartley Halvorson, age 4 and mother Aly will be participating in this year’s Kids for a Cure Lobby Day – Home Edition. 

Advocating for CGM/Flash GM funding ahead of the B.C. election

B.C. also heads to the polls in October, though a commitment to fund CGM and Flash GM was not included in party platforms – despite the fact that BC Pharmacare had been reviewing the possibility of coverage for advanced glucose monitoring systems prior to the election.

JDRF participated alongside Diabetes Canada and Type 1 Together in public and stakeholder consultations held by BC Pharmaceutical Services in August and September. 

Demanding more access in Ontario

Efforts continue in Ontario to convince the government to expand access beyond Flash GM (currently covered for those under age 25, on disability or receiving social assistance who have no private insurance coverage and those over age 65). But our efforts haven’t stopped. Thanks to your support, we have produced a new pre-budget submission in October, met with officials and arranged for testimony as part of the Minister of Finance’s pre-budget consultations.

There’s still time to take action! Send an email to your provincial representative, demanding CGM and Flash GM coverage today.

October 26, 2020

Prince Edward Island resident and JDRF advocate Brooks Roche is getting vocal about #AccessForAll.

The 23-year-old young man has taken it upon himself to create an online petition asking Canadians to lobby against the government of P.E.I’s age restrictions when it comes to diabetes technology coverage.

A strong advocate for the type 1 diabetes (T1D) community, Brooks is also one of 18 members of the Prime Minister’s Youth Council — a non-partisan initiative run by the federal government. 

After living with type 1 diabetes for almost two decades, he recognizes the struggles that come with the disease, and the importance of diabetes technology when managing it.

“The benefits of this are, frankly, enormous,” he said, adding that technology like insulin pumps give him peace of mind when managing his disease – taking the burden of manual injections away from him.

An insulin pump, combined with diabetes supplies can cost up to $10,000 per patient – a significant fee considering the role it plays in keeping him, and others in the T1D community alive.

“This is a chance for Prince Edward Island to lead on health policy and for us to set a standard for our neighbours to follow, rather than the other way around.” – Brooks Roche

In P.E.I, funding for insulin pumps was only available for people up to 18 years of age until recently, when the government increased funding for those up to 25 years old. Like Brooks, JDRF believes the age restriction should be lifted entirely.

Over 300,000 Canadians live with T1D, and 85% of people living with the disease are adults. Brooks believes that these age restrictions simply don’t make sense, considering the general population of those who live with T1D, and the role that diabetes technology plays in helping them manage their disease.

“This is a chance for Prince Edward Island to lead on health policy and for us to set a standard for our neighbours to follow, rather than the other way around.”

To read more about what JDRF is doing to demand #AccessForAll, click here.

People like Brooks need your help. And YOU can take action today.

Contact your provincial representative today.

Take a few minutes and send them a message now then share this action with family and friends. 

Sponsored Content

Back to school includes a lot more than just a backpack, notebooks, and a pencil case. Getting back into the school routine requires a lot of preparation and planning for kids who live with type 1 diabetes (T1D)

In a perfect world, all school teachers and staff would understand how to manage T1D. Since this isn’t always the case, communication is key.  It is important to meet and educate the teachers on T1D before school begins.  Providing information to the school as well as classmates on T1D management, and especially recognizing the signs of hypoglycemia (low blood sugar), will help kids feel comfortable returning to school and importantly will keep them safe and healthy, no matter what the school day brings.

Here’s some information on what can cause hypoglycemia, and how to recognize the signs:

Low blood sugar can be caused by the following¹:

• Changes to eating patterns such as skipping or delaying a meal
• More exercise or activity than usual, or exercising for a long time without eating a snack or adjusting insulin before exercise
• Too much insulin or a change in the time taking insulin
• Stress (tests, exams, etc.)

What are the symptoms?

It is important always to BE PREPARED!

In case blood sugar levels fall below 4 mmol/L, school staff should be provided in advance with fast-acting glucose (e.g. Dex4 tablets, gels, and liquids).  If teachers notice a difference in behaviour related to the signs of low blood sugar or children feel any of the warning signs of hypoglycemia, verify the child’s blood glucose levels immediately, and treat low blood sugar promptly if needed. In the event that a blood glucose meter is not available but low blood sugar is suspected, treat right away.

