Need Help With U.S. Diabetes Supplies and Medications?

159942_2191For anyone who has diabetes, the cost of staying alive is expensive.

This is a current list of currently available programs, co-pay cards, organizations and manufacturers that may help, and the requirements to participate in the programs.

Why did I create this?

Every other “diabetes financial assistance/resource” page that I would visit would give you a link to supposed help – but you had to dig deep to find out if there were exclusions or restrictions. Some of the resource pages had links that no longer exist. Others had a single page that said: “We no longer offer a program.” (And I’m talking major diabetes organizations and manufacturers… they’re not keeping their own pages up to date…)

This page will give you the restrictions/exclusions I’ve found and the contact information and site to get yourself started if you qualify. (And in some cases, all of us will qualify!)

These links are up to date and I will be adding additional resources as they are made available. (If you have links or resources, please list them in the comment section and if they’re legitimate, I’ll add them.)

Hope this helps you.

Share it if you please – no one should be “sick” with diabetes from a lack of medication or supplies – let’s help each other by getting the word out. 

Diabetes Medications & Needles

Astra-Zeneca Prescription Savings Program

If you take BYDUREON, BYETTA, FARXIGA, KOMBIGLYZE XR, ONGLYZA, SYMLIN, XIGDUO XR, you may be eligible for free medications mailed to your home or provider. Requirements include:

  • You must be resident of the US, or have a Work Visa or Green Card.
  • You aren’t currently receiving prescription drug coverage under a private insurance or government program, or receiving any other assistance to help pay for medicine.
  • Your annual income* should be at or below:
    • $35,000 for a single person
    • $48,000 for a family of two
    • $60,000 for a family of three
    • $70,000 for a family of four
    • $80,000 for a family of five
      • *Income limits may be higher in Alaska and Hawaii

If you are a Medicare Part D Beneficiary:

  • You aren’t eligible for or enrolled in Limited Income Subsidy (LIS) for Medicare Part D

If you have experienced a life changing event in the past year, and your financial documentation does not accurately reflect your current situation, we encourage you to apply for the AZ&Me Prescription Savings Program. You may still meet the criteria to enroll. Some examples of this type of event would be:

  • Loss of employment
  • Change in income
  • Loss of, or change in, prescription drug coverage
  • Marriage
  • Change in household number

For assistance and additional information, you can call  1-800-AZandMe (292-6363).

Eli Lilly – Lilly Cares

Eli Lilly offers Glucagon, Trulicity, Cymbalta, Humalog, Humalin, and Humalog Mix under the Lilly Cares program.

  • You must be a U.S. resident. (This program is not available in Puerto Rico or the US Virgin Islands.)
  • You must not have prescription coverage.
  • You must meet the household guidelines:

Household Income Guidelines:

  • The total number of people in the household includes yourself and each of your dependents.
  • Total yearly income includes incomes from all earners in your household before taxes and deductions.
  • To qualify, your total yearly income cannot exceed the values listed below.

 

Number of People in Your Home 1 2 3 4 5 6 7 8
Total Yearly Income
(48 Contiguous States and DC)
$35,310 $47,790 $60,270 $72,750 $85,230 $97,710 $110,190 $122,670
Alaska $44,160 $59,760 $75,360 $90,960 $106,560 $122,160 $137,760 $153,360
Hawaii $40,650 $54,990 $69,330 $83,670 $98,010 $112,350 $126,690 $141,030

For additional information about Lilly Cares, call at 1-800-545-6962.

*A 120-day supply of medicine will be shipped to your health care provider’s office. Prescription refills will be available during your 1-year enrollment period.

Eli Lilly Lilly MedicareAnswers

For those individuals on Medicare, you have an option!

Eli Lilly offers Glucagon, Trulicity,  Humalog, Humalin, and Humalog Mix under the Eli Lilly LillyMedicareAnswers program.

