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It is NOT an artificial pancreas

My rant…

The media has been shouting for a while now about the new “artificial pancreas” on the market.  This is driving me crazy.  It is not an artificial pancreas. It is a new insulin pump.  This new pump has some automated features but it does not completely replace a pancreas that is not producing insulin. It does not bolus for food on its own.  It is not a cure. What this new device is is a new device! It is another tool to help people living with diabetes live a better life.  That is it!

Medtronic® does not call their latest insulin pump an artificial pancreas. They simply refer to it as “The world’s first self-adjusting insulin pump system for people with type 1 diabetes” (over 7 years of age).  That is fair.

In auto-mode, this new pump will make adjustments and suspend itself.  It uses information from the continuous glucose monitor (CGM) to predict rises and falls in blood glucose levels. The 670G (this self-adjusting insulin pump) will get your background insulin (your basal rate) under control for you.  In turn, “the sensor must be calibrated at a minimum of every 12 hours throughout the life of the sensor. For better sensor performance, it is recommended that you calibrate your sensor three or four times each day.” (page 216 of users manual).  The manual also notes that “the Auto Mode feature still requires your input for meals, calibrations, and times when you need the target value raised.” (page 231).  Again, making this is not a true “artificial pancreas” but a new tool for people with insulin-dependent diabetes.

not an artificial pancreas
It’s just a new tool!

This is great! I am seriously all for better tools.  I am also all for choice as you can read here and here.  I even have developed a tool to help you make your own choices when it comes to purchasing an insulin pump here.

Choice is vital because everyone’s diabetes is different. Children have different needs from teens. Teens have different needs from adults. One adult requires different things from an insulin pump than another does. The good news though is that more choice is coming…or in some countries it is already here.

insulin pumps

In the US, besides the Medtronic® 670G, you have the option to use the t:slim X2™ with Basal IQ™ (this option is available in countries where the t:slim X2™ is sold and the Dexcom® G6 is approved for use). This pump also has a great automated feature. 

It predicts low blood glucose levels ahead of time and stops insulin delivery.  The Basal IQ™ technology will allow the insulin pump to turn insulin delivery on and off as often as every 5 minutes.  As I noted, this system works with the Dexcom® G6 Continuous Glucose Monitor which is currently the only CGM approved for use without the need for fingerstick calibration.  

These systems have been approved for use in the US and other countries. There are other projects that are still being tested like the iLet® project out of the University of Boston.  Bigfoot Biomedical® is working on some exciting projects and patients are creating their own closed loop in the #WeAreNotWaiting projects.

The world of diabetes management tools is once again expanding at a fascinating rate. It is an exciting time.

We are not however at a time when diabetes is cured with an artificial pancreas.  No system counts carbs—although the ILet potentially will allow the pump to learn how. Every system requires you to change out infusion sets that can kink or come out of the body.  All of these systems require learning on the part of the user and the machine. 

Perhaps in another 20 years, we will see a true artificial pancreas.  Maybe in another 30 years, it will be available to everyone who needs one.  In the meantime, people with diabetes must continue to educate themselves on the various features of insulin pumps and choose the pump that best fits their lifestyle.

Download our ebook to help you find the right insulin pump for you.

Takeaways from the Senate Committee Report on DTC

This article was originally created for insulinpumps.ca and published on June 19, 2019

Some background

senate review

During the summer of 2017, many Canadian diabetes groups were made aware of an increased number of rejected applications for the Disability Tax Credit (DTC) by people living with diabetes. A public letter was sent to both the media and finance department asking why the Canada Revenue Agency seemed to be implementing a policy change when there had been no change in legislation.

By December of 2017, the Senate Committee on Social Affairs, Science and Technology convened to discuss this issue. They met with various groups in February of 2018.

What the committee was told

The committee heard from a variety of groups and individuals including key players from the Juvenile Diabetes Research Foundation (JDRF) and Diabetes Canada. They were told that both the DTC and the (Registered Disability Savings Plan)RDSP are underutilized despite the potential to offer great assistance to qualifying individuals. The current DTC is only of financial benefit to those who have an income because it is a non-refundable tax credit. Individuals with little or no income are not applying and therefore are not eligible for any further assistance in the form of grants available from the RDSP.

They were told that currently the CRA (Canada Revenue Agency) employees are being given the power to overrule the certification of a medical doctor. This suggests that the employees somehow have greater knowledge of a person’s medical condition and restrictions than that of a physician.

JDRF and Diabetes Canada also requested that the 14 hour minimum for life sustaining therapy be removed. They noted that similar health burdens and financial challenges occur for all people with type one diabetes regardless of the time spent. They all require the same activity restrictions and higher costs associated with administering insulin regardless of whether it takes 10 hours or 14 hours per week.

