Managing Diabetes

Nothing stops comedian, actress, and jazz musician Lea DeLaria — not even type 2 diabetes. We spoke to the Orange IstheNewBlackstar about how her life has changed following her diagnosis and how she balances her diabetes journey and career in show business.

How has diabetes affected your life, both personally and professionally? It has affected my life incredibly in both aspects. I’m in show business and have been my entire life, so I’m used to a certain lifestyle of partying, staying up late, hanging out, sleeping during the day — all that stuff. Once I was diagnosed with diabetes, I knew I had to make a change in my diet, my drinking habits, and my exercise regime. It really made a huge difference. But as a result, I lost 50 pounds, which is great for one’s health.

Is there a part of your diabetes journey that has been particularly triumphant?

About two years ago, I got my A1C [a test depicting average level of blood sugar over the past two to three months] to 5.8 and I’ve hovered around 5.9 to 5.6 ever since. To me that feels very triumphant. I have the blood sugar of a normal person and that means a lot to me. Taking care of my body, my health, my work, and my life — I feel like I’ve really gone for it and done well.

Makes a Difference

We all play a role in ending diabetes. No matter how big or small, every action makes a difference.

Diabetes Canada

November is Diabetes Awareness Month and a time to shine a light on a disease that affects close to 11.5 million Canadians. It’s also a time to highlight the incredible, inspiring, and hopeful actions being taken by individuals, communities, governments, and organizations that help end diabetes. This year also marks the 100th anniversary of the revolutionary Canadian discovery of insulin. But insulin is not a cure, and we can’t wait another 100 years to end diabetes.

Building on the legacy of the co-discoverers of insulin (Banting, Best, Collip, and Macleod), and the incredible work of current Canadian

researchers and clinicians, Diabetes Canada is urging Canadians from coast to coast to take action to end diabetes. When we think of ending diabetes, we automatically think of a medical or scientific breakthrough. However, we end diabetes when we ensure that people living with the disease have access to the medications, devices, and supplies they need to live well, when we end the stigma associated with having diabetes and make people feel fully included in society, when we end the burden of having to test blood sugars 14 times per day, and when it no longer represents a 11-to 15-year loss of life expectancy.

It was a wake-up call for me to be told I was diabetic.

What do you want the public to know about diabetes?

In society, they shame people with diabetes and will say, “All you have to do is control your eating habits.”

People end up having terrible misconceptions about the disease. People out there who are shaming people with diabetes, please stop doing that. We’re all doing the best we can with what we’re given and the cards that we’ve been dealt.

If you could give one message to Canadians living with diabetes, what would it be?

More than anything, I want to say: you can do this. You don’t have to lose a leg, you don’t have to lose an eye, you don’t have to lose your life. You can do this. You can be healthier and happier. It’s not as hard as you think — you’re stronger than the disease.

There are many ways to get involved in this year’s November campaign. And every action, no matter how big or small, makes a difference. Whether it’s helping to dispel myths associated with diabetes, donating to support research and programming, attending a free diabetes webinar, speaking up with elected officials to improve access to medications, supplies, and devices, or even ensuring that you see your health care provider, every action matters.

It’s the collection of actions from across the entire diabetes community that will help drive progress and improve the quality of life of those affected by diabetes. Throughout November, Diabetes Canada is aiming to achieve 100,000 actions to help end diabetes.

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LEA DELARIA —

Despite Diabetes, the Show Must Go On

Continuous Glucose Monitoring System Provides Improved Diabetes Management

Abigail Cukier

For people living with diabetes, monitoring glucose levels is one of the most important steps in managing the disease.

“Diabetes requires continuous maintenance of glucose levels in the desirable range in order to limit complications,” says Dr. Akshay Jain, an endocrinologist in Surrey, BC. “This is a 24/7 requirement and levels can be affected by what we eat, our physical activity, stress, lack of sleep, alcohol intake, and many other factors.” Checking glucose levels helps people with diabetes make decisions like how to dose their medications, what food to eat, and whether it’s safe to exercise, explains Dr. Jain.

Traditionally, checking your glucose levels has meant pricking your finger and placing a drop of blood on a test strip and into a blood glucose meter. This can be painful and especially hard on people who need to check their levels multiple times a day and at night.

“Most importantly, it only gives us a snapshot, as it’s only a reflection of the glucose levels at that particular second. It doesn’t give us any idea of whether levels are rising, dropping, or staying steady. This is why we require several of these snapshots each day,” says Dr. Jain.

Continuous glucose monitoring helps the user to manage glucose highs and lows Alternatively, a real-time continuous glucose monitoring (CGM) system like the Dexcom G6 takes glucose measurements every few minutes, day and night, without the need for fingersticks.* This helps users manage highs and lows and lets them see the impact that certain behaviours have on their glucose levels.

The Dexcom G6 CGM system has a small, wearable sensor† and transmitter that sends glucose numbers to your smartphone± up to

every five minutes. Alerts let you know when you’re headed too high or too low. The predictive, Urgent Low Soon alert can notify the user in advance of glucose getting below a certain level. Users can also share their glucose levels with up to 10 people using the Dexcom Follow app §, providing more peace of mind for parents and other caregivers. Health care providers can also see a summarized report to help improve diabetes management.

