October 15, 2021 Back to School with T1D (During COVID-19)

 so welcome everyone my name is brooks

roach i am a diabetes education

specialist with diabetes canada and i

would like to begin by welcoming you and

acknowledging that i am joining this

webinar from the traditional and

unseated territory of the mig people

uh wherever you're joining washington i

invite you to express gratitude and

reflect for a moment on on the the land

on which we live and acknowledge the

past inhabitants of the lands on which

uh which we now call canada

we are here today to talk about a really

you know timely topic which is returning

to school for people and caregivers

living with type 1 diabetes both during

and after the coca-19 pandemic

so we're joined today we have the

pleasure of having three wonderful

guests uh dr constantine simon who is a

pediatric endocrinologist and associate

professor at mcmaster university at

mcmaster children's hospital

welcome constantine we have elizabeth

morrow director of communications and

knowledge translation at the canadian

pediatric society where she manages the

diabetes at school project welcome liz

and we have amanda sterzick who is our

very own manager of research and public

policy with diabetes canada and a type 1

mom

so i want to welcome the three of you

and thank you very much for being here

today our experts will be answering some

key questions that they and diabetes

canada have been hearing on this topic

we'd also like to note that there is no

right answer to this and you should

always consider your own family and your

own situation around key decisions

relating to school

we will also be taking questions from

you our viewers so um

some questions have already been

submitted and you can ask your own now

uh by replying at any time throughout

the webinar in the comments section on

facebook live

so we're going to get started with a

question for uh dr saman which is at

this time given that many canadians

especially adults have received the

coping 19 vaccine

what risks are remaining from the

pandemic for individuals especially

children who live with type 1 diabetes

and what's the relationship there

right well uh thanks very much uh brooks

and again i'd like to acknowledge uh the

lands that

i live in

which

the indigenous people of this land have

called home for thousands of years and

uh i thank them for their stewardship of

the land

i think the

pandemic certainly uh has evolved since

we had a similar meeting last year and

one of the things that have changed of

course is the vaccinations that have

rolled out over the past several months

and it is so great that so many

canadians have chosen to get the

vaccines and

the current traits of vaccinations of

course has allowed us to open the

economy and and think about opening

schools as well however this is not a

time to let our guard down and new

variants including the delta variant is

something that has been watched very

carefully

the good news is that vaccines still

continue to provide protection against

this variant

and also the

children who are less than 12 years of

age are not yet eligible for this

vaccine of course which is something

that's very important for us to think

about so i think these are probably the

the main issues that we're considering

and watching at this point

thanks very much constantine and

now many folks with and without type 1

diabetes are nervous about returning to

in-person classes

so

i want to ask what your advice would be

to children and youth who are impacted

by type 1 diabetes or other complex

health conditions including for example

type 2 diabetes

yes this is a very important question

i think the goal is really to get kids

and youth back in a safe manner to

return to school and so

uh kind of talking to school now and

discussing the specific needs of

children and youth who are returning to

getting ready to what these needs would

be

to ensure a safe return is really

critical

i think school has many benefits for

children and youth really beyond

learning in some cases school is an

important place for nutrition sometimes

safety checks on children so i do favor

a return to school

and careful planning should ensure a

safe return

um

one of the focuses i think for us is

really those who are less than 12 years

of age or unvaccinated and the virus

circulation in the communities and

especially the delta variant data

perhaps and there are other variants

perhaps that will emerge over the coming

months that needs to be monitored

it is important to know that children

with diabetes don't have a higher risk

of getting covet

and even if they do the they're not at a

higher risk of getting severe infection

um regular sick day measures should a

child or youth with diabetes get covered

provided by diabetes team and

consultation with the team if diabetes

control

is not necessarily

moving according to plan is really

critical to try and address um you know

the management of diabetes at home with

a covet infection

infections of children are happening

this is a true however uh just to give

you some perspective uh only about two

percent of children who are getting the

infection are actually requiring

hospitalization and then even a much

smaller number is needing intensive care

unit admission and these are usually

children who have chronic

conditions we don't have the breakdown

for diabetes but the numbers would be

very very small at this point

most children either have no symptoms or

have mild symptoms and the risk of

complications is actually quite small

i think vaccinations continue to provide

really an important anti-transmission

strategy and of course they are

preventing severe infections so for

those who are older than 12 years of age

and for their caregivers uh considering

the vaccine is is really an important

strategy

um and this is important not only for

schools but

i think when extra curriculars are going

to be

[Music]

