Author: Frank

The Cost of Having Diabetes For a Year

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It’s tax time. I’ve just spent the weekend being a good brother and completing both of my siblings’ tax returns, as well as my own a week ago.

The topic of conversation over dinner on Friday night was annual incomes, and how they stack up against all of our living expenses. Then, as if trying to prove his point, my Dad asked me how much all of my diabetes expenses would add up to.

I guess I’ve never really done the sums before, for a few reasons. My diabetes and broader health are non-negotiable expenses, drummed into me by parents (second only to eating). Obviously here in Australia, we are extremely lucky that most of the essentials are heavily subsidised, and I’ve never genuinely struggled to make ends meet. I’ve also received a great deal of support from my family in terms of meeting the costs associated with my diabetes care.

So, maybe I should count myself lucky that I’m only doing the sums for the first time today.

Test Strips – $918.50

I would go through at least 15 test strips to monitor my blood sugar each day.

That’s 5,475 test strips a year.

Or 55 boxes of 100 test strips a year.

A box of test strips will set me back $16.70, which costs me a beautiful $918.50 each year.

Infusion Sets – $217.10

I would change the infusion set on my insulin pump every three days.

Thats a total of 122 infusion sets each year.

Or 13 boxes of 10 sets per year.

A box of infusion sets will set me back $16.40, which totals a fantastic $217.10 a year.

Insulin Cartridges – $54.50

I replace the insulin cartridge in my pump once a week.

That’s 52 cartridges each year.

Or 5 boxes of 10 cartridges per year.

A box of cartridges sets me back $10.90, which adds up to a cool $54.50 each year.

Insulin – $77.60

A 3ml cartridge of NovoRapid insulin lasts me roughly 7 days.

That’s 52 cartridges a year.

Or two scripts per year, each containing five boxes of five NovoRapid cartridges.

A script of NovoRapid penfill cartridges sets me back $38.80, which is a cheap as chips $77.60 per year.

(Thank you Australia, for making insulin so relatively affordable. Unfortunately the rest of the world doesn’t have the same luxury).

Private Health Insurance – $918

I wouldn’t want to be without a private health insurance policy. It covers the cost of any hospital visits, treatment, as well as rebates on other services such as dental and optical. It’s a small price to pay for the peace of mind, as well as the $9,000 insulin pump that was fully covered under my policy last year!

I renew my policy annually, which set me back an awesome $918 this year.

(Not to worry, it only gets more expensive with every passing year!)

General Practitioner – $16

I would only visit my GP if I need something. Such as an examination, a signature, or a fresh script of insulin inbetween endo visits. Or if I’m dying.

I might visit my GP twice a year.

After a Medicare rebate, I’m usually left to pay $8 out of pocket, which adds up to an awesome $16 per year.

Diabetes Educator Sessions- $100

While I see an endo for free at the hospital, I choose to see a diabetes educator privately. Private education gives me invaluable support and one-on-one time that the public system simply does not allow for.

I would visit my diabetes educator five times annually.

After a Medicare rebate, I am left to pay $20 out of pocket for each session, which totals a cool $100 a year.

Hypo Treatment – $40

My go-to treatment for hypos are Skittles. 

I buy them in party buckets.

I would buy four party buckets a year.

A party bucket sets me back $10, which totals a nice $40 a year.

Grand Total – $2,341.70

It costs me $2,341.70 to live with diabetes for a year. That’s not even factoring in the intangible costs. It’s a fair chunk of my annual income. It saddens me, because it would definitely make a dent in a few bills at home, among other things.

However, I also count myself fairly lucky, because I know that my counterparts overseas might not be as fortunate as me. If I have to live with diabetes, then there’s no place in the world that I’d rather live with it than in Australia.

But seriously, I think it’s time we make these expenses tax deductible.

Better yet, give us a chronic illness tax offset. C’mon, Australia!

Getting the Most Out of a Flash Monitor

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I’ve recently started freelancing for Diabetes Daily, which means that from time to time I’ll be linking to some of my columns over there.

The topic I am most frequently asked about is the FreeStyle Libre. While my experience with the device has been an extremely positive one, I definitely didn’t hit my strides after my first sensor. Any shake up to your diabetes management is going to be an adjustment. In my first column, I wanted to share some of my tips and tricks for a smoother transition from finger sticks to flash monitoring.


Like the fact that getting out of the shower, or going from a dark room to a bright one, can cause momentary changes in the readings. 

Or that higher blood sugars can cause greater variances with a traditional blood glucose meter. 

And that I shouldn’t obsess over the small variances, because two blood glucose meters won’t ever produce an identical reading!

You can check out the full column over at Diabetes Daily right here.

(That being said, Your Diabetes May Vary!)

