Strength in numbers

Its that time of the year again…pre-budget time in Newfoundland and Labrador.  This means that its our opportunity to try and convince the current provincial government that money spent on insulin pump therapy now will save them money in both the short and long term.

Newfoundland and Labrador is one of the better places to live in if you have diabetes. They cover insulin pumps for those people with Type 1 diabetes who are under the age of 25. This is better than those people living in Alberta who have no provincial coverage but is not as good as those living in Ontario. 

Each year, I have worked to see this change. First to see pumps covered at all, then accepting the increase to 25 and now…well I am done with crumbs and I want the entire cookie for people with diabetes in this province!

I have spent the past few weeks researching and reading.  I took that information and spelled out exactly why we need the insulin pump program expanded to include all people with diabetes and continuous glucose monitors. 

Sadly the government only cares so much about the quality of life issues.  They only care so much about how much easier it will make your life.  Their main concern is how much it will cost them. They want bottom line so this year I gave it to them.

With the help of some great studies, I was able to show the cost of less than optimal control on the health care system. I was able to show them the dollar value of a person working versus someone who has had to leave the workforce because of diabetes related complications. I showed how money was saved and funds could be re-routed by adopting a more expansive program.

I am only one person though. I have shared the document with a group of people who want to see change. I have shared it with other people that I felt would be interested in seeing this happen. I have asked these people to share with their families and friends.  Every person who shares this plea with the provincial government brings us that much closer to seeing real change. Never doubt the value of public pressure…even when the government is crying broke.

If you live in Newfoundland and Labrador, or know someone who does, please send your own letter or email me for a copy of the letter that I have sent. There truly is strength in numbers.  Together we can make a difference! but hurry! The submission deadline is February 13th.  

Dear Government

Those of us in the Diabetes Community are quite well aware that November is Diabetes Awareness Month. For years, I have found something new and unique to do each year.  I have sent out general information letters to everyone I could think of, I created a book of the faces of diabetes with real people and their real stories, I have gotten a tattoo, and much more.  This year I decided that November was the perfect time to get back to a focus that is very dear to my heart–advocating for increased access to devices and supplies for people with diabetes.

November is a great time to do this because of course its Diabetes Awareness Month, but it is also the month after our new government formed and a time when they are beginning to plan for the spring budget.  I wanted politicians in my province to be thinking diabetes before they sat down to spend my money.  The following is the letter that I will be sending out to all Members of the House of Assembly.  If you live Newfoundland and Labrador, I would ask that you copy this letter and send it to the Minister of Health, the Finance Minister and your MHA (if you have a newly elected MHA, their contact can be found on their party websites).  I would then ask that you copy it and send it to your friends and have them do the same.  Public pressure works and we need to change this program. If you don’t live in Newfoundland and Labrador, please feel free to copy this letter and tailor it to your own needs. While a cure is ideal, until it is found our loved ones deserve access to the best equipment out there to keep them alive!

November is Diabetes Awareness Month.  There are now almost 3 million Canadians living with diabetes.  Approximately 10% of those are living with Type 1 diabetes, an autoimmune disease that attacks the insulin producing cells of the body leaving the victim reliant on an external source of insulin to live.  A person without insulin is like a car without gas, their bodies cannot function and they will die.

In Newfoundland and Labrador, people living with Type 1 diabetes currently are able to receive their insulin through the best available delivery system—an insulin pump.  This small life sustaining unit allows the user to pre-program their insulin needs into a computer which will then delivers the insulin to its user at specific, minute amounts throughout the day and with meals or to combat high blood sugar levels.  When a person with Type 1 diabetes reaches 25 in this province, they must either have the financial resources to pay the extra $5500 per year for an insulin pump and supplies or go back to a less reliable method of insulin delivery through injections. We hope that soon the government of Newfoundland and Labrador will see fit to change this and join Ontario in extending its pump program coverage to all of their residents with Type 1 diabetes who do not have private health insurance regardless of age.

Despite the advances in technology and the availability of insulin pump therapy to manage Type 1 diabetes, on November 2, 2011 the American Juvenile Diabetes Research Foundation publicly noted that one in twenty people living with Type 1 diabetes will die because of a low blood glucose level (this occurs when there is too much insulin in their body and not enough sugar).  This number is unacceptable.  In a technologically advanced society such as ours it is also unnecessary.  Beyond the incredible emotional strain that this threat puts on families and people living with diabetes, such a high mortality rate also has a large financial impact in provinces such as Newfoundland and Labrador which have exceptionally high incidences of this disease. 

This number can be changed.  A cure is the most glaring way to “fix” this problem.  A cure would eliminate the need for government funding of insulin pumps and subsequent spending on diabetes related complications.  Many great organizations throughout the world, including the Diabetes Research Institute work solely on this mandate. 

Until a cure is found, another way to reduce the number of low blood glucose related deaths is to provide real access to the technology that is available which would protect all people living with diabetes.  Recent advances in pump technology offer suspended insulin delivery when a person is already low and non-responsive as well as Continuous Glucose Monitors (CGM) which “speak” to the insulin pump.  A CGM is a computerized device worn by a person with Type 1 diabetes that monitors the trends in blood glucose levels. It tells its user when they are in danger of having their blood glucose rise or fall.  These predictions help to maintain a stable blood glucose level which reduces long term complications. The alarms also help to ward off dangerous lows that will render the person with Type 1 Diabetes unresponsive or dead.

According to a 2009 Canadian Diabetes Association report on the economic costs of diabetes in Canada, the indirect cost of diabetes related illnesses and death was approximately $8 million in 2010 and another $3.1 million in direct cost. Those living with Type 1 diabetes are responsible for 40% of these costs. The funding of insulin pumps and continuous glucose monitoring can dramatically reduce this economic burden. Insulin pumps have been shown to significantly reduce hospital visits by people with diabetes. 

As November is Diabetes Awareness month, I would invite this government to learn the facts about Type 1 diabetes.   This is a silent killer that is claiming one in twenty people as its victims on a regular basis (after drafting this letter we learned of yet another young person who died because of hypoglycemia during the night of November 9th). This number can be changed. It has to be changed.

With proper tools, education and awareness, people of all ages with Type 1 diabetes can live to be productive healthy members of our society. I would ask that you review the provincial insulin pump program and look to expand coverage to cover all people who live with Type 1 diabetes who do not have private insurance for both insulin pumps and continuous glucose monitors regardless of their age.
Barb Wagstaff
(mother to a 14 year old with Type 1 diabetes, diagnosed March 2000 age 2)