Dr. Akshay Jain calls diabetes a “silent disease,” and for good reason – people living with it are often unaware of their blood sugar levels.
“A lot of times people bank on symptoms, but you can’t do that with diabetes,” said Dr. Jain, a Surrey-based endocrinologist.
That’s why an essential part of managing diabetes is monitoring your blood sugar and as technology has improved over the years, so have glucose monitors. There are now sensor-based monitors where no prick of the finger is needed.
“These are sensors that inform the individual, not only what their blood sugar is at that instance, but how it was in the preceding hours, and more importantly, what the trend is whether it’s going down or up,” said Dr. Jain.
“And this is without poking the fingers.”
BC PharmaCare covers these monitors, but not everyone with diabetes is eligible for them.
Dr. Jain said only those who receive multiple insulin injections daily are eligible under BC PharmaCare. This means only a “small fraction” of British Columbians living with diabetes are eligible.
Pall Beesla told the Now-Leader about how one of these monitors was a game changer for his father, Jasbir, but it was not an easy or cheap path for him to become eligible. Jasbir lives with Pall’s family in Vancouver. His father worked for the family trucking company in Surrey for 25 years before retiring.
Jasbir regularly used test strips to test his blood sugars. One key factor with that method is that you must run the test yourself instead of the glucose monitors that automatically do it. Pall said Jasbir’s deteriorating health made this harder for him to do.
One night Jasbir fainted because his blood sugar was so low and they tried to bring him back but his sugars had crashed so low they called 911. An ambulance came and paramedics helped get his blood sugars up. That day for Pall and his family was the deciding factor for starting his dad on dialysis.
That night changed everything for the Beelsa family.
“It changed the entire dynamic of the household living in a multi-generational home, it wasn’t just up to one person, it was up to all of us to support my dad in one way or the other,” said Pall.
For the next three years, Jasbir was on dialysis, which required regular trips to the hospital. Getting to these appointments was not simple, as Jasbir could not take himself. Either a family member had to take time off work to take him, or they had to arrange for a HandyDart. For a time, he also needed home care as well. His limited English also complicated things.
“When diabetes progresses and gets worse, unfortunately, one of the damages that can arise out of that is worsening kidney function and with diet gets really bad, then individuals may require either dialysis or kidney transplant,” said Dr. Jain.
There are more than 460 people in B.C. on the waitlist for a kidney transplant, said Dr. Jain.
After three years, Jasbir received a kidney transplant and no longer required dialysis. He was not on insulin yet but it was important that he continue to monitor his blood sugar levels.
Due to his deteriorating hand-eye co-ordination, he could not test himself, so the family decided to pay out of pocket for a sensor glucose monitor. These sensors are attached to the back of your arm and only need to be changed every two weeks. The sensor is linked to an app on your phone where you can see your levels anytime.
Pall would set the alarm on Jasbir’s phone to go off throughout the day to remind him to check check the app. Due to the ease of the it, Jasbir could check his sugars whenever he wanted, even when his phone was not reminding him. At the time, Jasbir was not eligible for one under BC PharmaCare so the family had to pay out of pocket for the sensor. This was $90 every two weeks.
As Jasbir’s health continued to decline he was at the point where he required insulin, which meant his sensor was now eligible to be covered by PharmaCare.
“When we didn’t have to pay out of pocket anymore, it was a blessing,” said Pall.
The B.C. government recently announced coverage for two medications, empagliflozin and dapagliflozin, that will provide kidney protection. These medications will not work when there is already damage to the kidney Dr. Jain said.
Furthermore, Dr. Jain told the Now-Leader, South Asians are more prone to developing diabetes and disease complications like kidney disease, heart attack and strokes. They are three-and-a-half times more likely to develop type two diabetes. They are also more prone to developing diabetes earlier in life.
More than 360,000 people in the Lower Mainland are of South Asian origin, 14 per cent of the population according to the 2021 census from Statistics Canada.
Dr. Jain there are several reasons why South Asians are more prone to developing type two diabetes. One is genetics, but also a lack of access to healthier food and family physicians.
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