Diabetes Canada is pleased to present a webinar on destigmatizing diabetes. This conversation features Dr. Michael Vallis, Austen McDonald, and Quentin Valognes and will cover what we mean by stigma, how it affects us differently across life stages and types of diabetes, and how to recognize and respond to stigma when we encounter it.
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so good afternoon and good morning everyone my name is Brooks roach I'm manager of patient knowledge and
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connection with diabetes Canada and I'd like to welcome you all uh to this this really exciting webinar presentation
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I'd like to begin by acknowledging that I am joining this webinar from the traditional and unseated territory of
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the migma people so wherever you are joining or watching from I'll just invite you to take a moment to express
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recognition and gratitude for the land on which we live and to acknowledge the history of the indigenous lands that we
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now call Canada we are here today to talk about something that will be familiar to
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almost anyone living with or affected by diabetes this is an issue present in clinics in
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classrooms workplaces Social Circles and in all these tiny interactions scattered
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throughout our lives and what we're going to be talking about is stigma so we're going to do a few things we're
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going to introduce some definitions around stigma talk about the differences that may
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exist across types of diabetes and life stages and then we'll explore some steps
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that both individuals groups organizations can take to help in destigmatizing diabetes
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and to do this we're joined by three incredible guests that I have the pleasure of welcoming so first I'd like
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to introduce Austin McDonald who is currently an airline pilot with jazz Aviation or Air Canada Express flying
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the dash 8 Q 400. Austin was the first person in the world to earn a commercial pilot's license
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with pre-existing type 1 diabetes he holds a BSC in mechanical engineering
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from the University of Alberta and uh welcome Austin thanks for having me I'm happy to be
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here Brooks uh we're also joined by Dr Michael vallis so Dr vallis is a
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registered health psychologist and lead of the behavior change Institute at the QE2 Health Sciences Center in Halifax
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and an associate professor in Family Medicine at Dalhousie University Welcome Michael
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thank you very much great to be here and finally we're joined by Quentin Bellon former professional writer and
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current ambassador for the all type 1 professional cycling team team Novo Nordisk welcome Quentin
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thank you very much so in addition to just having some
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incredible backgrounds and CVS of what they've they've been able to do our experts today will be answering some key
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questions that they've heard from patients colleagues and seen in their work and research
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we will also be taking questions from you our viewers so you can ask your questions by replying in the comments
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Below on Facebook live and we'll do our best to uh to fit those in in the Q a
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session toward the end of this this talk so feel free to to ask those at any point throughout the session and we'll
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uh we'll pass those along to our panelists so with that uh I'd like to Dive Right
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In and start with a question to Dr Ballas so some foundations first uh Michael what
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do we mean by stigma and How might people with diabetes recognize it from their past experiences
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yeah I think it's actually really important to address this issue because it's kind of subtle it's sort of like
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you know under the surface so it's not immediately obvious but if we think about it we start with the individual so
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bias refers to individual attitudes or beliefs about the disease and the
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individuals living with diabetes and then those biased beliefs about diabetes
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and individuals actually can result in unfair treatment of the person living
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with diabetes but then it spreads and then we have stigma which is really the the societal
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social stereotypes that exist that our individuals are exposed to in the normal
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day-to-day course of their lives so it's not sort of just at an individual level
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We Believe very strongly that that individual bias has actually crept into
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the sort of social stereotypes and that impacts the experience that people have
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with diabetes great thank you thank you Michael
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um to take that into a lived experience or these sort of real-time experiences we
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might have had um I'd like to ask both Austin and Clinton uh to share any stories or
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Reflections on when you might have encountered stigma and how you responded or wish you responded and advice that
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you might gather from these experiences so I'll ask that to Austin first I've typically found that stigma in
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diabetes the diabetes usually goes hand in hand with a lack of understanding or a misconception about the the disease
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for example my attempts at getting my commercial pilot medical certificate was pretty much all about trying to dispel
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myths and stigmas such as all diabetics are very brittle the treatment
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technology hasn't changed since the 1970s another really important kind of
