January 19, 2021

A Dinner Date with Banting

By: Amanda Coschi

Amanda Coschi has been living with diabetes since 2002. She is involved in a variety of communities supporting those living with type 1 diabetes such as Diabetes Canada, Connected in Motion and the Diabetes Hope Foundation. Amanda is a registered nurse and certified diabetes educator with a passion for teaching and spreading awareness about diabetes. Outside of diabetes Amanda’s interests include most outdoor activities and fostering dogs.

The Discovery

Portrait of Banting with illustrated birthday hat and noisemaker
Including Banting in my birthday celebrations. This photograph is an old photo that has been in the Insul-inn (the name of the nursing station) at Camp Huronda for years. 

The discovery of insulin holds a more profound value to me than the sense of patriotism we feel upon hearing that a fellow Canadian is responsible for its discovery. As someone living with type 1 diabetes the legacy of the momentous discovery of insulin is not lost on me almost a century later. It starts with the simple fact that I would not be here today if it were not for Sir Frederick Banting’s initial idea. To be eternally grateful to someone who you have never even met provides easy responses to ice-breaker questions like, “if you could have dinner with one person from history who would it be?” The obvious answer for me is Banting, if not just for the simple reason that I would love to thank him and his colleagues Macleod, Best and Collip. It is hard to imagine the treatment plans that individuals went through before the discovery of insulin. These individuals were starving themselves in order to survive, by enduring strict caloric diets coupled with exercise regimens to prolong life. Fast forward to present day where I ensure a front row seat for Banting at my birthday parties where I like to believe he would have been a huge fan of the expression “let them eat cake”!

What else would I want to tell Banting since the discovery? The insulin is the first piece, the key component; it is what I need to survive. However, there is so much more to my life than that. I take my insulin and then what? The then what is what I would like to tell Banting about, the accomplishments I’ve achieved, the people I’ve met, the technology since then that has been created, the education and funding that still needs to be put in place. I would want him to see the next piece since the discovery of insulin.

I take my insulin and then…

Diagnosis

The summer of 2002 I presented all the classic symptoms of a diagnosis: increased thirst, increased urination, weight loss, fatigue; it was all there except the knowledge of what diabetes was. Without any family history or prior knowledge, it was a few doctor’s visits before that September at 10 years old when I was diagnosed with type 1 diabetes. Besides finding out I had diabetes, my biggest upset was I would be missing my first ever hockey practice. I am fortunate to have a relatively simple diagnosis story, as to this day the signs and symptoms of diabetes are not well known, and it can take many individuals a long time to be diagnosed, with fatal outcomes if missed*. Much like how the discovery of insulin is a defining moment for Canada, my diagnosis is a defining moment for me. Since that time diabetes has continued to impact and direct my life’s trajectory. However, diabetes does not define who I am as a person and has in fact opened opportunities up to me that I would have never experienced without the discovery of insulin! 

Experiences

My first experience that emerged due to diabetes was attending Camp Huronda, a camp for children living with type 1 diabetes. It was the first time since having diabetes that I was able to participate in activities without diabetes being at the forefront. The burden and responsibility of managing one’s own chronic illness starts to fade into the background when everyone around you intrinsically knows what you are going through. Throughout my summers at camp I learned to build my confidence in who I was besides someone living with diabetes. I learned new skills and was introduced to activities which have now become an important part of my life, like back country camping. I built life-long friendships like most people do at summer camp, however the friendships I built went on to be my support system the rest of the year when I was often the only individual facing the challenges that diabetes presents. Diabetes Canada offers camp to thousands of children helping them to manage their diagnosis of diabetes, build their confidence, and focus on who they are in spite of their diagnosis. I would love to paint a picture for Banting of hundreds of kids singing around a campfire after a day of mountain biking, rock climbing, swimming, and canoeing, all thriving thanks to insulin. I would also want to share with Banting the opportunity my diabetes presented to me in my early adult life to join another amazing community: Connected in Motion. This organization for adults living with type 1 diabetes allowed me to continue to build my confidence and discover who I am outside of my diabetes through community and adventures. It was with this organization that I was selected to join a small group to hike the North Coast Trail in British Columbia. I imagine trying to describe it to Banting, a group of adults living with type 1 loading up their backpacks with freeze dried food, tents, and diabetes supplies to take part on a six-day trek in the wilderness. It is one of my proudest accomplishments and an experience that I would have missed out on if not for diabetes.

A group of people hold hands and are about to jump off a dock into a lake.
Jumping in the lake after a day of activities at Camp Huronda

Education

I feel like being exposed to the world of medicine from such a young age was another door that diabetes opened for me. I cannot say for certain that diabetes is exactly what led me to pursue a career in nursing, but it certainly helped to shape my career path. After graduating from McMaster University as a registered nurse I also went on to become a certified diabetes educator. In the summers, my favourite job consisted of returning to Camp Huronda as part of the medical team. A few summers I worked as the trip nurse allowing me to attend the overnight canoe trips into Algonquin Park. I have always appreciated that I was able to combine my role as a nurse with one of my biggest passions and hobbies while helping kids to challenge their comfort zones and recognize all of their potential! I have also had the privilege of helping to encourage and guide many campers into taking their first dose of insulin on their own. The pride and excitement these campers show in their newfound independence and achievement causes a communal wave of emotions. I can only imagine what it would have been like to be in the room a century ago for that first shot of insulin.

I continued on to work as a nurse in paediatrics and the Neonatal Intensive Care Unit, but it was always the children coming onto the floor with a new diagnosis of diabetes that I connected with best. Helping them to understand all the intricacies in managing their diabetes but most importantly helping them to understand that a diagnosis of diabetes does not change any of their dreams for the future.
I am currently employed with an insulin pump company, Tandem Diabetes Care, as a Clinical Diabetes Educator. I love having the opportunity to share in people’s journey finding technology that works for them with the goal to increase their quality of life. 

Amanda is in a canoe, wearing a lifejacket.
Canoeing in Algonquin Park with Connected in Motion

Technology and Funding

It is amazing to think of the many medical and technological advances that have happened since insulin was first discovered. Diabetes technology has advanced at a rapid pace throughout the years. I’ve had the pleasure of working with individuals who tell me stories of how they used to only be able to measure their blood glucose by urine testing and now I am setting them up with technology that will automatically measure their glucose in their interstitial fluid every five minutes, sending an update to their insulin pump which will be able to modulate their insulin delivery based on the blood glucose reading. Even in my 18 years of living with diabetes, the advancements that I have seen personally and the new technology that I have been privileged to wear are outstanding, all stemming from Banting’s initial idea. I would love to share these advancements with Banting, describe to him the opportunities that they provide, allowing individuals to live out healthy lives independently. I would want to introduce Banting to the individual who climbed Mount Everest not despite of his diabetes but because of his diabetes, the individual who broke down barriers and restrictions for allowing those of us with type 1 to fly a plane, or be a firefighter or police officer.

Two women hike on rocky terrain.
Hiking the North Coast Trail

I would, however, want to have a conversation about the barriers that those of us living with diabetes still have to break through to even access insulin in some cases. The technology is out there that can make the world of a difference, but in some cases provincial funding or lack of insurance coverage prevents access to these benefits. While we have made huge strides from the discovery a century ago there is still much that needs to be done to ensure that everyone has equal opportunity and access to the best therapies available. 

Dinner and Dessert

The last thing I would share with Banting would be, “Would he like to share a slice of cake?”