Honourable senators, I rise once again as the critic for Bill C-237, An Act to establish a national framework for diabetes.

One in four Canadians live with pre-diabetes or diabetes, as we have heard. We have also learned from witnesses who have appeared at committees in both houses how important early detection is, as well as knowing the signs of diabetes. Education is the best way to teach people about the disease, and knowledge is the best way to equip those who have diabetes, who may develop it in their lifetime or who are caring for loved ones with diabetes.

I want to take a moment to thank the sponsor of the bill in the House of Commons, member of Parliament Sonia Sidhu, for her dedication to this important cause and the bill that will help so many Canadians. I also want to acknowledge member of Parliament Chris d’Entremont, the Conservative critic of the bill, and the members of the House of Commons Standing Committee on Health.

I also want to acknowledge the work of Senator Mégie, the sponsor of the bill in the Senate, and the members of the Standing Senate Committee on Social Affairs, Science and Technology. The witnesses, such as Kimberley Hanson, Executive Director of Federal Affairs at Diabetes Canada, and others, offered their expert insights and knowledge of this widespread health concern.

MP Sidhu, who appeared before the Senate committee, said:

. . . we can learn from Canada’s past diabetes plans and programs and make sure that the framework called for in Bill C-237 is data-driven, accountable and engaged with stakeholders such as Diabetes Canada, JDRF and others. A national framework for diabetes would provide a common direction for all stakeholders to address diabetes and, by extension, other chronic diseases with the same common risk factors. . . . The bill calls for promoting research, data collection and treatment.

Honourable senators, Bill C-237 received unanimous support in the House of Commons. Our colleagues in both houses and in committees on both sides heard from important witnesses and worked to ensure that this bill would come back to the Senate Chamber for third reading in a timely manner. Now it is up to us at third reading to support this important bill so that it can receive Royal Assent and soon begin helping millions of Canadians living with and caring for those with diabetes.

Thank you.

Honourable senators, I rise today to speak in support of Bill C-237, An Act to establish a national framework for diabetes. I will be very brief, as there is very little to be added that has not already been addressed by the sponsor, our physician colleague Senator Mégie, and the critic, Senator Martin.

As we have heard, this private member’s bill was introduced by member of Parliament Sonia Sidhu in the other place. MP Sidhu spent over 18 years in the health care field as a diabetes educator and research coordinator. She understands the disease and is perfectly placed to put together the framework outlined in Bill C-237 to support improved access to prevention and treatment, and to better ensure health outcomes for Canadian with diabetes.

As we have heard, diabetes affects one in four Canadians. That means it affects every one of us, even if not ourselves; it most definitely impacts the life of a family member or friend. While manageable, diabetes is not curable. As Senator Mégie pointed out so personally, diabetes can lead to life-altering and life-threatening complications.

Currently, 90% of all new cases diagnosed are Type 2 diabetes. Many of these cases were preventable through education and lifestyle changes. Bill C-237 mandates the Minister of Health to work with provincial health authorities, Indigenous communities and stakeholders to develop a national framework for the purpose of better preventing and treating diabetes. No one level of government, health care authority or sector of society can address the complex challenges of this chronic disease. Diabetes affects segments of society differently. Where one lives, one’s access to health care, one’s awareness of symptoms and the availability of nutritious food are all factors in the prevalence of diabetes. Unfortunately, according to the Canadian Indigenous Nurses Association, this is the reason Indigenous and Métis populations are at far greater risk.

A federal framework mandating the consultation and involvement of all stakeholders at all levels would go a long way in the prevention of diabetes through education, and its treatment and management in its early stages.

It was 100 years ago at the University of Toronto where Banting and Best discovered the protein hormone that could treat a disease that, when diagnosed at the time, was effectively a death sentence. Colleagues, Bill C-237 passed unanimously in the other place. This comprehensive framework, when proclaimed into law, will be a tribute to the discoverers of insulin by preventing and fighting diabetes. Please join me in supporting and passing Bill C-237.

Honourable senators, it is with pleasure that I rise to add my voice in support of Bill C-237, An Act to establish a national framework for diabetes.

I would like to express my gratitude to MP Sidhu and Senator Mégie for sponsoring this bill.

My interest in diabetes piqued about six years ago when my grandson Max was diagnosed with Type 1 diabetes, which led me to become passionately involved in issues relating to diabetes. My thanks to Senator Mégie, who delivered a concise and well-constructed speech in second reading, and my thanks to all of you who have worked on this bill.

