Have you ever had an uninvited or unwanted houseguest? He comes into your home out of nowhere, and no matter how hard you try to get rid of him he refuses to go away. He walks through the front doors and instantly changes the entire atmosphere. His presence affects your sleep patterns, meal times and holiday plans. No matter where you turn, he is lurking and constantly demanding attention.
Type 1 diabetes is like that unwanted houseguest.
“DC’s Legends of Tomorrow” actor Victor Garber described diabetes as running a marathon on a high wire for the rest of your life. “It is a constant balancing act,” Garber said. “Hundreds of calculations made each day, often with life-threatening consequences.”
Type 1 diabetes (T1D) is an auto-immune condition that occurs when the immune system attacks beta cells of the pancreas, meaning the person diagnosed (such as Garber) can no longer produce insulin. Insulin is a necessity, a substance that regulates the amount of glucose (sugar) in the blood.
People whose bodies struggle with insulin resistance are diagnosed with Type 2 diabetes (T2D). Here the pancreas initially produces extra insulin but fails at matching production levels and regulating blood sugar. Other types include Maturity Onset Diabetes of the Young (MODY), Type 3 and Type 3c, gestational and Latent autoimmune diabetes in adults (LADA).
The month of November has been designated “Diabetes Awareness Month” in order to recognize all types of the disease and rid the stigma that surrounds them.
Those not informed of how diabetes really works believe the sole cause of diabetes, no matter the type, comes from eating too much sugar. That is false. Lifestyle, smoking, obesity and a lack of physical activity are factors for the development of Type 2 diabetes, but are not exclusive causes. In Type 1, potential causes are linked to genetic disposition. It is not preventable, nor is it the person’s fault if they get diagnosed.
The lifestyle that follows a diagnosis is more draining that one might assume.
“Everyday there are highs and lows, multiple injections or a constant drip of an insulin pump,” said the owner of a diabetic Instagram page, Beautifully Broken Pancreas. “Everyday there are health issues to deal with. Everyday this disease has to be managed. It can not be controlled. It may be silent to you but Type 1 diabetics fight everyday.”
In 2020, diabetics are also fighting against the radical pricing of insulin. Frederick Banting, the inventor of the life-saving drug, originally refused to sign the patent of insulin because he saw it as “unethical for a doctor to profit from a discovery that would save lives.” His co-inventors, Charles H. Best and James Collip, ended up selling the patent for $1 to the University of Toronto. Like Banting, they wanted everyone who needed their medication to be able to afford it. Yet all three men would be outraged with how insulin is sold today.
The American Journal of Managed Care reported a 1200% increase on the original price of insulin. “Back in 1996, when Eli Lilly’s Humalog first came out, the price for a one-month supply of insulin was $21,” said author Danielle K. Roberts. “As of 2001, that exact vial’s price increased by $14 to $35. Now, that vial is said to be around $275.”
Unfortunately, these numbers do not include the additional prices of the actual insulin pens ($600), insulin pumps (roughly $4500), glucose monitors ($40-$60), test strips ($88 per 100 strips), emergency glucagons ($285), etc. Quarterly endocrinology appointments are also a part of the bill.
It has gotten so out of hand that many diabetics who experience the bankrupting effect of insulin costs are rationing monthly prescriptions. The National Center for Biotechnology Information (NCBI) released a qualitative study where one of their participants, Luis, explained how he found himself rationing insulin.
“I barely ate just to stretch it [insulin] out to about two weeks,” he said. “Because one vial would usually last me … between like four and eight days, and after that vial ended, that’s when things got really rough. I was living off water and an eight-pack of crackers for about four days.”
Insulin cannot and should not be rationed. Since 2017, there have been at least twelve deaths reported due to insulin-rationing and more are expected if insulin does not become accessible for everyone who needs it.
“No matter who sits in the White House after the 2020 election, the crisis that is insulin costs, should be acknowledged and fixed as soon as possible,” Roberts said.
So this November, take time to learn the truth about diabetes. Tomorrow, on Nov. 14 (aka National Diabetes Day), wear blue to show support for those diagnosed. Diabetes impacts over 1.25 million people, including your co-workers, classmates, friends and family. To learn more information, and to find out what you can do to help spread awareness, check out organizations such as Beyond Type 1 and the Juvenile Diabetes Research Foundation (JDRF).