launching again

there might be any to to provide

vaccination status

those who are less than 12 years of age

then who are not yet eligible to get a

vaccine

there will be data available

by september we think at this point for

this age group and perhaps vaccine

rollouts at the end of the year or early

2022 the best protection we can offer

them is by really building a wall of

immunity around them by vaccinating the

people around them

and that

again

coupled with other strategies that have

been implemented over the past several

months

it's really important to stay home if

sick

screening should play an important part

in isolating

those who are

exposed to the virus i think isolation

if symptoms develop testing and contact

tracing remains crucial for us to limit

the infections

using masks

social distancing and and maintaining

air quality and proper ventilation and

air filtration and close this space is

really critical continuing to maintain

clean surfaces

um public health are critical partners

in this in terms of closed monitoring of

community circulation of covet

is really going to be important again

going back to school this year and again

uh following sick day management

protocols should there be a coveted

infection would be really important uh

this advice will apply for type 1 and

type 2 diabetes um in children

in my view and i believe it does offer

us a safe path to return to school

thank you

i think i i appreciate the

the framing of providing that wall of

protection by by vaccinating other folks

i think oftentimes people um people are

rightfully feeling a sense of sense of

anxiety around you know if my child

isn't eligible to receive a vaccine what

can i possibly do and i think that you

know mental image almost of building

that wall of defenses is a really

powerful one

our next question is for

liz and it's

as a professional and as a parent

what is your position on whether folks

with type 1 diabetes ought to pursue any

exceptions or accommodations in a school

environment especially given this public

health climate

okay thanks for the question

um

so i think any conversation about

exceptions or accommodations needs to

start with a reminder of

the rights of kids with diabetes which

are essentially the same as any other

student in school so they have the right

to be safe they have the right to be

supported and they have the right to be

included and so it's all of our duties

to do the things that ensure that those

rights are upheld

regardless of whether or not there's a

pandemic

that should not be a barrier to

participating fully in school so

you know parents need to remember that

schools have a duty to provide care

and to accommodate for disabilities

which type one is

so

like any other school year families need

to ask for what their children need to

be supported at school and expect those

rights to be upheld

and i think that this year you know more

than ever there was so much disruption

in the last school year

we know that kids mental health has been

affected parents mental health has been

affected so there's probably a little

more planning that needs to be done both

on the home front and in school

you know parents and kids who did a lot

of online learning there may be some

anxiety going back to school um in kind

of letting go of the reins a little bit

we're at home we have everything under

control

more hands-on support so it's really

critical that everybody be prepared to

to support kids at school

we also know that teachers and

principals and educators are going to

have a lot on their plate at the start

of this school year so

you know some kids are starting next

week perhaps the week after

it's really important to get in touch

with them sooner than later

and try to be understanding with their

situation

that you know time may be limited and

opportunities to meet in person may be

limited however

it's also really important that kids

with diabetes start school on time

that diabetes not be used as a reason

for delaying entry into school

particularly this year after all the

disruption

so you know those supports need to be in

place so that kids are safe from day one

we know that every student's needs will

be different depending on their age

their level of self-care

but even older kids kids in middle

school high school are going to need

things like accommodations for tests for

example um if they experience a low in

the middle of an exam they're going to

need time to treat and to recover so

some extra time to do their test

and regardless of where a child is in

any school environment where there's a

child with diabetes everybody needs to

know at minimum how to

recognize and treat a low blood sugar

and i just want to mention before i

before i close that

diabetes at school just yesterday

actually launched an online

teaching module for educators and school

staff so to help it's for them but it's

also for all of you as parents to help

facilitate that training process

so i will um

i'm not sure if people can see a chat or

if i could leave it in a facebook

comment but i'll provide that link so

that folks can go and access it and

hopefully make that training process a

little bit easier so that you as parents

can focus on the specifics of your

child's situation

thanks very much liz and on the note of

sharing uh resources and information

there's gonna be two ways we can leave a

facebook comment with some some links to

some interesting and helpful resources

as well it'll be included in the

description of the youtube video when