Over 11 million Canadians, or 1 in 4, currently live with diabetes or pre-diabetes. There are three major types, as we have talked about: gestational, Type 1 and Type 2. During the ongoing pandemic, there has been an even more urgent need to develop a national diabetes framework to ensure that there is a cross-Canadian approach to so that those living with diabetes have access to new technologies, finance and medications needed to manage their diabetes.

Dr. Sarah Lord, who holds a PhD in diabetes research, has been employed as the Health & Wellness Coordinator for over 11 years at a local pharmacy here in my hometown of Riverview. She shared with me her expertise and practice around diabetes. She has been actively engaged with Diabetes Canada and JDRF. She believes in building a sustainable community, including a national diabetes framework.

In 2011, the New Brunswick government produced an excellent comprehensive diabetes strategy. However, a round table in the province, conducted by Diabetes Canada, revealed that many of the same issues existed eight years later, such as access to and cost of drugs and test strips. It was also noted that the province relies on other provinces in consideration of innovations, such as insulin pumps.

Bill C-237 would require the Minister of Health to develop a truly national framework on diabetes that focuses on improved and equitable access to treatment, with an emphasis on preventable measures. It must identify the training and educational needs of health professionals that relate to the prevention and treatment of diabetes, promote improved data collection to share regarding prevention and treatment and continue to promote diabetes research.

We don’t need to start from scratch, colleagues; there is a lot of expertise right here in Parliament, including Diabetes Canada’s Diabetes 360 framework. In addition, we already have two all-party parliamentary diabetes groups that foster dialogue, policies, best practices and awareness on diabetes.

Diabetes 360 was developed after extensive consultation with stakeholders, including experts, health care providers, governments, researchers and the diabetic community. It is based on the UN AIDS model, which combined successful 90-90-90 targeting strategy with the treatment as a prevention model to make ambitious inroads against HIV/AIDS epidemics.

Diabetes Canada saw an opportunity to adapt the strategy to diabetes and developed the 360 targets, which are composed of the four 90s: one, prevention and elimination of health inequities; two, awareness and screening; three, achievement of health outcomes through treatment and technology; and four, engaging in a patient-centred approach to reduce rates of diabetes and improve overall well-being.

The four 90s are achievable. They require a consistent, coordinated approach and the cooperation of all levels of government. Bill C-237 aims to facilitate this process and provides all the tools our government needs to do it.

Colleagues, as we’ve said throughout this last while, please vote in favour of this important bill that will really enhance the wellness of many Canadians. Thank you.

This is a very important bill and I do support Bill C-237, calling for a national framework and strategy on diabetes. I’m going to be very personal in my comments, building on the excellent speeches we’ve already heard. I’m going to start with the Nobel Prize-winning discovery of 100 years ago — that of insulin. What a great contribution Canada gave to the health of the world. Many Canadians have heard me say for decades that I believe scientists and artists are about 20 years ahead of the rest of us. They have a special makeup with an experimental curiosity to know more, find out more and help. That is a real gift. Sometimes we see both attributes and capabilities in one person, as with Sir Frederick Banting, who with Charles Best discovered insulin, and who went into the Canadian wilderness to paint with Canadian Group of Seven artist A.Y. Jackson. He executed quite remarkable paintings.

Now to the personal. Forgive me, I am going to be very personal in this. I do know that Type 1 and Type 2 diabetes are different diseases. My first husband, who died of a heart attack almost 17 years ago, was diagnosed with Type 2 some 10 or more years before he passed. I have to say he managed it expertly for years, but as you all know, diabetes and heart disease are connected. A year ago in early April, my granddaughter in the U.K., then 9, was diagnosed with Type 1. I have learned that there’s no hereditary link between Type 1 and Type 2, so there’s no link between the granddaughter and the grandfather she never knew. Her diagnosis was sudden and came as a real surprise. She’s bright and athletic and had no prior symptoms.