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stigma and and kind of myth I tried to dispel as well is that you know my life is controlled by insulin and blood
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glucose rather than I control my life or my blood group glucose and my insulin
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requirements around my lifestyle um when it comes to dealing with with dispelling this or dealing with this
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stigma The Motto I use is patience and consistency for example when I was
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working with our governing body Transport Canada which issue which issues flight crew licensing I did wish
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I practiced a little bit more patience with them and there's a few times where I quite nearly lost my cool but once
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once I I broke through the barrier and got my license I found for the most part everyone in my industry is very happy
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for me and and very curious about what it is like living with diabetes
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um and uh to to be frank with you they're they're they're really open and
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and wanting to learn more about it which hopefully helps in dispelling uh some of the myths and the stigma around the
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disease yeah thank you Austin
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um you know Quentin I'm curious to get your perspective having have the chance to to
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you know work as a professional athlete and travel the world and how you've encountered stigma in in your own your
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own experience yeah thank you for the chance to speak there um I I was thinking
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um I have been diagnosticated with type 1 when I was six years old I'm 26 right now and even before being professional
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right there and things start um it's quite hard for me to to remember
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because I have to tell I have to say all my family we are perfect with me they
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introduced me to to the school the school were perfect all the Cycling Club the claiming Club all the sport I did
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before being professional they were all nice with uh with my type 1 diabetes the
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thing it's quite funny I remember it's when I was like 13 years old I was
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already a cyclist I am a sprinter so at the end of the race you know we we find we with other people and one one day I
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crashed so this this finger broke and I have a teacher I had a teacher who
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planned to make a travel to Italy and when she saw that I have been I had an
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injuries she was she was like okay Quentin you have an injury so we cannot bring you to Italy with us the reality
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is she didn't know what was diabetes and she was afraid about it and it's fine
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because it's not your fault we I think as at least as people living with type
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one it's also our mission you know to to educate to explain what is what is
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diabetes so that that's the my story and I would add just something I have also a
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cat who has type one and he got a lot of stigma because all the time that people
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come in my home and they they see me giving him insulin they asked me okay oh that that's why he's little bit
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overweight because this type one so that kind of things I know he is upset we speak after between us but that's this
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kind of things foreign yeah I appreciate that example because
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it's uh you know it's so small and specific but at the same time that illustrates a lot of what people experience on the day-to-day this sense
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of like oh that explains that or they're looking for the what uh what Behavior brought this on what uh what can I link
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to the cause here when in reality it's far more complicated than that
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um [Music] so Michael another question for you and it's that we'll have some you know and
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Quentin you alluded this that uh you know you're speaking really with a type one focus and that's the you know team
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Nova Nordisk is a team of individuals with type 1 diabetes who are who are cycling and Michael I'm curious because
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we will have viewers living with both you know with with either type 1 and type 2 diabetes as well as some who are
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our caregivers and maybe experiencing it from a different perspective so our viewership will be diverse from
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perspectives of age or location ethnic background and I'm wondering if you can speak a bit
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on how all of these factors in in a viewer's identity could lead to people
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experiencing stigma differently absolutely yeah it's actually really important for us to um kind of elaborate
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on that point Brooks because you know we're sort of trying to understand stigma trying to figure out okay what
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can we do about it so we're sort of looking for answers and what I'd encourage us all to think about is let's
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find out what the questions are because each individual has to answer these questions for themselves so bottom line
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is is one size doesn't fit all so it's important for us not to try to paint everybody with the same brush so if we
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kind of flip the question around we could ask everyone who is listening in be it someone with diabetes or a
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caregiver and they can locate themselves on the dimensions of type of Diabetes
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age location ethnicity income Etc and then I would encourage everyone to to
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really ask themselves about their experiences with others have you ever encountered these biased attitudes or
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behaviors from others and listening to quinton's example of this cat is really really interesting isn't it because it
