Category Archives: advocacy

Diabetes Scholars Cookbook…Like Pinterest that you can hold in your hands!

The other day when I went to my mail box I almost screamed with glee.  Inside was a parcel from a lady I know, Mary Podjasek.  Mary happens to run a charity that I love–The Diabetes Scholars Foundation.  A parcel from her meant that my new cookbook had arrived!???????????????????????????????

I know you are thinking, “I don’t need a cookbook. I use Pinterest and get great recipes instantly without a tonne of books laying around my house.” I have to admit that when my friend Jane said that she wanted to do this and she was going to have a real, hold in your hands book, I was kind of thinking the same way.  I love Pinterest.  It makes my life so much easier. I have a zillion recipes pinned to try one day. I also have a cupboard full of recipes and recipe books that I always go back to.  Perhaps Jane was on to something and she was!

I bought my cookbook because it was a great price (only $20 and that included shipping to Canada!) and because it supported a cause that I love–Children with Diabetes’ scholarship funds. ???????????????????????????????

In 2015, there are many supports out there for families of children living with diabetes.  Every house has internet access.  Every child now receives a Bag of Hope either in the hospital or soon after going home.  In 2000, that was not the case.  When my son was diagnosed, I was given the phone number of a lady who would later become a good friend.  We were both fumbling, trying to deal with toddlers with diabetes.  There were few other supports.

Within a year after diagnosis, my mom convinced me to get this thing called the internet for my home computer.  My computer would dial a local number and I would be connected with the world–my phone line would be tied up during that time, but I could connect with my family all over the world.

What I didn’t realize was that the sound of clicks, rings, and whirls would also connect me to a new family–a family of people who were also living with diabetes.  I would be connected with people who had children the same age as mine with diabetes, older children with diabetes, and people who had diabetes themselves.  I would be accepted and welcomed into a family that would always be there for me through diabetes issues and even much more private ones.  They would be there with cyber hugs and real hugs when we would meet.  They would be available at all hours to talk and share.

???????????????????????????????Today, times are a little different.  The internet has evolved.  We now connect on Facebook, through emails or even the occasional text. The bond and the appreciation has not changed at all however.  I look forward to conferences when I get to see many of them.  I continue to plan to one day get back to Florida in July of some year to be able to sit around the hotel and chat with many more of this family that I don’t see often enough.

???????????????????????????????In the meantime however, I can now peruse through this cookbook and see many familiar names. I can sample recipes that I have drooled over in online photos.  With each page, I see love and compassion.  The layout of the cookbook takes me back to many of my favorite old cookbooks and I know without a doubt that this will become one of my new favorites!

If you haven’t ordered your cookbook, I would encourage you to head over to the Diabetes Scholars website and get one before they are sold out. There was only a limited number printed.  The goal is to be able to send three families to the Friends for Life conference in Florida and it only costs you $20!

That is one of my recipes in the bottom left :)

Thank you so much to Jane, Kara, Stacey, Mary and all of the others who contributed and put this book together. Thank you for bring a little piece of my diabetes family into my kitchen!

 

What can $400,000 buy?

According to MoneySense.ca, the average cost of raising a child to age 18 is a whopping $243,660.  

According to my calculations, the medical costs of a child with type 1 diabetes diagnosed at 2 until he is 18 years of age is $151,323.  That means that raising this child until he is 18 probably cost close to $400,000 in total!

old houseFor $400,000 I could have paid off a really nice house.  Actually knowing the cost of my first and second homes, I could have paid off more than one!

For $400,000 I could have travelled the world. I could have taken safaris in Africa or wandered the streets of Paris.  I could have enjoyed the tropical beaches of Bali.

For $400,000 I could have owned some amazing cars. I could have had my dream green Jaguar or a lovely Stingray Corvette.

$400,000.  Its not enough money to live on forever but I could have done a lot of things with it but that didn’t happen.  $400,000 kept a child in clothes.  It kept a roof over his head. It tried to keep pace with his ever growing appetite.  It paid for life saving medical equipment.

