Month: February 2019

Champagne Bubbles

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I stirred in my sleep.

A glance at the alarm clock behind my bed indicated that it was almost 3am.

I stuck my arm out from under the covers, fumbling around on the bedside table for my Libre reader.

A quick scan of my arm registered 8.6.

I knew what was wrong.

I gave a generous correction of 2 units, but I knew it wasn’t enough. I contemplated a temp basal rate, but I knew that I would only be putting band aids on the real problem.

Besides, I knew that I wouldn’t be able to lie still while knowing what I needed to do.

I sprang out of bed, switched on the lights and reached for the box of t:slim cartridges from my wardrobe. I made a dash through the hall and the dining room, making a beeline for the bar fridge where cold insulin was sitting.

I had swapped out my insulin cartridge just after dinner several hours earlier. I knew I hadn’t chosen the best timing before bed, but at the same time I prefer to run my insulin down to the wire if I can.

I knew I had drawn a lot of those fizzy little champagne bubbles into my syringe as I was drawing the air out of my empty t:slim cartridge. Part of me suspected that I hadn’t successfully drawn all of the air out of my t:slim cartridge amid those champagne bubbles.

I’ve had my fair share of moments like these in the four months since I’ve been using the t:slim. As much as I love this pump, it’s beauty, it’s wearability and it’s positive impact on minimising my device fatigue, I absolutely hate that I can’t see what’s going on inside those insulin cartridges. Which means that I’ve had to learn to rely on intuition.

I’ve come to assume that when I haven’t properly drawn all of the air out of my cartridge prior to filling it with insulin (a.k.a. champagne bubbles), the delivery of insulin from the pump is compromised. My blood sugars feel sluggish and harder to manage, even if I can’t see any visible signs of air bubbles in my pump line.

I’m slowly but surely working on my technique. Making sure my insulin is as room temperature. Pushing insulin from my penfill cartridge into my syringe using a pencil, rather than pulling. Holding my cartridge upright. Being really gentle with my syringe when I’m drawing from it.

Who knew diabetes was such a fine art?

The Cost of Living with Diabetes

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I think about the cost of living with diabetes. A lot. Moreso as I get older. When I think about building financial security for myself, my number one motivator is to make sure that I will be able to meet the costs of living with diabetes today, and into the future. Which don’t come cheap.

FreeStyle Libre Sensors: $1,140

I currently wear a FreeStyle Libre in a 2 weeks on, 2 weeks off pattern. Because a) it’s expensive, b) I don’t want to become too reliant on one if I can’t afford it in the future and c) I become too overwhelmed with the data after wearing one for too long.

1 sensor sets me back a cool $92.50. Let’s assume I use around 12 per year, which adds up to $1,140 per year. Admittedly, this is a luxury that I could do without if need be.

Test Strips: $476

I would go through at least 15 test strips to monitor my blood sugar each day for the 26 weeks of the year that I’m not wearing a FreeStyle Libre sensor.

That’s 2,730 test strips a year.

Or 28 boxes of 100 test strips a year.

A box of test strips will set me back $17, which costs me a beautiful $476 each year.

Insulin pump infusion sets: $217.10

I would change the infusion set on my insulin pump every three days. Let’s assume that the 4 week pump break I have taken in the past 12 months, where I wasn’t using infusion sets, will cancel out the cost of infusion sets that have failed on me or lasted less than 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 $16.70, which totals a fantastic $217.10 a year.

Insulin pump cartridges: $111

I’m replacing the insulin cartridge in my pump once every four days since starting on the t:slim (where cartridges aren’t as easily reusable).

That’s 92 cartridges per year.

Or 10 boxes of 10 cartridges per year.

A box of cartridges sets me back $11.10, which adds up to a cool $111 each year.

Rapid acting insulin: $79

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 $39.50, which is a cheap as chips $79 per year.

Long acting insulin: $19.75

I use an insulin pump, which means that I only use rapid acting insulin. However, I like to keep long acting insulin on hand in the fridge in case a) my pump dies or b) I’m ready to throw it at a wall and need to go back to injections for the sake of my sanity.

A script of long acting insulin will set me back $39.50.

The insulin has a shelf life of two years, which comes in at a cool 50% off, setting me back $19.75 per year.