  • You must be enrolled in a Medicare Part D prescription plan.
  • You must be denied or ineligible for Low Income Subsidy.
  • You must be a United States resident.* (This program includes Puerto Rico.)
  • You must meet the household guidelines:

Household Income Guidelines:

  • The total number of people in the household includes yourself and each of your dependents.
  • Total yearly income includes incomes from all earners in your household before taxes and deductions.
  • To qualify, your total yearly income cannot exceed the values listed below.
Number of People in Your Home 1 2 3 4 5 6 7 8
Total Yearly Income
(48 Contiguous States and DC)
$35,310 $47,790 $60,270 $72,750 $85,230 $97,710 $110,190 $122,670
Alaska $44,160 $59,760 $75,360 $90,960 $106,560 $122,160 $137,760 $153,360
Hawaii $40,650 $54,990 $69,330 $83,670 $98,010 $112,350 $126,690 $141,030

*A 90-day supply of medicine will be shipped to your home via mail order pharmacy. Prescription refills will be available during your 1-year enrollment period.

Boehringer Ingelheim Cares Patient Assistance Program

Tradjenta, Jentadueto, Jardiance, and Glyxambi are available under the BI Cares Patient Assistance Program.

  • You must be a U.S. resident ineligible for private prescription, Medicaid, or Low Income Subsidy coverage.
  • You must meet the established financial criteria, which was not posted online.
  • You must be 18 years of age or older. Please note, while people of all ages are eligible for the program, applications can be sent only to people at least 18 years of age.

Medication is shipped directly to the patient’s home.

Applications are evaluated on a case by case basis. Current application form, valid prescription, and patient’s income documentation are required.To learn more about the Boehringer Ingelheim Patient Assistance Program, please call 1-800-556-8317 or apply online at www.bipatientassistance.com.

GlaxoSmithKline

Avandia is available under the Bridges to Access Program for individuals not on Medicare.

To qualify for Bridges To Access, patients must:

  • Live in one of the 50 states, District of Columbia or Puerto Rico.
  • Have no prescription drug benefits through any insurer/payer/program.
  • Not be eligible for Medicaid or Puerto Rico’s Government Health Plan Mi Salud. Puerto Rico applicants who are financially eligible for Puerto Rico’s Government Health Plan must have documentation of denial of coverage through Mi Salud before applying to a GSK Patient Assistance Program.
  • Have gross monthly household income at or below the following:
Maximum Monthly Gross Income
Household Size 
48 states and D.C.
Alaska
Hawaii
Puerto Rico
1
$2,452.08
$3,066.67
$2,822.92
$2,000.00
2
$3,318.75
$4,150.00
$3,818.75
$2,500.00
3
$4,185.42
$5,233.33
$4,814.58
$3,000.00
4
$5,052.09
$6,316.66
$5,810.41
$3,500.00
For each additional person, add
$866.67
$1,083.33
$995.83
$500.00

You can apply by mail or fax (proof of income must be provided), or call Bridges to Access at 1-866-PATIENT (1-866-728-4368) after downloading the application.

If you are on Medicare and have a Part D prescription plan, you may be able to receive Avandia through GSK Access.

To qualify for GSK Access and enroll, you must:

  • Be enrolled in a Medicare Part D Prescription Drug Plan.
  • Have spent at least $600 on prescription medicines through their Medicare Part D Prescription Drug Plan during this calendar year.
  • Live in one of the 50 states, District of Columbia or Puerto Rico. Puerto Rico applicants who are financially eligible for Puerto Rico’s Government Health Plan must have documentation of denial of coverage through Mi Salud before applying to a GSK Patient Assistance Program.
  • Have total monthly household income at or below the following:
Maximum Monthly Gross Income
Household Size 
48 states and D.C.
Alaska
Hawaii
Puerto Rico
1
$2,452.08
$3,066.67
$2,822.92
$2,000.00
2
$3,318.75
$4,150.00
$3,818.75
$2,500.00
3
$4,185.42
$5,233.33
$4,814.58
$3,000.00
4
$5,052.09
$6,316.66
$5,810.41
$3,500.00
For each additional person, add
$866.67
$1,083.33
$995.83
$500.00

Upon initial enrollment in GSK Access and with a valid prescription on file, the first 90-day supply of GlaxoSmithKline medicine(s) will be shipped to the address provided on the application. (Some medicines are only available at a retail pharmacy. Patients will be notified if their prescription is for one of these medicines.) Medicines received from this program do not count toward True Out-of-Pocket Spending Costs (TrOOP).

Fill out this application online, download and add documentation to send or fax. If you have questions about this program, call 1-866-518-HELP.

Tanzeum Coupons, up to 12 months free.