For $400,000 I got a lot more than cars, trips or a new home. For $400,000 I have been able to touch the tiny hand of a new little person.  I was able to watch him bravely take his first steps.  I was able to watch him master hide-and-go-seek as he stealthy hid under a pile of laundry for hours, never revealing his position.

SCN_0002I was able to hold him tight as he lay scared in the hospital as his body worked to repair itself after being deprived of insulin for too long.  I was able to watch him play with his friends who would protect him and tell any adult who was curious that their friend’s pancreas had broken so he had to receive needles.

$400,000 bought me a young man with a quick wit whose strong arms can take away some of the greatest pain. It gave me my son–alive and healthy.  The value of my children is far beyond any dollar value that you could imagine.

Children are expensive. That is a fact.  Their needs are great.  Children with diabetes have an added expense that they will have for their entire lives.  The value of both and children with diabetes is immeasurable however. From the minute we know of their existence, our children grab hold of our hearts and never let go.  We do our best to protect them.  We are there to hold them and dust them off when things don’t go according to plan.  Through the ups and downs, they remain a very special part of us. They are worth far more than just $400,000.

How much would it cost me to manage my diabetes?

The other day, it seemed like I was constantly having to use the washroom.  I thought, what if I was one of those people diagnosed later in life with Type 1? How would I handle things? I don’t even want to go there!!!

I knew if was not a real concern.  I knew that I would do what must be done but I would not dwell on the daily routine.  I did however begin to think about the financial aspect.  What if I did have Type 1? I am over 25.  I have no private medical coverage. I would have to cover everything out of pocket.  How expensive would that really be?

First there would be the insulin pump.  I would definitely want the best technology to help me along.  Since I already know what is out there I would most likely look to purchase a sensor augmented insulin pump.  According to a recent letter from my son’s insulin pump company, the initial cost of such a pump would be $8240.  This would give me an insulin pump, a CGM transmitter and four sensors.  I am guessing that I would still need to buy the receiver for another $700.  A box of cartridges would last me ideally for one month as would the infusion sets.  Those items are $64 and $195 respectively. For a total of $9299 I would have a pump with no batteries or insulin but I would have a pump.

Obviously if I have type 1 diabetes, I would need to purchase insulin for myself.  That works out to approximately $70 per month if I am using an insulin pump and able to squeeze every drop of insulin from each vial.

I would also have to test by blood glucose levels 8-10 times per day. Perhaps I would test a little less because of my CGM but even at 4-8 tests per day I would require $90-$180 in strips per month.  This does not include having to purchase ketone strips which are over $3 per strip for use when high or ill.

Finally there would be the batteries for the pump, the alcohol swabs, SkinTac wipes, spare syringes, lancets and tape that would also be required to keep me healthy.

Our province does have a public medical program that I would qualify. It looks at our family income and then dictates that we must cover an amount equal to 7.5% of our family income first.  My partner runs his own business so our income can fluctuate.  I would anticipate that based on their formula, I would have to spend at least $4500 on my diabetes care before they would begin to cover any of my expenses.

Sadly, based on my calculations, the items that the government would cover under their program (insulin, some test strips and syringes) would most likely not reach the magic number of over $4500.  I would instead be left to cover, out of my own pocket well over $14,000 in annual expenses.

I honestly had no idea what the total of this would be.  People with diabetes tell me all of the time that the cost to keep themselves alive and healthy is the same as a car payment or a downpayment on their first house.  They are not exaggerating.  The costs of maintaining your diabetes care in the best way possible is over $14,500 by my calculations.

The chart below is based on never getting sick. It assumes that no sites will fail or fall out while hot, sweaty, or get hooked on a cupboard door and become removed. It assumes that insulin will never spoil and everything will work out as anticipated.  That never happens in life or when dealing with diabetes.