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kind of shows you it's a very straightforward one but it's so illustrative this cat did not contribute
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to this bias in any way shape or form this little kid he's just doing what it's doing and yet people are imposing
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these attitudes on them so if we could ask your cat your cat would probably say hey this isn't fair and that's the key
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and then we try to really build from that are you treated in a manner that makes you feel uncomfortable because of
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your diabetes I think that would be the question for everybody to reflect on because if you're in the presence of
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others and you're starting to feel uncomfortable because of your disease that's when we see the flag for bias and
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stigma and then you need to ask if that is shared by others if the person is aware of their attitude
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and so one of the things that is really important and I love being on a panel like this because we've got some some
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real citizen representations so we've got Austin and Quentin who live with this disease and have really determined
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that they're not going to be suppressed by the stigma in the bias so these are spokespeople who are are really willing
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to take a stand and that's actually really really important because we're trying to support the diabetes community
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in really claiming their voice so you might ask the person if they're aware of
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the impact that their attitude has on them and so if we could ask Quentin's cat we
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could ask the kitty you know does that make you feel good about yourself or does that make you feel bad and if it
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does then perhaps we could think about how could we potentially raise the issue
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with the person or how do we protect ourselves from potentially uneducated
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and judgmental individuals who aren't interested in a conversation so the key
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to my response here is If you experience it try to link it to where the source is and then make your decision is this an
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important person to me and if this person is maybe I could raise the issue with the person and that might be as
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simple as just take a a diabetes Canada leaflet and put it on the kitchen table so
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everybody could see it bring it with you when you're at a coffee shop and put it out there something that might cue a
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discussion and then you kind of decide to be honest who's willing to listen and communicate and who do I have to protect
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myself against I I really appreciate that um that
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framing Michael and and if I may I I I'm curious to pick up on something you mentioned which I I love the acid test
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of does this make me uncomfortable does does this provide me with this sense of
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have I done something wrong does make me question my role in all this um and then taking that forward into can
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I educate this person and if I encounter that resistance can I walk away you know knowing when to when to find protection
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um I'm curious if I can ask Austin you know I I know Austin you had a a pretty
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long Trek through your advocacy journey in going from you know to become a
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licensed pilot like it was it was an uphill climate times and I I imagine without naming names that you would have
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encountered a lot of folks who who wouldn't have understood or who would have been would have been tempting to
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walk away and I'm curious if you can speak a little bit to how you protected your own well-being
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when you were in those situations that's a that's a really really good question and absolutely I did encounter
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a lot of people that would just say it's not possible or it can't be done uh not to go into too much detail but
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um several uh officials at the government level basically said this is not achievable and they were medical
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experts however their Viewpoint at diabetes hadn't changed from what I thought since 1980s or 1970s
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um the best advice I could give again was the the patience and consistency and having a excuse me a fantastic support
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team I leaned heavily on my family and specifically my dad he was the the
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champion for my for my fight with all this so I'd say the key to all this is having an excellent support team to kind
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of help you vent and help you um come to terms with the the biases and
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the stigmas you're facing a little story I guess I have is my mom uh once I was
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on the phone with with Transport Canada kind of arguing my point about specific kinds of insulins it's a it was a very
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very specific conversation but it got to the point where I was you know vibrating Madoff after the phone call and she just
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after I hung up she she took me aside and said listen you know you're doing good this is going to be a long uphill
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battle but you got this and it's it's a fight worth fighting so like I said having a a great support team is is
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massive massive for this yeah thanks Austin I appreciate you sharing that
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um I I think a major component to this whole issue as we've touched on is is a
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misunderstanding of diabetes or its causes its severity a lot of a lot of people try to dial down how severe it
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can be um it's complications you know whether it's they're not aware or they don't really grasp the interconnection with
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that this this can be a really severe really dangerous condition to live with