Tanzeum, a GSK product, has a “dollars off” coupon program. Coupon program eligibility is extended to patients with or without insurance coverage with a valid signed prescription.

  • You are NOT eligible to use this coupon if you are a government beneficiary. You are a government beneficiary if you are enrolled in any federal healthcare program, including Medicaid, Medicare (Part D or otherwise), or any similar federal or state programs, including any state pharmaceutical assistance program. Further, you CANNOT use this coupon if you are Medicare eligible.

Eligible patients without insurance can receive the dollars off amount specified on the coupon. Patients with insurance can receive up to the amount for which they are responsible for the prescription, less any amounts specified on the coupon.

Invokana or Invokamet CarePath Savings Program

This program offers 12 months of prescription co-pay relief (According to Invoking CarePath’s marketing material “12 months NO COST to you” for those who have been prescribed Invokana or Invokamet.) You must have commercial insurance.

After registering, you receive a savings card that you use at your retail pharmacy. It is subject to a $4,600 annual program benefit, 12 months after activation or 12 uses, whichever comes first. It is not valid for those enrolled in Medicare Part D or Medicaid, or those enrolled in a federal or state subsidized healthcare program that covers prescription drugs such as TRICARE. The offer is only valid for new enrollment until December 31, 2016.

Johnson & Johnson Patient Assistance Program

If you do not have prescription coverage, you may be eligible to receive Invokana or Invokamet through the Johnson & Johnson Patient Assistance Program.

Requirements are:

  • You do not have public or private prescription coverage.
  • You reside in the U.S. or a U.S. territory.
  • You are being treated as an outpatient by a U.S. healthcare provider.
  • You meet annual financial eligibility criteria:
    • Single person: $23,540 annual income or less
    • Two person family: $31,860 or less
    • Larger families: income levels are adjusted “accordingly”

You can begin the application process online by clicking here or by calling 1-800-652-6227.

NovoNordisk

Novo Nordisk Patient Assistance Program (PAP) provides free medicine (to those who qualify), including: Levemir, Novolog, Novolog Mix 70/30, Novolin, GlucaGen Hypo Kit, Victoza, and disposable needles for FlexPens and Victoza. (Please be aware that all insulin is vial only; no FlexPens.)

The application for Novo Nordisk’s medication assistance program is downloadable here. 

  • There are several restrictions to the program. Please download the application and review.
  • You must be a U.S. citizen.
  • You must have a household income less than 200% of federal poverty level. 200% FPL* $47,700
  • You cannot have private prescription coverage,VA prescription benefits, any federal, state, or local program such as Medicare or Medicaid. Exceptions include patients who have entered the coverage gap (donut hole) in Medicare Part D and patients who have applied for and been denied Medicare Extra Help/Low Income Subsidy (LIS) and are Medicare eligible.

You can get more information by calling the Novo Nordisk Patient Assistance Program toll free at 866-310-7549.

If approved, a free 120-day supply of medicine will be sent to the prescribing health care providers’ office to be picked up at the patient’s convenience. Novo Nordisk will automatically contact the health care provider 90 days later to approve the medication reorder.

Merck Helps

Merck Patient Assistance Program

Merck offers a prescription assistance program for Januvia, Janumet, and Janumet XR.

  • You do not have to be a US citizen. Legal residents of the United States, including US Territories, are also eligible.
  • Your prescription for a Merck medicine from a health care provider licensed in the United States.*
  • You do not have insurance or other coverage for your prescription medicine. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, veterans assistance, or any other social service agency support.
  • You may qualify for the program if you have a household income of $47,080 or less for individuals, $63,720 or less for couples, or $97,000 or less for a family of 4.

The application for this program must be downloaded, filled out, and brought to your medical provider. Click here for the Merck Helps application.  (It is also available in Spanish.)

Individuals who don’t meet the insurance criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial and medical hardship, and their income meets the program criteria. A single application may provide for up to 1 year of medicine free of charge to eligible individuals and an individual may reapply as many times as needed.

If you have any questions about the Merck Patient Assistance Program including the status of an application, please call 1-800-727-5400, 8 AM to 8 PM EST, Monday through Friday.