Without private insurance or a rich great uncle, there is no way the average person can afford to maintain optimal health care if they also have type 1 diabetes.  Yes, you can live and function on injections.  Yes, you can live and work without a Continuous Glucose Monitor (CGM) but if you want to use the best tools available to give you the very best quality of life….well find a job with great insurance because if you have to rely on just your wallet and the help of the provincial government and you are over 25, its not going to happen.

sensor augmented pump costs feb 2015

Choice. YDMV

Choice.

Your Diabetes May Vary.

Everyone is different.

What works for me, may not work for you.

These phrases are very important in the world of diabetes and specifically in the world of Type 1 diabetes.

I have always been vehement about people’s right to choose. I believe that individuals have to do what is right for them.  What is right for you may be not right for me but does that mean that I should stop you from doing it, right?

I have been equally as dedicated to the right to choose since entering the world of diabetes. I believe that people should be able to go on an insulin pump at diagnosis and not wait for a specific period of time…if they so choose.

I believe that everyone should have access to a Continuous Glucose Monitor. Access should not be restricted by income level or insurance plan…if they wish to use one.

Most importantly I believe in the right to education.  Education allows people to make informed choices.  Just because an insulin pump has been the best treatment option for my son, doesn’t make the best option for you.  Every person is different. Every body reacts differently. Each person should have the right and be educated to make the choices that fit their lifestyle regardless of budget.  That is my point.

I know of adults who have pumped and hated it. They did not want to be tethered to something. They felt that they had better control with injections.  That was their choice and they made it armed with information about themselves and the alternatives.  Everyone is different.

I have met parents who have seen great success using NPH on their children. I was able to learn how to use NPH and a rapid acting insulin in such a way that my son rarely did without at birthday parties or other food related events. We were educated.  We could make choices that worked for our families.  What worked for us does not always work for someone else.

If someone chooses to use an insulin pump, they have to choose the pump that works for them.  Some people don’t like tubing. Some people want a pump that is water-proof. Some people require larger reservoirs or a sensor augmented pump. It is vital that they be allowed to learn about their options and then make the choice that fits their lifestyle.

We all have seen how amazing Continuous Glucose Monitors are…but some people still don’t want them. My son is one of those not sold on the benefits of wearing yet another device. They have a right to make that choice but that choice should not be driven by money.  It should be made based on their own desires and knowledge of their diabetes care.

No one should have to choose insulin or bread, pump supplies or car payment, insulin pump or house down payment, a cab ride home after a night out or a sensor for their CGM.

No one should be forced to use an insulin regimen because they are ignorant of the options.

No one should be stuck in one treatment form or the other because it might take a bit more time to educate them.

Options should be given to everyone regardless of age or income.

People with diabetes should be shown all of the insulin options–do you want to go with limited injections? Do you want to use a basal/bolus regimen? Do you want to use an insulin pump? What features are important to you? Do you want to have a pump with tubing or without? A pump with CGM compatibility or without? Do you want to try a CGM? What works best for you and your lifestyle? What will give you the best quality of life?  Yes it can be overwhelming but knowledge is power.

One treatment option does not work for everyone. I have come across people who have created their own insulin cocktails to maintain great control on injections. I have known people who only used their pumps to cover meals and used an injection to deliver their background insulin.  I am hearing of people looking to add in the use of inhaled insulin for very specific needs.

Everyone is different but everyone deserves the right to make their own informed choices.  Those same people who make informed  choices then deserve our respect because what works for them may not necessarily work for everyone else.

Thank you DiabetesInsight.ie
Thank you DiabetesInsight.ie

15 Years later and its still happening

On my Facebook news feed, there has been a lot of mention of a child who was recently diagnosed with Type 1 diabetes.  Too many children are diagnosed each day but this story is getting greater attention because she was not diagnosed until she was in a coma and now appears to have brain damage.

I can’t give you the details of this particular story.  I haven’t followed it.  I see the photos.  My heart breaks for the family and the young girl but I can’t sit down and read about them.  I can’t follow their story.  It cuts me to the core because I know that there but for the grace of God go I.