To treat, the child should eat or drink fast-acting sugar such as¹:

• 15 grams of Dex4 glucose tablets (4 tablets), gel (1 pouch), or liquiblast (1 bottle). These are fast-acting and pre-measured
• 3 teaspoons or 3 packets of table sugar dissolved in 15 ml water
• 3/4 cup of juice or soft drink (non diet)
• 1 tablespoon of honey

Afterwards, wait 15 minutes, then check blood sugar again if possible. If blood sugar cannot be tested, monitor the child closely to ensure symptoms of hypoglycemia improve.  If symptoms persist and/or glucose is still below 4 mmol/L, try one of the above methods again, wait 15 minutes, and do another glucose test. If lunch is more than one hour away, provide a snack with both carbohydrates and protein.

As low blood sugar can happen at anytime, it is important to be prepared.  Dex4 Glucose products help raise glucose levels FAST. 

Dex4 Glucose products are:

• Fast-acting
• Pre-measured so you know exactly how much glucose you are consuming
• Fat-Free
• Caffeine, gluten, cholesterol free
• Various great-tasting flavours

^{Additional Resources:}

^{The JDRF Mentor Program provides one-on-one support to families and individuals living with type 1 diabetes (T1D). Trained volunteers that have experienced understand the daily challenges of living with T1D are there to provide emotional support, and connect you with resources in your local area.}

^{The Diabetes Hope Foundation supports mentorship programs for youth. Buddy systems are available, for more information visit www.breakthrought1d.ca/living-with-t1d/newly-diagnosed/mentor-program-request-form and www.diabeteshopefoundation.com/mentor-biographies}

^{1 Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37(suppl 1):S1-S212.}

^{Disclaimer
Information in this article is provided for informational purposes only and is not a substitute for professional medical advice.}

September 29, 2020

By: Jonathan Peretz, CBRE, Senior Vice President, Managing Director and Ride Team Captain

I want to tell you a little bit about my resilient wife, Audrey.

Since the age of 13, Audrey has learned to live with type 1 diabetes (T1D), displaying patience and courage amidst countless pokes and prods, all while caring for our family and three beautiful children.

I’ve seen first-hand what it looks like to test your blood sugar upwards of 10 times a day, manually inject insulin and manage highs and lows. This is what normal looks like for her – and she does it while juggling a family and a career.

We know a cure is possible, and looking back on the medical advancements achieved last year alone, we know we’re closer than ever to finding one.

This October, the Sun Life Ride to Defeat Diabetes for JDRF is where I will be spinning, sweating or stretching for a cure for my wife, and you can join me in doing just that. Once you pick an activity that suits you best (cycling, yoga or a fitness class), you can spend an hour with your corporate peers moving for a cure.

The event will be virtual this year – meaning you can make a massive impact on the lives of those living with type 1 diabetes all while staying safe at home.

Help us raise critical funds for ground-breaking research. My wife’s life has changed for the better over the last 22 years…just think about what more we can accomplish together in the next 22!

We can’t thank you enough for your support. Let’s turn type one into type none together. 

UPDATE – October 1: Yukon will fund CGM for adults. This follows announcement last month to fund Flash GM.

September 25, 2020

The Yukon government has made the decision to fully fund flash glucose monitors (FGMs) for those 18 years of age and older with type 1 diabetes (T1D) starting on October 1^st. While this expansion of access to T1D technologies is a step in the right direction, the decision was made after ending a pilot program that covered continuous glucose monitors (CGMs) for those 18-25 years old.

Improving access to advanced glucose monitoring for everyone living with T1D is the goal of JDRF’s Access for All campaign. Patients should have the choice of which device to use – whether it is CGM or FGM – that is most effective in managing their disease and this decision should not be based on which devices are publicly funded. Technology cannot be approached as one size fits all because each device has its own benefits and the best option will vary from person to person based on their circumstances and needs. For example, for someone with hypo unawareness, extra protection is provided by alarms offered on a CGM that alert the wearer of high or low blood sugar levels, including while sleeping, and allow them to take quick action.

