Navigating the Holidays with T1D during COVID

December 21 2020

With the holiday season quickly approaching, it’s time to start thinking about shopping lists, holiday plans with friends and family members, and how to keep our children active during their time off from school, while adhering to the safety measures influenced by the global pandemic.

What should not be missed is being mindful that the virtual manner in which we communicate, combined with the colder weather brought on by the coming of winter can make isolation and inactivity a reality for many families during the 2020 holidays. It’s also a time that can be challenging for people with type 1 diabetes (T1D). During this time of year, it’s important to remember that having T1D doesn’t mean missing out on the celebrations.

On Tuesday, December 8th we held our final Let’s Talk T1D of 2020 with special guest Michael Watts, who led a discussion on Staying Connected during the Holidays.

Michael is a medical social worker, and a university sessional instructor. He is trained as a therapist and counsels on and psychosocial issues related to adolescents and families impacted by T1D, chronic respiratory challenges and weight and health issues.

Michael’s presentation explored diverse ways in which to protect against isolation while enhancing activity levels during the holiday season. References to the mind, body, spirit and emotional quadrants were explored, as well as practical strategies which aim to create appropriate levels of structure and routine during the holiday season.

This year, as gatherings should be kept small and limited to your household due to COVID-19 – there is more time for idleness and snacking. Pre-planning to try and keep your blood glucose as steady as possible can be very helpful. Work together with your family to plan exercise activities that you can do together; bake or prepare healthier snacks and make sure to carb count.

Navigating holiday time while living with T1D using these tips may help to decrease your stress, relax and recharge:

This year more than ever, the holiday season is about more than cookies and gifts. However you can reach out and connect to your loved ones and friends, whether it be over video chat, text or phone call – stay safe, stay well and look forward to a better year ahead.

  • Stay active. You’ll feel better and have more energy, it will help you regulate your blood sugar and it’s something you can do as a family.
  • Don’t skip meals in preparation for a larger one. Make sure to eat regular and balanced meals that include carbohydrates, protein and some fat. Not only will this help control your blood glucose, but it will make it easier not to overeat at a single meal.
  • Plan ahead. Learn the carb counts of holiday treats that you might love, like Christmas cookies or a glass of eggnog. Plan to accommodate them, so you don’t end up feeling deprived or resentful.
  • Be considerate of what you eat. Do you really want something placed in front of you, or are you just considering eating it because it is there? Eating mindfully can help keep your glucose levels steady and help you better enjoy the food you really want.
  • Test your blood sugar levels frequently so you can stay on top of it and hopefully avoid any crashes or spikes.
  • Be kind to yourself. This will be a different kind of holiday season. Everyone will be feeling the strain, give yourself time and space. If you find that your blood sugar levels drop or spike, correct, move on and don’t beat yourself up over it.

This year more than ever, the holiday season is about more than cookies and gifts. However you can reach out and connect to your loved ones and friends, whether it be over video chat, text or phone call – stay safe, stay well and look forward to a better year ahead

COVID-19 Vaccines and T1D

UPDATE: On December 23rd Health Canada authorized the use of the Moderna vaccine in the fight against COVID-19 for individuals of 18 years of age and older.

JDRF welcomes the authorization of the first COVID-19 vaccine by Health Canada, which we hope will be one of many to be approved in the coming months to address the pandemic. We are grateful for the unprecedented effort by the many research scientists, clinical trial participants, industry partners and government officials who contributed to global efforts to rapidly bring COVID-19 vaccines through the pipeline and to our communities.

The one vaccine approved thus far in Canada is the Pfizer-BioNTech vaccine, which has been approved for use in people aged 16 and over. The vaccine will be given in two doses, at least three weeks apart. Vaccinations have now begun in Canada, with vaccine roll-out plans still evolving. It is currently unclear whether and when people with diabetes may be prioritized for receiving the vaccine. However, JDRF will be advocating on behalf of the T1D community, making it clear to decision-makers that those living with diabetes must be included as a priority group to receive early COVID-19 vaccinations. Evidence does suggest that those living with diabetes, T1D or T2D, could face more severe disease and an increased risk of COVID-19 complications if they develop the disease. As such, JDRF strongly believes this group should be considered a high-risk population and have earlier and easier access to the vaccine. We will keep our T1D community up-to-date as further decisions are made around vaccine roll-out and administration.

Should I get the COVID-19 vaccine if I live with T1D?

Vaccination will not be mandatory in Canada. However, for people living with diabetes, we encourage you to receive the vaccine when you are offered one, pending consultation with your doctor about your individual circumstances. This is because adults, especially older adults, with diabetes (type 1 or type 2) are at risk of developing severe illness if they do get COVID-19, and vaccines are the most effective way to prevent that from happening.

Is the vaccine safe for people with T1D?

Thus far, the Pfizer-BioNTech vaccine is the only COVID-19 vaccine approved in Canada. Trials of this vaccine included people with diabetes, and the data to date show the vaccine is safe and effective for people with T1D.

Health Canada has issued specific guidance on the Pfizer-BioNTech vaccine for people with serious allergies.

Will the vaccine work just as well in people with diabetes?

People with T1D are not immunocompromised, and previous research indicates that the immune response to fighting coronavirus in people with diabetes is no different to people without the condition. In addition, data on the Pfizer-BioNTech vaccine made available by the US FDA indicate that the vaccine is just as effective in people with diabetes as without. However, there is still uncertainty about the length of protection any of the vaccines will provide.

For further information about the availability of COVID-19 vaccination in your community, refer to your Provincial or Territorial Health Authority. As well, please be sure to speak with your healthcare provider with any further questions you may have and to help you make the most informed decision around vaccination.