There is also the ACT Program. The ACT Program provides free reimbursement support services to help answer questions related to insurance coverage and reimbursement. If you do not meet the prescription drug coverage criteria, your income meets the program criteria, and there are special circumstances of financial and medical hardship that apply to your situation, you can request that an exception be made for you. If you have any questions, the ACT Program Specialists are available 8 AM to 8 PM EST, Monday through Friday at 1-866-363-6379.

If you don’t meet the criteria, you can also try and use the “Januvia copay assistance coupon”. 

Januvia’s coupon is for “as little as $5 per prescription” for up to 12 months. Here’s the information on the restrictions and what you’d need to do. 

Pfizer

If you use Glucotrol, Glynase Prestab, Glyset, and Lyrica, Pfizer offers a discount card for individuals who have NO prescription coverage. You’ll need to call 866-706-2400 to apply. 

  • You must be prescribed a Pfizer medicine available at a savings.
  • Have no prescription coverage.
  • Live in the United States, Puerto Rico, or the U.S. Virgin Islands

They also offer free medication for uninsured individuals through some clinics and hospitals. You can see if there is one located near you by entering your zip code at this website

Lyrica Co-Pay Savings Card

Lyrica Co-pay of $25 per month up to 12 months. There are restrictions, but worth checking out and downloading. 

Sanofi Patient Connection Program

Provides Apidra, Lantus, and Toujeo at no cost to patients who meet program eligibility requirements.

Eligibility requirements include:

  • Patient must be a U.S. citizen or resident and be under the care of a licensed healthcare provider authorized to prescribe, dispense and administer medicine in the U.S.
  • Patient must have no insurance coverage or no access to the prescribed product or treatment via their insurance
  • Patient must not be eligible for Medicare or Medicaid
    • See program application for Medicare Part D eligibility criteria
  • Patient must meet the following financial criteria:
    • Annual household income of ≤250% of the current Federal Poverty Level for all non-Oncology/non-Hematology Products
Persons in family / household Poverty Guideline 2015* Maximum Annual Household Income (for uninsured or functionally uninsured patients)
250%
1 $11,770 $29,425
2 $15,930 $39,825
3 $20,090 $50,225
4 $24,250 $60,625
5 $28,410 $71,025
6 $32,570 $81,425
7 $36,730 $91,825
8 $40,890 $102,225
For families / households with more than 8 persons, add $4,160 for each individual person All products except Oncology / Hematology

Sanofi- Apidra

Those who take Apidra can use the Apidra® No Co-Pay Savings Program with their Apidra® prescription payments. Activate your card by checking this box and you can get No Co-Pay* on Apidra®. If you’re registering someone under the age of 18, please call 855-242-6938.

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible, even those with insurance that places Apidra® on the 3rd tier.
  • Cash-paying patients are also eligible for a benefit of up to $100 off per prescription.

Sanofi – Lantus

Sanofi offers a discount card for those who use Lantus SoloStar – pay no more than $25 for up to 3 prescriptions. (Maximum $100 benefit off of each prescription, for up to $300 for three prescriptions.)

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible.

Sanofi- Toujeo

Pay no more than $15 for the 12 months after activating the savings program. (Maximum benefit is $400 off per prescription depending on your out of pocket costs.)

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible.

 

Patient Access Network Foundation

The Patient Access Network (PAN) Foundation, an independent, national 501 (c)(3) organization dedicated to providing underinsured patients with co-payment assistance through more than 60 disease-specific programs that give them access to the treatments they need.

Diabetic Foot Ulcers

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must treat the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 400% of the Federal Poverty Level. (Here’s the handy chart showing you what that is based on how many people are in your household.)

Diabetic Macular Edema

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

Kidney Transplant Immunosuppressants 

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

Solid Organ Transplant Immunosuppressant Therapy

This will cover pancreas transplants and kidney-pancreas transplants.

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must treat the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 400% of the Federal Poverty Level. (Here’s the handy chart showing you what that is based on how many people are in your household.)

Retinal Vein Occlusion (RVO)

From the Patient Access Network Foundation website:

Central and branch retinal vein occulusions (RVO) happen when the vein at the back of the eye is blocked. This blockage causes pressure build and some of the small blood vessels in the eye may burst and cause fluid to leak into the retina. If untreated the vessels may be able to repair themselves and bypass the blockage but there may be permanent damage to the retina resulting in vision loss. 