“Devices like the Dexcom G6 have been shown to reduce A1C (average glucose levels over three months) and improve the time spent in your target glucose range,”1,2 says Dr. Jain. “The latest Diabetes Canada blood glucose monitoring guidelines recommend the use of this device, especially in individuals requiring several injections of insulin or insulin pumps.” The Dexcom G6 is now covered under many provincial health plans and by most private insurers, helping more people with diabetes access this life-changing technology.

Improved glucose control is empowering

Laura Sabourin, a 45-year-old high school teacher from Chatham, ON, says the Dexcom G6 CGM system changed her life. Diagnosed at age two with type 1 diabetes, Sabourin’s family found it difficult to manage her glucose levels as a young child. As she got older and became a teacher, she says consistently checking her levels by pricking her fingers was “nearly impossible.” She also had to take four insulin injections a day.

absolutely changed the way I live. The control I have now is so empowering. To know what my glucose level is and where it’s headed at a glance is unbelievable. I feel more in control, and that’s going to help me live a longer and healthier life.”

* If your glucose alerts and readings from the Dexcom G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

† Adults can use their bellies or back of upper arms for sensor placement. Patients age 2 to 17 years old can choose their bellies or upper buttocks.

± To view a list of compatible devices, go to www.dexcom.com/compatibility.

§ Internet connectivity required for data sharing. Following requires the use of the Follow app. Followers should always confirm readings on the Dexcom G6 app before making diabetes treatment decisions.

1 Beck RW, Riddlesworth T, Ruedy K, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND randomized clinical trial. JAMA 2017;317(4):371-8.

While it helped to get an insulin pump, which continuously delivers insulin, checking her glucose was still difficult. In February of 2021, Sabourin started using the Dexcom G6 CGM system. “This is when my life changed to the best life I’ve ever lived,” she says. “This has This article was

2 Welsh JB, Gao P, Derdzinski M, et al. Accuracy, Utilization, and Effectiveness Comparisons of Different Continuous Glucose Monitoring Systems. Diabetes Technol Ther 2019;21(3):128-32.

LBL022177 Rev001

sponsored by Dexcom

This has absolutely changed the way I live. The control I have now is so empowering.

LAURA SABOURIN, PICTURED ABOVE WITH HER DOG

Exploring the Connection Between Diabetes and Heart Disease

For Canadians living with type 2 diabetes (T2D), taking an active role in the protection of your heart is critical. Dr. Shelley Zieroth discusses actions that T2D patients can take to help prevent heart disease.

How can diabetes affect your heart?

People living with T2D can develop heart disease 15 years earlier than those without. In fact, heart disease is the number one cause of death for Canadians living with the disease.

Diabetes can affect your heart in many ways. First, it’s a known risk factor for the development of coronary artery disease, which causes blockages in the arteries of the heart. This can lead to angina or chest pain, heart attack, stroke, and even death. Diabetes is also a known risk factor for the development of heart failure, which often presents as a weak heart that isn’t able to pump blood.

What factors increase the risk of heart disease in people with diabetes?

Risk factors of diabetes and heart disease are linked and share common contributing factors including low physical activity, poor diet, smoking, and obesity. High blood sugar levels

can increase the risk of developing heart disease. There are medications that help reduce the threat of early death from heart disease, along with diet and exercise.

How can you prevent heart disease if you have diabetes?

If you have T2D, you can take steps to modify your risk of heart disease. First, it’s important to take an active role in your care and to ask your doctor about steps you can take to help manage your risk of heart disease. There’s a useful acronym for clinicians and patients called the ABCDES of diabetes care: A1C, blood pressure, cholesterol, drugs to protect your heart, exercise, screening, smoking cessation, and self-management. You can use this acronym during conversations with your health care provider to guide your discussion, bring attention to your priorities, and reduce your risk of heart disease.

Q&A

Zieroth Cardiologist

For People Living with Diabetes, Regular Hearing Assessments Are Crucial

Veronica Stephenson

People living with diabetes know that managing their symptoms is key to maintaining a healthy lifestyle. We know that fluctuations in blood sugar levels can have an effect on the retinas, kidneys, and blood vessels. However, what isn’t well-known is that those same fluctuations in sugar levels can also damage the blood vessels and nerves of the inner ear, resulting in hearing loss.

Studies have shown that people living with diabetes are twice as likely to have hearing loss than those without diabetes. People with pre-diabetes have a 30 percent higher rate of developing hearing loss than those without. Based on research, the relationship between diabetes and hearing loss has been established,

however the connection is less well-known than other diabetes-related complications.“Symptoms usually begin with muffled hearing or difficulty understanding what people are saying,” says Jacqueline Wong, Audiologist and Clinical Mentor and Trainer with Lifestyle Hearing Corporation. “You may listen to the TV louder than before or avoid social interactions because it’s too tiring to maintain conversation.”