 

Mixing Up Finger Sticks and Flash Monitoring

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I don’t cope well with the continuous nature of glucose data. After prolonged periods of using my FreeStyle Libre, I tend to get a little fatigued and overwhelmed. I know that I’m not getting the most out of my flash monitor, which I pay a pretty penny for. Perhaps I might feel differently if I were not an insulin pumper as well, and the Libre was the only technical device I had to deal with.

Over the last couple of months, I’ve settled into a routine of wearing a FreeStyle Libre sensor for the first two weeks of the month, and then imposing a break which sees me going back to fingersticks.

Mixing up flash monitoring with fingersticks helps to keep things fresh and exciting for me. These little breaks help me to clear my head from the constant flow of data that’s just a scan away. It helps me to re-evaluate my glucose monitoring habits, and whether I am checking my blood sugar out of necessity or simply for the sake of it. It also keeps me from becoming too reliant on the Libre, considering it is costly and not currently subsidised here in Australia.

However, I have also found fingersticks challenging after using the Libre. Over the past year or so, I’ve been learning a lot about my blood sugars and applying some of these observations towards my diabetes decision making. I usually apply a new sensor with the intent of, for example, analysing my overnight line or basal testing my work day mornings. But with diabetes being diabetes, two weeks is simply not enough to complete all of those little tasks I’ve set out to achieve.

Coming off the Libre has felt a bit like driving somewhere south of the river without directions. I’ve often found myself feeling lost in those little problem spots, anxiously trying to keep my head above water with finger sticks. By the time my self imposed break is up, I’m ready for a new sensor.

However at the moment, I find myself in somewhat unchartered territory.

I’m currently in my longest stretch on fingersticks since I first began using the FreeStyle Libre last year. There are two unopened boxes of Libre sensors on my shelf, and I haven’t felt any desire to put them to use in some time.

I don’t feel like I am struggling without it. I’ve applied what I’ve learned and observed. The problem spots are slowly but surely smoothing out, and starting to feel less problematic. I feel…comfortable.

I guess I have always perceived the Libre as a tool to evaluate elements of my diabetes management, rather than a tool to directly make my decisions from every day.

At the moment, I feel like I am where I have wanted to be for a long time.

Review: MedAngel Insulin Temperature Sensor

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Earlier this year, I was contacted by Amin from a company called MedAngel. Having lived with type 1 diabetes for ten years, he began to tell me about an incident where his refrigerator completely froze his supply of insulin. From there, he created a solution to his problem in the form of the MedAngel temperature sensor.

(Disclosure: I received a MedAngel One to try. There was no expectation that I would blog about the product, and all opinions expressed here are my own).

The MedAngel consists of a small oval shaped temperature sensor, which is stored in the same place as my insulin. The sensor then connects to an app on my smartphone, and transmits the temperature of my insulin via a Bluetooth connection. 

I must admit that I couldn’t muster too much enthusiasm for the MedAngel, initially. It sounded a little…unnecessary. Honestly, I didn’t think that I needed it.

I know that insulin needs to be refrigerated when it’s not in use. It’s good for 28 days once taken out of the fridge, and should then be disposed of. I’ve often stretched out post-holiday supplies beyond that timeframe, feeling guilty to waste something that’s so expensive. However, I guess I’ve never really given too much thought to what that exact storage temperature should be.

I first learned the concept of “spoiled insulin” last year, when my levels became seemingly impossible to tame. I’m also really conscious of temperature every time I go to the beach on a blazing hot day. But do I give a lot of thought towards the safe storage of my insulin day to day? Probably not.

Two weekends ago, I put my MedAngel to the test. I placed my sensor in the bar fridge with my insulin, and connected it via Bluetooth to the MedAngel app on my iPhone. There was a list of medications to choose from, and I was easily able to find both my Novorapid Penfill cartridges and Lantus pens. I told the app that I was “Storing” unopened medication, and I was good to go.


Soon enough, the app began alerting me that the insulin in my fridge was below the safe storage temperature of 2-8 degrees. 


I spent the rest of that weekend cautiously adjusting the temperature in my fridge. When I started out, the temperature dial in my fridge was sitting inbetween “Colder” and “Midpoint.” By the time my fridge had reached a safe storage temperature, the dial was sitting inbeweeen “Midpoint” and “Warmer.”

While I suspected that I might have to make my fridge a bit colder, I was hardly expecting the complete opposite. I couldn’t believe that my insulin had been sitting at borderline freezing point for all this time.

My only negative is that I had to be in the same room as the sensor, in order to receive the temperature via Bluetooth. There was also no ability for me to manually “refresh” to obtain a new reading, but that’s just me being impatient…

The results really did speak for themselves. It was a lower trafficked fridge, and it was a really cold weekend. But still…the results were eye opening.

This is a really, really amazing product.

If you think this issue doesn’t affect you, then you need to try this product.

The MedAngel is available online, and it ships worldwide.