this this recording goes on youtube so

if you'd like to access it later your

year something over again and or access

those resources

you can check out our youtube channel um

our next question is for amanda and it's

essentially what's your take on this so

as not only an expert in science and

policy around the situation but as the

parent of a soon-to-be post-secondary

student

how does this change the situation does

it change it how does it change if so

ah thanks for that brooks

well it's it's been tough we can you

know everybody has the same

level of anxiety and exhaustion from

what we went through in the past year

and a half it's been necessary

but taxing on the students teachers and

parents

and speaking from our experience the

school closures have been quite

difficult for high school students

especially in their final years of high

school and just to reiterate what

elizabeth was saying about anxiety

the anxiety of not having done any

written any tests or exams for a year

and a half is a huge issue for

young people going into first year

university

our daughter who has type 1 diabetes was

relieved as were we to hear that her

university of choice will be open for

in-person learning this fall

that's as of now we don't know what's

going to happen in the future

in terms of elementary and secondary

schools all the provinces and

territories are currently planning for

in-person learning when school reserves

for the

2021-2022 school year

i just want to reiterate also what

elizabeth was saying regarding the

supports for students living with

diabetes

pandemic or not they need an individual

care plan that outlines their daily and

emergency diabetes management plan

and it needs to be supported by school

staff

across the country we know that there's

inconsistency with mandatory guidelines

for students with diabetes in school

diabetes in canada is in the process of

updating

our comparison document where we

highlight the gaps in the policies

across the various provinces and

territories

now a few months ago maybe june

ontario's covet 19 science advisory

table released guidelines and research

on children returning to school in

school learning in the fall

and i just want to quote what they had

to say about children with medical needs

the additional resource requirements to

facilitate safe return to school

should not be a barrier to meaningful

access to in-person education for any

child

and we at diabetes canada agree with

this assessment

our guidelines for the care of students

living with diabetes at school outline

necessary components of a comprehensive

diabetes management policy

this type of policy will ensure students

physical health and safety

but it also reinforces their right to be

full and equal participants in school

and all school-related activities

without a fear of being excluded

stigmatized or discriminated against

because of their diabetes

thanks amanda and i'm curious you know

this is

not a question we had discussed before

but i think we've all to some degree

touched on it and i'm wondering if if i

can gauge the three of your thoughts if

you if you'd like to share and it's

it's around you know pandemic or not the

importance of

developing the capacity to ever advocate

for oneself in a school setting

um

what you know i'm wondering if you could

just state a little bit of the some of

the resources that are out there

for from a student perspective if you

know if we have students who are

watching this tuning in if they're

wondering um it can be hard enough to

stand up for you know what what they

need if they live with diabetes let

alone adding a pandemic into the mix

what advice would you have and what

would be sort of

a next step or a piece of guiding advice

you could provide

you want me to go first

so certainly the diabetes at school

resource is is really beneficial and i

think

you know as our daughter went through

high school she became more independent

with interacting

with school staff around her needs and

you know at post-secondary level

she's an adult now so she has to take on

ownership so it's just you know making

sure you're having the conversations

with people understanding at a

post-secondary institution you need to

be proactive as parents caregivers of

younger students do when we're

contacting

school officials

and it becomes an even bigger issue

about

having the

permissions to be able to

take food and drink into classes and

exams to treat a low have your

you know

glucose monitor or your phone if you use

an app to read your glucose monitor that

you're able to use so that you're not

having it taken away during exams that

type of thing so it's just it's making

sure that you you know doing the

research and being vocal and

um and talking to your healthcare

providers your healthcare team because

they often will have the experience of

having other

people go through young adults who've

been asking for help with completing

forms that are required

in post-secondary so they you know they

will know what's needed for you to go

through and and make sure that you have

the accommodations you require

i i fully agree with amanda on all the

points that she raised and i would add

maybe for younger children again for

parents to advocate

with the school but also again to speak

with the diabetes team to have any

services that are available for support

in school like blood sugar checks or

insulin administration to be ready

you know to support the the child or

youth when they return to

i school the only other thing i would

add is

