Unexpected Diabetes Hurdles

Living with type 1 diabetes is hard enough and for Abby Wirth it can be even more difficult because she is allergic to the adhesive on the diabetic pumps.

“I would get these big welts on my body so it forced me to use the Freestyle Libre sensor," said Abby. The sensor automatically tells her what her blood sugar is but it doesn’t alert Abby when her blood sugar is dropping like adhesive pumps from Dexcom or Medtronic.

This is extremely problematic because if Abby's blood sugar drops unexpectedly in the middle of the night, that alert system could save her life.

“A hypoallergenic adhesive on the diabetic pump would really help,” she said.

Abby, diagnosed with the disease when she was just 3 years old, faces another defect with the sensor.

“The pharmacy and insurance companies will only cover three Freestyle Libre sensors for a month. It’s supposed to stay latched on to your arm for 10 days, but Abby says the most it’s stayed on is 6 days.

“You think it would be perfect because 3 sensors a month is supposed to last 30 days, but I live a very active lifestyle going to the gym every day and I take two showers in a day, and so sometimes insertion isn’t always perfect. There’s definitely been days where I go without it, which is life-threatening to me,” said Wirth.

The rising costs of diabetic supplies is also an extreme concern, especially as she ages out of being under her mother's insurance plan.

"I have Blue Cross Blue Shield in Connecticut but I age out of that at 26 so I have 6 months to find health insurance."

Cost of supplies is a massive issue that Abby and many others are facing. The American Diabetes Association released new research in March 2018 estimating the total costs of diagnosed diabetes rose to $327 billion in 2017 from $245 billion in 2012, when the cost was last examined. This figure represents a 26 percent increase over a five-year period.

“If an insurance plan deals with the high cost of diabetic medications the same way they deal with oncology drugs, they would institute prior authorization requiring step therapy, to force the use of lower cost drugs before resorting to the high cost medications,” said oncologist Philip Dien, MD

For Abby, being on injections is much more cost effective.

“The higher cost drugs are almost laughable because the synthetic insulin has been out for almost 30 years, and even the cheaper insulin is at least $800 a month. Then you have the needle caps, the syringes themselves, testing supplies for blood sugars, meters , strips, and pump samples if you’re on a pump."

Since diabetes is an autoimmune disease that affects the entire body, Abby has to see multiple doctors, an eye doctor twice a year and an endocrinologist every 3 months, but she's lucky in one way. “My endocrinologist will sit with me for 45 minutes and talk to me, while some of my friends with diabetes barely get 10 minutes....with an illness that fluctuates you need someone who can lead you down the right path. You try to do everything you can with this illness and you still end up with high and low blood sugars.”

Abby has to use a lot of supplies to maintain her blood sugar several times a day.

“I always check it before any food goes into my body, and after I wake up; 8-10 times a day is an average amount," she said. But if you think about testing supplies in quantities of ten strips a day, the cost adds up. The biggest box is 100 strips, so that's $200 depending on what meter you have, which equals three boxes a month for about $600. That’s $600 a month just for the strips,” she says.

Diabetes has passed cancer as the most expensive disease for chronic illness at $15-18,000 a year.

“The newer drugs are very expensive and they have a price tag, but every patient doesn’t need to start on the new top of the line drug...that’s not necessary,” said Paola Sandroni MD, PhD, a professor of neurology and the practice chair at the Mayo Clinic in Rochester, MN.

For Abby and others like her, the physical and financial challenges in some ways put a strain on mental health too. “I was fortunate to be diagnosed so young so it didn't abruptly change my life but on the other hand it’s not only hard physically, it’s hard mentally. Diabetes is a huge mental battle every day. There’s a higher chance of getting depression. you have these other illnesses where the doctor treats you and you’re better, but diabetes is a minute by minute disease."

-Erin O'Donnell