The government’s plan will allow adults to be reimbursed up to the maximum cost of the FGM if they prefer to opt for a CGM instead. However, this will still pose a financial burden for some.

Public funding for T1D technologies continues to be an issue in provinces across Canada and JDRF is committed to working with the T1D community and provincial governments to get to our end goal of Access for All.

To learn more about JDRF’s #AccessForAll campaign check out breakthrought1d.ca/accessforall.

JDRF seeks $15M in funding for research

August 26, 2020

As 2021 draws near, we move closer to an important milestone that changed and aided the type 1 diabetes (T1D) community in an enormous way – the 100^th year of insulin.

In the past, treatment for T1D meant restricting calories, carbs and certain foods altogether to nearly the point of starvation. Life for people with type 1 diabetes before insulin was short and dreadful – typically two years for adults and a year for children– ending in blindness, loss of limbs, kidney failure, heart attack or stroke. Banting House in London describes diabetes before insulin as a “death sentence.” The discovery of insulin in 1921 by Canadians Sir Frederick J. Banting and Dr. Charles Best made it possible to manage diabetes and is often described as Canada’s gift to the world – saving the lives of up to 200 million people globally.

As we prepare to mark the 100^th anniversary of this life-saving drug, we know that research and clinical trials cannot stop. That is why we are asking the government to make a commitment to move beyond insulin and towards prevention and cures by committing to renew crucial funds for T1D research.

In 2017, the government committed $15 million to a new Partnership to Defeat Diabetes between JDRF and the Canadian Institutes of Health Research (CIHR), in order to improve the lives of Canadians with T1D and drive efforts to find a cure. Matched with $15 million from JDRF, this funding will support at least 11 high impact, internationally relevant projects. Five projects are currently underway and six more commence next year.

This year, our 2021 Federal pre-budget submission includes three recommendations, including the renewal of funds with the Canadian government in order to remain the world leader in T1D clinical trials, transnational research and tools to prevent, treat and ultimately cure T1D.

Funding for this partnership will include:

• Prevention of diabetes, especially in children and youth;
• Early treatment of diabetes, thereby delaying its progression and reducing the risk of complications;
• Accelerating development of diabetes device technology to enable automated insulin delivery, including in special populations;
• Leveraging data using various approaches, such as artificial intelligence, to drive development of personalized treatment of diabetes and its complications.

We hope to have an opportunity to testify in front of the Standing committee on Finance’s pre-budget consultations committee, and these same recommendations will be relayed to MPs and senators as part of this year’s 2020 Kids for a Cure home Edition.

While we send over 30 delegates to speak to decision-makers in our Kids For a Cure Lobby Day Home Edition, you can take part in it too by speaking out about the need to accelerate the pace of research through funding from our federal government. Share your message on social using #KidsForACure2020 and tell lawmakers why this is important! There is strength in numbers, and we know that together, we can turn type one into type none. 

Help us continue to advocate for the T1D community

August 26, 2020

There’s good news for pumpers in BC! BC Pharmacare has added YpsoPump by YpsoMed to its Tier 1 list of approved insulin pumps. BC residents with type 1 diabetes of all ages can now choose between the Omnipod by Insulet or the YpsoPump under the province’s pump program.  

Thanks in part to our JDRF Advocates, the province has also added the Medtronic MiniMed 670g to its list of Tier 2 pumps. Medtronic pumps can be obtained under a special exemption based on a recommendation from the person’s doctor or endocrinologist. Patients may be responsible for paying some of the cost for a Tier 2 device.

Nearly 400 JDRF Advocates responded to our action last summer urging the BC government to add the Medtronic 670g and the Tandem t:slim X2 to their list of approved pumps. While Tandem’s pump is still not available through BC Pharmacare, the addition of the Medtronic 670g is a small victory for our community’s choice and means that some of the costs for this device will be covered.

At JDRF we continue to push for expand access to the medical technologies – insulin pumps and advanced glucose monitoring systems – that Canadians with type 1 diabetes need. We hope that one day soon sensors too will be covered. To learn more about JDRF’s #AccessForAll campaign check out breakthrought1d.ca/accessforall.

