January 28, 2023 Changing lives through research

At age 57, Leslie Ann Bent has seen the world—the United States, Peru, Mali, Senegal, Ethiopia, Japan, France and most of Europe—and everywhere she has gone, her diabetes has been right there with her.

Diagnosed with type 1 at the age of 10 in 1975, before finger pricks and blood glucose monitoring, Leslie Ann says, “Living with diabetes in different eras has had different challenges.”

Learning by experience

Born in Nova Scotia, she and her sisters, brother, mom and dad travelled during her dad’s summers off from the college where he worked. “My parents believed in what we’d now call experiential learning. If you see something and you feel it and you touch it, you remember it and you understand it better than just reading it in a book.”

When she was 12, she took her first family trip to Europe. “Back then, you had to calculate that you had a longer or a shorter day depending on which direction you were travelling, and then you had to take more or less of your insulin,” says Leslie Ann. “And at that time, there wasn’t a standard universal system for measuring insulin. It was a lot of math.” Despite the challenges, she was able to manage her diabetes well and have a great time.

“With only one injection of insulin each day and no blood testing, you were really running blind with diabetes,” she says. “I was told by the time I was 20, I would start losing my eyesight, my kidneys would stop functioning, and I would start losing the feeling in my hands and feet.” Anyone hearing this prognosis today might be shocked, but at the time, these potential complications were possibilities that could result over time with poor diabetes management.

With no Internet at the time, people did not have the same access to current information; however, thanks to a neighbour who was involved with the Canadian Diabetes Association (now known as Diabetes Canada), Leslie Ann was introduced to the organization and was able to stay up to date on medical developments.
 

Finding (some) solutions for small complications

For Leslie Ann, the complications she first experienced were perhaps less severe than what she had been warned about, but they were nonetheless worrisome. They started with pain and tenderness in her fingers (tendonitis), which developed into a condition called trigger finger, in which any of your fingers can lock when bent and be difficult to straighten. Turns out it is more common among people with diabetes. “I’ve had it on and off since my 20s and it’s extremely painful,” she says. “I’ve had cortisone injections and minor surgery, [and] it’s manageable.”

What is just as common as trigger finger among people with diabetes—and not always as manageable—is a condition called lipohypertrophy. “That’s scar tissue buildup from the more than 23,500 injections I’d given myself by the time I was 40. This condition severely impacts my ability to absorb the insulin I need to live,” says Leslie Ann.

The solution for avoiding scar tissue? Change your injection sites regularly. But it’s not always that simple, Leslie Ann says. “I’ve been changing my sites since I was 10 and you run out of sites. You do as much as you can, but when you get what I would call a bad site, you’re not getting very much insulin. Toward the end of working life, I was getting these very high blood sugars and taking more and more insulin even on the pump.”

In the end, what worked for her was changing the type of infusion set she used with her pump. “I originally chose one that went in on a side angle rather than one that goes in straight which was better for people like me who are active. Moving to one that went in straight helped a lot.”

However, Leslie Ann was still concerned about the fact that built-up scar tissue made some injection sites unusable. Could it be corrected with surgery? Many conversations with endocrinologists and even a plastic surgeon later, she learned that due to a lack of research, they simply do not yet know.

Thanks to advances in research in other areas, there have been improvements not only in self-management but in helping people lead healthier lives and in treating various complications associated with the condition.

That’s why I like the research, because although there’s not a cure for diabetes, research has led to important improvements that have such a profound impact on your ability to self-manage and on your life,

Leslie Ann says. “For example, home blood testing came out in the ’80s, about eight years into the disease for me. And, suddenly, I had this information that I could do something with.”

Coping with bigger challenges

Despite leading a healthy and active life that has included regularly participating in half marathons for fun and to fundraise for Diabetes Canada, she had a heart attack in November 2019. “I had just gotten my snow tires on and was driving home when I felt this tightening in my chest. And I thought, ‘Oh, that’s kind of odd.’ It was a few hours after I ate and I’m not someone who gets indigestion. But during the 25-minute drive from town to my home, [the feeling] wasn’t going away. Even though my cholesterol levels have always been very low, I wondered if this was a heart attack, because of Diabetes Canada and the education that I'd been exposed to over the years.” When she got home, she called 9-1-1; the paramedics confirmed what she had suspected.

Leslie Ann is not alone. Forty per cent of all heart attacks are attributed to diabetes, and people with diabetes are three times more likely to be hospitalized for heart attacks, strokes, or heart failure.

Initially, the doctors were vague about whether she could return to running, so Leslie Ann interpreted that as maybe she couldn't. “Thankfully, I recovered,” she says. “But no matter what I do, there are a number of factors out of my control that contribute to a very high risk of complications.” However, she has not let the heart attack or the possibility of complications overshadow her passion for life, including one of her favourites activities, power walking (which has now been replaced by walking).

Over the years, Leslie Ann has had the chance to meet and support others through her various volunteer opportunities, both in Ontario where she and her husband, Andy, lived for 20 years and now in British Columbia where the couple moved in 2019.

In 2021, she took part in Diabetes Canada’s Lace Up to End Diabetes event, which challenges people to be physically active for a month and raise funds to support diabetes advocacy, research, and education. In addition to organizing two musical events and a book sale, Leslie Ann walked 100 kilometres over four days. “I wanted to do something challenging, promote fitness, and remind us how much diabetes management is required when we take on this type of effort—stopping for blood sugar testing, carrying foods and tools for diabetes management, and taking breaks to course-correct plunging glucose [sugar] levels as needed. It was a big accomplishment not only for my feet and legs but to manage my type 1 diabetes through five or so hours of walking each day,” she says, adding, “I could not have done this without the advancements in diabetes care over the past 46 years. Although there is no cure, research has made tremendous strides in care possible for those of us living with diabetes to help us live more normal lives. For that, I’m extremely grateful.”
 

Did you know?

February is Heart Month. People with diabetes may develop heart disease 15 years earlier than those without diabetes. That’s why we need to act now. We can all play a role in helping to ending diabetes. Help us fund research like that of Dr. Brian Rodrigues, who is working to improve heart health, which has the power to change the lives of people with diabetes. Donate now. #LetsEndDiabetes