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

 

Healthwell Foundation

For children under eighteen years of age

HealthWell Pediatric Assistance Fund® assists children 18 years old or younger living with a chronic or life-altering condition that their families are struggling to treat due to cost. They provide financial assistance to families so their children can start or continue critical medical treatments, including diabetes.

Families must meet HealthWell’s standard income and insurance eligibility criteria to qualify for a grant. Grants are awarded on a case by case basis. To apply for a grant, call 1-800-675-8416 anytime Monday through Friday, 9:00 a.m. to 5:00 p.m. (ET).

  • You must have some form of health insurance (major medical or prescription drug) that covers part of the cost of your medication.
  • Families with incomes up to 400 percent of the Federal Poverty Level may qualify. HealthWell also considers the cost of living in a particular city or state.
  • If you appear to be eligible for assistance through the Pediatric Assistance Fund, additional information and documentation is required for review and consideration prior to grant approval. Once all information has been received and reviewed by the committee, grant determinations will be made.
  • You will be asked to provide the Foundation with the patient’s diagnosis, which must be verified by a physician, nurse practitioner, or physician assistant’s signature. The patient must receive treatment in the United States.

Immunosuppressive Treatment for Solid Organ Transplant Recipients

HealthWell will pay for the following medications for immunosuppressive therapy:

Astagraf XL, Cellcept, Gengraf, Hecoria, Imuran, Myfortic, Neoral, Nulojix, Prograf, Rapamune, Sandimmune, and Zortress.

  • You must have some form of health insurance (major medical or prescription drug) that covers part of the cost of your medication.
  • Families with incomes up to 400 percent of the Federal Poverty Level may qualify. HealthWell also considers the cost of living in a particular city or state.

You can apply online for this medication grant here.  or call 800-675-8416. Agents are available Monday–Friday 9am–5pm EST.

Insulin Pumps

Medtronic MiniMed

The Medtronic Financial Assistance Program offers help to those who:

  • Use an insulin pump and/or continuous glucose monitoring
  • Meet specific income guidelines
  • Have an insurance company that allows for additional assistance

It also provides temporary coverage for specific situations:

  • Unemployment within the last 12 months
  • Gap in insurance coverage because of a pre-existing condition
  • Multiple pumpers in one household
  • Permanent disability

You’ll need to call Medtronic 1-800-646-4633 and select option 4 to get specific information.

Other pump companies offer self-funding payment programs. You should call them individually to find out the particulars. (The plans may change based on what you are looking for…)

*** If you have information regarding insulin pump programs, please contact me via email at theperfectd [at] gmail.com – you’ll be helping us all out!***

Equipment

Charles Ray III Diabetes Association

The CR3 Diabetes Association, Inc. is a 501(c)3 non-profit organization. 

According to the website, the organization is currently accepting applications for insulin pumps, blood glucose meters, and blood glucose test strips. You must review the following criteria:

  • You are uninsured
  • You are under insured (which means that your yearly deductible is unattainable)
  • Household income is less than $60,000
  • Your physician has recommended insulin pump therapy for you

They will only accept online applications on their website. The link to the online application is here.

Supplies for CWD Foundation (For children aged 18 years and younger)

Supplies for CWD Foundation (SCWDF) is a branch of the Children with Diabetes Foundation, a non-profit 501(c)(3) organization, providing short-term (up to three months) diabetes supplies for children with type 1 diabetes who are in emergency situations. (An emergency situation may be defined as: loss of health insurance, loss of a parent’s job, or a local disaster, combined with the family having no other resources with which to purchase diabetes supplies.)

Diabetes supplies is defined as any of the following: blood glucose meter, blood glucose test strips, insulin, insulin pump supplies, blood or urine ketone strips, lancets, syringes, and glucose tablets.

Download and fill out this application after reviewing all the requirements on the website.

Blood Glucose Meters/Test Strips

Freestyle Promise Program – $15 copays and a free Abbott Freestyle meter.

  • Co-pay assistance is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs or in Massachusetts.
  • Eligible patients are responsible for the first $15 of co-pay under their insurance coverage, and can receive up to a maximum of $50 in co-pay savings. Uninsured patients are also eligible for savings in most situations.

Contour Choice Program – For ContourNext test strips. Eligible patients pay the first $15 in co-pays each month. Insured patients can receive savings of up to $35 per month of co-pays using the Contour Choice Card.