August 26, 2020

JDRF’s attention has been focused on Canada’s west coast increasingly as the BC government inches closer to a decision on whether or not to cover continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) systems. BC Pharmacare commissioned a health technology assessment on these technologies more than a year ago but the results have yet to be released.

Things began heating up this spring for JDRF’s #AccessForAll campaign with youth Advocate Sage Stobbe’s testimony to BC’s pre-budget committee in support of JDRF’s 2021 Pre-Budget Submission studying these technologies for more than a year now. The Victoria teen testified about the daily “battles” she and others with type 1 diabetes (T1D) face against “unpredictable high and low blood sugars”. She also appealed to them on a cost-benefit basis pointing out that she often uses up to 15 blood strips in a single day, much higher than the cost of sensors for either FGM or CGM. Listen to Sage’s testimony here (she comes on around 08:10:30 am).

This summer JDRF made formal written submissions to the Canadian Agency for Drugs Technology and Health with respect to two different draft reviews of flash glucose monitoring, the first summarizing clinical and cost effectiveness evidence, and the second based on feedback from a panel of clinicians. 

We’ve also partnered with Diabetes Canada and Type 1 Together to develop a joint submission to the BC Pharmacare Your Voice patient consultation that was launched this August. The three diabetes organizations met with officials from BC Pharmaceutical Services Division via Skype to better understand the process and contribute feedback on behalf of the diabetes community.

Do you live in BC and have type 1 diabetes? Contribute your feedback in the Your Voice patient survey. If you’re a caregiver, the BC government would like to hear from you as well. Have your say via the caregiver survey.

Help us continue to advocate for the T1D community

August 19, 2020 

A recent increase in type 1 diabetes (T1D) diagnoses in children under 18 in some hospitals in north-west London, UK, has triggered news stories that COVID-19 could cause the disease in children. But experts have stressed that the locally reported increase in diagnoses is not yet clearly linked to the pandemic. 

In the new study, 30 children at five hospitals across north-west London presented with new-onset T1D during the peak of the pandemic, approximately double the number of cases typically seen in this period in previous years. Increased cases were clustered in two of the five hospitals. 

21 children (70%) were tested for COVID-19, and only 14 (47%) had antibody tests to see whether they had previously been exposed to the virus.  Five (17%) of the children with newly diagnosed T1D had evidence of past or current coronavirus infection. 

No clear link between COVID-19 and T1D yet

Scientists have long suspected viral infections could play a role in triggering T1D – at least in some people. The authors of the study recommend a larger analysis to establish whether there is a definitive link between COVID-19 and new-onset T1D, and if so whether COVID-19 has any impact on the severity of the disease. 

Prof Deborah Dunn-Walters, Chair of the British Society for Immunology taskforce on COVID-19 and Immunology, said in a responsive statement: “This paper reports an increase in the number of type 1 diabetes cases in children in part of London during the months of April and May compared with previous years. As not all children in the study were tested for COVID-19, the findings do not show that this increase was linked to the COVID-19 pandemic – in fact, it is currently unclear what was behind this rise in cases.” 

Prof. Dunn-Walters said further: “Currently, there have been no comprehensive studies published linking COVID-19 to the development of any autoimmune disease, including type 1 diabetes. However, we are still in the early days of finding out about the longer-term effects of COVID-19 and follow-up studies in this area will be important.” 

The findings from the UK study contrast with those of studies from other parts of the world that instead suggest delayed diagnoses of T1D during the pandemic due to fears about accessing healthcare. For example, a recent report from Italy indicated that pediatric diagnoses of T1D in children were decreased 23% during the peak of the pandemic compared with the same timeframe in 2019, with a greater proportion presenting with diabetic ketoacidosis (DKA). However, the Italian study did not rigorously address whether COVID-19 may have been a precipitating factor to T1D diagnosis. 

Diane Wherrett, Professor and pediatric endocrinologist at The Hospital for Sick Children in Toronto, says: “This observation based on a very small number of cases suggests that diabetes researchers and care providers should examine larger national databases, particularly in countries with high rates of COVID-19, to determine if changes have been seen. Given that type 1 diabetes develops over many months to many years, it is very unlikely that COVID-19 triggered the process that causes type 1 diabetes.” 

