Liz Wilton-McMahan was 10 when she took her first cab ride. The Toronto native had moved to a new neighbourhood and her mom had scheduled a routine checkup for her with the family’s new doctor. At the end of the visit, her mom mentioned that her daughter had been losing weight recently and developed an unquenchable thirst.
“I think my mom just thought it was the beginning of puberty,” Wilton-McMahan, who now calls Vancouver home, says in a phone interview. “The doctor said, ‘Let’s do a quick [urine] test.’ She came back and said, ‘You need to get in a taxi and get to Sick Kids Hospital right away. You’re really sick.’?”
A few hours later, Wilton-McMahan found out she had type 1 diabetes, a life-threatening and incurable disease.
“I was diagnosed on February 2, 1988,” Wilton-McMahan says. “It’s very clear in my mind. It was such a shock to me and my family. I was in the hospital for about two weeks.”
During that time, Wilton-McMahan was learning how to manage the disorder, which occurs when the body’s immune system attacks and destroys insulin-producing cells in the pancreas. Insulin is a hormone that helps the body transport glucose from food throughout the body, which it uses for energy. When the body can’t produce insulin, glucose stays in the blood instead, where it can cause serious damage to all of the organ systems.
As a result, people with type 1 diabetes—also known as juvenile diabetes—must take insulin to survive, whether through multiple injections daily or via an automatic pump. Those with the condition also have to carefully balance their food intake and physical activity to regulate their blood-sugar levels to avoid hypoglycemic (low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be fatal.
Looking back at the day she was diagnosed, Wilton-McMahan says she’d been feeling terrible for months.
“I would get home from school and drink one of those big cans of apple juice by myself,” says Wilton-McMahan, who works as director of operations for Bard on the Beach. “I was going to the bathroom all the time. I remember my teacher started giving me a hard time because I would put up my hand to go to the bathroom almost every hour; I think she thought I was up to no good, but I was legitimately really not feeling well.”
She started feeling better as soon as she started taking insulin, but the regimen takes a lot of getting used to. Up until recently, Wilton-McMahan had to give herself at least five injections a day, usually in her abdomen but also in her thighs or arms. Two months ago, she turned to social media to find out about getting an external insulin pump and got lucky.
“Working in the arts, I don’t have extensive health-care coverage, and a pump costs $7,000,” she says. “I went to Facebook and joined a group of people who’d gone to a particular camp for kids with diabetes. I posted on there if anyone had had any success finding a donated pump. A woman I went to camp with 20 years ago donated one to me. It’s been life-changing already. My blood sugar is under a lot better control, which means I feel a lot better.
“For the last few years, I’ve been waking up with blood sugar that’s quite high,” she adds. “My bones would hurt; my muscles would hurt. I’d wake up to have something to drink, then to go to the bathroom. It’s not a cure, and it still requires constant attention on my part—I test my blood about 10 times a day—but the pump has made a huge, huge difference.”
To help find a cure for diabetes, Wilton-McMahan will be participating in the upcoming Telus Walk to Cure Diabetes. Her team is called 34 and Still Juvenile, and she’s made a video that’s posted on YouTube and gives a glimpse of life with the disease.
Dr. James Shapiro is working to find a cure too. The director of the Clinical Islet Transplant Program at the University of Alberta is overseeing an ambitious trial of islet transplantation being carried out at nine sites internationally, including Vancouver.
“The treatment basically comes from the premise that if type 1 diabetes destroys cells that make insulin, we can put new cells in that make insulin and release it in a perfectly timed, perfectly controlled fashion, something you never get with injections,” Shapiro says in an interview from the University of Alberta Hospital. “There have been a lot of advances in many areas in diabetes—advances in insulin-delivery systems, glucose-monitoring systems, continuous-monitoring systems—but all of those are far from perfect. Through these trials, we’re trying to find a cure.”
He adds that hundreds of other treatments have been found to cure or prevent diabetes in mice—and “none of those have made a real long-lasting difference to patients.”
Although promising, islet cell transplantation comes with its own challenges. There’s a lack of pancreatic organs from human donors, and the procedure requires chronic immunosuppression.
In the past 10 years, 1,000 islet transplants have been successfully conducted globally. However, many patients have to go back on insulin five years later.
“We’re doing a lot of work in trying to understand why that is and how to prevent that,” Shapiro says. “We’d like to be able to do cell transplants that last forever and have no risk to the recipient. We’re not quite there yet, which is why we need research dollars.”
Islet transplantation can also reverse or stabilize many of the serious complications of diabetes, he adds. Long-term diabetes can lead to problems in the eyes, nerves, kidneys, and cardiovascular system, resulting in blindness, amputations, kidney failure, and premature heart disease.
According to the Juvenile Diabetes Research Foundation, signs of type 1 diabetes include extreme thirst, frequent urination, drowsiness or lethargy, sudden vision changes, increased appetite, sudden weight loss, laboured breathing, stupor, and unconsciousness. The cause isn’t known, but it’s believed that autoimmune, genetic, and environmental factors are involved.
Wilton-McMahan is optimistic about the future of diabetes research and treatment, but she concedes that it is sometimes hard not to feel down. She’d like to have a family, and diabetes can cause problems in pregnancy. More than a year ago, she went for a pedicure and still has an infection in one of her toes as a result. And just a few weeks ago, she ended up in hospital.
“I had a bad [pump] insertion site and wasn’t getting any insulin for a couple of hours,” she says. “It got to the point where I was completely dehydrated and needed emergency medical attention. It’s a life-and-death situation every day.
“It sucks, but I’m still here,” she adds. “It was Canadians who discovered insulin, so why not a Canadian finding a cure?”
The Telus Walk to Cure Diabetes takes place this Sunday (June 10) at Lumberman’s Arch in Stanley Park at 11 a.m. In the Fraser Valley, the walk happens at 2 p.m. the same day at Abbotsford Exhibition Park.