Hearing loss is often underdiagnosed in those living with diabetes Despite the increased prevalence of hearing loss in people living with diabetes, hearing health isn’t always discussed at health checkups. “Often, it’s the family and friends

of the hearing-impaired individual who notice it before the individual does. All types of hearing loss can have a huge impact on one’s communication ability,” says Wong. “Having hearing loss can lead to disengagement from daily activities, social isolation, and an increased sense of loneliness.”

You can take control of your hearing health and begin your personalized hearing care journey today. “Having regular hearing examinations is a great way to obtain a baseline and then monitor your hearing profile over time,” says Wong.

This

Visit myheartmatters.ca to learn more or to download a discussion guide to start a conversation with your doctor.

Dr. Shelley

Director, St. Boniface Hospital Heart Failure & Transplant Clinics

article was sponsored by Lifestyle Hearing Corporation

Sanofi Canada Is Invested in Improving the Lives of People with Diabetes

Diabetes is one of the major contributors to the global challenge of chronic disease. It affects about 10 percent of Canadians and is expected to grow to 12 percent by 2030.1

Diabetes affects people’s quality of life across multiple dimensions and throughout their lives. Aside from having to adapt to a new lifestyle, check blood glucose levels daily, and monitor their risks for complications, people living with diabetes often feel stigma around their disease and require additional emotional and mental health support. Currently, there are significant support gaps facing people living with diabetes in the health care system, and more needs to be done to improve outcomes from both a physical and mental health perspective.

Making mental health a priority Sanofi Canada is striving to help people living with diabetes lead full and productive lives, not only by improving the medical management of their disease but also by developing a better understanding of their specific mental health needs. Sanofi Canada recently commissioned online market research with 1,000 Canadians living with diabetes. Forty percent said that mental health checks are an important aspect of their care since COVID-19. However, only two percent reported having a mental health practitioner or social worker as part of their health care team.

Based on this information, the Sanofi Canada team is working to fill this critical gap by identifying mental health programs specific to diabetes to ensure that people living with diabetes’ priorities and needs are put first. “We’re focused on delivering simple,

convenient, and patient-centred solutions to health care providers and the people living with diabetes who they support,” says Sabina Steinkellner, General Manager of General Medicines at Sanofi Canada. “All people living with diabetes want to live life to the fullest, so we think it’s important to look at solutions beyond insulin.”

Leveraging the past to contribute in the future Sanofi Canada can trace a direct line back to the discovery of insulin 100 years ago. “We’re very proud of our heritage in innovation and contributions to public health, especially in the discovery of insulin but also our decades of insulin production,” says Steinkellner.

But equally important to where Sanofi Canada is coming from is where it’s going. “It’s about how we can leverage where we’ve been in terms of our commitment to people living with diabetes and public health overall and how we can contribute moving forward,” says Steinkellner. “It’s a really integral part of our culture and who we are at Sanofi.”

One way Sanofi Canada is demonstrating its commitment to improving patient outcomes is through evidence-based discussions, sharing cutting-edge research. “We recently participated in the 81st Scientific Sessions hosted by the American Diabetes Association, where we had multiple studies on identifying optimal therapies for sustained diabetes management and remission,” says Steinkellner. Two of these were Canadian-based research abstracts funded by Sanofi, highlighting the importance of partnership and collaboration with the Canadian medical community and a global lens on diabetes research.

Innovative and entrepreneurial thinking can improve the lives of people living with diabetes

With the diabetes world ever changing, Sanofi Canada is focusing on continuing to cultivate agility and an entrepreuneurial spirit. “Just like the pioneers of insulin kept trying and innovating, we’re carrying forward the same willingness today to try new things, innovate, and be entrepreneurs in the pharmaceutical industry,” says Steinkellner.

What hasn’t changed is Sanofi Canada’s commitment to people living with diabetes. “We continue to support people living with diabetes beyond the therapeutic realm,” says Steinkellner. Sanofi’s global ambition is to reverse the course of diabetes by 2030. “It’s a long-term goal that underpins everything we do,” says Steinkellner. “It’s really inspiring for us because it’s about not just helping the patient manage the disease but working to actually reverse the course of the disease — maybe one day, like the prevention of polio through vaccination, it will be something of the past.”

Canadian Diabetes Cost Model. Ottawa: Diabetes Canada; 2016. Diabetes statistics in Canada are estimates generated by the Canadian Diabetes Cost Model, a forecasting model that provides projections on prevalence, incidence, and economic burden of diabetes in Canada based on national data from government sources.

If you’re living with or caring for someone with diabetes, visit diabetescarecommunity.ca to gain knowledge and self-management skills to help support your diabetes journey.

Sabina Steinkellner

General Manager, General Medicines, Sanofi Canada

Sanofi Canada’s focus on the patient experience and innovative way of working aim to achieve the best outcomes for Canadians living with diabetes.

Anne Papmehl

As exciting as it is to commemorate the 100-year anniversary of the discovery of insulin in Canada, what’s even more exhilarating is what we’re doing today to making the next 100 even better. We Will.