Each person with T1D is different. If you are concerned about your health status and have questions about your own situation, seek guidance from your healthcare team. You can also write to us at T1Dquestions@JDRF.ca  or check out breakthrought1d.ca/coronavirus for more information. 

August 17, 2020 

Download this document here.

As students across Canada get ready to head back to school—some after nearly 6 months of being away—parents have many questions. The first is usually, “Is it safe to send my child back to school during this pandemic?”

Here are some things to consider when making a decision about sending your child with type 1 diabetes (T1D) back to school.

• The situation in your community: The risk ofillness in schools depends to a large extent on how much virus is in a community. Your local public health authority is the best source of this information that can help you decide what the overall risk of illness is for all students.
• The protocols your school has in place: Preventing students and school staff from getting the virus in the first place is the top priority. How is your school ensuring they are following public health guidance to create safer spaces?
• Risk of your child getting sick: Type 1 diabetes is an autoimmune condition. This is not the same as being immune suppressed or immuno-compromised, which increases risk of COVID-19. Children with well-controlled type 1 diabetes face the same risk of getting COVID-19 as their peers without T1D. If children with T1D do get the virus, they are not at a higher risk of complications. But any virus may cause blood sugars to be higher, so proper sick day management is essential.
• How you feel about the risk of illness: During a pandemic, there are many things we can do to reduce our chances of getting sick. But as long as the virus is in a community, there will always be some risk. Everyone feels differently about risk. Ask yourself whether you would be comfortable sending your child to school if they did not have type 1 diabetes.
• The risk of serious illness and death: Children with COVID-19 infections have rarely become sick enough to be admitted to hospital. In fact, the chance of a child being hospitalized with COVID-19 maybe lower than it is for influenza, a virus that occurs in the community each year.
• Your child’s overall health and well-being: The long and unexpected school closures, along with other restrictions on activities and socializing, may affect children’s physical, social, and emotional well-being. When deciding whether to choose remote learning or inperson schooling, think about how your child has done over the past few months.
• Supports for your child with diabetes: Students with diabetes have the right to be safe, supported, and included at school. A global pandemic does not change this. Will your child be well supported in managing their day-to-day diabetes tasks?

 

Key Points

Type 1 diabetes is an “auto-immune” disorder. This does not mean that people with T1D have a weakened immune system. Children with well-controlled T1D are
not at an increased risk of getting COVID or of more severe COVID illness. Many factors will go into the decision about returning to school, including local conditions, your family situation, your child’s learning style and temperament, and so on. While each family’s situation is different, type 1 diabetes alone should not be considered a medical reason to delay return to school or work. Consider whether your child will receive the supports they need to help manage their diabetes during the school day.

 

Are children with type 1 diabetes at higher risk of contracting coronavirus?

You may have heard that people with diabetes are at higher risk of developing complications from COVID-19. This is based on information about adults, mostly with type 2 diabetes and not youth with type 1 diabetes. While we lack specific evidence about type 1 diabetes and COVID-19, leading medical experts say that children (and adults under 65 years) with well-managed type 1 diabetes are NOT at increased risk of contracting COVID-19 or developing serious complications from it.

 

How do I keep my child with type 1 diabetes safe at school?

Take steps to prevent getting coronavirus

When it comes to keeping students safe from COVID-19, all Canadian schools should have measures in place to help stop the spread of the virus. These will vary depending on what part of the country you are in and what is happening with infection rates in your community. Some ways that schools are helping to reduce the risk of COVID-19 include:

• Smaller class sizes or cohorting (keeping small groups of students together for the day)
• Frequent handwashing and/or hand sanitizing
• Enhanced cleaning and disinfecting of schools, especially surfaces that are frequently touched
• Physical distancing
• Wearing masks or cloth face coverings
• Changes to school schedules or other school-day routines
• Not sharing personal or school-owned items like supplies or musical instruments
• Limiting the number of people coming into the school
• Reducing other high-contact situations, such as bus transportation (by driving, walking or cycling to school)

Help your child become familiar with the guidelines for their school and be sure they know what to do. Check your child every day for symptoms of coronavirus, and keep them home if they have symptoms or are sick.

