xMenace
06-01-2007, 01:33 PM
Our provincial CBC afternoon show (think NPR in the USA) had a piece earlier this week on new tech devices that will improve our lives. One was the recently announced Biosign Technologies' non-invasive CGMS (http://www.thestar.com/living/health/article/217457). The piece was brief and it sounded positive with the host and subject being all excited and what. Of course it only got me riled. Later that night I rolled out a response and sent it in. They read it the next day, but I missed it. Several people commented on it though: "man you are expensive!" was my fav so far. Here's the text.
It was interesting to hear your discussion today on non-invasive glucose monitoring for us diabetics.
Yes this device, if it ever proves viable, will eliminate finger pricks and enable better control of our disease. But Paul, finger pricks and injections are not what makes diabetes so hard to live with. It's the blindness, loss of limbs, failed kidneys, and the heart failure that 80% of us will die from that are so devestating. I can live with 7 to 15 finger pricks a day. Writing this letter with no eyesight is a little more cumbersome. The real concern I have is will everyone be able to afford them and will they know how to use them effectively.
Similar devices do already exist. They are great tools for profiling responses to food, insulin, and exercise. They are especially useful for for profiling middle of the night behavior and for warning you when you are in danger. But most diabetics don't know how to profile their diabetes. One of the causes I believe are our diabetic caregivers, doctors and diabetic educators who are stuck in a rut. Their standard advice is test before and two hours after meals. By doing this you can achieve good control of your disease. Next patient please! Well I and many others have found that self management is a little more complicated. One must FULLY understand the impacts of food intake, carbohydrates, protein, and fat, of glycemic index and glycemic load, of insulin dosages, timing, duration, and quantity, of both aerobic and anaerobic exercise, of metabolic patterns such as basal rates and variances, dawn phenomenon, and rebounding tendancies, of the impacts of stress and illness, and of managing hypoglycemic unawareness. There is so much to know and so few competent educators or advisors working in the system. The current educators do what they can, but they are swamped by the 7% of the population that are diabetic.
Then there's the cost. One of the existing continuous monitoring systems will cost you around $700. Supplies will cost you $50 per test which is designed to last you 3 days. Most users stretch them out to a week incurring a worthwhile risk of infection. You still need to regularly calibrate them by comparing to a test from a standard glucose monitor. Regular strips are only 80 cents each.
So the $5.50 a day for regular strips doesn't sound so bad, huh? I didn't include the $100 for a two week supply of insulin or a $7000 insulin pump or $300 for my monthly pump supplies or $45 for a box of syringe tips. Yes, it's expensive to manage diabetes properly, and most can't afford the basics.
My health insurance is pretty good. They pay for all my supplies and 80% of the rest. They won't, however, pay for a continuous monitor. Blue Cross doesn't think it necessary and cost effective.
The province cares even less. Most people cannot afford even the basic supplies. The government apparently would rather we live with marginal control and suffer through our complications, dying off early to reduce their burden.
I'm sure the taxpayers don't object to my health care costs. I saw my opthamologist eight times last year. He performed laser surgery on me twice. I also visited a retinal surgeon in Halifax who performed a vitrectomy. Look that one up on google and tell me you'd enjoy that while being awake! I was also 911'd twice when my sugars dropped too low while I was sleeping. I estimate I cost the New Brunswick taxpayers about $60,000 last year and Blue Cross about $10,000. Surely to God someone can see it's cost beneficial to hand these things out and teach us how to use them properly!
Sorry for the rant.
It was interesting to hear your discussion today on non-invasive glucose monitoring for us diabetics.
Yes this device, if it ever proves viable, will eliminate finger pricks and enable better control of our disease. But Paul, finger pricks and injections are not what makes diabetes so hard to live with. It's the blindness, loss of limbs, failed kidneys, and the heart failure that 80% of us will die from that are so devestating. I can live with 7 to 15 finger pricks a day. Writing this letter with no eyesight is a little more cumbersome. The real concern I have is will everyone be able to afford them and will they know how to use them effectively.
Similar devices do already exist. They are great tools for profiling responses to food, insulin, and exercise. They are especially useful for for profiling middle of the night behavior and for warning you when you are in danger. But most diabetics don't know how to profile their diabetes. One of the causes I believe are our diabetic caregivers, doctors and diabetic educators who are stuck in a rut. Their standard advice is test before and two hours after meals. By doing this you can achieve good control of your disease. Next patient please! Well I and many others have found that self management is a little more complicated. One must FULLY understand the impacts of food intake, carbohydrates, protein, and fat, of glycemic index and glycemic load, of insulin dosages, timing, duration, and quantity, of both aerobic and anaerobic exercise, of metabolic patterns such as basal rates and variances, dawn phenomenon, and rebounding tendancies, of the impacts of stress and illness, and of managing hypoglycemic unawareness. There is so much to know and so few competent educators or advisors working in the system. The current educators do what they can, but they are swamped by the 7% of the population that are diabetic.
Then there's the cost. One of the existing continuous monitoring systems will cost you around $700. Supplies will cost you $50 per test which is designed to last you 3 days. Most users stretch them out to a week incurring a worthwhile risk of infection. You still need to regularly calibrate them by comparing to a test from a standard glucose monitor. Regular strips are only 80 cents each.
So the $5.50 a day for regular strips doesn't sound so bad, huh? I didn't include the $100 for a two week supply of insulin or a $7000 insulin pump or $300 for my monthly pump supplies or $45 for a box of syringe tips. Yes, it's expensive to manage diabetes properly, and most can't afford the basics.
My health insurance is pretty good. They pay for all my supplies and 80% of the rest. They won't, however, pay for a continuous monitor. Blue Cross doesn't think it necessary and cost effective.
The province cares even less. Most people cannot afford even the basic supplies. The government apparently would rather we live with marginal control and suffer through our complications, dying off early to reduce their burden.
I'm sure the taxpayers don't object to my health care costs. I saw my opthamologist eight times last year. He performed laser surgery on me twice. I also visited a retinal surgeon in Halifax who performed a vitrectomy. Look that one up on google and tell me you'd enjoy that while being awake! I was also 911'd twice when my sugars dropped too low while I was sleeping. I estimate I cost the New Brunswick taxpayers about $60,000 last year and Blue Cross about $10,000. Surely to God someone can see it's cost beneficial to hand these things out and teach us how to use them properly!
Sorry for the rant.