According to the World Health Organization, diabetes affects 285 million people. Since we know they don't all live in the United States, we have been (virtually) traveling around the world to learn what life with diabetes is like elsewhere, visiting countries like Spain, Serbia and England.
Today, Margot Vanfletern, a 17-year-old student living in Belgium who's had type 1 diabetes since she was two-and-a-half years old, shares what it's like in her country. Margot lives in Westende, a small coastal village near Bruges, where Dutch is the main language (French is the other national language in Belgium).
Note that Belgium's healthcare system is different in that's it's compulsory like other universal healthcare systems, but it's built on a payback system — so the patient fronts the cost, and then most things are paid back later. We'll let Margot tell you more...
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A Guest Post by Margot Vanfletern
I always say that I am living WITH diabetes. In other words, it's a part of me and I take it with me on every occasion. When I was 16, I decided to do something for and with diabetics. I designed an online game for children and young teenagers with diabetes, which is still in the development phase.
Now, I speak about diabetes at different places and I am a supporter for children and teenagers who have it difficult with their diabetes. In April, I was elected as a Lions Young Ambassador for what I'm doing. As a result of that, I also made a Twitter account, and this is how Allison found me and asked me to write this blog for DiabetesMine about diabetes in Belgium.
I will start with one of the differences. In Belgium, we have three "conventions," or classifications used by our insurance system. Each convention is a for a specific group of diabetics. A convention pays back all the stuff you basically need for your diabetes, which includes: insulin, meters, insulin pump or injection equipment.
The first one is for people who test their blood sugar more than 4 times a day, and also need to inject themselves 3 times a day. This one is also for people who use a pump. The second one is for people who test themselves less than 4 times a day and inject themselves 3 or less times a day. The last one is for people who test themselves minimum 30 times a month. We have also other conventions for people with gestational diabetes.
In Belgium, most of the people go four times a year to their doctor. At those consultations, they take your blood and check your weight. Of course, you also discuss with your doctor your insulin treatment and difficulties. For insulin, we need to go to the pharmacy with our prescription (i.e. there is no mail order option).
We have 610,000 Belgian diabetics between the ages of 18-79 years. We have 1,800 children in Belgium with type 1 diabetes. Injections are still used most, but pumps are being used more and more. Some people use continuous glucose monitors, but there are not so many people who use them because they're still not reimbursed by the conventions. I use one when I have exams because of my lows...
We do have some organizations that work for the rights of diabetics.
- The two most important associations are the Flemish Diabetes Association (de vlaamse diabetes vereniging) and l'Association Belge du DiabÃ¨te. You can compare them both with ADA.
- In our capitol city Brussels, we also have the headquarters of the International Diabetes Federation.
- You probably all know the Juvenile Diabetes Research Foundation in America. Well, in Belgium we do not have JDRF. We have Belgian Diabetes Registre, which works together with the JDRF. What do they do? They do research for diabetes and collect information about diabetics. As a patient you can always apply to join a research study and help them this way.
We have also a foundation for children started by a mom. She spreads the word about juvenile diabetes and helps other parents and kids with their problems. She started it because she couldn't find information about juvenile diabetes in Dutch when her daughter was diagnosed at the early age of 8. With the foundation, she also supports the Belgian Diabetes Registre and she plans events for the children and parents. These are mostly theme days, for example, a Santa Claus party at Christmastime.
Apart from these organization, we have also Force Douce. Besides their passion for sailing, ForceDouce members share a social and therapeutic ambition: to give disadvantaged young people new opportunities for integration through learning the sport of sailing. In collaboration with organizations and institutions active in youth welfare, ForceDouce committed to organizing internships and sailing competitions (national or international) through a long-term program.
In my opinion, these were the most interesting organizations I know in Belgium.
As an ambassador, I have some specific things that I'd like to improve in Belgium:
One thing is the fact that the focus most of the time is on type 2 diabetes. I'm working to bring more attention and information that is accessible to youth, and also to people who are working with youth, like teachers, for example.
Another thing I'm working on is trying to get more attention for type 1 in the media. In Belgium, we also need to get more attention for research. We do not have specific programs like the JDRF Walks to support the research.
And something completely different is that CGM sensors aren't reimbursed yet. I did some research myself last year about a sensor in combination with the Animas VEO pump. With the paper I wrote, I'd like to help all the other people who are doing research concerning the sensor. In my opinion, there are enough numbers which show the importance of a sensor. Hopefully we will get coverage for them!
I love all my diabetic friends because we are an incredibly close group who are always there for each other when we need each other. The fact that we have certain programs that support the meetings is great because on psychological level, it's well-known that it's important to surround yourself with people who understand your problems.
Every year we attend a diabetes camp for one week, and I can assure you that these 10 days are an inspiration for all of us. We learn a lot from each other!
At least I'm blessed to live in a country like Belgium where we have a good health insurance system, and we get the most important basics paid back.
Thanks for sharing, Margot!
We are always looking for folks from other countries to share for our Global Diabetes Series. If you're interested, please get in touch! And don't hesitate if English isn't your first language. We can help!