For those of you in Australia, MedAngel is also available through One and 2 Diabetes Accessories.

From Uni Procrastination, to a Type 1 Diabetes Diagnosis

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Monday, May 3 2010

It was the first week of May 2010. A warm May, from memory. My head was buried in uni assignments and a part time job, with my 18th birthday looming just a few weeks away. 

In an attempt to make some kind of headway with those assignments, I decided to skip uni for a few days. I was never the kind of person who could smash out a 2,000 word paper the night before it was due. There were at least three or four separate papers I had to write, each in need of ten credible journal references. This meant hours and hours of reading through painfully long and boring PDF documents. I needed all the time I could give myself, because I knew I would be working later in the week.

Being left to my own devices in an empty house was a recipe for procrastination. Over the course of three days there were many Facebook sessions, browsing breaks, and heading to the kitchen for a drink. In fact, the latter seemed to be happening more often than I was normally inclined. A glass of soft drink was over no sooner than I had poured the glass. Even plain water, which I found unpalatable, was tempting. 

Try as I might, I just couldn’t seem to find the energy to focus on those papers I had to write. I felt rather tired and lousy. Rightfully so, given I had just wasted away three whole days doing next to nothing.

Thursday, May 6 2010

I really didn’t want to get out of bed. My mouth was ever so dry, and I felt really lethargic. Feeling the shame of a very unproductive three days, I forced myself up out of bed. Thinking I had to snap out of my rut, I prepared a super healthy lunch to take to work. A salad sandwich, Ski yoghurt and carrot sticks.

The energy to remain standing on my own two feet at work that day was lacking. I might have lasted half an hour, at best, before I gave in and went home.

I wasn’t even sure I’d be able to drive myself home. Although tempted to call Mum and Dad, I knew they were out and didn’t want to interrupt their errand. It took every last ounce of my energy to drive myself back home. No sooner than I had walked through the door, I collapsed onto the couch and buried myself under the comfort of a blanket.

When my parents arrived home, I told them that I wanted to go see a doctor. Mum relayed to me that the earliest available appointment to see our family doctor was Saturday, and I knew I simply couldn’t wait until then. 

We visited a medical centre later that morning. After explaining my symptoms of exhaustion and excessive thirst, the doctor sent me home requesting bed rest and hot fluids for three days.

I spent the next three days in bed, which speaks volumes for me. Never in my life had I stayed in bed when I was unwell. Sick days were often spent eating Mum’s chicken noodle soup, reading a book or watching the midday movie surrounded by tissues. 

My mouth was now stripped of all of it’s saliva. I was struggling to find any food even remotely appealing, much to Mum’s distress (eat something!). I questioned my diet and lack of interest in physical activity, truly under the belief that these symptoms were of my own doing.

Sunday, May 9 2010

It was very early on a Sunday morning. Mothers Day, to be exact. I was restless, and had gravitated from my now uncomfortable bed to the living room couch. Ice cold, refreshing drinks were now a craving. These cravings were becoming insatiable, and more frequent. I was struggling to pass the mere minutes in between refreshing glasses of ice cold Orange Juice on the rocks.

In the kitchen, I was frantically trying to get ice cubes out of the tray and into the Snow Cone machine. I was onto my third or fourth orange juice granita when my rumblings in the kitchen got Mum out of bed.

“What are you doing? The doctor told you to have hot drinks!”

My heart rate was becoming more rapid by the minute, and I was going to the toilet at least once every hour. A bout of nausea finally made me feel slightly better, and got me settled that night.

When I woke up a few hours later, I was panting. My heart rate was extremely rapid and I felt breathless. I was still extremely thirsty and exhausted, and going to the toilet every hour. I told Mum and Dad how I felt, just waiting for them to suggest what I was thinking.

No sooner than Dad had started talking about going to a doctor, I shot it down. I knew that it would be pointless, and that I couldn’t hold out for that long. My mind was made up. I had to go to hospital.

The car ride was a blur. I was panting the whole time, eagerly staring out the window the way Scruffy does on the way to the park. I had no idea what was wrong with me, or if I would ever have my salivary glands restored. Honestly, then and there, I wasn’t even sure that I would survive this.

Soon enough, I would learn that my pancreas had stopped producing insulin, the hormone that regulates blood sugar levels, through no fault of my own. I would become dependent on insulin injections and frequent blood glucose monitoring with finger sticks for the rest of my life.

I was diagnosed with a condition called type 1 diabetes, the minute I walked through the emergency room door.

It’s National Diabetes Week here in Australia, and the reality is that many individuals and healthcare professionals aren’t aware of the symptoms of type 1 diabetes. Case in point. Had these symptoms been properly diagnosed when I first visited the doctor, my hospital admission may well have been avoided. I’m sharing this story today, with the hope that it might stop another person from going through the same ordeal as me.