It was almost 15 years ago when my then two-year-old son was behaving strangely. He was clingy and tired. He was constantly soaking his diapers but he also was constantly drinking when he was awake.  We couldn’t keep him away from fluids. If we restricted what he drank to try to save his diapers, he marched his little body to the fridge and would guzzle apple juice from the carton.

We had taken him to the emergency room.  He had the flu we were told.  We waited for him to get better but he didn’t.  We made an appointment with our family doctor and our world came crashing down in waves.  Our doctor thought he had diabetes. He had ketoacidosis.  He needed x-rays.  He had to go to another hospital.  This was very serious.

I understood x-rays, hospital and serious.  My son was laboring to breathe in my arms and his body was cold.  It was serious but it couldn’t be that serious could it? He had been healthy all of his short life.

A trip to another hospital led to another wave of terror.  Now we were told new things. We heard diabetes again. We heard brain damage, heart attack, stroke, kidney damage, and “if he makes it through the next 24 hours.”

That was almost 15 years ago.  Someone missed checking his urine or blood during the first visit to the emergency room.  It almost cost my son his life.

Today we have insulin pumps. rapid insulin, continuous glucose monitors, and sensor augmented pumps.  We have meters that read bg levels in under five seconds but still we have children literally dying because a diagnosis of diabetes was missed.  A routine test of urine for sugar or ketones is not done when they are checking for everything else.  Doctors assume that its flu season and the child must just have a bug.

Its not their fault.  We feel that it is when its our child but they have to know so much and what ails the human body can be such guess work.  They could help themselves and our children however if they remember to add that one little screen to routine blood or urine work-ups.  A stick in urine will still show the presence of ketones.  Asking any parent of a child with diabetes how long it takes.  Its a matter of seconds and the urine sticks are cheap. ketostix_intensity

In 15 years a lot has changed.  Our meters no longer take 30-60 seconds to produce a reading.  There are other background insulin options besides NPH.  Insulin pumps are now so smart that they can talk to continuous glucose monitors.  Continuous Glucose monitors are no longer items that are blinded and reserved for only select hospitals.

Type 1 diabetes is finding itself in the mainstream media.  Insulin pumps are being shown and discussed in various television shows.

Despite all of these strides ahead, children are still dying.  People do not know what to look for.  As a parent, I didn’t know what diabetes looked like or even that I should be looking until the signs were literally posted right in front of me.

Healthy children get sick but they don’t need to die.  We need to work harder to get the word out there.  Families should not suffer this pain. No one should die or suffer the damage of undiagnosed type 1 diabetes in 2015.

 

Make this month’s Hallmark Holiday Truly mean something!

Maybe it’s because I am getting older.

Maybe it’s because every month there seems to be some occasion that is asking for access to my wallet.

I am sure it is a combination of the two.  We literally have only just finished putting away everything from Christmas so another occasion is just too much for me to handle so soon.  I cannot get excited about more chocolates (I still have to lose the weight I gained from all of last year’s chocolate) or an overpriced card that says the things we should be sharing on a regular basis.  I can get excited about saving the life of a person with diabetes however.

For the third year in a row, the Diabetes Online Community has come together to help the IDF’s Life for a Child Program.  The idea is that a dozen roses cost $60.  $60 would cover one year’s worth of insulin under the IDF’s program.  Since no one wants to see anyone end up in the dog house for not giving your loved one the required flowers for Valentine’s day, the idea of “spare spare a rosea rose” was born.

Give your loved one 11 roses.  Spend $55 and then give that extra $5 to the IDF.  That $5 donation will last a lot longer than the rose.  With a lot of TLC, I am guessing you will only get a week out of the roses and a day or two of goodwill.  If you spare a rose you will get the week of seeing those 11 roses blossom, but a child will get one month’s worth of insulin and your sweetheart will know how much you care about others and which might be worth an extra week of goodwill from him/her!

This year its easier than ever to get involved.  I just made my donation as I was finding all of the links for this post! You click on the donation page, choose the currency you would like your donation in (you have a choice!!), decide if you want to make a one time or monthly donation, decide how many roses you are willing to forfeit for a great cause (one? two? the entire dozen?), and finally choose how you want to pay.  You can pay from your PayPal account, a credit card, or a bank account.  It really is that simple to save a life! You can even share this idea with your office and create an office campaign.

