Three years after she was first diagnosed with Type 1 Diabetes, nine-year-old Annabelle Groulx has become an expert on taking care of her own health.
The third-grader, who lives in Capreol with her family, two dogs, and a cat, carries a bright pink bag around with her every day. In it, she has all the supplies she might need, from insulin injectors and fast-acting tablets, to a blood glucose monitor and lancing device. She can rattle off the name and purpose of all of her supplies and recites brand names like "Humalog" and "BASGLAR" with the practiced ease of a miniature medical professional.
“I learned how my things work," she said. "How I give myself insulin, how to give myself my own needle. Now, when I have a sleepover with my Nana, I can show her and teach her how to do stuff.”
It's a level of independence that even her mother, Francine Groulx, is astonished by.
“I love listening to her talk about this stuff," said Francine. "She just blows me out of the water.”
At six years old, Annabelle received her diagnosis after being admitted to hospital.
“I got really sick," she said. "When I was there, I did some tests and they found out I had diabetes. I had to stay in the hospital for a while.”
Type 1 diabetes, which is most commonly diagnosed in children, is a chronic condition where the pancreas doesn't produce enough insulin. As a result, diabetics need to be vigilant about their blood sugar levels, monitoring what they eat and injecting regular doses of insulin to make sure their body can absorb glucose into the cells to produce energy.
In Canada, one in three people will develop diabetes in their lifetime. For many young children, it's a life-changing diagnosis.
Had to learn to adjust
"At first, I was kind of upset," said Annabelle of her diagnosis. "Because it's not fun having diabetes. I couldn't eat candy like the other kids and stuff like that."
The first month was the hardest. Throughout the day, she was constantly having her finger pricked to test check her blood glucose levels. If her blood sugar was too high, she'd be irritable, and emotional, and had to take a dose of insulin with an injector in her belly, arm or leg. If it was too low, she was drowsy and weak, often needing to sit down to eat something with a high sugar content.
Sleep was also difficult early on, with her parents waking her up often throughout the night to check her levels manually.
“She was a trooper," said Francine. "She would sleep through it, and sometimes, she would just roll her eyes and put her finger out.”
November marks National Diabetes Awareness month, and this year, medical experts and diabetes advocates are calling on decision-makers across the country to improve access to medical devices that can make life easier and safer for people with diabetes.
After spending the first few weeks manually checking her levels day and night, Annabelle was able to make the switch to a continuous glucose monitor (CGM). Her Dexcom, which attaches to her arm and transmits data to a portable handheld device, automatically alerts her to changes in her glucose levels throughout the day, without the finger prick.
For both her and her family, having access to the device has taken the guesswork out of glucose management.
“Every second now, this checks my sugar," said Annabelle. "Now I can go outside and play around. And when my parents ask what my sugar is at, I take this out of my pocket and check. My parents don't have to follow me around, and I'm not poking my finger all the time. It helps me ready my sugar and it beeps really loud."
Day and night, she can be alerted to her highs and lows, giving them time to react before her symptoms can get worse.
“It gives me so much peace of mind," said Francine. "She can’t always feel her symptoms during the night, so it’s peace of mind knowing that it’ll send us an alert. I like that time to be able to respond. I’m able to sleep, which I wasn’t able to do the first couple of weeks; we were checking her at all hours of the night. So as soon as we got on that, it was a game changer.”
It also allows Annabelle to be more independent and take charge of her own needs. She carries her reader with her in her pink bag, and when it goes off, she knows how to respond.
In a few years, when she has her own cellphone, they'll also be able to sync the Dexcom to her parents' phones.
“I could go to and my phone would alert me that she low at school, all the way across town," said Francine. "I don’t know how some people with diabetes can go without it."
Ontario coverage for CGMs a game-changer
Despite their benefits for diabetics of all ages, CGMs can be extremely expensive.
When Annabelle first got her Dexcom, her parents were making large payments to cover the costs, before switching to a more manageable monthly rate.
But in March 2022, the Ontario government expanded its Assistive Devices Program, to cover the costs of a CGM device and other related supplies for those with Type 1 diabetes.
For Annabelle's parents, the program significantly reduced the financial burden of all of the supplies she needs.
“You don’t play middleman," said Francine. "The government goes right to Dexcom and they handle everything. It’s so nice, because every quarter we get deliveries for all her devices and the government is covering it now. It’s been really beautiful.”
Still, there are some supplies, like insulin and test strips for her manual glucose monitor, that need to be paid for out of pocket.
“Unfortunately, not all supplies for diabetics are covered," said Francine. "But this is the most expensive part. I’m really glad they did that. I think everyone should have this. I don’t know what diabetics did before it. You’d have to be constantly checking, and I’d probably poke her fingers over 100 times a day.”
While many people with type 1 diabetes have been able to benefit from the Ontario program, advocates said the eligibility criteria remain too strict.
At this point, only those with type 1 diabetes can obtain coverage, leaving those who don't meet the criteria, or who have type 2 diabetes, to keep making expensive payments on CGMs or go without.
Later this month, Annabelle will be celebrating her "Diaversary," marking three years since she was first diagnosed.
"Time just flew by," said Francine.
When the day comes, they're planning to celebrate with a family dinner and a special shopping trip to the Dollar Store.
In the meantime, Annabelle has lots of big plans: painting pictures, playing sports, learning cursive, and spending plenty of time outdoors, all with her trusty monitoring device by her side.
The Local Journalism Initiative is made possible through funding from the federal government.
mjensen@postmedia.com
Twitter: @mia_rjensen
Mia Jensen, Local Journalism Initiative Reporter, The Sudbury Star
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