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and I'm wondering you know what have you found to be the keys to shifting how people understand
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we've talked about that that importance or that that Duty in some cases to educate others to help people
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clear that hurdle of understanding what have you found helpful to to help change
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how others understand or think about or speak about diabetes so it could be could be family friends Healthcare
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Providers Transport Canada or you know it takes a lot of forms um Quentin I'm wondering if you can can
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share yeah um I think first of all we need to
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to see to sing also about oh we are thinking about how our diabetes
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ourselves a small story when I have been diagnosticated I was like why me why
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when my diabetes is not well controlled people are upset about me my parents the
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the doctors another of them what I mean not my my friend my brother my sister I did not
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understand what happens so I started I started to fight against my diabetes at this point then when I was 14 when I met
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for the first time team novel artist who is only um athletes with type 1 diabetes
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I was like wow they are like me they are as as I want to be and then they invite
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me to a training camp in Atlanta Georgia and I was there and the CEO and the
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co-founder of the team Phil stood around spoke to us and asked us questions what do you think about diabetes how do you
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see so I explained my English was perfectly bad at this moment but I understood this sentence and I was like
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okay I fight against my diabetes I'm sure to say one thing that changed my life he said okay Quentin if this works
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for you perfect but don't forget diabetes only choose Champions so okay it's it's marketing it's what whatever
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you want but for young a young kid with a lot of dreams that changed my life
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from this I learned to use level difference to make the difference
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but I I think that's worth repeating to to use the difference to make a difference it's interesting because it
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can be can be a lot on on our shoulders to to feel you know responsibility to
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take everything on on top of the demands of living with diabetes and
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um yeah using the difference is is an interesting really great perspective
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um Austin can you uh speak to this a little bit I can and I like to say I really like the uh the analogy diabetes
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only chooses Champions that that's that's a really really good one and it shows how we have to be resilient and
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have to have to be tough so to speak but um uh talking about you know misunderstanding and
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um and having to kind of educate one of my favorite favorite kind of Segways into doing this to educating is you know
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are you sure you can have that cake or ice cream or how many needles do you give yourself a day
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um and the analogy I use nowadays with the kind of the way Car Technology is going is uh diabetes control is just
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like an autopilot for those fancy new Tesla cars or even for the airplanes I fly where
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um everyone without diabetes has this perfectly good autopilot that manages everything for them they almost don't
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have to think about it whereas us we have to think as if we're driving a
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1960s Mustang with three gears let alone even cruise control and so that's a
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that's kind of one of the analogies I use to provide um education and kind of show the
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misunderstanding that a lot of people have with diabetes and I think that's really the my in my opinion analogies
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are a great way to educate people um a little side story about understanding is that actually uh one of
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my best friends is a as a medical student right now and during his first year they made him do uh have diabetes
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for a week exercise where he had to test his blood sugar four to six times a day he had to give himself saline shots to
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stimulate insulin carb counted did all what we do on a daily basis in day in and day out and during that week we had
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a little get-together with him and he actually with him and a few other friends and he pulled me aside and said
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I never really understood what this was like and this is only a fraction of what you go through every day and so having
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somebody recognize that it was massive and I hope more and more people today get to learn learn from this from these
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webinars as well as from diabetes kind of information pamphlets about what this disease is and what we're capable of
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doing yeah yeah thanks Austin uh Michael I'd
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like to turn the same question your way and I just wanted to add something that came to mind and it's
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I can imagine some folks may be watching this and and might struggle to view
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themselves as a champion might struggle to to Really grasp that uh it can feel
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sometimes like a burden to to have to go out and keep doing your best and Performing it's at a high level just to
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do what what seems like what everyone else can do so easily um and whether that's educating others
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or just going about your day can it can at times feel really tough I'm wondering if you can speak to the role of yeah you
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know burnout and this this sense of consistent motivation when it comes to