Private Health Insurance: $996

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 in 2016!

I pay $83 per month, which comes in at just under a cool 1k, or $996 per year.

General Practitioner: $32

I’ve visited my GP four times in the past year. When I’m not feeling well, if I’m in need of a more potent drug, a doctor’s note or a fresh script of insulin inbetween endo visits. Or if I’m dying.

After a Medicare rebate, I’m usually left to pay $8 out of pocket, which adds up to an awesome $32 per 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.

Diabetes care: Free

I’m currently accessing all of my diabetes care at the diabetes outpatient clinic in a public hospital, which is completely free thanks to the Medicare system in Australia. Sometimes the wait times are long, and the continuity of care isn’t always there, but it’s free. I’m pretty switched on and well connected with my diabetes today, so that is enough for now.

My annual eye and foot examinations and are also bulk billed through Medicare, even though I access these privately, leaving me with no out of pocket expenses.

Grand Total – $3,110.85

I could assign a dollar value to the sum of all of these various costs associated with living with diabetes, and whinge about how I’m sacrificing coffees or Spotify subscriptions or overseas travel.

However, the real price tag on all of the above is my life.

Without insulin, test strips, needles, hospitals or healthcare (to name a few), I would not be here today to tell the tale.

Sadly, this is still a reality for many who don’t have the privilege of being born into countries as lucky as ours.

You’ve more thank likely heard of the Spare a Rose campaign going through the diabetes community at the moment, so I’m just going to leave this very self explanatory graphic here.

Your donation will enable Life for a Child to provide life saving insulin to a child in need for a month, as well as support ongoing efforts to provide blood glucose monitoring and diabetes education to children in 42 different countries.

Please consider making a donation this month by simply hovering your cursor over these words, and spread the word around.

My Wish For the Diabetes Community In 2019

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Let’s have more collaboration and less disconnect. Organisations, healthcare professionals, researchers, pharmaceuticals, industry, people with diabetes and people connected to diabetes. We are all doing amazing things. We all want the same thing, too! Imagine how much more we could achieve if we put our minds together and joined forces?

Let’s respect each other’s differences in the way that we choose to manage our diabetes. Two people will never be exactly the same, so why do we expect two people with diabetes to be? I don’t subscribe to the notion that one size fits all when it comes to managing diabetes. Whether that be pens, pumps, meters, sensors, needles, syringes, Twitter, Facebook, carbs or no carbs, we are all unique and can peacefully co-exist together.

Let’s remember that no one issue is more important than another. Whether that be insulin pricing, insulin for those less fortunate, funding for CGMs, funding for better healthcare services or greater awareness of diabetes. If it’s important to one person, then it’s important. Full stop. But by turning it into an ‘us against them’ scenario, we are marginalising other groups campaigning for equally worthy causes.

While I’m there, let’s put an end to the calls for greater distinction between type 1 and type 2 diabetes. Yes, there are two (well actually, many more) types of diabetes. And yes, it’s important to know the differences between the two. But let’s also remember that nobody asks to get diabetes. This need to separate ourselves from people with other types of diabetes only serves to stigmatise people with different kinds of diabetes than us. We’re all in this together, right?

Let’s bring the voices of more people with diabetes to the table. Let’s see more people with diabetes talking to those in the industry. Let’s see organisations who are representing us, engaging with us. Let’s involve people with diabetes in all aspects of the research and development process, and not just at the launch phase. After all, how can people with diabetes not have a place in discussions that are about us?

Let’s celebrate the small victories (I’m the first to admit to being a glass half empty kind of guy…). Many of us don’t appreciate, for example, the research and development that goes into a product, or the advocacy that goes into securing funding from the government. Good things take time.

Let’s never give up on striving for more. Whether that be talking to your local Member of Parliament to advocate for better outcomes for people with diabetes, or challenging yourself to reach new goals in your own diabetes management. Energy spent complaining (and I’m the first to admit to being a serial whinger) is energy that we could be putting towards something productive.

Let’s never lose sight of why we all joined the diabetes community in the first place. To connect with other people just like us. To raise each other up on the tough days. To bask with us in the glory of our small victories. To know that we are never alone in what we are dealing with. Let’s continue to amplify the peer support that this community does best.