If you are like me and not a big fan of February’s Hallmark Holiday, I encourage you to turn it into something meaningful and become a part of the Spare a Rose, Save a Child campaign.  Tell your loved one how important they are to you and then show them how much you care about others by donating a rose (or twelve) to save a life!

To learn more about the Spare a Rose, Save a Child campaign, please check out these frequently asked questions.

If its not sexy, how to we make them care?

Its something that has really been plaguing me the last few days…how do we make people care? How do we help them to get it? Many people sympathize with all of the challenges that goes into dealing with diabetes.  Some people will look wide-eyed and dazed as they realize all that it entails but very few truly understand the serious and overwhelming nature of this disease.  In order to receive better funding for research or support with devices, its vital that common people understand but how do we do that? I hope you can help me with that.

My son was diagnosed with type 1 diabetes almost 15 years ago.  Before his diagnosis, I didn’t get it. I knew one child growing up who had the disease and knew one person as an adult who had type 1 diabetes.  She had to watch what she drank and could only use diet 7-up for her drinks.  That was the depth of my knowledge.  Today  I am a walking encyclopaedia.

We don’t need the general public to have as much knowledge as those of us living with diabetes.  We don’t need government officials who understand the ins and outs of the disease either but we need a greater empathy and understanding.

For years I have shared stories. I have given people the scariest moments to ponder. They have watched as my son ate meals at regimented times or devoured food with the voracity that only a teen can do followed by a large bolus of insulin. Despite that, I can hear in certain comments and see in various facial expressions that they still don’t really understand.

They think I worry too much…and maybe I do.  They don’t understand the costs associated with the disease–emotional or financial. They cannot begin to understand having to spend thousands of dollars each month just to stay alive–we have insurance that covers that right?  Obviously we have over dramatized things–they aren’t really that bad are they? Wrong.

Some people understand the freedom offered by a pump but fail to understand the importance of a sensor. The cost seems ridiculous when you can just lance your finger and have it done with. They don’t understand how important it is to “see” what is happening inside the body and to be able to anticipate and react to problems as they happen rather than later.

How do we make them understand? How do we make loved ones who don’t deal with this 24/7 truly comprehend what a person with diabetes goes through on a daily basis? How do we convey the stress and worry that they carry with then all of the time? How do we make an invisible disease visible and serious to those around us without the loss of limb or life? How do we remove the blame and create understanding?

These are real questions and I am looking for real answers. How do you handle these issue in your life? Please share them with me.  I would like to be able to use new and more effective techniques as I continue to advocate for my son and others living with diabetes. I would like to see the world come to a better, more real understanding of what people go through so that they can be more kind and more thoughtful to those living with diabetes.  That is my goal for 2015. Please help me to reach it. miss-idaho-insulin-pump-instagram-doodle__oPt

Test Strips. How many is enough?

Recently the BC government announced that they would be restricting the number of test strips that they covered for people with diabetes.  Those using insulin would only receive 3000 test strips per 365 days.  Those who did not use insulin would be given significantly less.

BC is not the first province to do this.  The table below shows that there are very few provinces offering strip coverage that truly matches the needs of individuals with diabetes.

Province Coverage for those on insulin
Alberta 700 strips for 100 days (2555 per year)
Manitoba 500 strips for 100 days (1825 per year)
Ontario 3000 per year
Quebec Limited to the amount prescribed
Saskatchewan Ongoing coverage
New Brunswick 50, 100, or individualized number of strips per year depending on diabetes regimen
Nova Scotia Limited to the amount prescribed
Newfoundland 2500 per year
Prince Edward Island 1200 per year

What does this mean? Are we simply too greedy? Do we want our provincial governments to cover too much? Are we testing too often? 3000 test strips is a little over 8 tests per day.  Shouldn’t that be enough?