COVID-19 and Type 1 Diabetes – What We Know Now

December 17, 2020

It’s been just over a year since the virus SARS-CoV-2, which causes the disease COVID-19, was identified.

The COVID-19 pandemic was declared in March 2020. As knowledge about the effects on people with type 1 diabetes (T1D) grew, we updated our information on a dedicated page and in numerous blogs. Unfortunately, most areas of Canada (with the exception of the Atlantic provinces) are deep into the second wave, and many communities are back in some form of modified lockdown.

However, there has recently been reason to have optimism as a number of COVID-19 vaccine candidates have been identified. The UK has already begun its vaccination program.

As of December 2020, Canada had sources more potential vaccine doses per capita than any other country in the world, and as of December 14, 2020, a selected few began to receive their inoculations, although most will be vaccinated in 2021.

As we head into the winter and the cold settles upon us, social opportunities that could take place outside will be limited – and many of us will again begin to feel the strain of isolation. Combine this with living with T1D and the everyday burden of maintaining healthy blood glucose levels, hydration and nutrition throughout the holiday season, when outdoor activities aren’t as accessible.

It’s a lot – and it’s understandable if COVID fatigue is starting to set in. Protecting yourself from the virus on top of everyday diabetes management is a lot to deal with.

Fortunately, we are now better equipped with knowledge of how the virus works and how to best protext ourselves from contracting it. And there is hope on the horizon.

What we know now

How it’s most likely transmitted

At the beginning of the pandemic, it wasn’t immediately clear how COVID-19 was spread, or how contagious the virus was. We didn’t know if was spread by ‘fomites’ (virus particles that remain on surfaces), droplets (from sneezing and coughing) or aerosols (meaning it spreads through the air and can be passed on by an infected person through talking or breathing).

We now know that fomites are not a likely source of virus spread – but that the virus itself is highly contagious and infectious. And that it can be spread via both droplets and aerosols.

Initial advice about protecting yourself and others still stands. Being diligent about frequent handwashing and trying not to touch your face remains true today. The best measures people can take are practicing hand and respiratory hygiene, physical distancing, wearing a face covering, sanitizing high touch surfaces and keeping social contacts limited.

Are people with T1D at greater risk of contracting the virus that causes COVID-19?

There is still no evidence that people with T1D are at any increased risk of being infected by SARS-CoV-2 than anyone else in the community. At the beginning of the pandemic, there may have been higher infection rates among the diabetes community as they had more healthcare contacts.

Are people with T1D at a greater risk if they do develop COVID-19?

People with T1D do not generally have a compromised immune system. However, they may be at higher risk of complications if they do become infected, especially if they are older or have other risk factors, such as kidney disease.

There is no new evidence to indicate that children or young adults with T1D are, on average, at increased risk of complications of COVID-19 if they develop the disease. However, as with any viral infection, blood glucose can be much more difficult to manage, meaning that extra glucose and ketone monitoring is advised for anyone with T1D who develops COVID-19.

Can COVID-19 cause T1D?

A small number of case reports have proposed that COVID-19 can cause diabetes in selected individuals. However, most larger studies do not support this finding. Thus, to date, there is no compelling evidence that COVID-19 can cause T1D. Some effects of the pandemic – such as changes in exposure to the usual, seasonal viruses due to public health restrictions and wearing masks – could potentially affect incidence rates of T1D in the future.

Are COVID-19 vaccines safe for people living with T1D?

The Pfizer and Moderna COVID-19 vaccines use new and cutting-edge technology – known as mRNA vaccines. This is different from other vaccines you get from your doctor, like the MMR or flu inoculation, most of which use an attenuated (or ‘weakened’) form of the virus to trigger an immune response in the body.

These new vaccines work by injecting genetic material called mRNA (messenger RNA) into the body. The mRNA carries instructions that direct the body make the “spike” protein found on the outer surface of the coronavirus (the red edges poking out the ball), and in turn generates a protective response against it – or to the coronavirus, if you should later be exposed to it.

The National Advisory Committee on Immunization (NACI) has issued preliminary guidance on waves of vaccine roll-out. Prioritized groups will include immunocompromised individuals and those with high-risk conditions. Every province and city will have different vaccine roll-out plans. It’s best to speak to speak to your healthcare provider about your specific community.

There is no information to date to suggest that the COVID-19 vaccine would not be safe for people with T1D, should they choose to receive it. Generally, people with diabetes have been prioritized for vaccines for infectious diseases, such as the flu.

This information should not be taken as medical advice. Every individual is different and will have unique healthcare needs. Speak to your primary care physician and endocrinologist to come up with the treatment plan that works best for you or your child with T1D.

What you can do now

Stick to the basics

The basics are still the best way to keep yourself and your family safe.

Try to find time for hobbies, books, movies and games that bring you joy and relaxation. Turning off devices and taking a break from news can also help. Filling your time with activities that bring you satisfaction and fulfillment can help ease some of boredom and isolation that may occur over the winter months.

How to get support

JDRF offers a series of virtual events and seminars to help foster connection to other members of the T1D community. Our Let’s Talk T1D Education and Connection series are held monthly to bring people together to discuss issues important to families living with T1D and provide the opportunity for social engagement. These series are meant to both educate and help ease potential loneliness and isolation. Both are offered in both English and French.

The COVID-19 pandemic has been a time of incredible emotional and physical strain. The burden has been even greater for those with T1D. But there is light at the end of the tunnel. With each day that passes, we get one day closer to our new normal.

If you don’t already, please follow us on our social media platforms, where we post tips and articles of interest and encourage you to engage and provide feedback.