“Not just another diabetes patient. This is My Life”
Smile, nod and say okay—do you do this when you’re talking to your healthcare provider about the best ways to manage type 2 diabetes (T2D)? Do you feel uncomfortable asking follow-up questions or providing a solution that may counter your doctor’s?
It’s common to feel this when you’re visiting your family physician or endocrinologist. After all, we defer to our healthcare provider to give us the best possible recommendations to ensure we can manage our diabetes.
Before she was diagnosed with type 2 diabetes, Leijsa Miller used to “smile, nod and say okay” when it came to her doctor’s visits. But since her T2D diagnosis in 2021 at the age of 30, she’s learned that doctor visits are the best time to advocate for yourself.
“It’s something I’ve had to grow into,” says Leijsa, pronounced “lee-sha.” “I was always a very shy people pleaser. I didn’t want to cause any trouble. But now? Not anymore. I’m taking my health seriously. I may be just ‘another diabetes patient’ to some, but this is my life and I’d like it to be a nice, healthy long one.”
Leijsa’s diagnosis came as a surprise. She had no noticeable signs or symptoms of type 2 diabetes. She went to the doctor for another reason and after getting blood work done, she received a call a couple of days later that she had diabetes—with her A1C at 8.1 percent. Leijsa also had no history of prediabetes.
“I went home and cried that night because I didn’t know anything about diabetes,” recalls Leijsa. “I thought of diabetes as being an old person’s disease. I didn’t know anyone my age with it, especially type 2 diabetes. I was scared, thought I couldn’t eat anymore and they’d cut off my feet. I had this intense fear of diabetes.”
Initially, she was prescribed metformin but couldn’t tolerate it due to gastrointestinal issues, and later a GLP-1 but later discontinued it for the same reason. Other recommendations provided to her were to lose weight and eat cheese with her meals.
Being in panic mode, she started to do some of her own research and decided to cut carbs—including fruit—something she’s enjoyed eating her whole life. Leijsa stuck to this eating plan for about six months and lost over 60 pounds. However, it didn’t bring her any happiness or satisfaction with how she was managing her diabetes.
“I got a lot of praise from my doctor and my A1C went down, but I was miserable,” says Leijsa. “I started to allow carbs back into my diet and wore a continuous glucose monitor (CGM) occasionally. Also, I didn’t like to prick my fingers, so I didn’t. But I was still managing it decently.”
Finally seeing the signs of diabetes…Two years later
This summer, Leijsa began to experience signs of hyperglycemia for the first time. From extreme thirst to urinating frequently, she knew her glucose levels were higher than normal. When she tested her glucose, her meter read 15 mmol/l.
However, living in Annapolis Valley, a small, quiet rural town in Nova Scotia, there aren’t a lot of options when it comes to getting basic diabetes care. It takes an hour and a half to drive to her family physician and can take two to three months to get an appointment. Leijsa says this routine means she has to “plan out her problems.”
To fill the gap, her pharmacy in the next town over has a clinic where the pharmacists are the healthcare providers. The pharmacist took note that Leijsa is active, doing activities such as hiking, biking and kayaking, and eats healthy, but her glucose levels still rise to up to 17 mmol/l. The provider suggested she start taking basal (long-acting) insulin.
“I didn’t want to do it, but if that’s what it takes to not be scared to eat, then I’ll do it,” says Leijsa. “I still have this fear in the back of my mind about what could happen to my eyesight. I didn’t expect to need insulin two years into my life with diabetes, but if it’ll help me, that’s fine.”
Currently, Leijsa is waiting to hear back from her local diabetes center about beginning insulin. It could take a couple of weeks before she hears from them.
As a teacher, Leijsa is preparing for the upcoming school year and would like to be able to get started with her insulin regimen before work gets hectic. But still, she needs a quicker solution to address her high glucose levels other than waiting weeks to get a medication she needs.
When she went back to the pharmacy clinic, she had an unfortunate encounter with another pharmacist—not the one who suggested insulin to her.
“This other pharmacist at the clinic looked at me and said I should eat less and wouldn’t put me on insulin,” recalls Leijsa. “At the time, I was barely eating because I was too scared of my glucose spiking. She also suggested I be more active, but I’m already active.”
“Fortunately, I was able to book an appointment with my doctor to discuss insulin, but it’s not for several weeks. The pharmacist looked at me and said ‘a few more weeks of high sugar won’t kill you.’ That’s appalling to say to someone with diabetes. But me especially, because I’d just lost a close friend to complications from type 2 diabetes.”
Hopeful about insulin’s impact on relationship with food
It’s experiences like these that’ve helped Leijsa use her voice to ensure she can get the answers, tools and resources she needs. Losing her friend, her own fear of complications and knowing the tools are out there to help motivate her to be proactive in advocating for herself.
She’s also learned that her hard work in managing diabetes wasn’t in vain.
“When the first pharmacist mentioned insulin, I thought ‘it’s not fair.’ I worked so hard to improve my health and it still wasn’t enough. But through that experience, I learned there’s so much more to diabetes than just what you eat and how active you are.”
As she awaits her new medications, Leijsa is excited for the ways insulin can improve not just her T2D management, but her relationship with food.
“I’m really hoping that insulin will help me feel like I don’t have to worry about everything I eat,” says Leijsa. “I know I’ll still have to watch what I eat, but I hope I won’t be as anxious to have potatoes with my meal. I think this will bring some balance back to my life.”
For those who can relate to Leijsa’s experience, she has some encouraging words:
“You can have a very normal, happy life, even when you’re experiencing challenges like this. It’s not a walk in the park but once the scary part of being diagnosed is over, it becomes a normal part of your life. Being open to different tools like insulin can be helpful because it’s what your body needs to thrive.”