Nova Scotia Government is Scrooge for those with Diabetes

After the announcement earlier this month  by the Saskatchewan government that they would be expanding their coverage of diabetes devices and supplies, Nova Scotia has sadly announced this week that they will not cover insulin pumps for residents of any age. I have to admit that I remain very shocked and disappointed by this announcement.

I have met a number of people who have worked hard in Nova Scotia for a lot of years to see improved access to devices and supplies in that province. I am surprised that their efforts continue to go for not.

When Nova Scotia elected an NDP government, I thought that a pump program would be guaranteed.  My knowledge of politics is minimal. I have no political affiliation or loyalty. I vote for you if I like you and think that you are actually doing your job.  Its that simple for me.  I also have a very limited idea of the basic principals behind of most political parties.  In Grade 10 social studies I was taught that the Liberals are “liberal” and believe in social programming.  The Conservatives are not as interested in social spending and believe you should make it on your own merit.  The NDP are far right and thus believe even more in social responsibility that the liberals.  That was how I saw it. 

It was because of this view that I felt that an NDP government in Nova Scotia would ensure improved health care.  They were about social responsibility right? They believed in helping those less fortunate or those who cannot afford the best medical treatment, weren’t they? I guess not.

This scare me.  I am not concerned with the fact that my general view of  political parties is obviously off but I am concerned with a government that has just said NO.  If our socialized health care is not a priority for a social party what hope do we have? If they will not help out those who cannot afford to avail of the latest technological advances and best medicines, then what will happen when devices like the Artificial Pancreas are developed? We will be living in a very two tiered system. Perhaps we already are. Those who can afford to quality care for themselves or their loves ones will get it. Those who can’t don’t and won’t. That is disturbing.

What happens in those families with more than one person with diabetes? How do they cope without government help? How do they keep themselves healthy? I have already seen families where Mom does not test as often so that her son can have more test strips. I have seen families where a parent has to decide which child will get an insulin pump and which child will have to stay on shots because she/he cannot afford to pay for it for both. 

During the holiday season, we think of spending money on gifts. Can we afford to buy our child the latest xBox game? Have we bought them a new laptop or tablet to put under the tree? Should we buy our loved one a new iPhone? The list goes on but for many living with diabetes, one xBox game is equal to a box of 100 test strips.  A tablet would cover a month’s worth of pump supplies.  An iPhone may be the same price as a CGM. 

This is not the way our country is supposed to be.  This is not how Canadians should live.  This needs to be fixed.  We need governments that care.  No to medical devices and supplies is just not acceptable. We must say yes to compassion, yes to improved health, and yes to looking after those who cannot look after themselves. Access to medical devises and supplies should be a given not a budgetary issue.  Things must change.

My take on the Artificial Pancreas Project

The other night we sat in on a lecture about the Artificial Pancreas Project.  In all honesty, I have paid very little attention to this project. I heard the hub-bub when the JDRF announced that they were funding research that was not cure based.  I have seen the online petitions asking for the FDA to move the project along a lot faster. Other than that I have been fundamentally ignorant.

I have however slowly worked to educate myself whenever possible.  I had many concerns about the project and looked forward to learning and seeing if my fears were founded. Sadly I think that they are.

Dr’s. Anhalt and Krishna (his first name but his last name is far too long and complex for me) explained that the project had many levels.  They were working on simply suspending insulin during a low and ultimately reaching the point where they could truly close the loop.  Their main focus at the moment was to see a viable product on the market sooner rather than later (within 4-7 years).  The bringing together of glucometers, CGM, insulin pump technology and human intelligence was a huge obstacle.  These things work fabulously apart but bringing them together brought many new issues. To make matters more complex, regulatory bodies have never before been asked to rule on the safety of medical devices that make decisions like this one will.

For me, one of the obstacles to an Artificial Pancreas as I envisioned it was the number of sites and devices that one had to carry and use.  I asked how this was to be handled.  They stated that it was a real challenge. You cannot get down to only one site (which my son would want) because you cannot deliver insulin and measure glucose levels in the same area. They would work towards one device but felt that the loop may never truly be closed.  It was also stated that artificial intelligence would not be put into the system in the foreseeable future. 

Another issue is in the fact that sensors lag behind in what they say the blood glucose level is.  Insulin lags behind in its action time.  There is no way, at the moment to get immediate results to immediate problems. We need more accurate and timely sensors as well as faster insulins. To date there is only predictions and educated guesses.  This is very concerning to me. 

Larry voiced his concerns as well. At the moment we are talking about devices “talking” to one another.  We have so many devices that we use on a regular basis, how could we be guarenteed that they would not interfere with one another? He wondered how my son could sit in his room with his cell phone, his laptop, his XBox head set, his pump, and his CGM and not have any of it interfere with each other.  We were told that this was a real concern.  At the moment they were working to secure specific radio frequencies to ensure that there would be no interference but we still had worries.

My final concern, and the concern of many others in the room was cost.  This is a huge project.  The actual dollar figures were not available but we all knew that it was way more than what we had in our pockets. Some of the cost of the project will most likely have to be recouped in sales at a later date. Would the Artificial Pancreas then be out of reach to those who need it most? 

We were assured that the JDRF in the US was working with insurance companies so that when the product did come to market, they would cover the device.  This does not help those of us in Canada.  Our system works differently and while it is important that private insurance companies are onside with this device, it is even more important that provinces recognize its value.  Who will be working on that angle? Currently we are asking our governments to cover the pieces–pumps, glucometers, CGMs and supplies.  Will they cover the Artificial Pancreas when it comes to market? We can hope.

While there are many issues to be overcome, the project does have some positive points as well.  Moving forward with sensor technology will hopefully provide us with more and better data on blood glucose trends. This data can be used to keep A1c’s down and reduce the chance of complications.  These same sensors can ideally act as our watchdogs at night.  They can wake our children or ourselves when a blood glucose level is rising or dropping to a dangerous level. That is one thing that would help this mother sleep a lot easier at night. Now to just convince my son that this would be a far better system than him building me a room in his house!