I don’t think this is how efficient markets are supposed to work.
this is a long post, and i apologize greatly for it, but please read, coming from a type one diabetic herself.
i feel like a lot of people aren’t grasping the severity of this situation. some people, by no fault of their own but because of a lack of education, believe that type one and type two diabetes are interchangeable. they are not. some type two diabetics need insulin, and some other type twos do not need insulin. this is because type two is essentially insulin resistance, where your body overproduces insulin to accommodate for a carb heavy or sugar heavy diet, so the body builds a resistance to it or it loses its effectiveness. the pancreas can still be pushing out insulin, it’s just not as effective. sometimes all type twos need is to moderate their diet and exercise, some may need to do that in conjugation with insulin. that’s type TWO.
type one is the complete lack of the production of insulin. the immune system attacks the insulin making beta cells and insulin production STOPS. it stops completely. some type one diabetics can experience what we call a “honeymoon phase” where the body is still spitting some insulin out, but not nearly enough. the honeymoon phase doesn’t last forever. when the honeymoon phase is over the body NO LONGER PRODUCES INSULIN. full stop. no more. adios, insulin. therefore, type one diabetics NEED insulin to survive. we can help keep our numbers in range with diet and exercise, but that is not enough. we need insulin.
to give an example of how much insulin a type one diabetic needs, let’s look at my intake. i use only humalog, a short acting insulin because i use it in my insulin pump. other type ones who don’t use pumps and some who do, also use a long acting insulin. before i got my pump, i used the long acting insulin lantus. long acting insulin is taken once every 24 hours. short acting insulin is used several times throughout the day depending on carb intake and blood glucose levels. in my insulin pump (the omni pod if anyone is curious) i put in about 280 units of humalog. these 280 units will get me through only THREE DAYS. why 3 days? because that’s how long the battery on my type of pump lasts (it’s a tubeless pump so batteries can’t be replaced like with other pumps like medtronic or t-slim). now, assuming i have a perfect blood sugar all day (i wish) and i don’t eat anything so i don’t get any insulin to cover my carbs, i will still go through 22.3 units of insulin in a day. that’s because i get a certain amount of insulin per hour to keep my levels where they should be. if you’re not a diabetic, your body does that automatically to cope with blood sugar changes that can be caused by almost anything: stress, exercise, menstrual cycles, even the fucking weather can affect absorption. so i get at least 22.3 units a day. now let’s look at my correction factor. this factor tells me how much insulin to give myself when i’m over range, or hyperglycemia. my factor changes depending on the time of day, ranging from 30-55. so let’s say my blood sugar is 300, i subtract 120 from that (120 is the upper level of my range) and divide by 55 or 30 depending on the time. let’s divide by 30 just so we use the maximum amount of insulin. that comes out to 6 units to correct my high. it’s hard to stay in ranger especially with school and work and other stressors and life in general, so sometimes i correct a lot. now let’s look at my carb ratio. mine is 5 to 1, which is relatively low, actually. that means for every 5 carbs, i get one unit of insulin. so let’s say i’m eating 25 carbs, that’s five units. add on my high blood sugar and that brings me to 11 units. 11 units of insulin for what could be a snack (large apples can be anywhere between 20-30 carbs, i do a lot of guesswork but i’m usually pretty good at it). add all this insulin up and the fluctuations of my levels and the meals i eat and my ratios, and i usually average around 280 units for three days. my bottle of humalog has 1,000 units in it. so i can get about 3 pump changes out of that. i change my pump every three days as the battery dies, so that’s 9 days for one bottle of insulin. that’s about 3 bottles (3,000 units) of insulin for 27 days. we’re not counting in pump failures (due to the design of my pump i can’t pull insulin back out of it to reuse like i use to with my old one). so about 3 bottles of insulin a month. i’ve seen people quote insulin at about $675 a bottle. that may be on the high end but let’s go with it. thats $2,025 a month for insulin. without insurance.
i’m lucky. i’m young, only 19, so still on my parents insurance and my dad has a great job so insurance covers most of the cost. let’s say i’m not lucky anymore. i don’t have a job, my parents can’t support me, and i need insulin. if that were happen to me right now, i would not even be able to afford one months supply of insulin. now let’s say i do have a job paying minimum wage (where i’m from, 8.50 for non tipping and 4.85 for tipping), but the insurance i get through my work doesn’t cover insulin. i still need to pay rent, utilities, and buy food. i need gas in my car, i need emergency funds, and i need other types of insurance (renters, auto, dental, what have you). i wouldn’t be able to afford insulin. i wouldn’t be able to afford the thing i depend on most to live.
there are consequences to not controlling your diabetes, including but not limited to: blindness, loss of limbs, DKA, and death. there was a boy on my street before i was diagnosed. he went three days without insulin while on a trip and he died. he was 14. we cannot ration our insulin. we shouldn’t have to decide whether we should eat or save that insulin for a dangerous high that could come later.
do you understand now? do you understand why the rising price of insulin can have deadly consequences? i’m lucky. i am so terribly, terribly lucky. i’m on my parents insurance until i’m 26. that gives me seven years to finish school and find a job with insurance that covers my insulin costs. i have time. and even if i can’t find a job with good insurance, i’m lucky to have parents who saved well and care for me to help me out. some others aren’t as lucky for me. i know this was a long read, but i think it’s important people understand what can happen. we need insulin to survive. it’s not optional. it’s not like vitamins we can just stop taking. we can’t just stop eating, we can’t ration our insulin. lower the price of insulin, or there will be more deaths from a manageable disease. if i ahd been born 150 years ago, i wouldn’t have lived past 11. if i was born 150 years in the future, maybe i wouldn’t have made past 11 either.