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tackling this yeah absolutely so if people are sort of listening notice how this conversation has been going we
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start with stigma which is this subtle societal level assumptions that people
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make and it's true it's there we cannot deny it and so it's really important for individuals like Quentin and Austin to
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call it out in the experience of their lives critically important for diabetes Canada to to Really champion this to
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take this forward but stigma then is really based on on misunderstanding
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which really is about being uneducated and so ignorant in in the descriptive
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way people just don't know better most of the individuals who people encounter
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actually are not bad people wanting to do you harm
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they're simply following the sort of General beliefs that we have like you know if you're
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really really sick if you've got a life-threatening disease shouldn't you have an IV pole hanging on you and
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you're walking around in a Johnny shirt or how long are you going to live look at look look at Austin's wearing a a a
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an Air Canada suit and and Quentin is wearing an athlete's Jersey they can't
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be sick if they were sick I would know they were sick so it can't be that serious so these are just very kind of
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natural sorts of beliefs we need to look to the media there was a paper just published in we have a journal in Canada
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called the Canadian Journal of diabetes and a group in Montreal Just published a paper in which they looked at some of
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the misbeliefs presented by Stu by TV and movies in which there's what you and citizens
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see on the screen promotes misunderstanding oh you know
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the person is in a coma oh they're diabetic give them insulin and you know or in you know
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the great big needles you know get brought out when people are uh so so there's a lot of reasons that we
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understand that so it's really important that we you know look for these opportunities to re-educate and that's
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what can happen at a broad level and right now in our society we sort of need
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diabetes Canada and we need people like Quentin and Austin to sort of call it out but let's be honest most of us are
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just ordinary people with ordinary lives but those are where the extraordinary accomplishments really happen and so
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everybody talks about you know particularly type 1 diabetes you know is like all those poor people let me share
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something with you as a psychologist people living with type 1 diabetes especially if they've been diagnosed as
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children end up being as adults less neurotic than the average person
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and better friends and let me show you what I mean most of us are privileged we grow up in a
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society in which we're safe and so we kind of get neurotic you know I wanted a blue one and they sent me a red one oh
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my goodness let me complain because I really wanted the blue one and they sent me a red one well if you're living with
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diabetes and you're having you know worrying about nocturnal hypoglycemia you don't care about blue and red so
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you're actually less neurotic you're actually more able to focus in on what's important in life and also you know
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friendships most people are fair where they're friends it's like oh let's go out to a party oh I'm not doing so well
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I think I'm just going to sort of go for a walk and sit and stare at the stars oh oh well we'll be at the pub if you need
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us whereas someone living with diabetes who every day recognizes the burdens is
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likely to say oh okay I'll sit with you so I think it's really important for us to understand that there are definitely
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burdens but it's really the opportunity to to act on those burdens and what we
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really need to do is establish and call this conversation out so that we can
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begin to promote more correct types of models and we should call out the the
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industry around how people are presented so
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there's a movie um called the whale that's just been released uh and and uh by with Brendan
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Fraser playing a a super obese man with type 2 diabetes and and people from
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obesity Canada actually were involved in the script so we're beginning to see some of this
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openness so it's very much true that that diabetes can be a burden but in
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fact that life isn't about happiness life is about meaning and people living with diabetes often have the opportunity
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if they have support to actually bring meaning to their own lives so we're
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starting with the talk on stigma but what we're really trying to do is promote well-being or what we call empowerment
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so people actually are able to actualize and by the way people living with diabetes who are
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doing the least amount to take care of their diabetes are healthier in their behavior than the
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average Canadian so before people start thinking about what they're not doing they need to recognize the average
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Canadian's diet is a mess their activity is a mess their Stress Management is a
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mess and the average person living with diabetes is way more advanced in terms
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of knowledge of nutrition and knowledge of how to manage their lives so it's interesting isn't it in a way and that