 

Ensure your child has a diabetes care plan in place

The most important tool for keeping your child with diabetes safe at school is an Individual Care Plan. Many boards have their own forms, or you can use the one on the Diabetes@School website.

The care plan includes all the details of daily diabetes management at school including: when and where to do blood sugar checks and give insulin; how to deal with low and high blood sugars; and who has been designated to provide support to the student. Before school starts, make sure this plan is up to date, and ask your clinic for help if you need it.
If your child requires support for lunchtime insulin from an adult who is not on the school staff, ensure that you contact the school about these arrangements before school starts, since schools may be limiting the number of people allowed on site.
School staff will also need education or training to support your child. The Diabetes@School website has many tools, such as videos, that make it easy to do this training virtually or online if you are unable to do it in person.
Encourage your child to be extra vigilant with hand hygiene, especially when they are checking blood sugars, using their insulin pump, or doing any other diabetes task. You may want to include some extra hand sanitizer and/or wipes in their kits, as well as extra masks or gloves in case an adult at the school needs to provide help.

 

What if my child gets COVID-19?

Having any virus or illness can affect blood sugars in people with type 1 diabetes. Since the chance of high blood sugar and ketones are increased when your child is ill, make sure you are familiar with sick day guidelines. In particular, know:

• How to check for and manage ketones, which can develop with high blood sugar. You can use a blood ketone meter or urine strips. Ensure you have supplies on hand at all times and be sure to check expiry dates.
• How to prevent DKA (diabetic ketoacidosis), a serious complication of diabetes that needs hospital admission caused by not having enough insulin.
• How and when to use mini doses of glucagon, for children with low blood sugar who are vomiting and cannot take fast-acting sugar. If your clinic has not trained you to do this, ensure you know when to call for help. Have an injectable glucagon kit on hand, even if you have a nasal glucagon product (Baqsimi) as well.

Since anyone with viral symptoms must stay quarantined for 14 days, be sure to always have a supply of prescriptions and diabetes medications at home.

 

How can I prevent DKA?

Symptoms of DKA (diabetic ketoacidosis) include abdominal pain, nausea, vomiting, high blood sugar and ketones (which cause fruity-smelling breath, and laboured, rapid breathing). Without treatment, DKA can be life threatening.
Here are some things you can do to prevent DKA:

• If your child is sick and/or has ketones, follow your clinic’s sick day guidelines.
• NEVER stop insulin: During an illness, even if your child is not eating well, insulin needs are usually higher.
• If your child uses an insulin pump, make sure you have either syringes or an insulin pen on hand, in case you need to give fast-acting insulin by injection. Have a supply of basal (long-acting) insulin on hand in case your child’s pump malfunctions.
• Keep your child well hydrated with sugar-free fluids.
• Seek help from your team as directed.

If your child is showing signs of DKA, you need to seek medical attention immediately.

 

What else can I do?

• Do what you can to prevent all family members from contracting coronavirus. That includes practicing physical distancing, hand hygiene, and wearing masks—especially when inside and when physical distancing is not possible. Follow the advice of the Public Health Agency of Canada and your local public health authorities.
  • To help minimize possible exposure, know what others in your circle are doing to prevent illness, including child care providers, friends outside of school, and extended family. If your child is taking part in extracurricular activities, ask what precautions are being taken.
  • Don’t send your child to school if they have any symptoms of coronavirus.
  • Ensure all your child’s vaccines are up to date and that they get an influenza vaccine as soon as they are available in the fall.

 

For more information:

• COVID-19: Guidance for School Reopening (Joint statement from pediatric hospitals in Ontario)
• JDRF Canada: T1D and returning to work and school in the wake of COVID-19
• JDRF Canada: Type 1 Diabetes and Coronavirus
• Provincial Council for Maternal and Child Health: Illness management guidelines
• Diabetes at School: Video series
• Diabetes Canada: Kids with Diabetes at School

 

www.diabetesatschool.ca

www.breakthrought1d.ca

www.diabetes.ca

 

Developed by Diabetes@School (Canadian Paediatric Society, Canadian Pediatric Endocrine Group, Diabetes Canada) and JDRF Canada, in collaboration with the diabetes teams from the Children’s Hospital of Eastern Ontario (Ottawa) and the IWK Health Centre (Halifax).