Today is Day 2 of Diabetes Blog Week and already it’s been amazing to read and share with our thriving #DOC. I feel completely inspired and in awe of the writing talent out there and if you are reading this, you guys are my diabetes heroes! Even though I was diagnosed 9 years ago I still feel like the new kid on the block when it comes to managing this disease. After yesterday’s topic, I feel armed with a whole new arsenal of tools to manage my diabetes. Thank you!
Here’s today’s prompt…
So today, let’s discuss how cost impacts our diabetes care. Do you have advice to share? For those outside the US, is cost a concern? Are there other factors such as accessibility or education that cause barriers to your diabetes care?
I feel like I am one of the lucky ones. I was born in Holland, grew up in the U.S and moved to Australia when I was 18. I can still remember the day I received my medicare card and my shock at how anything related to doctors and medical tests was free. While my siblings and parents complained about the costs of doctors and insurance in the States and worried about my health care, I told them not to worry. Australia isn’t called the lucky country for nothing.
That was when I was 18… things are definitely more costly now, but as my friend, Frank from Type 1 writes just shared on his blog,
” If I have to have diabetes, then there’s no place I’d rather have it than in Australia.”
Living in Australia with Diabetes has been affordable and it’s one of the reasons I feel grateful to call it my home. But I do live and travel often to other countries and have come to realize that Insulin, test strips, needles and diabetes devices aren’t always on tap and don’t come gift-wrapped.
Recently I’ve been living in South Africa. It’s a land of contradictions with a huge disparity between the people who have and the people who have not. I’m basically a tourist here so not really part of the medical system but recently the harsh reality of what it’s like for the people here hit home.
A friend came for a visit and with her was Abongile. Somehow it came up in conversation that I had type 1 diabetes. Abongile just happened to be a dietician in a clinic in Johannesburg for about 30 kids with type 1 diabetes. I was showing her my freestyle libre flash glucose monitor and how it worked. She was astonished. The kids she cares for and their parents can’t even afford the insulin they need to survive. Not only that, because there is no awareness of type 1 in the school system, the kids can’t take the risk of being on more than two shots a day. Apparently, hypos are a no go because the teachers don’t have the skills to respond appropriately. So all the kids in the clinic are on mixed insulin and do something called ‘carb blocking.’ They are allowed a certain number of carbs per day, based on the types of foods they eat. A packet of sweets is one block, a bag of potato chips another.
As a nutritionist, Abongile works hard to educate parents about the types of foods that are good to help the kids manage their levels. But some parents can’t even afford healthy fruits and vegetables. When I asked her if there was any money from the government to help the kids she laughed and shook her head. The one thing they have been able to achieve is to give each child a glucometer.
After speaking with Abongile I was completely floored and felt ashamed. How could I even consider complaining about the fact that the freestyle libre was $90 out of pocket, or that my favourite brand of test strips was on back order, or that I have to pay very little for a years supply of Insulin when these kids don’t even get to take the Insulin they need.
It immediately made me want to help. Before Abongile left I made sure I had her contact details I told her about an organization called Type 1 International which helps people get access to Insulin and medical supplies. I wrote a letter to one of the founders about the clinic and my meeting with Abongile. It felt good to put them in contact with each other and that somehow I could make a difference.
Abongile wrote back to me a few days later…
“Thank you very much for your quick connection with the T1 international on my hospital’s behalf. I am very grateful for your keeping to your word as well :). I will keep you updated with any/all positive developments for the clinic from the T1 foundation. “
Something I learned from my exchange with Abongile was that whatever we can do to help others have access to Insulin and diabetes-related supplies we must do. Whether it’s helping someone with less access, lobbying our governments, writing about it or networking to spread awareness.
Even the smallest action helps.
With great respect…Rachel