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strength really develop through hardships so there's the burden element but we believe I'm a health professional
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in diabetes and we really do believe that there's an opportunity for empowerment and people like Clinton and
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Austin are really necessary right now because they are kind of Trailblazers and they show us the way
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and I hope I didn't talk too long not uh not a worry Michael because that
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was a really beautiful answer I I think [Music] it's really resonant that uh sort of the
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power in the everyday and the recognition that a lot of you know to to go through or at this the
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old language of suffering from diabetes yes well there's a lot of uh a lot of strength that can be built through the
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problems that are inherent to it the challenges that have to be solved by definition living with this they build
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things up yeah just I won't elaborate just want to let the audience know if
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you're interested in this language issue recently diabetes Canada published in the in the Canadian journal and it could
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be accessed through the website a very important paper called language matters
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and it's very accessible it's not an academic paper and it will just give you
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an explanation of the Damage Done by these judgmental types of words and it
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calls out some of the words and some of the strategies so it might be informative to the audience and it would
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certainly be something that you might want to code if you had a friend who was trying to help like maybe I'm trying to
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help Austin and I say Austin should you really be eating that because I don't know and maybe Austin if he feels
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comfortable might give me this paper to read which by the way is quite informative
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yeah yeah it's an excellent example I've just um I think we'll be posting that in the chat if anyone's interested uh on on
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Facebook and comments um this is this is a great conversation and
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before we get dive into a couple of questions that folks are submitting um I just want to ask
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you know what and we've touched on it a little bit but the the actions that we can really take you know we've talked
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about the and a lot yeah this this call is a real privilege because we're dealing with people that have taken a
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lot of action to change the conversation um what advice or what uh what action
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would you would you suggest would you share with people affected by diabetes with
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organizations or Media or viewers who want to once this this webinar is over go out
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and be able to make some changes and I'll ask that to to Quentin first
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thank you um I would say I will come back our mission there is to inspire educate
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people living with diabetes around the world and I think it's the mission of everyone living with diabetes we have to
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to inspire to be proud of our diabetism to to live with it I won't repeat what
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just Michael said that I I definitely agree so I think the the best way is to be proud
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of ourselves thank you Austin
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diabetes um isn't what it used to be uh compared to when I was diagnosed around 10 15 years ago let alone back in the
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1980s the 50s or even the 30s um pardon the airplane pun but the sky's
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the limit for those living with diabetes I try to demonstrate as as many people as I can that this is possible
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um when I was first diagnosed at 14 years old I was told by the social worker at the The stallery Children's
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Clinic that in terms of careers anything is possible you can do anything you want except serve in the military or be a
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professional airline pilot and I managed to myself take away one of those answers like that that is now off the table you
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can become a professional airline pilot and that's something I'm proud of doing and I'm very proud to say that I have
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removed a barrier from those living with diabetes um to say the least we have come so far
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we have such great treatments and Technologies um and we're this close to a cure but my
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advice until then is that we should shouldn't stop we shouldn't say we're doing good enough
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and we shouldn't Pat ourselves on the back and call it a day we need to continue to keep pushing forward but the
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very least take care of ourselves and make sure we we manage our treatment of diabetes appropriately from that from
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that basis from you know managing your diabetes and taking care of yourself anything is possible it's the starting
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Foundation I believe for for for anything no thank you Austin's good it's a great
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point to you have to you know as they say filled with the watering can before you can water the plants so taking care of yourself first
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is uh is a great Foundation um so folks we're going to open the the
31:26
Florida questions we have a few that have rolled in and the first is one that I'll ask to to Quentin and uh this
31:32
person is wondering as an athlete with with type one um what steps do you take to manage
31:39
blood glucose while you're in on a race or preparing um
31:45
and what advice do you have for young athletes and what I would add is how do you
31:51
add to this the the you know the the time that it takes to prepare those around you to know what you might need
31:57
in as a as an athlete to know how to support you thank you for the question I would say
32:05