when i think of advocacy i think of you

know um kind of preventative advocacy

and

building that starts really with

building relationships right especially

when our kids are younger and we as

parents are kind of in control of the

whole school situation

um

we can help set the stage i think for

their own personal advocacy um by what

we model and modeling

um forging good relationships uh

relationships that are full of

communication with the the people at

school with the office staff with the

teachers

with the principal

um being very upfront about you know the

diabetes to the degree that your child

is comfortable of course but always you

know putting it forward as this is just

a part of this is a part of our lives

and you know we need to do what we need

to do to

to keep you safe and you know to keep

you healthy every day

but really thinking about those

relationships and the mutual benefit

always communicating that mutual benefit

so

um yes my child needs these things but

also by learning about this condition

you can prevent

you know the worst case scenarios that

people are so afraid of and fearful of

we never have to get to glucagon if we

have good processes in place on a on a

daily basis

thanks everyone i i really resonate you

know if someone lives with type one i

really resonate with that sort of uh

relationship based rather than uh

almost worst possible outcome based

because it's very understandable as

someone that's not familiar to be

fearful of having to use glucon or

having to engage when someone's

you know experiencing a crisis

and

i think that's just really a really

important message to to build it around

the relationship between the individual

and the care provider or uh teacher or

whomever it might be rather than saying

this person might experience a really

shocking traumatic event and you need to

be prepared that made that that can

still be true but it can be it can the

foundation can be the quality of the

relationship and the ongoing

conversations so i really appreciate

that

um

i'd like to open the floor to a few

questions that we've received now so um

the first one is

is from a viewer who asks

how do you quote unquote build a wall

surrounding your kids with vaccines

when the classmates surrounding them

aren't of age to get a vaccine

so i think this this comes back to that

that element of you know protection

within a family unit or within folks

that they often interact with but

recognizing that that may not uh extend

into the classroom

so that's an important point i think the

the issue of trying to protect the

children as you know as far as we can

until these vaccines are available to

this age group is really important and

um i think there are several approaches

that have been taken now uh today for

example the toronto district school

board has mandated that uh you know

the school's

staff will need to be vaccinated to

again prepare that return to school

the additional measures that are taken

within that those spaces that children

are and are going to also play a part in

a protection

but also remembering that actually

children also spend time outside the

school and then by providing community

supports and protections for them we

reduce the chance and we're not going to

eliminate the chance of an infection

this virus is out there and

some children will get infected this is

true

uh i think applying all these measures

again until we get to the vaccination

stage of of young children um

will reduce the the risk

and make it more manageable for us

um can i just jump in i wanted to go

back to what elizabeth said about

building the relationships and having

conversations in the school and i think

a part of this is also having

conversations with other parents

in your child's classroom because

they're all going to be in the same boat

with not being able to have the kids

vaccinated you know so making sure that

you all sort of have a common front

about reinforcing the public health

measures the mask wearing the physical

distancing the good hand hygiene keeping

your kids home from school if they're

sick

so that you know it can be sort of a

wall a community wall versus just trying

to

fight on your own in the classroom um

and the other thing i want to mention is

there was a great analogy in

epidemiology about

you know how to keep case numbers down

and how to minimize the spread and it's

called the swiss cheese analogy

and the idea is that no one measure is

perfect and when you look at

a stack of slices of swiss cheese each

slice has holes but they're in different

spots

so when you stack them up when you have

everyone who's eligible to be vaccinated

has been fully vaccinated you know

you're following the public health

measures

you're doing the contact tracing and the

testing you're staying home and

isolating if you have symptoms or if

you've tested positive

as you stack all of them up you close

all the holes so you're less likely to

have the community spread

that's a great point amanda thank you

and thanks for your answer councilman

um we have another question and it's uh

it's a little bit

extraneous to the the topic but i think

it's really interesting and timely

and the question is what government

party is doing what for diabetics

uh recognizing we're in federal election

mode right now now

full disclosure if you don't uh if

you're not fully up to date on different

platforms that's that's okay there's a

lot of pages to write through but does

anyone have any any thoughts on that

so seeing none i think i appreciate the