My son ideally tests before each meal, two hours after every bolus, before and after exercise, before bed, and at least once during the night. He has used up his eight test strips before he has done his regular work out or retested after a low.  He does not have any strips to spare if there is a strip error.  He also doesn’t have anything extra for sick days when we know that a person will go through a ridiculous amount of strips thanks to highs, ketones, and vomiting.

I read somewhere that the idea behind these restrictions was to help make people think a bit more before they test.  We don’t want them to just be testing willy-nilly and wasting strips.  That made no sense to me.  Why does someone willingly want to lance their finger for the fun of it? Yes, some people without diabetes like to do this to make sure that their blood glucose levels are in check but why would a person with diabetes whose finger tips already are a mess of black dots and scars want to poke themselves just for giggles?  They won’t!

My son is 17.  He tests when he has to and absolutely no more.  He tests when he feels that his blood glucose is on a fast rise or fall. He tests when he knows that something is off in his body and it needs his immediate attention.  It is never something done for fun.  It is done to keep him alive, healthy and productive.

Why is it such a big deal for people to have their test strips covered? Why should tax payers care about covering the cost of test strips for people with diabetes who do not have private insurance? Because the cost of not helping them is far too high.

If people with diabetes are not testing their blood glucose levels, they are not able to note consistent highs or even lows that will silently damage their bodies.  They will not feel as healthy and they will  begin to miss more days of work. Over time they will develop complications that will completely take them out of the workforce and put a huge drain on the health care system.

4500 test strips per year for example would equate to testing just over 12 times per day.  That would be an extra $1050-1500 per year for those individuals who max out their test strip limit. Compare that amount to $263,000 per year that governments pay for hemodialysis which can result from poor diabetes control. Sadly, too many of provincial governments do not see the long term.  They see the possible $1500 per person per year that they are saving and stop there.  They are not concerned with the drain on the health care system in 5 or 10 years down the road.  They won’t be in office then and it will be someone else’s problem.

This thinking needs to change.  It is not just about the health concerns that they are creating for tomorrow by failing to properly care for people living with diabetes today. It is also about the money that they are losing from these individuals today.  People living with diabetes can lead very full and productive lives. They can be doctors, lawyers, plumbers, and mechanics.  There is very little that they cannot do when they are able to avail of the tools that help them to regulate their blood glucose levels properly.

When these individuals do not have the proper tools they miss time from work or may even have to remove themselves from the labour market.  They require the assistance of more government services rather than helping to pay for them.  Keep people living with diabetes healthy is to the benefit of everyone in society.  The reward in quality of life, longevity, and productivity far outweighs the cost of a few thousand dollars each year.

pl131037-one_touch_ultra_diabetic_test_strips

 

 

 

 

 

 

*table is compiled from data found on provincial websites and http://www.chspr.ubc.ca/sites/default/files/publication_files/Test%20Strips%20in%20BC%202014_0.pdf

Happy Birthday Mr. Banting!

bantingToday is a very important day as both a Canadian and as a parent of a child with diabetes. Today is Sir Frederick Banting’s birthday.  Were it not for the birth of this man, his hard work and his dog Marjory, my youngest son would not be alive today.

According to the Nobel Prize website, Frederick Grant Banting was born November 14, 1891 into a large family.  He grew up in Alliston, Ontario and studied divinity before going into medicine.  I am sure many would agree, that this change in his course of study was truly Divine in nature.

Dr. Banting used his medical degree in the Canadian Army Medical Corps during WWI where he was injured and later received the Military Cross for heroism under fire.  Upon returning to Canada, Dr, Banting set up a small private practice but it was not that lucrative and he was forced to take a teaching position at the University of Western Ontario’s medical school.