It was further noted that “these rules can often mean that young adults cease to qualify for the DTC when they turn 18 simply because their parent’s time is no longer included in the amount of time spent administering a therapy. In reality the only thing that has changed is that the person has turned 18. “

Finally, the committee was advised that people with life-long conditions, like diabetes, are being forced to reapply for the disability tax credit. This is a waste of time and resources.

The Recommendations:

On June 27th, 2018 the Senate Committee on Social Affairs, Science and Technology released its recommendation on the Disability Tax Credit and the Registered Disability Savings Program. These are the ones that apply to people living with diabetes.

  • implement legislation that would limit the fees disability services providers can charge to complete the Disability Tax Credit application (this has been tabled but not brought into force yet)
  • Re-examine the arbitrary 14 hours required for life sustaining therapy
  • Eliminate the need to reapply for life long conditions
  • Improved transparency for those who have to appeal their DTC denial
  • Allow people to keep all contributions made to their Registered Disability Savings Plans for periods in which they qualified for the Disability Tax Credit.
  • Work with all levels of government to ensure that all people with qualifying disabilities over the age of 18 can access the Registered Disability Savings Plan program.
  • Change the 10 year wait to access RDSP funds and grants
  • Make this a refundable credit so that it also helps those with lower or no incomes
Senate committee recommendations

Everything you need to know about RDSPs

RDSP

If you have successfully applied for the Disability Tax Credit, the savings do not end with your tax return. You are also eligible for FREE money from the government! I know that sounds too good to be true! That is why I asked Jane Buchanan, District Leader, Representative of Primerica Financial Services, to explain exactly how easy it is to get FREE money!

What is the Registered Disability Savings Plans (RDSPs)?

People with disabilities and their loved ones face a distinct set of financial challenges throughout their lives. To help address these challenges, the Government of Canada introduced the Registered Disability Savings Plan (RDSP) in 2008. Designed to help build long-term financial security for disabled persons, the RDSP makes it easier to accumulate funds by providing assisted savings and tax-deferred investment growth.

 Who is eligible for an RDSP?

To qualify for an RDSP a beneficiary must:

• Be eligible for the Disability Tax Credit

• Be a resident of Canada

• Be less than 60 years of age

• Have a valid Social Insurance Number

The Disability Tax Credit is available to individuals who have mental or physical impairments that markedly restrict their ability to perform one or more of the basic activities of living, such as speaking, hearing or walking. The credit is also available to those who spend more than 14 hours per week on life-sustaining therapy.

The impairment must be expected to last longer than one year, and a physician must certify the extent of the disability. There can only be one RDSP account per beneficiary, and only one beneficiary per plan.

Click here to see if you might qualify.

What are the key benefits of an RDSP?

RDSP
  • Money contributed grows tax free.
  • Anyone can contribute to an RDSP with the written consent of the account holder.
  • Contributions can be matched, based on family income, with up to $3,500 a year in Canada Disability Savings Grants (CDSG) and up to $1,000 a year in Canada Disability Savings Bonds (CDSB).
  • Carry forward on CDSG and CDSB is available back 10 years or to date of diagnosis.
  • The total lifetime contribution for each beneficiary is $200,000, with no annual contribution limits.
  • If a parent or grandparent passes away and has a financially dependent child or grandchild, they can transfer up to $200,000 of their RRSP/RRIF or RPP to the dependent’s RDSP on a tax-deferred basis.

Who can qualify to be the beneficiary of an RDSP?

To qualify to be the beneficiary of an RDSP, an individual must:

  • Be eligible for the Disability Tax Credit
  • Be a resident of Canada
  • Be less than 60 years of age
  • Have a valid Social Insurance Number (SIN)

How do you maximize your savings?

  • Start saving early. Make it automatic by enrolling in a pre-authorized chequing program.
  • Take advantage of government grants and bonds and contribute every year to get the maximum annual Canada Disability Savings Grant and Canada Disability Savings Bond.
  • Plan withdrawals to avoid federal grant and bond repayments.

What is the Canada Disability Savings Grant (CDSG) and the Canada Disability Savings Bond (CDSB)?

The Canada Disability Savings Grant (CDSG) and the Canada Disability Savings Bond (CDSB) are federal programs that provide payments to RDSPs to encourage long-term savings through an RDSP.

Grants and bonds are available to beneficiaries up until December 31st in the year they reach age 49. Contributions can be matched, based on family income, with up to $70,000 in Canada Disability Savings Grants and up to $20,000 in Canada Disability Savings Bonds.

RDSP with drawls are also known as disability assistance payments. There are two types of payments from an RDSP lifetime disability assistance payments and disability assistance payments.

How do you contribute to an RDSP?

 Once an RDSP is set up there are five ways to put money in:

  1. contributions by the account holder.
  2. contributions by people the account holder has authorized.
  3. federal grants and bonds.
  4. transfers from a qualified or RRSP, RRIF or RPP.
  5. transfers of the accumulated income from a registered education savings plan on which the beneficiary is on both RESP and RDSP.