question and i would probably i would

direct you to to look at the different

party platforms um they're generally

quite searchable they would have a

section on health um to which a reviewer

asked this question

i would look through the platforms and

see and see where they specifically make

reference to

uh to diabetes care and

you know if if so to compare which party

is is proposing what measures or you

know what what they're proposing to stop

start and continue and that will help

you help you understand and if you if

you would like to ask more you can shoot

an email to

to us at info diabetes.ca and we can

do some

we have another question um

which is

it was submitted sort of at the

beginning of the webinar and it was

how long does it take to reverse your

pre-diabetes pre-diabetes diagnosis

um

so again not necessarily to do with with

returning to school but a valid question

nonetheless perhaps constantine do you

have any thoughts on this

um

i suppose the question is

related to perhaps children

who are dealing with

insulin resistant and perhaps being

overweight and are in the impaired

glucose tolerance phase which is an

intermediate stage between having

normal metabolism and developing type 2

diabetes i suspect that's what the

question is related to

um there isn't really a clear answer in

youth

and it is not a very well studied area

either

it all depends on the drivers of

the impaired

insulin or glucose tolerance and

targeting those specific factors through

specific strategies including things

like lifestyle intervention with healthy

nutrition and physical activity cutting

down screen time um maintaining a good

mental

health

but also more recently there has been

evidence to suggest actually using

medications like metformin which is a

drug that is used in type 2 diabetes

that appears to be quite effective and

improving sensitivity to insulin and

actually reducing the

risk of maintaining impaired glucose

tolerance and reversing that to normal

glucose tolerance so these are the

strategies that we would use in youth to

try and

reverse

the timeline for reversal if it's if the

program is followed and if medications

are effective because again there are

multiple drivers here um usually is

within months and maybe up to 12 months

before we see the full result

but again that's really highly dependent

on the

uniqueness of each person and and what

factors are driving that in soil

resistance in them

thanks very much for the answer um we we

have a question

uh and this this viewer says

my son and i are both type one with

asthma and fully vaccinated however his

classes at ceja are jam-packed with no

space between students at all

how safe is it to return to school in

this situation

and answer how old is

uh

your child

um doesn't

they would be probably seventeen or

eighteen percent

i i would

suggest that

the same kind of points and and elements

that we've highlighted really would

apply in this particular case um

if diabetes is well controlled and

if asthma is well controlled i think

the

uh and if vaccinations are in a place

uh the precautions for indoor activities

are applied uh that will reduce the the

risk of of acquiring the the infection

um

spacing

in schools

is going to be a challenge in some

spaces uh but again there are

multiple other ways that schools are

trying to deal with this and every

school probably is going to be unique in

how they approach that challenge because

no school is probably similar to the

other one

but again i think the the same elements

that apply to

diabetes that we've highlighted will

apply in in this particular case

thank you we have another question from

a type 1 parent

who says

my four-year-old daughter was diagnosed

with type 1 in the spring she's

returning to school this fall we've been

told that her ea educational assistant

will have eight students to manage

do you have any tips or advice on how we

can ensure

that my daughter receives proper care

throughout the day

and that's that's uh

an important stage

for your daughter to to go to school

which is fantastic and

the question again with with the younger

children um especially the

four-year-olds five-year-olds there are

going to be perhaps different approaches

to

um managing the the cohorts in a school

i think the conversations at the moment

are about younger children being more in

cohorts compared to older children

um and i suspect that eight unit i'm

suspecting this is the cohort that is

gonna be traveling around

um

again the the

question of spacing of students within

that space within the environment

uh

using masks if the space is limited

proper ventilation filtration of that

space

good hand hygiene

and this is again can be practiced as a

group with the ea perhaps

helping the young children do that

together and developing those habits

cleaning those surfaces keeping them

pristine for kids to use

all these things will help reduce that

risk

can i comment on the piece the question

about the diabetes care and

so if i understand this is a little one

who's going to kindergarten for the

first time hasn't been to school

and then there's an ea with other

students to manage and i think

typically i don't know where this where

this parent is but i know in ontario

eas are often

helping out kids with behavioral

difficulties or learning difficulties

and then a little bit of their time is

carved out to check a blood sugar and so

on so one can imagine

um the challenges for an ea with all

that on his or her plate and so i think