Not valid for patients with prescription benefits covered by federal and/or state government programs (e.g. Medicare, Medicaid.)

Free Meter Offers

Accu-Chek Nano or Aviva

One Touch Verio or Verio IQ Meter

Low Cost Meter/Strips Offers

Abott Neo Coupon Offer – The Neo is a low-cost meter and strips option, often costing less than co-pay prescriptions.

Clinical Trials

Do not forget about participating in clinical trials, some of which provide monetary compensation in addition to supplies and medications at no cost. (Some also provide physician/medical visits!)

Please seriously consider participating in these trials – in some, you can get access to pumps or medications that would not be available to you due to cost – or FDA approval. And… you can help others (and yourself) through clinical trials.

Click here for a list of clinical trials for diabetes that are recruiting  (general, which include both Type 1, Type 2, LADA, MODY, and gestational).

 

 

Any other sites/supplies/organizations/medication programs that might be helpful to others? Help us!

Diabetes & Personal Space

Different cultures have their own idea of “personal space”. I’ve lived in other countries and worked in companies where my own concept of “umm… you’re a little too close…” has been questioned. It’s a matter of how you were brought up and how comfortable you are in your own skin combined with the ability to be perfectly fine with someone standing very, very close to you when having a business discussion.

This isn’t an anthropology blog (although, really, aren’t we all studying human behavior in relation to diabetes, so…), but I am starting to feel like my personal space is being invaded and I don’t like it.

I’m a hugger. A snuggler. A squisher and a giggler and a tickle monster when it comes to my daughter. I am sometimes the instigator but as The Kid has grown older, she wants to attack me with the same happy ferocity and fire the first shot across the bow of runaround shenanigans that I used to incite. And the sensors and infusion sets on my abdomen are getting in the way… and they hurt. And that hurts me.

The real estate I have on my body is limited (seeing as I’m limited in stature and subcutaneous tissue locations). The current trial I’m conducting with the Medtronic MiniMed 530G with Enlite only allows placement of the Enlite sensor on my abdomen. I had three failed sensors last week. Three. Every time one failed, I had to find a new place to put the next one.

I am placing my infusion sets on my upper abdomen to stay out of the way of waistbands that chafe. I’m reluctant to put the sets anywhere else (I rip them out of my arms and legs far too easily, even with taped down tubing), but I’m thinking I may have to rethink things here, because…

I’m running out of my own personal space because of diabetes.

braveheart-crazy-faceThe worst part of this all is the reaction that I have when The Kid comes barreling straight for me, screaming wildly (causing me to have Braveheart flashbacks) for a hug… I tilt my abdomen inward as if pulling away from her. To protect the sites in the small space I have to use, I sacrifice the full body hug that I want to give. Every time I lift her up, I must be careful not to scrape her legs against my abdomen. Tickle war on the bed begins with a “Careful of my pump, sweetheart…”

And of course, I know that I have options. Take all the diabetes gear off. Go back to MDI and no technology. I understand that I am lucky. The technology has kept me alive and healthy so I can complain about not being able to hug The Kid as tightly as I want… and I hope I’ll be able to continue to complain about that long after we send her off to university. By then, I am sure it will be she that complains that I am hugging her too tightly.

But today, diabetes is invading my personal space. The space that is sore from repeated pokes and prods and insertions. How do I tell it politely to step back?

I have no idea.

 

Sometimes It Is My Fault…

Minolta DSCIt was an idyllic day yesterday. Good cups of coffee, a happy daughter, jovial husband, and a trip to the park. The light breeze complimented the sunny warmth and I felt…content.

“You want to go get some ice cream?”

I like ice cream. With some foods, I never quite know what will happen with my blood sugar (i.e. pizza or a bagel), but I SWAG (Scientific Wild Ass Guess) for ice cream with a confidence that I rarely have with other sweets. So, the answer was a resounding yes and with The Kid firmly set on John’s shoulders, we marched a block to the local ice cream shop.

Peanut butter fudge ice cream with peanut butter sauce. Small cup. BG was going up a little (Snacks at the park – Pirate Booty), but manageable. I dosed and enjoyed every minute of that peanuty goodness. We walked back to the car, chattering away about birds and cars that go beep. I checked my graph on the Medtronic MiniMed 530G and it was stable.