um when you are when you are living with diabetes what we we ask you is to have a good way of life at the end of the day
32:12
what we ask to uh to an athlete it's to have a good way of life so here we have
32:18
an advantage I would say when uh I I go to the pro level I was roommate with
32:24
another Pro provider in another team without diabetes and we compare what we
32:30
add and all these kind of things you know and now I don't there is some company making some CGM from
32:37
non-diabetic people for sports and performance and he is using this this
32:42
kind of things and at the end of the day I am making a less viability I would say
32:48
less less I manage better my diabetes than him even if he's not diabetic so
32:54
that's exactly what you said before Michael but yeah that that's that's an advantage after what I would say it's we
33:03
are all different every diabetes is different and what works for me won't
33:08
work won't work for for someone else so the the thing is to find your way the
33:15
way to find different Zone the zone for the a long physical exercise a short
33:22
physical exercise and when you go down of this Zone then you you can eat differently if you go down very fast if
33:28
you go down very slow uh the same if you if you go higher very fast or very very
33:34
slow I think the the thing is to find your way
33:40
that's a great point Thank You Clinton um I have someone that that's that's
33:45
shared that they've faced some criticism of their diabetes self-management uh
33:52
even in the context of healthcare provider when they've been referred to another Specialist or someone that's in
33:58
passing getting access to their their records and and you know may not be Trey may not be a specific uh may not be
34:05
their endocrinologist or their care team but going in for example for pre-surgery admission
34:11
um and I'm curious I'll pose this to Michael if you have any any thoughts on addressing this or navigating that
34:17
absolutely yeah it's a it's a really important question and just to sort of normalize the context so you may
34:25
mentioned about burden and one of the things that we've really focused on in the last number of years is what we're
34:31
calling diabetes distress and so we really very strongly believe that everyone living with diabetes in a
34:37
medical context should be screened for diabetes distress and when we talk about diabetes distress it's really
34:43
interesting if we think about it in four components the emotional burden of
34:49
living with diabetes that sort of emotional weight that can get heavy at times
34:54
the regimen to stress the distress associated with all of the tasks and the work
35:00
but importantly two other aspects of distress what we call social support distress which is that kind of stuff
35:07
that we're talking about with other people and then my favorite aspect of diabetes
35:13
distress we call provider-based distress where individuals living without with
35:19
diabetes gets systematically sort of judged by Healthcare Providers and what's really interesting is that and
35:25
this represents a lot of the work that we're doing in Canada is that sometimes the medical profession can can sort of
35:31
look at things in just in terms of what's the diagnosis what's the treatment and let's implement the
35:37
treatment and then see the outcome and they do that in a way that's really simplified almost as if it was surgery
35:43
where the surgeon is in charge they do their thing and it works that's
35:49
not how chronic disease or diabetes is managed it's really about the complexity
35:54
of that and so a lot of clinicians will sort of be trained in here's the problem here's the solution why aren't you doing
36:01
it and there's a really strong strong initiative in amongst the sort of chronic disease
36:08
management to really flip that around and do what we call patient-centered care
36:13
and so the next time anyone experiences this with their medical provider depending on how comfortable you are you
36:21
might actually sort of respond to that treatment by sort of saying are you aware of the Canadian clinical practice
36:28
guidelines for diabetes management um do you believe that chronic disease
36:33
has to involve the patient and these are questions what's interesting I spend most of my time training doctors how to
36:41
really communicate and support people living with diabetes and other chronic diseases and one of the things that I've
36:46
learned and I really hope that this comes across is that if the doctor knows that they're missing The Mark with you
36:52
they will not be happy with themselves so if you sit there passively taking
36:57
that treatment they won't know that's the problem with that because these doctors in fact are uneducated they
37:05
would say diabetes is a glucose regulatory disorder and here are some
37:10
therapies that will correct that so the evidence says they work so do it what
37:16
could be simpler and in fact that's completely wrong and if we can start to communicate this back and so we did
37:23
something a number of years ago we called it the it was a part of a study called diabetes attitudes wishes and
37:28
needs and it was called Dawn d-a-w-n and we called it the dawn experiment
37:34
which is we just encourage people living with diabetes to say to their health care provider can I ask you Doctor why
37:42
haven't you ever asked me how diabetes affects my life
37:47
that one question was a bit of a groundbreaker because all of a sudden the doctor goes oh okay well how does it
37:54
affect your life and this you see if we start with stigma and it's subtle and it's at a societal level
38:00
what do we do with that but if we start at the at the micro level between you and the person who you're who's making
38:07
you feel uncomfortable then you can see change happening so it's actually a
38:12
super important issue to identify that and and really is that this word notice
38:18
that that Clinton's sort of raise on Tetra in his team is empowerment that's
38:24
part of their their initiative and and I would like to you know link us back to
38:29
to small changes uh to empowerment happens in Little Bits right now we need
38:34
these iconic features the figures like Quentin and and Austin to sort of show
38:40
us the path but then we don't expect everybody to turn into these groundbreaking uh accomplishments what
38:47
we are trying to do is use as an example for people to find that they're victories that they can because remember
38:52
the Journey of a thousand miles begins with a single footstep
39:00
Michael thank you thank you again for just a wonderful answer and and we've uh
39:05
We've shared the clinical practice guidelines in the in the Facebook comments as a reference point if
39:13
with a healthcare provider because um can be really helpful to to come into an engagement like that armed with some
39:20
knowledge you know armed with something that can can help the that person learn I don't want to interrupt you but let's
39:26
be honest if you're not talking to a diabetes specialist you know so much more about your disease
39:33
than that family doctor that surgeon that physiotherapist that I don't think
39:38
that just because they've got a diploma on the degree on a degree on the wall that that gives them more knowledge than
39:45
you you live this disease you know this disease and and if we start to bring that voice forward we really believe
39:53
that will change the conversation and again I'll just end by saying if the doctor knows that they're not hitting
39:58
the mark that they will not be comfortable with that and that can shift that Dynamic where they can do more
40:04
