The State of Diabetes

The French author, Jean-Baptiste Alphonse Karr is credited with saying:

 plus ça change, plus c’est la même chose”

which when translated means “the more things change the more they stay the same”.  This phrase lends itself very well to describing the state of diabetes, research, treatment and prevention.  Last week was my 39th Diaversary. Today, as I write this post, I am 50 years and 13 hours old.  My world changed 6 days before my 11th birthday. For most intents and purposes, my perspective has mostly been about having diabetes, day in and day out. Like the shampoo bottles say “Lather. Rinse. Repeat.”

When I was diagnosed things were a lot simpler than they are now.  Please allow me to hit the highlights below:

Available Insulin in 1979
Short Acting Intermediate Acting Long Acting
 Regular – Beef  NPH – Beef  Lente – Beef
 Regular – Pork  NPH – Pork  Lente – Pork
 Regular – Beef/Pork  NPH – Beef/Pork  Lente – Beef/Pork

Recognize any of these? They don’t exist any longer. You can still find their cousin the rDNA biosynthetic human based insulins like Humulin or Novolin. The options were slim and there were only two major manufacturers in the game, Eli Lilly and NovoNordisk.

My parents had top of the line insurance and at that time I wasn’t concerned with the cost of the insulin. I know that even in the scope of things, the insulin was not astronomical in price.  I used “R” and “N” combined. I don’t think I used more than a bottle of each in a month. I remember, as a teen going to the pharmacy and getting my insulin, and the whole thing cost less than $20.

Eli Lilly Pork insulin, NPH

Let’s fast forward to today. My Humalog Kwik pen , 30 day supply, retails for $2,086.09. My Tujeo is $916.59 for thirty days.  My  co-pay is $40 for each. I haven’t purchased needles or pen tip in several years because I inherited over 500 tips a couple of years ago, and I re-use them until they can’t be used. (Don’t shake your head. You know what I am saying.) If insulin was the ONLY medication I used, and I did not test, my monthly expenditure would be $3002.68.  I have been unemployed and had to pay out of pocket before getting assistance.

Back to 1979.  I believe that I was sent home from the hospital with a U-100, 1cc 25G 5/8″ disposable insulin syringe. There was one BIG manufacturer of insulin syringes, Becton-Dickinson (BD).  They had the insulin syringe market wrapped up. Terumo and Monoject were in the race but were happy to have the hospital syringe market.  BD had a quality syringe.  I remember having to inject at a 45° to make sure the insulin was delivered into the subcutaneous layer and not muscle. Now the needles are 30-31 Guage and so short they are referred to as ‘shorts’ or ‘nano’. No longer do you need to inject at 45°. Perpendicular all day long!

Monoject Syringe and needle with rigid pack.

Part of my luggage, coming home from the hospital, included the ever popular Clinitest home chemistry set and it’s little brother the Acetest Ketone Test Kit:

Clinitest Urine GLucose Test Kit and the Acetest Ketone Urine Test Kit


My doctor also wanted to know the volume every time I urinated. So, I also had a graduated pitcher, in the bathroom, along with my marble notebook, to document it all.  Going to the bathroom took 10 minutes sometimes! This was part and parcel for me for several years.

Eventually, The home self-blood glucose meter (SBGM) became “affordable”. I remember my parents saying that my meter was roughly $300. That is the equivalent of $770 today.  I do not think that insurance covered it at the time. I may be wrong. What did I know? I was a teenager.  What I do remember growing up was that deciding on which meter to use was never a question of coverage.  I picked a meter system and insurance paid for it.  Fast forward to today.  I know in my plan, I have the choice of any of the OneTouch meters. Period.  And even then they restrict the number of test strips I can use in a month. When I was a telephonic disease management nurse my patients used to ask me “What is the best meter I should get?”  My answer was always the same, “Let’s look and see what your plan will cover. That will be the best one for you.” A little bit of trivia for you: The “Accu-Chek” meter, by Roche, is the clinical name for requesting a blood sugar value, whether from a vein or a fingertip. “Get an Accu-Chek on Mrs. Jones.” Regardless of the meter being used. The same as when you are making a photocopy you say you are making a Xerox despite the machine being another brand.

There is been a petition and campaign circulating called “Coverage2Control”. The JDRF started the campaign which targets these three factors:

“1) keeping out-of-pocket costs for insulin and diabetes management tools predictable and reasonable, 2) giving people the freedom to choose the insulin pump that’s right for them; and 3) covering all life-saving technology, including artificial pancreas systems.”

You can read the entire message from JDRF here.

We are still taking insulin.  Now it costs a whole heck of a lot more!

