Health Committee on Nov. 27th, 2012

[Patrick Brown, Conservative, Barrie, ON]

Thank you.

[The Chair, Conservative, Joy Smith]

Mr. Strahl.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Thank you, Madam Chair.

I want to thank Patrick for bringing this idea to our attention. He knew when you were coming months ago, and suggested that we meet with you here today. I certainly can speak for myself, and I think everyone here, when I say that this has been one of the best meetings we've ever had.

Michael, I used to think I was quite good. I could do a hundred keep-ups. I was on a rep soccer team, and we travelled all the way to Vancouver. But you've shown that this was minor league stuff.

I want to talk to Maksim and Miguel.

Maksim, you said that you felt like a bit of a cyborg when you first got your insulin pump. Now, I have an eight-year-old son, and he might think that's pretty cool—to be a cyborg, that is, maybe not to have a pump.

What is it like at school? Do your teachers and your friends understand what you're going through? Are they supportive of you as you deal with your type 1 diabetes?

[Maksim Stadler]

Well, at school I don't really like to talk about it. I don't really think a lot of people need to know, but I'll let my teachers know. I don't tell a lot of my friends, but a few of them do know. Some found out. Some I told.

I don't like to tell a lot of my friends, because, you know, they'll ask questions, and I really just don't like to answer questions. They'll get the wrong idea. It just kind of irritates me.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

I can understand that. I won't ask you any more questions, then.

[Voices]

Oh, oh!

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Miguel, you said that you want to be a pro hockey player. Hopefully there's a league to play in and they're back from their lockout by the time that comes up.

Could you talk about how it works for you when you play sports? Do you find support from your coaches and your peers there as well?

[Miguel Rémillard]

Usually my parents are in the stands. If I need to test, they come down to the bench and I check my blood. I just spit out my mouthguard if I need to have something to eat, and then I get back on the ice and keep going.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Well, good luck to all of you. Thanks again so much for being here today.

[The Chair, Conservative, Joy Smith]

Thank you so much.

Now we'll go to Mr. Scarpaleggia.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Thank you, Chair.

Today is my lucky day. I'm not in fact a regular member of this committee—I'm replacing a colleague who couldn't be here—and I just happened to come here on the most interesting day.

I'm really moving up a steep learning curve here, but I've learned more from your presentations on this issue than ever before. I have also had good contact with one of JDRF's advocates in Montreal, Bob Hindle.

Do you know Bob?

[Andrew McKee]

Yes, very well.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Bob has been keeping me in the loop on progress on this file. He has done an excellent job, but there's nothing like really hearing the life stories of those of you who are here today. As I say, I've learned a great deal in a very short time.

I'm not that familiar with the technology involved, so I'm having a hard time understanding the progression—from how people with type 1 diabetes would manage the diabetes at the very beginning, to the point we are now, and the point to which we're going. Perhaps you could just explain to me what it used to be like.

Ms. Sissmore, I think you talked a little bit about that. In the early days, if you were diagnosed with type 1 diabetes, what did you have to do on a daily basis?

[Deborah Sissmore]

It was very little, actually, because we didn't have blood glucose monitors. Glucose then was not measured in the blood, at home; it was measured in the urine. It was not very reliable. I took one injection a day, and it was primitive insulin, at best. There was no carb counting. You watched what you ate. It was like a sugar-free diet, a diabetic diet they would put you on—nothing to the extent it is today.

I marvel at the gains that have been made since I was diagnosed. Over the last 46 years there have been so many gains. The quality of insulins, the kinds of insulins, the pumps, the continuous blood glucose meters—oh, my goodness, it's extraordinary. But it's still not perfect.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Can you tell me this, though? We're going from a stage where you just watched what you ate and you took one insulin injection a day to the next level, which was.... Was it continuous glucose meters? What would that mean, a continuous glucose meter?

[Deborah Sissmore]

The first meters, the first glucometers—and they were not continuous blood glucose monitors—weren't available until I was a late teenager. You pricked your finger. Still, we didn't have the sophisticated insulins of today. So then I think I was bumped to two injections a day. Now with the better insulins, the rapid-acting—you use them in combination with the longer-acting—it's far better. So you would have an insulin injection or a pump, where you have it all the time. But you have an extra amount of insulin before you eat your food. We didn't have that then.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

What do you mean by the insulin pump? I'm sorry, I don't understand that.

[Deborah Sissmore]

I'll let....

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Would somebody mind showing us a pump?

I see. So you wear this? Is that how it works?

[Marley Greenberg]

It works 24 hours a day.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Twenty-four hours a day, it pumps insulin, but it's triggered by...? How does it know when to pump the insulin?

[Marley Greenberg]

To tell it what to do, you have to program it; you have to tell it when to give insulin and what to do.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

So based on your readings and your carb counts and so on and so forth, you would then program the pump?

[Marley Greenberg]

Yes.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

So the next step is the artificial pancreas. Is that the next stage?