listening than speaking yeah fantastic
40:10
um one more question that we we have is um and I'll actually I might pose this to the three of you because you'd have a
40:17
I'm sure an interesting but a but a slightly different perspective on it and the question is
40:22
what advice would you give to kids in building their confidence around diabetes stigma to someone who's young
40:28
who's encountering a lot of this maybe for the first time still learning sort of social rules of engagement how do
40:35
they uh advice to approach this whether for the the child themself or for a caregiver or a friend to support them
40:42
um I might pose that to uh to Austin first any thoughts you have I would say don't be ashamed of it wear
40:49
it as a badge of honestly honors the wrong word but embrace it you know it
40:55
embrace it as a unique part of who you are and and and What Makes You Different to others
41:02
um Dad don't don't be ashamed of it it's uh it's it's something that can be cool as well you can kind of show all you
41:08
know the cool toys you have extra or you know diabetes Christmas when you get a new pump or a new CGM or something like
41:14
that that's a unique experience for for people and it's something that you can Embrace as being unique
41:20
yeah um Quentin any thoughts yeah um I agree
41:26
with your team thank you for this and I I would I would say it's it's normal uh
41:32
to have this different step before the resilience to be upset to to try to
41:37
negotiate with the diabetes and then to to be to depress the decrement to the
41:43
price uh and then to have the resilience that's normal and even when you are the
41:48
resilience then you come back to the fight result because your daily is because it's not perfect for the time
41:54
even when you don't have that it is it's not perfect all the time so that's normal that's what I would say
42:01
uh Michael any advice yeah uh so um I would say
42:07
um don't try to fix what's not broken um I I love kids I think kids are a great example we should learn from the
42:14
children uh in two ways because children don't don't get stuck in Old ideas I've been doing this for years and so you
42:21
know kids are are in a developmental stage they're innocent they're they're learning about the world and so they
42:27
they incorporate so they they absorb diabetes much much easier than adults do
42:33
and the second thing about children that's really lovely is children without diabetes
42:39
they just get it right so like you know let's imagine that Quentin is eight years old and I say Quinn what are you
42:46
doing you're sticking yourself with a needle and and he says yeah I've got this diabetes I have to take this three times
42:51
oh cool can you get can you give it to me and then all of a sudden it's like oh look at that this is they don't start
42:57
doing all this judgmental stuff a lot of the challenges with children are excuse my language the parents and the system
43:03
like you know we heard about oh you can't go to Italy because you've got a broken finger what that's ridiculous
43:10
right but it's because you're living with type 1 diabetes and a broken finger that we don't think you should go to Italy which is not fair so I think it's
43:17
really interesting I I would make the note that with adolescence it's a little delicate because you know what we need
43:23
to do is try to protect adolescents from their diabetes so that they can do what they're meant to do which is to be as
43:30
different from their parents as they possibly can be and as most like their friends as they can possibly be that's a
43:36
normal stage of development and so it makes it important to get good care in adolescence but generally I would leave
43:42
the children alone by the way most psychological interventions with
43:47
children are directed towards the parents and managing the parents anxiety and we
43:53
kind of try to leave the kids alone because they are actually I love the to see how kids adapt because like you know
44:01
we heard from Austin like it just becomes cool um so so I think it's a great great
44:06
point and uh and I find as a psychologist you don't really work to help people
44:14
with type 1 diabetes diagnosed as children with the self-management tasks that's
44:20
like drinking water for them it's the adults who have been stuck in patterns for years that struggle to to change so
44:28
I think it's a great a great comment yeah
44:34
um folks that's that's all for uh audience submitted questions but um what I'd just like to to close off with is to
44:42
our audience I'd like to thank those that have submitted your questions and and um I I'd like to say that to learn more and
44:49
stay up to date on what we're doing at diabetes Canada on this topic and Beyond you can visit diabetes.ca uh you can
44:56
visit our social media at diabetescanada and if you want specific Direction you can call 1-800 Banting or email info
45:04
diabetes.ca if you have any questions and uh finally I'd just like to one more
45:09
time turn the floor to our guests uh if you have anything final that you'd like to share or anything that you're struck
45:15
by after this conversation or that you'd want to leave our audience with um some final remarks so I'll I'll pass
45:21
it um maybe we'll go back through that that order in reverse and I'll hand the Florida to Michael
45:27
yeah my words here are way less important than listening to what and Austin have to say about this but what I
45:35
would really just want to say is is kind of you know keep your friends close and
45:41
be and protect yourself from those people who aren't willing to listen to you
45:47
um and you know we don't we need to really create an environment that that really matches us and so I think that
45:54
that would be my comment then I'm really interested in hearing what the real experts have to say about this
46:00
uh Quentin your thoughts yeah firstly it would be a comment to to
46:05
make her the when I asked my cat what do you think about it I know that's Kimberly yes the neighbor why he is
46:13
getting weight and because all my neighbor gives to him some food
46:19
that's that's the thing yeah it's it's uh once all this remainder uh are done perfectly when I
46:27
speak about reminder is having a good ovarian among good friend good family
46:32
like explaining to family explaining to friend what is diabetes once everything is done just one more time we have to
46:40
use our difference to make the difference thank you Quentin and uh Austin
46:48
um like I said earlier have patients have consistency in like Michael and Quentin have emphasized have a good
46:53
support system good friends good family know who you're surrounding yourself with who can support you when you need
46:58
them um that I think is the the the big takeaway I think in this is when it comes to stigma uh with diabetes
47:07
yeah well listen um Austin Quentin Michael I'd like to just sincerely thank the three of you
47:13
for a really fantastic conversation and for being willing to to share your own experiences and your expertise and uh I
47:21
know it's you know personally living with diabetes this has been a really wonderful session to to be part of and
47:27
and I hope that it's been helpful for our audience as well so a sincere thank you to the three of you and uh and to
47:33
our audience uh feel free to get in touch with further questions and uh we'll be happy to assist wherever
47:38
possible so thank you and take care and uh use your difference to make a difference as they say
47:44
thank you Brooks thank you diabetes Canada thank you thank you
Category Tags: Children & Adults, General Tips, Healthy Living;