January 30, 2023 Lessons learned from managing my diabetes

Having raised five children of her own, Beulah Farrell had finely tuned “spidey senses.” She quickly knew that something wasn’t right when her young granddaughter, Jenika Myers-Jennings, came to her cottage for a weekend visit in 1990. Jenika was extraordinarily thirsty, urinating frequently, and just not her “usual exuberant self.” Beulah took Jenika to the doctor, and on her second birthday, Jenika was diagnosed with type 1 diabetes. “I still remember them bringing me birthday cake, and me grabbing fistfuls of it,” says the 34-year-old, who lives in the Greater Toronto Area. “Thank goodness they didn’t take that away from me!”

Live life to the fullest

Jenika says her journey with diabetes has been relatively smooth: she has been able to keep her blood sugar in her target range, and her A1C has never been higher than 7.0. As a result, she has contributed to diabetes research by participating in a number of studies. She credits her parents for some of her diabetes management success.

My parents taught me that every action has a reaction. I was never prevented from doing anything because of my diabetes, but instead I was taught to anticipate and prepare for the consequences. So, I never felt like I was missing out on anything.

This year, Jenika, who works in compliance and risk governance for the Canadian Mortgage and Housing Corporation, will complete her Master of Public Health. She plans to travel to the University of Aberdeen in Scotland to get her degree in person and then spend time in Northern Europe afterward.

Strengthen your resilience

When COVID-19 hit in 2020, Jenika’s resiliency came in handy. Although the pandemic had a big impact on her day-to-day routine—including the drastic difference in scheduling when I would exercise and/or eat, which affected her blood sugars—she says the overall adjustment was not very difficult. Able to work from home, she says her insulin pump gave her added flexibility in adjusting her insulin ratios, since she was no longer commuting to downtown Toronto early in the morning, and also ate her usual meals or snacks at different times. She still had time to participate in diabetes studies conducted by Mount Sinai Hospital in Toronto.

At the beginning of the pandemic, Jenika experienced some fear as a person who lives with diabetes and who is Black, as both groups can be at increased risk if they get the virus. And with not a lot of research and information available, she says, “I managed my own fear based on my faith in God that everything would work out and the comfort that I am managing a certain type of fear every day. Diabetes can be unbelievably unpredictable, so the added layer of COVID-19 seemed manageable.”

Post-pandemic, Jenika still works remotely. “My dosages, carb counting and activity have been changed to cater to my new normal.” She has returned to regular in-person appointments with her endocrinologist, and is comfortable going to the clinic, which follows some pandemic protocols, such as the completion of a COVID-19 screening questionnaire in advance of a visit. 

In the summer of 2022, she volunteered as a model in Diabetes Canada’s Pump Couture Fashion Show, walking the runway with her diabetes device on display, along with others living with type 1. “The experience was a great way to demonstrate that people with type 1 are all ages, genders, sizes, races, backgrounds, social statuses and cultures,” says Jenika. “By acknowledging and seeing that there are other characteristics that are a part of us, we can work to eliminate any diabetes stigma and provide an opportunity to truly see how great this community is as a whole.”

Recognize that there will be challenges

Nine years ago, Jenika’s cousin Tanisha McClean was also diagnosed with type 1 diabetes, making her the second family member living with the condition. For Tanisha, the journey has had its challenges: “My cousin has a hard time taking insulin because needles cause so much pain and blistering for her and she would like an insulin pump which would mean less pain,” says Jenika. “However, the gap between her needs and the medical eligibility criteria that would qualify her to receive a pump from the government is apparent due to her challenge controlling her blood sugar levels. It’s hard to see her struggling.”  

While Jenika is able to control her blood sugar, she has faced other diabetes-related challenges. For example, just before the 4-year warranty on her pump expired in January 2022, her pump developed a keyline fracture, which could cause issues with insulin delivery and the mechanics of the pump if water got inside or they were exposed to the elements. As part of the Assistive Devices Program (ADP) in Ontario, she had to wait a year, until January 2023, to get a new one. In the meantime, she received loaner pumps from the manufacturer—a total of four since each one developed a keyline fracture. “In addition to dealing with the provincial requirements related to the pandemic, the unknowns, such as whether or not anything could affect my ability to receive the loaners before I transitioned to my new pump and sensor, were concerning,” she says.

Improving diabetes management for everyone is important

For Jenika, her diabetes journey has also been complicated by the systemic racism she experiences as a Black woman. “It is possible to manage diabetes with the proper resources, time and supporting parties, but not everyone has those,” she says. One key area where she sees room for improvement is in research, support and access to information that considers women of colour with type 1 diabetes. “I participate in diabetes studies at hospitals a lot and have asked about this over the years. I've always felt dismissed by doctors and nurses based on their visual shock once I ask my question, like that isn’t a key part of my being.”

She welcomes the Diabetes Framework, which focuses on improving care for those living with diabetes, but says, “It’s imperative to cater the objectives towards the needs of people of colour.” She also offers this challenge to others living with type 1: “I encourage people of colour who are involved to speak their truths and join in to bettering health care for all T1D across the country.”

See diabetes as a journey

For those recently diagnosed, Jenika has this advice: “Diabetes isn’t about being perfect. It’s about trying and learning every day. It’s a journey. 

“I believe everyone living in Canada should have confidence in their healthcare system, no matter what their racial or ethnic background is. For those in a position to provide care and offer a positive influence for people living with T1D, it is crucial to continue to present opportunities and share information in a way that diligently considers all social dimensions, such as race, gender, ethnicity, of those who are living with this chronic disease.”

Did you know?

Every person living with diabetes is unique in their needs, which is why it’s important and helpful for healthcare teams to see the person first, especially when it comes to people of colour. In the webinar, Individualizing Diabetes Care for Black Canadians, South Asian Canadians and Those Fasting During Ramadan, Dr. James Kim and Dr. Akshay Jain discuss the impact of diabetes in different communities.