My research does not give a clear reason why but only states that Dr. Banting had become very interested in diabetes.  He was fascinated by the works of other doctors and after one sleepless Halloween night in 1920, jotted down a research idea.  His idea was aimed at isolating the internal secretion of the pancreas, a jelly-like gland behind the stomach. He recalled from his lectures at medical school that this secretion supposedly regulated sugar in the bloodstream. If he could isolate this secretion, it might hold the key in the treatment of diabetes.

banting and marjoryDr. Banting approached Dr. J.J.R. Macleod, a physiology professor at the University of Toronto who gave him a small lab for him and his research assistant Charles Best to work in.  May 21, 1921 the two began working with dogs to try and isolate this “internal secretion of the pancreas”. After many failures, by the winter of 1921, Banting and his research team were able to announce that they had isolated something he called “insulin” that was working to treat diabetes in dogs.  On January 23, 1922 Banting and Best were able to take insulin made of ox pancreas and inject it into a 14 year old boy with diabetes. ..and the rest as they say is history.

without insulin
Before and after the invention of insulin

Dr. Banting set out to find a for diabetes and he was not completely successful.  He did however find a lifeline.  Thanks to his discovery of insulin, my son and millions like him around the world are alive and thriving today.

Thank you Dr. Banting for your hard work, your diligence and for saving my son’s life!

 

 

References:
http://www.collectionscanada.gc.ca/physicians/030002-2000-e.html
http://www.nobelprize.org/nobel_prizes/medicine/laureates/1923/banting-bio.html
http://www.thecanadianencyclopedia.ca/en/article/sir-frederick-grant-banting/

Can I get the DTC if I am an adult insulin pumper?

For a number of months there has been concern about a video posted on the CRA website stating that using an insulin pump did not allow a person to be eligible for the Disability Tax Credit.  Many people have written letters to their MP as well as CRA.  The CDA has made the issue of easier qualifications for adults with Type 1 diabetes a priority for the upcoming federal election but what does this really mean to people living with diabetes?  Do they no longer qualify for the DTC if they are using an insulin pump?

A member of the Insulin Pumps.ca staff received the following response from CRA….

In receiving a qualifying therapy, the person must dedicate time to the process. This means taking time away from his or her normal everyday activities to receive the therapy. For portable devices, such as an insulin pump or implanted devices like a pacemaker, the time the device takes to deliver the therapy does not count toward the 14‑hour requirement. Activities like following dietary restriction, exercising, traveling to receive therapy, attending medical appointments, shopping for medication, or recuperating after therapy also do not count toward the 14-hour requirement.

Early on in the fight for fairness regarding the Disability Tax Credit and people living with type 1 diabetes, a court case was won in which it was successfully argued that a person using an insulin pump was actually injecting insulin 24/7 and thus easily spent more than 14 hours per week on life sustaining therapy.  It is not surprising that CRA quickly made an amendment to their policy stating that they would not consider the time a machine/device requires to deliver therapy as part of the 14 hour total.

This does not mean that people who use insulin pumps no longer qualify for the DTC. It means that the time the pump spends delivering insulin does not count towards time spent on therapy. The amount of time dedicated to diabetes related tasks such as bg testing, ketone monitoring, logging, making dosing adjustments, as well as site changes and pump maintenance is still used in the 14 hour calculation of therapy.  The video posted online and the CRA website, unfortunately do not clarify this.  That can be problematic.

Doctors who rely on the CRA website to guide them on what is considered therapy when dealing with Type 1 diabetes may be led to think that insulin pumpers in general do not qualify for the DTC.  Even those living with Type 1 diabetes may wrongly think that they no longer meet the qualifications.

Being an adult with Type 1 diabetes does not automatically qualify someone for the the DTC–being a child under 18 with Type 1 diabetes does.  Using an insulin pump does not automatically qualify you for the DTC–neither does using multiple daily injection therapy. The key to qualification is to intensively manage your diabetes care. This means that you spend over 14 hours per week on such things as testing your bg levels, monitoring for ketones, changing infusion sites, injecting insulin, logging daily diabetes related activities, and other diabetes related tasks that a person without diabetes does not have to do to maintain life.  Tasks such as carb counting does not count towards therapy nor does the amount time spent recovering from a low blood glucose level but many other tasks do and can quickly add up to spending over 14 hours per week on life sustaining therapy. fairness report