How do to get money out of an RDSP?

RDSP withdrawls are known as disability assistance payments. There are two types of payments from a RDSP. 

Lifetime disability assistance payments are recurring annual payments that one started must be paid until the plan is terminated where the beneficiary has died. These may begin at any age that must start by the end of the year in which the beneficiary turns 60. 

The other type of payments are disability assistance payments which are lump sum payments made to the beneficiary or the beneficiary’s estate.

When withdrawing funds from the RDSP, it is important to be aware of the 10 year rule. If a person withdraws amounts that were contributed in the ten-year period prior, grants and the bonds from the government must be repaid to them. The repayment is three dollars for every one dollar withdrawn (aka the Holdback amount).

The purpose of the holdback amount is to ensure that RDSPs are used for long-term savings, and it also ensures the government funds contributed are not withdrawn and used otherwise.

Have more questions?

Contact Jane Buchanan, District Leader, Representative of Primerica Financial Services Call: (506) 863-4425 Email: Buchanan.janeann@primerica.com

To see if you might qualify for the Disability Tax Credit, try our short quiz. If you have been putting off filling out your application form, get our easy to follow step-by-step guidebook.

Choosing an insulin pump is personal

chosing an insulin pump

Choosing an insulin pump is a very personal experience. Anyone who tells you otherwise is basically lying to you. To pump or not to pump, to go with tubing or no tubing, it is all a matter of personal preference.

When we first began looking for an insulin pump for my son it was 2002 and he was 4 years old. The only requirement he had was that it could NOT be the blue pump. Everyone he saw seemed to have a blue insulin pump and he wanted to be different. As a parent, I knew that there were other things to consider. At first, however, I wasn’t quite sure what they were.

I read books like Pumping Insulin. I reached out to the parent email list on the Children with Diabetes website. Finally, I consulted with friends and began to compile my own list of features that our insulin pump had to have.

Get our insulin pump shopping list ebook.

It was important for this to be the most up-to-date insulin pump. I was paying for this pump out of my own pocket and would have it for the next four years. I wanted the best technology for my money.

My son was only four so it had to be able to deliver very small amounts of insulin. Because we were new to pumping, certain alerts were also going to make our journey a little easier.

I didn’t order the blue pump. I didn’t order from the rep who became a lifelong friend. The other rep whom I met for coffee and answered every question I had, also did not get our business. I felt horrible not purchasing from either of these amazing people but pumping is personal. I had to go with the pump that fit us. They understood.

wearing an insulin pump

I chose a brand new insulin pump. It had everything that we wanted in a pump. It had features that he would need in the coming four years and features that were perfect for our life at that time. This was an insulin pump that was ideal for our family.

Let me repeat that…it was ideal for our family. It was not ideal for everyone’s family. This was a pump that was not ideal for every person with diabetes. That is the thing with insulin pumps and with diabetes in general…everyone is different. Everyone’s needs, wants, and budgets are different. The technology has to fit the person.

If you are looking at an insulin pump for the very first time, here are five things to consider…

insulin pumps

1. Do you want tubing or not?

For some people, being attached to something 24/7 can be overwhelming. This might mean that an insulin pump is not for them. It may also mean that they might be better suited to a pump that has no tubing like the Omnipod. Other people find that having a pump at the end of their tubing allows them to know where their “pancreas” is at all times and gives them peace of mind.

2. Is a Continuous Glucose Monitor important to you?

Do you need a continuous glucose monitor with your insulin pump? Are you already using one? Do you want a pump that “talks” to your CGM? Do you prefer the Flash Meter system?

There are some insulin pumps with CGMs built into them. This can be a pro or a con depending on how you look at it. It is great to not have to be concerned about carrying or dealing with another device but technology is changing so rapidly that it can be nice to have a stand-alone device that is more updated than the one integrated into your pump.

3. Does it update itself?

As I said, for me it was vital to have to most uptodate technology. My thinking was that if I was spending that kind of money, why did I want a Kia when I could get a Cadillac for the same price?

Insulin pumps are constantly changing. New models are being brought to the FDA and Health Canada on a regular basis for approval. Some people, like me, want the most advanced technology for their money. Other people are okay with any insulin pump as long as it delivers insulin. Again, an insulin pump is a personal choice.

Currently, in the Canadian and US markets, there is only one insulin pump company that offers upgrades without having to purchase a new insulin pump. A Tandem insulin pump has the capability to remotely update its software without the need to purchase an entirely new device.

4. How much insulin do you need?

The reservoir or insulin cartridge is what will hold the insulin in your pump. Depending on your age and needs, size can make a huge difference.

Teens for example, tend to go through a lot of insulin. An insulin pump with a 2mL(200 unit) cartridge will not last them nearly as long as a 3mL (300 unit) cartridge. Changing the reservoir takes time out of your day and that can be annoying to some. If you hate changing out your insulin reservoir, this might be something that you have to think about.