I know many of us have had to deal with such surprises as partners, parents, grandparents and friends. In Zoe’s case, she was rushed to King’s Hospital London at the height of their COVID first wave. She was the only child in the whole pediatric wing of that esteemed hospital. Her father, who took her there, had to stay with her for the whole time, which was more than a week. Given COVID rules, her mother and sister were not allowed to visit at all. They were some very dicey days, and I am so blessed that she and her immediate family have the spirit, resilience and determination they do. Of course with COVID, I have not been able to see her or any of her family, save on Zoom or FaceTime, for over 18 months. However, I’m lucky we have the technology we do today. For my part, in the midst of my stress and anxiety through all this, I want to thank Senator Ravalia. He kindly heard me out in my state and underlined the research and the lead Kings was doing internationally, coupled with researchers here in Canada.

Since then, I have to say I am very proud of young Zoe. Just after her tenth birthday several months ago, she administered her insulin injection herself and is now on top of calculating the carbohydrates for her next meal — thus her insulin need, which she has to give herself 10 minutes before she eats, and on she goes. Early on, she instinctively knew when her sugars were too high or too low and could do the finger pricks herself to confirm where she was at. She has declined an insulin pump for now, which really surprised me. However, in one of our long and wonderful two-person FaceTimes, she said:

Mama, I need to know how to do it without technology, in case technology fails. Then I will get the technology. That way, I’ll know what to do.

I was pretty proud of her approach.

The personal aside, you can appreciate, as Senator Hartling said, how family experiences feed one’s desire to dig deeper. They are in the U.K., I am here. I well know all the services my family has had there — and does have — and could not be more grateful or admiring. I know the depth of the medical, nutritional and psychological team Zoe’s whole family has. I know her school hired a fully qualified nurse after her diagnosis. I hasten to say it was not just for her. With other children’s needs, it seems Zoe’s reality tipped the scales, for which I am a very grateful grandmother.

Let’s talk about Canada now. I want to sincerely thank Kimberly Hanson from Diabetes Canada and our entire Manitoba leadership team at Winnipeg’s St. Boniface Hospital. They provided a wealth of knowledge and vision. I am so impressed by what they do and that they do it with patience, skill, first-hand experience and compassion.

I also want to thank Senator Mégie, who sponsored this bill in the Senate. I thank Member of Parliament Sonia Sidhu, who sponsored the bill in the other place, for her leadership on Bill C-237, a bill that I wholeheartedly support. Her family and her community face huge challenges, and they are so fortunate to have someone like Ms. Sidhu making changes at the national level to address such considerable needs.

I support Bill C-237 fully. We do need a national strategy that gives equal access to research, funding, technology, diagnoses, information, equipment, awareness, treatment and more all across this country. The fact that equipment is not equally accessible across Canada amazes me. Why don’t all Canadians get the support my Zoe gets in London? Why do some supports stop at 18 or the age of majority? When will we grasp that research funds spent now will pay for themselves later in treatments, lives saved or corollary impacts now and in the future? Will all those with diabetes be able to access the latest technology? I do know how that has changed since the days in the 1990s when John had to test his sugar levels with finger pricks. Zoe, in the 2020s, does hers with a reader, which goes to hers and her parents’ phones.

This disease is a major health risk and determinant in Canada. It links to so many other diseases. Research between diabetes and COVID is in full swing. As Senator Mégie clearly outlined in her speech, we do know the connections to heart health, circulation, vision and so many other conditions. Money spent on research and prevention, and for a cure, is absolutely critical. So too is making sure those findings and treatments are equally accessible across our country. Research entails patience, diligence, care, detail, compassion, teamwork and a long-term focus. Many people and policies only deal with short-term focus. In this case, both the long term and short term must prevail.

A national strategy is now essential and is a perfect way to celebrate the hundredth anniversary of the massive contribution Canada made to research on this disease. I was naturally pleased to see funding for diabetes in Budget 2021, which will have a positive impact on people all across the country. I also want to thank all of the volunteers who are raising money to expand that research, which is so needed.

I want my Canada to continue as a diabetes leader through the next 100 years as it has in the last 100 years.

In conclusion, back to the personal. This grandmother is sending the hundredth anniversary stamps — the first day cover celebrating the discovery of insulin — to her granddaughter in honour of our past Canadian contribution, in thanks for Canada’s present-day research and in hope for the future cure. Colleagues, please support this bill. I doubt there are few of us who are not affected one way or another by this critical disease. Canada deserves a national framework and strategy. It can only improve the health of our citizens and the future well-being of many.

Thank you.

Is it your pleasure, honourable senators, to adopt the motion?

Hon. Senators: Agreed.

(Motion agreed to and bill read third time and passed.)