The freefall happened within 20 minutes, and it was my fault. The idyllic day called us outside and an impromptu walk around our neighborhood. The magic number said 173 mg/dl with two arrows pointing down. We weren’t going far and weren’t going for long. A casual meander. Fifteen minutes later, it said 82 mg/dland I was not feeling content anymore. We got home and as we walked through the door, the alarm started to chirp. BG 72 mg/dl and falling. Meter said 62 mg/dl and I said juice. Drank it. Felt better.

It was my fault that I didn’t suspend the pump. It was my fault that I didn’t check 15 minutes later. It was my fault that I snuggled down into the couch and began to watch TV. I got sleepy. Thought I needed a nap. Stood up, waved at John and motioned to our bedroom, mouthing that I was going in.

Did I check before I went in? Nope. But the alarm kept going off on my pump and I ignored it. The threshold suspend feature kicked in and through my haze, I realized that this was not a drill.

I vaguely remember wandering into the kitchen, walking past my family and pouring myself a glass of juice. I was intent on getting “just eight ounces” into the cup, holding it up to analyze my measuring capabilities. I didn’t guzzle it down, but casually sipped at it as if I was at a cocktail party and didn’t want to pay $10 for another drink. John’s voice was fuzzy…or was it me that was fuzzy?

“You OK?”

“Oh, yes. I’m fine. I’m not fine. I’m low, but I’m fine. I’m drinking my juice and I’m going to be fine.”

He knew that I wasn’t fine. He verified that the pump was still suspended and told me that he’d come back in and check on me in ten minutes. (He checked on me in five minutes, but was in the next room in case I needed him.)

I drank my juice. I ate some things. I came up slowly. I shuffled past my peeps and back into bed, mumbling that I was tired but my blood sugar was coming up.

And up it did. You know the drill. Overtreat. Bounce. Soar. Dose a few units to stop the rise past 400 mg/dl.

When I went to bed, my blood glucose was 132 mg/dl.

Threshold suspend happened again around 2am. 54 mg/dl.

It was my fault. I take blame for this one for my choices of nourishment and my failure to check. I thank the pump for catching not one, but two sucky hypoglycemic reactions in twelve hours. (And yes, I know about the increase of more hypoglycemic reactions after a serious low. It’s my fault that I didn’t take more precautions when coming down.)

So, this morning, I’m running on fumes. And a BG of 97 mg/dl.

This disease is not my fault.

My choices are my own, and when they’re incorrect and cause issues with my disease…

it’s my fault.

 

A Beeping Mess

headphonesI’m a beeping mess right now.

And beeping is not a substitution for an expletive, although it could be. Since my trial of the Medtronic MiniMed 530G with Enlite, I’ve become my own electronica band, beeping melodically throughout the day and night. No rhyme or reason, thus no rhythm at the beginning, but I’m starting to see some trends.

The MiniMed 530G with Enlite has a unique feature beyond the Threshold Suspend (The pump suspends if the Enlite sensor says your BG reading is below your “low” threshold.). It has a “predicative high” or “predicative low” setting, which will warn you if the algorithm believes you are going to go outside of the ranges you have set. When we did the initial setup, I put my low range at 80 mg/dl and my high at 200 mg/dl. (I drop pretty quickly, so I’m trying to catch it before I get to that point where I am not thinking straight and ignore the sensor readings in favor of…well, anything, because I think it my blood sugar will come up on its own while I’m walking around. Hint: it doesn’t.)

It is the new equipment adjustment period or is it my body? The food choices I make? (Pizza, oh pizza… I love you, but that 400 mg/dl? Even my broken pancreas rolled its eyes.) I beep, look at the pump, and it says that a low is predicted, yet less than ten minutes later, it says that a high is predicted. I’m still not used to the arrows that are on the MiniMed screen and everything is pretty wonky overall. But I’m learning, and that’s the point of this trial. I will figure this out.

The accuracy is not really in question at this point. How do I know? Because along with the MiniMed 530G with Enlite, I threw my Dexcom G4 sensor onto my arm on Thursday. There have been several times when both the 530G and the G4 have buzzed and beeped at exactly.the.same.time. If there’s any inaccuracy issues, I’ve found that sometimes it’s the G4 and sometimes it’s the 530G, but neither one is perfectly accurate all the time. Thus is life.