Also, depending on your age and lifestyle, basal rates and bolus amounts are important. The basal rate is the amount of background insulin that your pump is delivering to you every hour. Each pump delivers that background insulin differently and has different maximum and minimum amounts.

To get a rough idea of how much background insulin you might need, look at the amount of long-acting insulin you are currently using and divide it by 24. This is a very rough guess and will change with an insulin pump but it will tell you if you need smaller or larger basal rates.

Bolus amounts are the amount of insulin that you will inject (or bolus) to cover your meals. If you are a big eater or you have a high carbohydrate to insulin ratio, you are going to want a pump that can handle that. If you are someone who is very sensitive to insulin, then small, precise bolus amounts will be very important to you.

5. What sort of alerts will you need?

Will you remember when to do an infusion set change? Do you need a reminder to let you know if you forgot to take insulin to cover a meal? Is it important to you to have an alert that lets you know if you are dropping low or spiking during the day?

These are just some of the alerts that are found on some of the insulin pumps currently on the North American market. When searching for an insulin pump, take a look at the alerts and see which ones you will use and which ones you can do without.

Choosing an insulin pump can be overwhelming. Make a list of what you require in an insulin pump. Think about the five key things I mentioned above. Add your own features that you feel are important like screen size and temporary basal patterns.

Once you have your list (we have a great checklist of features here), contact your local insulin pump reps. Contact all of them, not just the one from the pump company that you know the most about or the one that you are leaning towards. Get to know them. Get a feel for how they treat you. Learn about their payment plans and customer service. Will they let you try out the pump?

Get our questions to ask your pump rep.

Make sure that you choose the pump that is the right fit for you. You are the one who will have to deal with it 24/7 for the next 4-5 years, no one else.

If you are unsure where to start when looking for an insulin pump, our insulin pump workbook can help.

10 Things to do When Life with Diabetes Becomes Too Much

stress

We know that diabetes is stressful and can be overwhelming at times. The day in and day out grind of carb counting, injecting insulin, and checking on blood sugar levels can wear a person down. That is why it is so important to look after your mental health as well as your physical health. Here are a few things that myself and others have done over the years.

Cry, scream or yell in the shower

cry

Whether you are the person living with diabetes or you are helping someone you love, there are those days when you have had it. You want to kick and scream. You just don’t want to “diabetes” anymore.

Guess what? That is okay! In fact, it is pretty darn healthy! It isn’t healthy to keep those feelings and frustrations bottled up, however.

When you are completely overwhelmed and want to throw in the towel…do it! Find a private spot, like the shower, and just let out all of that pent up emotion. Allow yourself to cry. Go ahead and scream at the universe. Yell at diabetes itself. Simply vent and then…let go. I promise you that while it won’t fix everything, you will feel a little better.

Go for a walk

walk

We all know that we are supposed to exercise. Did you also know that it really can be good for your mental health?

Take some time to join a gym, sign up for a yoga class or just take the dog for a walk. Do something to get moving and get out of your head for a bit. Shake off the cobwebs as you stretch or lift. Allow all of that stress to hit the pavement as you go for a walk. Taking in some fresh air and taking some time for you will help you to improve your overall health.

Go out on a date

date

Go out for a lunch date with a friend. Meet your significant other for a lovely meal. Take one of your children out for a playdate that involves just the two of you. Simply get out and put diabetes on the backburner.

If you are living with diabetes, you will sadly still have to bring it along but, for just an hour, make it sit at another table. Don’t complain about it. Don’t worry about it. Just focus on the person you are with and leave the rest behind for 20 minutes, an hour, whatever you can spare. Recharge yourself with someone you care about.

Grab a glass of wine

At the end of the day, allow yourself to unwind with a glass of wine, a shot of rum or simply a great cup of tea. If you enjoy essential oils, make sure you have your favourite blend diffusing. Light a candle. Just breathe and relax. Let your mind go blank for a bit and simply unwind. It is okay. You need it. You deserve it.

Enjoy a book

Take a few minutes to unwind with a good book. Put on a Netflix show. Turn on your favourite music and let it flow through you. Dance a little if you like or allow the music to put you to sleep! Do something that requires minimal thought and maximum relaxation.

Live life 4 hours at a time

4 hours

This is advice that truly kept me sane through toddlerhood, preteen years and the teens. Live life 4 hours at a time.

When living with diabetes, there can be highs and lows that appear out of nowhere. There can be highs and lows that show up because you got a bit of air in your tubing, you injected into a different site, or you counted the carbs in a meal wrong. There are more reasons for highs and lows than the average person can imagine. Obsessing over them can drive you completely insane.

My advice is simply to deal with them in short blocks. Rapid-acting insulin has a life of 4 hours (on average). Take your day and break it up into those four-hour sections. When you get up and check your blood sugar, that is the start of your first four hours. If that reading is perfect, do a happy dance and get some breakfast. Savor the victory over the diabetes gods.