We are still testing. Now the supplies cost a whole heck of a lot more!

We have a lot of products available on the market to help manage our condition. Unfortunately, the insurance industry prevents us from being able to have the choice to use the products that will work best for us, not just the products that have the highest profit margin for the insurance company. Again, to do your best it costs a whole heck of a lot more!

The more things change. The more they stay the same!

You get the picture!


Stay safe. Do good!


Tim, aka The DiabetesDude



What do these things have in common?

Can you tell me what the common denominator is in the four items listed below:

  1. Your Amazon Prime membership
  2. A membership to the local gym
  3. A subscription to your favorite magazine
  4. Renewed funding for the Special Diabetes Program-Type 1

Got your answer?

I hope that you said all these things require that you renew them, after consideration.  Do you really use your Prime membership enough to justify the $99/year?  Do you really go to the gym frequently enough to justify the monthly fee?  How many of those magazines are still sitting in a pile, never having been read? Lastly, Have all the cases of Type 1 diabetes been cured and no more people will ever suffer from it again?

I really think that this is a no-brainer. Maybe I am wrong?  In 2015 Congress reauthorized the funding for the Special Diabetes Program for Indians (SDPI), which includes the Special Diabetes Program-Type 1, for 2 years. The quote below is from the American Diabetes Association Website,

“The American Diabetes Association has long been a leader and partner in efforts to increase the federal commitment to cure and prevent diabetes and to address the diabetes epidemic in disproportionately impacted populations. Since 1997, a key component of these efforts has been the Special Diabetes Program for Indians (SDPI) at the Indian Health Service (IHS) and the Special Statutory Funding Program for Type 1 Diabetes Research (SDP-type1) at the National Institutes of Health (NIH). These two programs represent a significant contribution from the federal government to combat, prevent and cure diabetes. Both of these vital programs require periodic Congressional re-authorization.”

The Bill (S.747) (H.R. 2545) to reauthorize the program for 2 more years was introduced to Congress on March 28, 2017. The 2015 Bill would expire on September 30, 2017.  The funding was extended to December 31, 2017. Congress had to think about it before giving it a thumbs up for 2 more years. Now, there are two thoughts that run through my mind:

  1. Congress being the omniscient legislators that they are, know something that we don’t. Perhaps they know that a cure is finally sitting in a research lab somewhere that needs until New Year’s Ever of 2017 to gestate and on January 1, 2018 there will be no more need for funding because the cure and preventative measures will roll out to the world, finally ridding the globe of this insidious disease.  I mean, every newly diagnosed PWD has been told “In 10 years we will have a cure for you and you will never have to worry about it again!”
  2. The other thought is that not one member in the Senate or the House of Representatives either has diabetes or has a relative with diabetes, so they really are not impacted, directly or indirectly, by the effects of this disease, including emotional, psychological, physical and let’s not forget financial.  It is damn expensive to be able to afford to stay alive!

Congress approves and earmarks millions and billions of dollars a year for programs, studies and grants that are unnecessary and sometimes outright ridiculous.  You can do the research on your own – I found too many examples to include,  None of which included a study or program that involved saving the world population from a deadly disease – at this point it could be any disease, not just diabetes. Not ONE!  But congress funded a production of Hamlet, in a field, in New York. The characters were all played by DOGS! What?!?!?! (I had to throw this one in because it was just so out there.)

Get your act together Congress!  You were elected by the people of your state, to represent them and create and pass legislation that will benefit, protect and hopefully enhance their lives. We have to start with the basic needs. Until everyone across this place we call the United States of America has enough food to eat, a safe place to sleep, a way to earn an adequate income and last but not least, affordable access to health care to allow them to maintain their ability to live and breathe. Until then, forget about the non-essential requests that come across your desk. Renewing the Special Diabetes Program for Indians & the Special Diabetes Program – Type 1 should not be an option. It should exist in perpetuity until there is both a way to prevent it AND cure those who already suffer from it!

As a constituent, human being, PWD or a loved one of a PWD, here is how YOU can help:

Tell your elected representative(s) in Congress to support the SDP on January 19th, 2018.   Then share it with your friends and family, Instagram, Twitter, FaceBook, anyway you can get this out there.  Remind your representative in Washington that they are elected and may be replaced by someone who SUPPORTS the SDP!


Thanks for stopping by. I hope you got something out of this rant. If you did let me know in the comments. Follow me because I have plenty more to come. Tell someone you know to stop by. Maybe they will like it too.  I you didn’t like it – leave me a comment. I am always open to other ideas.

Stay safe. Do good!


Tim aka “The DiabetesDude”