this is where i might engage in a

conversation with the principal

about finding someone else in the school

who can help out your daughter

because i would be concerned about the

level of care and also about the safety

um you know when it comes to just you

know checking blood sugars and and

treating lows and things like that

especially with a little one who is both

young and newly diagnosed and may or may

not feel lows i don't know what kind of

technology you have to work with if you

have a cgm or if she's on a pump but of

course those things would factor in um

but i really think that this is a you

know you're in a tough situation but

it's um a question of really kind of

communicating to the principal

what it is that your daughter needs

perhaps the principle is not entirely

clear on what that is

but it seems to me anyway unreasonable

to be one of eight

especially and kind of the

well i shouldn't even say especially in

the current environment in any

environment being one of eight um

doesn't seem very reasonable to me

um i know when my daughter was in

kindergarten she she was diagnosed in

april and started kindergarten in

september

and we were told we couldn't have an

ea's time which

is what's got me started in advocacy in

the first place

but thankfully the eces because we're

here in ontario and there are eces in

the classroom the kindergarten

classrooms the ec's agreed to be trained

to check her blood sugar and help her

out so sometimes there are options i

unders i realize that principals cannot

mandate anyone to do this work but it is

heartening how many people in the school

system in schools are willing to step

forward and volunteer to help our kids

and can i just jump in and i want to

mention to you that and brooks is going

to put the link in for this the diabetes

candidate guidelines

um for the care of students with living

with diabetes in school has specific

information about

daily and emergency diabetes management

that is sort of you know that is

required and that we really recommend

all schools ensure that kids with type 1

or type 2

have these plans in place it's part of

their individual care plan

and i just want to say i was thinking

about this

as um my daughter was eight when she was

diagnosed and the one thing i can think

of in terms of covid for parents of

children with diabetes the so there is a

silver lining

in that

there's no issues around

food sharing in school i'm sure those of

you who have kids with type 1 have had

issues with either kids being excluded

because someone's brought cupcakes in

or they've gone higher low

based on whether or not they've been

allowed it or it's been planned and the

timing has been changed so in my mind

it's a little bit of a bonus that shared

food in the classroom isn't happening in

the time of kovid so it helps a little

bit with management of diabetes they're

only eating the food that you send to

school with them

thank you all those are really helpful

answers um

we have a question that's that says a

side note uh this person is is an ea in

ontario and also a type one mom

uh and

she says that eas are not allowed to do

diabetes care as part of their role

which is

just i think worth noting um

we we have a question as well that says

uh

our our child with type of diabetes is

entering school for the first time next

week for a primary school

in their experience

the endo clinic and the school have both

told them to

quote unquote manage their expectations

regarding what they can expect for care

in school

wondering if if we have any advice

it's this person's stance that type 1

kids should have the support to be safe

and healthy and it doesn't seem like the

system is set up to offer both

yeah i think uh

elizabeth

highlighted this issue earlier um

yeah i think the expectations probably

needs to be recalibrated in favor of a

safe and and

effective diabetes management strategy

for your child in school

and you know um i completely agree with

um with you uh with this parent

um

that your your your child should be safe

and healthy i'm sure

this is um a time of anxiety for you

thinking about you know hearing that

from the school and even from your

clinic and and sending your child back

to school for the first time it must be

incredibly anxiety provoking um but i

think that you have the right attitude

that

your child should be safe and healthy

and one thing that's changed in the

years

since i think amanda's daughter was

diagnosed and my daughter is that

there are so many

experts and and strong credible groups

standing behind you

um you know

groups of experts like dr saman who are

saying

this is you know your all of our kids

have the right to go to school they have

the right to full participation they

don't sit on the sidelines anymore

because we're not sure what to do and

whether they're going to go high or low

no they have the right to participate

there are lots and lots of resources so

those barriers are gone um there's

diabetes canada's uh guidelines there

are guidelines from the canadian

pediatric society and the canadian

pediatric endocrine group so

you know all of the experts who care for

our kids are in agreement um that this

is what our kids should have so you're

not alone as a parent

when you go to school and you say no my

son or daughter has has the right to

start school on time um and let's work

together to figure out what we can do to

to make it happen and it may mean at the

you know at the beginning of the school

year if you can kind of set yourself up

to provide a little more support and be