If you find that you are running a bit high or low, you treat with food or insulin and move forward. By lunch time, you will either have everything under control or you won’t but that is a four hour time period that is behind you. It is something to look at later and see what you could have done differently. It is not something to dwell on. You have another 4 hours to deal with.

In those next four hours, you can celebrate in range readings. You can ponder out of range numbers but know that there will be another four hours for you to look at and you will get through.

Give diabetes away for the day

share

Seriously, give diabetes away for the day. Have someone else think about the blood checks and carb counting. Take the day off.

If you are a parent of a child with diabetes, have your partner or a family member do your child’s care for the day. Remember that they will do things differently. That is okay. As long as your child is okay and you can rest, it will be okay.

If you have diabetes yourself, ask your partner, good friend or even parent to deal with everything for a day. Okay, maybe you won’t be able to handle an entire day but let them scan your sensor. Have them push the buttons on your pump. Let someone else do your site change. Give your brain a break for an hour, an afternoon, a full day if you can!

Join a support group

No matter what, there is nothing like talking to people who get it. If you are on Facebook, join one of the many online groups that are there. Most are private or secret so that what you say in the group will stay there.

If you are a Twitter person, look for the hashtag #DOC or #DSMA and join in diabetes chats. It is a great way to share and meet other people who live the same life as you.

Some people prefer to meet in real life. Check with your diabetes clinic for support groups or diabetes-related events in your area. There are many conferences and camps for both adults and youth that are worth checking out.

Journal

It can be very therapeutic to simply write out your feelings. Start a journal online or in your favourite notebook. Write about your victories and your frustrations. Get your feelings down on paper so that you can better handle them in your daily life.

Seek help

Finally, if you are still finding diabetes too much to handle, please look to finding the help of a professional. There are mentor programs for teens. You can connect with diabetes educators in other areas who will help you tackle getting blood sugars in a more manageable range. You can also connect with therapists who will assist you in person or via remote networks. Some of them like Virtue Bajurny and Joe Solowiejczyk are not only therapists but live with type 1 diabetes themselves.

No matter what you decide to do. Remember that you never have to do it alone. If you are struggling, please reach out to someone or contact us. We will try to help you to find someone in your area who may be able to help.

Diabetes Advocacy Keeps Growing!

Its a new year. A lot of people make resolutions to do things like lose weight, check their blood sugars more often, or to get a bit more active. Another option is to choose a word to live by for the year. This is a word that inspires you and encourages you. A word that resonates with you and helps you move towards your goals. My word for this year is growth.

If you have been following Diabetes Advocacy for any length of time, you have seen a lot of changes.

We started out as a place for people to share information about the Disability Tax Credit. We grew to help families who were struggling with their children with diabetes in schools. Diabetes Advocacy became a hub for insulin pump program advocacy and so much more. Over the years, we added a blog to document our lives, review books and products, and share information.

Diabetes Advocacy has also undergone some cosmetic changes. The website is now completely mobile friendly. We can be found on Instagram, Twitter, and Facebook. We have a monthly newsletter once again that shares tips and information.

Do you see how perfectly the word fits? Diabetes Advocacy is growing! This year I will continue to update the site and provide great content and more products. There will be more downloads and tools to make your life easier! There will be more of the great content you have come to love over the past 16 years.

What would you like to see added to the Diabetes Advocacy site? What topic would you like to see us tackle?

All of our downloads can now be found in our new digital store! We will continue to add more products on a monthly basis so be sure to take advantage of our growth!!

Did you make a resolution this year? Do you have a word that will inspire you? Let us know!

Tax Tips for People with Diabetes

Tax tips for people with diabetes

If you are like me, you aren’t overly excited by tax time. The thought of paying in more money is so depressing that you are probably digging through every receipt trying to figure out how you can write off that last Ice-cap from Tim Hortons as a diabetes-related expense. Here are a few tax tips that you may have overlooked.

Diabetes supplies

Keep all of the receipts for your diabetes supplies such as:

  • insulin
  • syringes
  • test strips
  • ketone strips
  • alcohol wipes
  • medical tape
  • Glucagon kit
  • pump supplies including the insulin pump, tape, infusion sets, reservoirs, batteries, and mastisol 
  • Continuous Glucose Monitor, transmitters, and batteries

If you have paid out of pocket for these items or a co-pay after insurance, make sure that you have a prescription for them.

Travel

You can claim the cost of travel to medical appointments.

In Canada you must travel at least 40 km one way to get to your appointment. Make sure that you have a signed letter from the office before you leave stating that you have been there. You will then be able to deduct the cost of public transportation or vehicle expenses.

If you must travel over 80 km one way, you will also be able to claim the cost of meals. You are allowed up to $17 per meal up to a maximum of $51 per day. You can learn more here.

Finally, you can also claim your accommodations and parking fees for travel over 80km. Again, make sure that you have a letter stating that you have traveled for medical appointments.

