Government shutdown leads to insulin rationing


#21

In 2015, federal employees gave $177.8 million to charities through the CFC, and many give to charity privately as well.

I’m not sure why you assume that none of the people furloughed or working without pay would be willing to help you out if you were put in a bad situation.

Given that most Americans live paycheck to paycheck, I think there are many people who are being harmed by the inaction of elected officials in our country. Deductibles just started again in January, and DC has one of the highest cost of living in the country. People may not yet be at the point of death, but that doesn’t mean they’re not deserving of empathy.


#22

So what is the truth here? Are there people in dire straights or not?


#23

Some people affected by the shutdown can’t pay their rent. They can’t pay their bills. They can’t buy food. They can’t pay for their heat or electricity.


#24

Truth is in the eye of the beholder.

There are always people in dire financial straits.

Good luck finding objective reporting with no additional political spin other than the actual politics involved in the underlying issue.


#25

Oh Sam… I wish I could have an extra 3 week supply of everything. My insurance doesn’t cover that. I guess we’re not all lucky like you.


#26

Have you asked your endo for samples or extra? They often have some from sales reps.


#27

One of the tricks with insulin is to get the prescription for your max amount, not your average.

Suppose someone takes 40-50 units per day. Somebody might say, that averages to 45 units per day, so that is what the script is written for.

But instead, get the prescription for the max amount you might use on any particular day, 50 units per day.

Also, use everything from the vial, don’t discard it after 30 days, trust me the insulin is fine.

It is easy to build up a supply doing it this way.


#28

Also, usually you can refill prescriptions a few days before you actually run out. If you do this every month for years, you’ll gradually build up some extra.

Also be sure any insulin used in priming pens/sets or filling tubing is accounted for in your prescribed amount.


#29

Just ask your doctor to prescribe more than you use so that you have some extra. Eg If you use about 40 per day, ask for a prescription for 60… it’s a lot more about being proactive than being lucky


#30

Oh, glad you mentioned this, it reminds me of another thing.

You can actually save your primed insulin instead of wasting it.

You can buy sterile empty vials for extremely cheap. Like only a couple of dollars. Prime into the empty vial instead of losing that insulin. Occasionally remove some air to make room for the insulin in the vial.

Over the course of months the small units of primed insulin can add up.

This is very easy to do, and sterile vials are super cheap.


#31

And of course everyone who is insulin dependent should have a few vials of R and NPH sitting around for emergencies… they’re only $25 each. Maybe not ideal… but the people who did so in advance aren’t the ones setting up insulin go-fund-me pages now, unless they’re just trying to make a political point…

Despite my luck and privelage I keep around a years worth of R and NPH. I ask relatives for vials of them for Christmas—- so it’s never actually cost me a dime to have that safety net… and of course I don’t pay attention to expiration dates, so the safety net just keeps growing.


#32

Our doctors write “as directed” and there is never any hassle at the pharmacy.


#33

I can feel empathy for those who find themselves in an emergency situation, even if they are partially to blame through lack of planning. And I understand that there is more than enough blame to go around — big pharma, politicians, etc. But I also understand that none of those contributors is likely to change quickly.

I gave some thought to what I would do if I suddenly was placed in a situation of limited income and insurance. While it would not be a change I would welcome, I would survive. There would never be any thought of rationing my insulin or other diabetes supplies. As others have noted, insulin at Walmart and perhaps other places can be had for $25/vial. And blood sugar strips at Walmart or Amazon are less expensive today than what I was paying for many years.

But what separates many of our forum members from the general diabetic population is the knowledge of how to adjust to different insulins. I could be wrong, but I suspect that many of our forum members could make it with older insulins and fewer tools than are currently available. Reforms in our political system and reining in big pharma are desirable goals long-term. But many people could be helped immediately with the right education. Of course, the people most affected by a financial crisis are often the least prepared to get that education. However, I think public awareness could be raised by articles and public service announcements on how to cope with diabetic emergencies.


#34

Yes and yes. I frequently encounter expressions of confusion or ignorance even by long-term T1s who have just never had access to—or known where to seek out—in depth information. Not just the patients themselves, but frequently there are caregivers in underserved regions who are working from ca. 1980s concepts as well. For my part, my understanding of the disease is orders of magnitude greater than it was before I first visited this site. I’d hardly ever even met anyone else with T1 up to that point, let alone had any in depth discussion of treatments etc. I’m still astonished at how many things you can get wrong even if you consider yourself intelligent and well-informed.

As regards R/N, the problem is amplified because it is not a simple one-to-one swap. It’s very different stuff, and you really need some guidance and experimentation to use that regimen without crashing and burning. One thing I try to do, personally, is in comment threads and FB posts about the many death-by-rationing articles we’ve been seeing is to point these facts out:

  1. You can get cheap(ish) R & N insulin from Walmart
  2. It’s not equivalent to Lantus/Novolog MDI, so you need to learn how to use it
  3. Even so, it’s a far superior alternative to DKA

#35

Even if they still have ins if they aren’t getting paid they may not be able to pay the obscene copays or full cost if there is a large deductable. etc. older insulins are not an option for many- very difficult to manage and dangerous.


#36

Good article. I hope this commission actually does something to greatly lower all insulin and other costs so that those in need will be able to afford it whether they are being subjected to something such as this immoral shutdown or not.


#37

The older insulins are not dangerous, and many people here, myself among them, successfully used them for a long time. Which is not to say newer insulins aren’t superior, but in a pinch, the old ones have their place.


#38

That is your opinion, and your experience. It would not be the case for many. Ydmv


#39

Once upon a time we didn’t have any choice. With hindsight it wasn’t perfect, but I don’t remember people dying because they were on R and N. It was all we had.


#40

Many of us used older insulins for years or decades before the analogues were available. You’re probably not going to be getting a 5% A1c with them. You’ll have to be more careful about highs and especially lows. You’ll have to respect their ability to force you to eat on a schedule. You’ll have to do some reading up about how they work (and don’t work). If it were me, I’d want to be testing often. But if the only alternative is risking DKA, there’s no real question that using the older insulin, used carefully, is better and less dangerous.