a little more available

but just to get them off on the right

foot

and for them and to demystify it a

little bit so that they see that oh this

isn't as scary as i thought it was going

to be we can do this you know as a

school community

because more often than not

you know people come together and they

come they come through so

um

good luck

thank you folks and i think like you

know myself

um having grown up and gone through

public school living with type one um

it's been pretty amazing to watch the

the evolution and to look now and see

how many wonderful groups and experts

are

you know behind the cause and have so

much so many resources out there to to

be used and there there's such a wealth

of information and data and support

there is a lot of community behind this

too so it can feel

quite like a like quite a lonely

condition at times but there are a lot

of folks in the same boat and a lot of

folks that um have

you know

next steps and have

tools for you to make use of

um we have another question that says

what advocacy is being done to ensure

sports are not shut down this year my 15

year old daughter's insulin needs

doubled when ontario shut down from

november to june and we saw insulin

resistance

with the return to sports in this case

swimming she is sensitive again so less

insulin is required we dread another

shutdown

[Music]

well i can say that the canadian

pediatric society has advocated for

um a return to all extracurriculars so

um and my understanding in ontario at

least is that that's the plan

um is for sports and extracurriculars to

continue um you know if and when that's

pulled back uh we certainly will be

advocating and and we do have um info on

our website or our statements on our

website to that effect if anyone wants

to reference them in their you know in

their communities

and another resource is change for good

health diabetes canada's participated in

an initiative that came out of the

founder of good life fitness earlier

this year because

they were really concerned about the

reduction in physical activity across

all age groups so they have some great

resources as well

thanks everyone and i think that's

that's the end of the questions we've

received but i want to say a sincere

thank you to our experts for giving such

thoughtful advice um a lot of folks

expressing their gratitude want to pass

that on to to all of you that it's

making a real impact to to people that

have that care enough to attend this and

ask questions so it means a lot to get

this this level of of advice and to be

heard so thank you

um

so that's that's all from from our

viewers thank you for uh for your

questions and i'd like to just take a

moment before we wrap up to

tell you a bit about how diabetes canada

and a few other organizations are

helping to support this cause so as

mentioned uh there's been reference made

to the guidelines for the care of

students living with diabetes at school

there are interferential comparison

documents for kids in school with

diabetes so you can compare based on

your province how that stacks up and

what the current situation is for your

province or territory

we have resources specifically around

covid19 and diabetes

diabetes at school as mentioned

liz has done some wonderful work and

there's a lot of resources there

and there's also a an initiative through

mcmaster children's hospital and

hamilton health sciences foundation that

constantine has shared and that's at

www.covid19

childhooddiabetes.com and again all

those will be shared in the comments and

on our youtube videos so you can feel

free to visit our website our social

media at any time to stay up to date on

our work and resources and if you'd like

specific direction you can call the

diabetes canada helpline at 1-800

banting or email info diabetes.ca for

any questions and we'll do our best to

give you direction

um

i want to give another sincere thank you

to our guests for your time and and your

your thoughtful responses before we wrap

up is there anything else that you'd

like to share with our viewers

uh i just want to say for parents out

there

we're all behind you we've been in the

situation and we know it can feel lonely

but

we can't be in the classroom with you in

the principal's office talking to them

but

you know we've put all these resources

out there for people and we're there in

spirit with you so you know be strong

and be there for your kids because

you know you're their best advocate

and i would say actually it is really

important to connect with your diabetes

teams and have their support as well ask

questions look for information

and don't be afraid to reach out

it's really

an important time we understand how hard

these times are and if there are any

questions if there are any issues again

feel free to reach out to your diabetes

team

i can't say it any better than what you

both said

agree you're not alone and reach out for

for help if um

if you feel that your child's health

safety or inclusion is being compromised

in any way

thank you so much folks um to our

viewers please

again never never hesitate to reach out

to us diabetes canada or to

the other organizations that we'll we'll

share shortly

um you know personally i really hope i i

found this to be such a wonderful

conversation and i hope that this was

helpful for uh your viewers and uh

thank you again for for joining us and

being part of this conversation i wish

you all all the best in

the coming back to school season and uh

thank you and take care everyone

bye now