Wil Dubois

Hey, All -- if you've got questions about life with diabetes, then you've come to the right place! That's our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1 and diabetes author  Wil Dubois.

This week, Wil is fielding a cry for help regarding insulin. Times are tough and Wil, who has many years' experience working with PWDs (people with diabetes) as a clinical specialist, can provide some helpful tips, we hope.

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

 

Kathi, type 2 from Oregon, writes: I have been a diabetic for over 20 years and have progressed from pills to insulin. I take 42 units a night. I lost my job in a Reduction in Force in June. I’m running out of insulin and recently decreased my dose to 38 units to make it last. Over the past week I’ve had to take it down to taking my insulin every other day. I will be out by the end of the week and my blood sugars are running between 400-500. I do not know what to do because not only can I not afford hundreds of dollars for my insulin, but I also cannot afford to even go to my doctor to see if there is anything else I can do. Do you have any advice?

Wil@Ask D’Mine answers: Call your doctor’s office. Right now. Ask to talk to the nurse. Tell her what’s going on. Stay calm, be polite, but make sure that she understands that you simply cannot afford the office visit right now. Tell her what happened with the job and your insurance. Give her your blood sugar readings. Tell her you need her help.

Rather than let you die—which you might otherwise—your doc will likely prescribe NPH insulin, which is very cheap. It should be less than $15 at Wal-Mart. If your sugars get much higher though, you need to go to the Emergency Room. They will give you insulin, but not much, and then you’ll be stuck with a huge bill—which is not going to help your situation much.

That said, it still beats the hell out of death.

A Word About NPH

I’m the first to admit it: NPH ain’t great. You’ll need to take it twice a day. It’s slow to work and it has a nasty peak in the center of its action curve. That means you’ll need to spend some serious time thinking about when you take it and how you time your meals. You’ll need to test your blood sugar more while you get the hang of it, and that’s expensive, too. But it will get you safely out of those 400-500 blood sugars.

Other Options

Working with the doc you’ve worked with for years is always the first, best choice. But if for whatever reason your doc is a heartless SOB who’s only concerned with his Beemer payments and tee time—and luckily these kinds of docs are exceedingly rare—then your next best option is to turn to a community health center.

Community health centers are non-profit clinics that have a wide variety of programs, and their fees are based on what you can afford to pay, which in your case would be nothing. That link up above takes you to a cool health center finder at the Health and Human services website. Trust me. There will be one near you. At least for a little while, because in this changing political climate, I can’t say how long these outfits will continue to be funded.

But for today it’s an option.

And, of course, while you are working all these angles out—or nearly out—of insulin, you need to eat as low-carb as humanly possible. This is emergency medicine. You need to live on hamburger meat alone, and don’t even think about ketchup. With no insulin, you can’t afford any sort of sugar coming into your body.

Help from the Big Bad Wolf

Now believe it or not, it’s possible to get help from big, bad Pharma. All of the makers of insulin have “patient assistance” programs that will literally give insulin to people in need. For free. Some companies will even ship it right to you. Others send it to a local clinic where you can pick it up.

The only bad thing about the assistance programs is that it takes some time to work through the paperwork involved, so this isn’t a solution for your current predicament, but it could be an excellent solution for you in the longer term.

Here’s the link for Lantus. For other readers facing similar issues, here are the links for Novo products and for Lilly products.

Speaking of paperwork, as you’ve lost your job and your insurance, you may qualify for Medicaid, which is still the best insurance in the nation. Go meet with the folks at your state Medicaid office and get the process started.

Never Give Up...

I have this crazy repeating nightmare. I turn on the TV and well-dressed insane people in high places are calmly talking about putting 20 million Americans at risk of dying while making it sound like the noble thing to do. Then I realize: It may be a nightmare, but I’m fully awake and it’s all true.

There are dark times ahead. Whether or not the Affordable Care Act gets axed, it does have real problems. I just got a note from my insurance company telling me that my “affordable” premiums are going up between 30 and 49 percent (depending on the plan) next year. Are you kidding me? I can barely afford the damn premiums and copays as it is, and now I have to come up with an extra $425 every month?

That still puts me in a better boat than you are. I fully understand that. My point is that there are a lot of people who are getting squeezed to death in one way or another by this economic kraken, this modern American disgrace we call health “care.” Some people are losing insurance, others can’t afford to keep it, still others can’t afford to use it.

But here’s the thing: We can’t fight back, we can’t make our voices heard, if we are dead. Or too sick to put up a good resistance. So the one thing none of us can ever afford to do is to cut back on our meds to try to save money or try to make them last longer. Please don’t take that as an insult. Your back was up against the wall and you did what you felt you had to do. But for the rest of you readers who might be facing the same situation, that is NOT the solution.

Instead, prepare early. Talk to your doctor’s nurse. Find a health center. Apply for patient assistance right away. See if you qualify for Medicaid. Or go rob a bank. Oh. Wait. Don’t do that, I got carried away.

But find help before that last vial of life-saving liquid starts running out.

 

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.
Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

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.