Need help navigating life with diabetes? Ask D'Mine! That would be our weekly advice column, hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, Wil lets us know where we can find lower-cost diabetes supplies, and addresses a question that might just get under your skin. Don't worry, though, he's got some advice you're probably itching for!

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Melinda, type 3 from Texas, asks: How can you get free insulin & strips if you're low- income and have no insurance? My husband has been a type 1 since 1982. He's now 43 years old and takes Humalog and Lantus. Please help. Thank you.

Wil@Ask D'Mine answers: Questions like this always depress the hell out of me. No, no, don't get me wrong! I'm glad you asked. It just reminds me of how far we still have to go as a society. When we think of type 1s with no insulin we tend to think of Tanzania and Tunisia, not Texas. I know your state tourism board likes to advertise that Texas is "like a whole other country," but I don't think this is quite the image they were after.

And while there are sometimes ways to get free insulin if you qualify, strips are a greater challenge. If you really want both free insulin and free strips you need to go from a place that's like a whole other country to a place that really is a whole other country. You'll need to emigrate to Europe.

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Free is really tough here in the USA. But affordable can also be an attractive option, and one I can help you with. The first thing you—or any other reader having a hard time affording insulin and strips—should do is go the federal Health and Human Services Rural Assistance Center website. Here you can enter your zip code to find the nearest Friendly Qualified Heath Center...err...I meant to say Federally Qualified Health Center (FQHC). Don't worry, they aren't all in rural areas. Plenty are in cities. These are non-profit clinics subsidized by both federal and state dollars. They aren't free clinics, but they all offer what is called "sliding fee" rates. How much you pay for services depends on your income. The less you make, the less you pay. FQHC services vary, but always include primary care. Many also have in-house minimal-cost pharmacies, and dental clinics. Some have mental health services—and a good thing too, because being poor and having no insulin and test strips will make you crazy!

The FQHC will be your home base. The portal through which you can hopefully line yourself up with the services and supplies your husband needs to survive and thrive. They'll have folks on staff who can check to see if you might qualify for Medicaid, for instance, or any unique plans in your state that might help you get insurance you can actually afford. And remember, if you don't quite qualify for Medicaid today, you might tomorrow. Part of "Obama Care" is an expansion of Medicaid eligibility that's being accomplished by raising the income level, or how poor you need to be, to qualify. You still need to be poor, but just not as poor as you used to have to be. (Although as of today your state is currently refusing to sign on to this, that might change. Here in New Mexico our "red" governor initially dug her heals in against it, but finally signed on.)

Your FQHC can also help you apply for the one thing you might actually be able to get for free: patient assistance programs from Eli Lilly and Sanofi—the two big outfits that make your hubby's insulins. If he qualifies—and the Pharma companies really are pretty generous about who qualifies—they'll give him his insulin totally free for as long as your income stays where it's at. And if for whatever reason that doesn't work out, say for instance you're both illegal immigrants, then the clinic docs may be able to switch your husband to older insulins like "R" and "N" for super-cheap. Hey, these aren't my first choice, but they'll keep him alive. Healthy even, when used right. Again, not free, but pretty close.

But the test strips are a whole 'nother kettle of fish. There's not as much help to be had, and frankly, the strip makers don't seem to be very interested in helping out the less fortunate. That's rather disgusting in my opinion, given their historic grotesque profit margins (although that seems to be changing). Of course, see if your new friends at your FQHC clinic can help you out, but it's also worth a call to your state's Diabetes Prevention and Control Program. Every state has one, and some are better than others. The Centers for Disease Control has a master index of programs here. A fair number of these state programs have free strips and meters for those in need, but demand always outstrips supply. So while they might be able to give you free strips for a while, you really can't count on those kinds of programs long-term.

Which leads me to the "health plan" of last resort for strips. Yep. Your friendly local Walmart store may prove to be your new DBF (Diabetes Best Friend). They now have, no shit, lowered the price of their ReliOn test strips to $9 for a vial of fifty. Hell, even if you have insurance it might be cheaper to switch to Walmart than make your current copayment on strips. A while back I put a ReliOn meter through the paces, and I gotta say, I was pretty impressed both with the gear, the strip accuracy, and the software. Oh, and Walmart also has those older insulins we talked about at a pretty good price, plus $1 glucose tabs, and syringes for 12 ½ cents each! Again, not free, but about as close as you can get.

So I know that's not quite what you wanted, but it's as close as I can get you, because while Texas may be "like a whole other country," it isn't, and free healthcare is hard to come by here in the USA.

 

Matt, type 1 from California, writes: I have a persistent red rash on both my thighs and the back of my knees that I can't get rid of.  It doesn't itch, but it burns or prickles. I've been to the dermatologist, twice, and have used high-potency steroid creams for several weeks but to no avail. Oh, and I've been tested negative for fungus.  The rash is only on certain locations on my thighs (front, baStop Scratchingck, inside) but is spreading. Could this be somehow related to the diabetes? Any thoughts or advice? 

Wil@Ask D'Mine answers: I'd freak the f** out. Oh, that wasn't my advice. That would just be my personal reaction if it happened to me.

So this is a weird one, and going to a dermatologist was a logical first stop, but I think you should check in with your endo instead. What is leading me to say that—and let me be clear that I've never clinically seen anything like what you are describing, I'm just speculating—is that you describe the rash as having a "burning" or prickling sensation. Gosh, sorry, but that sounds sorta neuropathic to me. Can you get neuropathy of the skin? Sure. It's called (what else?) diabetic dermopathy. It generally isn't a painful condition, but most types of neuropathy do seem to come in two flavors: the flavor where you lose sensation; and the flavor where your nerve endings go crazy and you end up with stabbing, painful, electrical sensations. Or, using other words to describe the sensation: burning and prickling.

There's actually a host of other funky, little-known diabetes complications that deal with skin. We've written about them here in our 411 Series on complications. For example: it could be necrobiosis lipoidica, but that would be more likely on the shins than higher up the leg like you are reporting, and your symptoms don't quite match up. Other diabetes-and-skin conditions (many of them harmless) that you almost never hear about include eruptive xanthomatosis, vitiligo, and bullosis diabeticorum. Plus disseminated granuloma annulare.

Again, none of these sounds quite like what you have, and my point here certainly isn't to offer a diagnosis, but to point out that there are a lot of weird skin issues that are diabetes-specific -- so perhaps a diabetes specialist might be the one to turn to on this prickly issue, rather than the derm guy. Of course, one would hope that a dermatologist would be tuned into these diabetic possibilities, but if he/she didn't see a lot of D-folk, then maybe not.

So get thee to an endo. Hopefully he or she can sort it all out for you. After all, diabetic skin is like a whole other country, too.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

 
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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.