In the US, you can deduct 23 cents per mile in lieu of gas and oil, plus any parking fees and tolls for travel to medical appointments. If you take a taxi, bus, train, airplane or ambulance you can deduct the actual expense. You can deduct the cost of any accomodations, but unlike Canada, you cannot deduct the cost of meals.

In the US, these expenses must exceed 7.5% of your gross annual income. The amount will rise to 10% in the 2019 tax year. For those living in Canada, medical expenses must be above the lesser of $2,208 or 3 percent of your net income.

HSA/FSA

If you live in the USA, you can also save by contributing to a Health Savings Account (HSA) or a Flexible Spending Account (FSA).

These accounts are managed by financial institutions and accessed in the same way as you access your chequing account.

Both a Health Savings Account and a Flexible Spending Account are made up of tax-deductible contributions with pre-set contribution limits. Contributions can be set up through your employer. Both accounts also share the same list of “qualified expenses”.

The difference, however, is in who is eligible. Anyone can contribute to an FSA but only those with a high deductible ($1,350 or more for an individual or $2,700 or more for a family in 2018) health plan are eligible for the Health Savings Accounts. 

The maximum contribution to an HSA is $3,450 for an individual and $6,900 for families.  The maximum contribution into an FSA is $2,650. (at the time of this writing)

Disability Tax Credit

In Canada, we do not have Health Savings Accounts. We do however have a Registered Disability Savings Plan. To access this plan and the associated government grants, you must first apply for and be approved for the Disability Tax Credit (DTC).

The DTC is a non-refundable tax credit that reduces your taxable income. To qualify, you must be insulin-dependent and spend over 14 hours per week on your care.

See if you might qualify for the DTC here.

To make sure that you have all of the receipts you need, download our checklist before you start your tax return this year!

19 years later and the guilt remains

I found this photo the other night. It was tucked away in an album I had created for my son when he was just a baby. There were sweet memories and even a bit about the time he spent in the hospital after his diagnosis with type 1 diabetes.  When I saw this photo however I wanted to cry.

It has been nineteen years since this photo was taken.  My son is now a  strong young man living on his own.  The years have brought both of my children many challenges in their short lives and the way they have handled them makes me proud. Looking at this photo, however, cuts me to the core. How did I not see?

When I posted this photo to social media someone commented that the boys looked happy.  Another person commented on how cute they were.  I was struck by how thin my youngest was.  His little face was hollow looking.  His eyes seemed to be sunken in his small head. How did I miss that?

My youngest was always the slimmer of the two boys. He was born a pound lighter than his older brother.  Throughout his life, he has always managed to remain slim. Looking at this photo though, he was beyond slim.  As some would say, he looks poorly.  He has a sickly pallor behind the glimmer in his eye. Why didn’t I see that then?

I now know that his body was eating itself to survive. He was just making enough insulin to keep himself out of the hospital. I know that holiday treats and Christmas dinner must have been hard on his small body.  His blood sugars would have been skyrocketing out of control.  No one was stopping them.  No one was helping his tiny little body to work properly. What sort of parent was I?

I made sure that my children ate very few preservatives.  I attempted to keep my them safe from toxins.  While I thought I took good care of them, this picture suggests otherwise. Somehow I missed this. I didn’t see him fading before my eyes.

19 years ago this picture was taken.  I thought that I was long past the feelings of guilt and sadness. It would appear I was wrong.  An image of two sweet, small faces smiling from under a Christmas tree brought it all rushing back.  This picture of innocence has unleashed a flood of reprimands for my former self.

This is why parents of children with diabetes don’t need society to blame us for our child’s diagnosis.  Years later, we can still berate ourselves for what we didn’t do.  We can still cry over the fact that we failed to protect our children from their own bodies…even when it really isn’t our fault. We still feel carry that guilt.

Make sure that you know the signs of type 1 diabetes. 

Insulin Can Be Deadly. An Insulin Pump is a Tool.

Recently the CBC and partnering news agencies released an article on the dangers of certain medical devices.  In the article, it was suggested that insulin pumps are lethal and should be more closely scrutinized by Health Canada. I would have to correct the CBC in that it is not just insulin pumps that are deadly, but insulin itself.

insulin can be deadly

Too little or too much insulin can lead to death and the amount that constitutes too much or too little varies from person to person, from hour to hour.  There is a term used in the diabetes community, “your diabetes may vary”.  It is because there is no one size fits all dosing when it comes to insulin. A doctor cannot prescribe 6 units of long-acting insulin and 2 units of rapid per meal for all 6 year old children. She cannot tell all young males of 25 that they should set a basal rate of 1.2units per hour in his pump and bolus 10 units for his meals.