I haven’t had a night in which beeping hasn’t woken me up. The Threshold Suspend alarm has gone off, only to check my blood glucose level and find it to be a beautiful 110. Other nights, I’ve woken myself up and I’m low, except the 530G hasn’t caught it. (Until a few minutes later when I’m standing in kitchen over a glass of juice.) That’s been frustrating, along with the lack of response by the system to recognize that I’m coming up from a low, insisting that despite my canceling the threshold suspend, it throws up another beep and alarm and threshold suspend less than 10 minutes later.

John and I have had several discussions about the “is it me or the technology?” He maintains that it’s the technology, and to a large degree, he’s right. I need to train the technology to work with me… and I am also recognizing that I need to begin basal testing again. (It’s springtime in Paris and my insulin regimen. Hooray!)

I’ll have to adjust the predictive settings as well with the trainer, so that I can cut down on the beeping. I do find that it causes undue stress (and I’m full up on stress, thankyouverymuch) and worry that I didn’t have before.

So, if you need me, just follow the beeping. I’ll be dancing with the glowsticks in the corner.

Medtronic CareLink and Browsers of Yesterday

516892_68656024On the FAQ pages of Carelink. it plainly states:

Which web browsers can be used to access CareLink Personal software?

The system is currently validated to work with Microsoft® Internet Explorer® version 7, 8 and 9, Internet Explorer 10 Desktop, Apple® Safari® 4, 5 and 6, and Mozilla® Firefox® 5.0.1. Other browsers might still work although Medtronic Diabetes is not able to guarantee proper operation of those browsers.

 

I use a Mac. (According to Dexcom, I’m already a complete loser, as their CGM software won’t even run on a Mac unless you use a PC emulator program.) I have two browsers downloaded on my system: Safari (which comes standard on most Macs) and Firefox (which is easily downloaded and what I use occasionally for some banking transactions that demand Firefox).

I know that CareLink works on a Mac, because I’ve uploaded my pump data before on this laptop. So, the other evening, when I needed to upload data so that my trainer and I could look at it together while talking on the phone to adjust settings, I thought it would be easy.

I got this screen when I went to Medtronic’s CareLink link on their website:

Screen Shot of Safari Browser

My Safari was “too up-to-date”, so I couldn’t access CareLink through that browser.

Well, shoot. OK. Fine. I’ll fire up the Firefox browser I have… Version 21. (Not Firefox 5.)

Too up-to-date.

And by the way, if I wanted to download Internet Explorer right now, it’s IE 10 – or 11. And wait, they don’t have a version for Mac.

Frustration

If I didn’t have an amazing husband who is a web developer and happened to be home and was willing to sacrifice a pocket protector to the Geek God, I would have been not been able to upload my data. (He somehow configured something and magically, I have a Firefox browser that is…workable.)

I was able to examine the data that I uploaded, but I can’t imagine how frustrating it must be for others who expect that along with the latest technology they get from Medtronic, they get an upload system that will only work with the browsers of yesterday.

Yes, I expressed my opinion to the support team at Medtronic. I was polite, but I did use the phrase: “Unacceptable.” People who know me smile, as that means I’m pretty angry.

Will they do anything? Time will tell, which is pretty much been my phrase about this experience. What I do know is that it takes just one web developer to fix it and make sure that it works with all systems when there is an upgrade… I’m sure they can spare someone in their IT department.

Like I told you before, Medtronic, while allowing me to trial the system and all that comes with it, does not expect that everything I say will be rainbows and glitter about my experience.

The diabetes community talks incessantly (and I believe, sometimes to the wall) about the crucial need for integrated technology to make our lives easier to manage our diabetes. The Medtronic MiniMed 530G with Enlite is an integrated pump and continuous glucose monitor (and that threshold suspend, which I’ll write about soon… promise), but it’s an utter fail if you can’t use the browser… or two browsers…. or system… that you have to review the data and reports. Fail. (It’s not just Medtronic… Dexcom has failed me, too.) What good is the data if you can’t get to it?

Parting Thought

Heads up, Medtronic IT department. Please update your CareLink application and browser compatibility. (I’m not going to even talk about Chrome, which you supposedly don’t support at all…)

P.S. I’ll write about the actual reports that CareLink provides in another post. They do deserve a post of their own. But jeez.

Come. On.