All across the world, countries are facing a difficult economic time. But there are few places in the developed world in as critical condition as Greece, where unemployment has reached staggering heights. Like the U.S., Greece's healthcare is built on private insurance companies, and nowadays, more and more people with diabetes are unable to afford their medications.
In our continuing series on diabetes across the globe, Lena Zafeiriou, a 37-year-old type 1 living in Athens, shares what it's like to live in a country in a paralyzing economic crisis. Diagnosed with type 1 diabetes when she was 11 years old, Lena now works as a customer service representative. Lena's road with diabetes has been bumpy, strewn with several complications. But she doesn't let diabetes slow her down!
Lena writes her own blog (in Greek) called The Essence of Life and she is committed to raising awareness about diabetes in Greece.
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A Guest Post by Lena Zafeiriou
I have been a diabetic for 26 years now. I was diagnosed as a child, but along the way, doctors discovered a few other health issues: autoimmune thyroiditis, diabulimia, depression, and anemia. I have three diagnosed diabetes complications to deal with: gastroparesis (due to neuropathy), diabetic mastopathy and frozen shoulder. I have worked in customer service for 15 years and I am working towards a university degree in Psychology.
In Greece, it is estimated that about 8% of the general population has either type 1 or type 2 diabetes. That's about 800,000 people, and about 10% have type 1 diabetes. Greeks see an endocrinologist every month to get our prescribed insulin, and every three months to check our A1c and any possible complications. We see all the other doctors (cardiologist, eye doctor) at least once a year to get our annual check up. Our goal is to have the A1c below 7%, although this goal is met by less than 20% of type 1 diabetics.
Over the last 30 years, the number of diabetics in Greece has at least quadrupled. Many of them don't even know they have diabetes, or choose to ignore the symptoms. That is why is imperative for Greek people to have a broader view of the matter. Sadly, in our society, we have not fully understood what diabetes really means and what its complications are. The reason resides in poor health education. There are a lot of misunderstandings about diabetes, because people don't usually acknowledge diabetes as a debilitating disease, but as a fact of life, that "just happens when you get older." This belief makes the lives of type 1 diabetics difficult (especially young adults who work) because they are treated like they are invisible, either by society or by the healthcare system.
There are three major state health care providers in Greece. Health insurance is a shared cost, so people who work in the public sector (teachers, doctors) join the state health insurance program, while those who work in the private sector have private insurance. Workers are required to pay for their insurance, along with their employers. Hospitals are part of the National Healthcare System, but appointments are hard as hell to get. Private practice doctors get a lot of work done, for those who can afford it. Doctor appointments are paid by the patient, and then patients get reimbursed by the insurance. All types of insulin and pills for type 2 diabetes are fully covered by insurance, because they are considered "drugs essential for the survival of the diabetic." But we pay 25% of the cost of our diabetic supplies (meters, strips, pumps, transmitters).
We use blood glucose meters to measure our blood sugar and analog insulins in prefilled pens. But the use of insulin pumps and CGM's isn't as widely spread as it is in Europe and America. This has everything to do with the cost of the devices. They aren't fully covered by any health insurance. There are pumpers in Greece, but they are only 10% of our diabetic community. It isn't easy to get a pump, because we need to have a reference letter from a hospital doctor, and an approval by a health committee that usually consists of officials and doctors. There is a lot of red tape concerning the reimbursement procedure, too.
Right now, I take insulin shots using Lantus, but I'd like to be on the pump — hopefully within the year. The system is so slow that it can be months before we can get back the money we paid for diabetes supplies. So people get somewhat discouraged, while they should focus their efforts on managing their diabetes.
Right now, Greece is in a very difficult economic situation. Unemployment has reached a record 16% and cuts have been made in health care expenses. People with diabetes are living in a highly insecure environment, and trying to make ends meet. Many people have lost their jobs and have no insurance at all or a chance at a decent pension in the future. There is a Public Health program for people who are unemployed, which helps cover hospital appointments, insulins and some diabetes supplies. But they don't have access to all the benefits that are available, like new treatments. Those who are unemployed have to help pay for insulin, as well as supplies, doctors' appointments and their lab work. The cost is over 600 Euros per month (equivalent to US $820).
It is a gloomy reality and every day, it gets darker and more frustrating. I wish we could be more organized, have better health education and spend more money in our health care system. In Greece, we need to consider people in need much more than we do.
There are a couple of organizations for people with diabetes in Greece. Doctors exchange opinions, knowledge and organize educational seminars in Greek Diabetes Society, while people with diabetes can join the Panhellenic Fight Against Juvenile Diabetes community. Their purpose is mainly to educate, but not to support. There is also the Hellenic Diabetes Federation.
As far as research in Greece is concerned, I recently discovered that a group of researchers from the Institute of Biology at the National Centre of Scientific Research. Researchers found a marker called "prosort," and this marker, which is found in the blood of people with diabetes, is used to indicate faulty production of a certain protein in the surface of kidney cells. This can help in the early detection of both diabetic retinopathy and nephropathy. Also, a Greek researcher, Iphigenia Economopoulos, was in charge of a group of scientists that manage to create, in vitro, pancreatic and liver cells from embryonic skin cells. Most promising!
My main goal in life is to educate people about diabetes and create awareness about its complications, so I created my blog called The Essence of Life. For the past 6 years, I support diabetics in my country by blogging about my life. Since I was a child, I have written short stories and a few of them are even published in Greek newspapers! I focus my work on people who are dealing with diabetes, cancer or depression. I hope to help people with how they cope in everyday life.
Lena, thank you for sharing your story! And we think the PWDs of Greece are lucky to have someone as passionate and caring as you in their community.