Diabetes varies

Diabetes varies between two seemingly similar people.  One six-year-old could be taller than the other.  One could be in hockey all day while the other was in a piano recital. The twenty fives year old males could both be on the same soccer team but one is a vegan and the other will be enjoying a post-game meal at Boston Pizza.  While both individuals need insulin to live the amount of insulin that they need will vary in every one of those situations.

It is just as impossible to prescribe one insulin treatment for one person.  As one person with diabetes discovered, there are over 42 things that can influence blood glucose readings. There is the fat content of a meal.  How many grams of carbohydrates are in the meal? What activity level occurred before the meal? How active will the person be after the meal? What was their blood glucose level before they ate? Are they coming down with a virus? Are they menstruating? Do they feel stressed at work? The list goes on making the “take 2 units a day and call me in the morning” adage impossible to follow.

insulin pumpsInsulin pumps are an insulin delivery method.

Instead of injecting a long-acting insulin, the pump administers small amounts of insulin on a regular basis throughout the day.  The amount of insulin it delivers is decided on based on a number of factors.  These factors are examined by both the person’s diabetes team and the person with diabetes themselves. They examine blood glucose and/or a continuous glucose monitor readings.  This is the same way that a person on injections will decide if they need to inject more long-acting insulin.

An insulin pump also allows delivery of insulin for meals and the correction of high blood glucose levels. Instead of injecting a syringe of insulin into their body, a person with diabetes is able to do the calculation with the help of their pump.  They then tell the pump how much insulin he/she needs based on previous glucose readings, trending arrows on a continuous monitor, amount of carbohydrates in a meal, planned activity levels, and much more.

Insulin Pumps do not think

As Dr. Peter Senior stated, the insulin pump does not think for you.  It will help you to make decisions but it is just a machine. Machines malfunction.  As pumpers, we understand this but as Dr. Senior also states “Type 1 diabetes carries life-long risks regardless of how people with the condition choose to receive their insulin.”

We understand that machines can fail.  We can only imagine the heart-break of the families who were interviewed for these articles.  The diabetes community is very familiar with how deadly diabetes is no matter what method of delivery you use.

blue candleDiabetes Kills

If you spend any time in the Diabetes online community, you will quickly know whenever a member passes.  A sea of blue candles will appear on your feed. Our hearts break.  We know all to that it could be us. It may very well have been a friend.

We understand that diabetes is not about the jokes or the memes about Starbuck’s drinks. It is a careful balance of diet and insulin and never knowing when something will tip the scales.

To manage that balance, we need tools. Tools like insulin pumps that carefully mimic the insulin delivery of the pancreas.  We need tools like continuous glucose monitors that now tell us and our insulin pumps what blood glucose levels are in real time and are able to track if they are rising or falling. This ability to predict glucose readings can help to avoid further impairment.

Impairment like the 1445 incidence of hyperglycemia mentioned in the articles.  Hyperglycemia is a very real threat when you use an insulin pump.  There is no background insulin.  If you infusion set kinks inside your body (this is the piece that delivers insulin under the skin), you will not be getting the proper amount of insulin and blood glucose values will begin to climb.

t:slimX2 insulin pumpInsulin Pumps and Sensors are helpful tools

A sensor in the body tracking glucose levels on a continuous basis tells the wearer that more insulin is required. They are able to stop, examine their infusion set, the insulin pump, their activity level and diet to decide the best course of action.  It might be changing their infusion set. It could mean injecting insulin through a syringe.  There could be a problem with the insulin pump. This complete system allows a person with diabetes to more quickly access the issue before they begin to suffer the cognitive impairment that can accompany high blood glucose levels.

Checks and balances

Checks and balances for medical technology are very important.  Devices such as insulin pumps must be thoroughly tested and reviewed before being approved for use.  Companies must be held accountable for their customer service and providing proper education to their clients.

The recent media stories, however, creates fear in the wrong place.  The CBC and its partners need to understand that diabetes is unlike most other diseases.  Most people with diabetes walk around and look like everyone else.  They fix your plumbing, teach your children, climb mountains and run countries.  You might see their pump or their glucose monitor sensor.  What you don’t see however is the hundreds of life and death decisions that they make each and every day.  You don’t see the challenges that they face.  They often don’t see them either because it becomes part of who they are.

wearing an insulin pump

Please understand that diabetes is terrifying.  Insulin pumps are simply helpful tools that allow our loved ones to live full and healthy lives.  We need more access and understanding not more fear of something that is already well regulated.

If you are considering an insulin pump, download our ebook to ensure you get the right pump for you. 

Because sometimes you have to laugh at life with diabetes

laugh at life with diabetes

Life with diabetes is stressful but often we can find humour in the most
interesting places! Here a few things that have made us all chuckle over
the years.

Who can forget this video….

Where is the strangest place you have ever found a test strip?

We all know that test strips are actually alive. They move on their own. They can be found in the most unique locations. Here are some of the interesting
places that we have heard of.  These ones made us laugh…a lot! Please feel free to share with us some of the strange places your test strips have ever been found.

test strip in coffeeThanks to Michael for sharing!!

“Somehow, a One Touch Ultra strip ended up in my coffee cup at work this morning. No idea how it got there, but probably involved a morning blood test of 211 that caused
me to cuss and toss my case across my desk. There must have been flailing test strips at hand, also. So, in the spirit, my Blood Meter decided to pose nearby the swimming test strip.”

Teresa I. found one in her daughter’s thick, curly hair after her daughter brushed it with a brush that was next to Teresa’s bed. The strip stayed in there through a full day of school!

Someone else found on that had been used as a bookmark in a school novel!

Test strips have also been found…

  • In the yard
  • Frozen in the ice
  • In a salad
  • In the washer and the dryer
  • Fishing tackle box
  • The teacher’s sweater pocket
  • On the back of the toilet tank
  • In a make up kit that was cleaned out on a weekly basis. How do they find their way to these places??
  • In a clean pair of underwear!

and of course…

test strip on the stoveOn the stove!

 

Strange infusion set locations!

Not to be outdone, we have also found infusion set sites in some very odd places. We have found them in the tub, by the garbage, in the car and even the bottom of my Swifter vac! Always something new.

Fun Diabetes Diddies

Here are some great diabetes poems and tunes that make us laugh and appreciate the creative people in the diabetes community!

Oh A1c songOh A1c

by Alissa

Oh A1c, Oh A1c, I raise my voice to heaven
Oh A1c, Oh A1c, in hopes it’s less than seven
The past three months we’ve had a slump
Despite corrections from the pump
Oh A1c, Oh A1c, just please don’t be eleven

Oh A1c, Oh A1c, we’ve tried to stay in range
Oh A1c, Oh A1c, so it seems very strange
That when I download from her Flash
I see the spikes and then the crash
Oh A1c, Oh A1c, you shall this Mom derange

Oh A1c, Oh A1c, I wake with such a fright
Oh A1c, Oh A1c, to my alarm’s delight
But one day when the Cure has come
I’ll beat that clock until it’s dumb
Oh A1c, Oh A1c, and sleep a silent night

Count the carbs song Count the Carbs

by Alissa

Count the carbs with cups and scales
Fa la la la la la la la la
Guesstimate when all else fails
Fa la la la la la la la la
Hands and fists are quite a treasure
Fa la la la la la la la la
When without a one cup measure
Fa la la la la la la la la

Factored carbs are even greater
Fa la la la la la la la la
But require a calculator
Fa la la la la la la la la
Units you must designate
Fa la la la la la la la la
Don’t forget to tare the plate!
Fa la la la la la la la la

Candy canes are roughly twenty
Fa la la la la la la la la
You will have to fudge a-plenty
Fa la la la la la la la la
Guess them now and fix it after
Fa la la la la la la la la
Just correct and meet with laughter
Fa la la la la la la la la

I have a little meterMeter (Dreidel)

By Barbie Paulsen

I have a little meter
I use it through the day,
When finger’s done with bleeding
Then dreidel I can play

Chorus:
Oh, meter, meter, meter
I use it every day
And when I’m done with testing
I throw used strips away (Hah!)

I have a little meter,
It counts down really fast
And keeps a steady record
Of when I tested last

–Chorus–

I have a little meter
I take it everywhere
But when I need to use it
Sometimes it isn’t there

no more lows songNo More Lows!

by Alissa

(to the tune of “Let It Snow!”)

Oh the numbers at night are frightful
And the meter now seems spiteful
I’m exhausted and I think it knows
No more lows! No more lows! No more lows!

All this sugar shoving has me praying
That those teeth are not decaying
How much longer is this going to go?
No more lows! No more lows! No more lows!

For a while things worked out right
Numbers were steady till dawn
But now it seems every night
I’m thinking about Glucagon!

Now I’m thinking it would be nifty
If we could see one-fifty
‘Cause the glucose tabs are running low
No more lows! No more lows! No more lows!

rufus the bearRufus the Type 1 Brown Bear

by Alissa and Samantha

Rufus the Type 1 Brown Bear
Had to always prick his toes
And if you checked his sugar
You might come to find he’s low

All of the other brown bears
Thought that Rufus had Type 2
So when they had some candy,
They would tell him, “Not for you!”

Then one day a CDE
Helped him to explain,
“I take insulin, you see,
Sugar is just fine for me!”

Then all the brown bears nodded
As they came and shook his hand
“Rufus we’re really sorry,
Now we finally understand!”

Test Strips

by Alissa

(to the tune of “Latkes”)

Test strips, test strips, I see test strips
Not a little, but a lot of test strips
Test strips, test strips, I see test strips
Not a little, but a lot! Of test strips

Test strips are so useful when they show me my bg
But they turn up later, reproducing magically!

Test strips, test strips, I see test strips
Not a little, but a lot of test strips
Test strips, test strips, I see test strips
Not a little but a LOT!!