Tagged: insulin

You Deserve More Than Roses…

1526731_10153042281067328_1047114686242280778_nI hear her laughter and my heart swells with love.

I cannot imagine my life without my daughter.

I cannot imagine my life without the insulin that keeps me alive so that I can hear her laughter.

And yet… there are children in the world who do not have access to the insulin that will keep them alive.

No laughter.

No life.

No more. 

In parts of the world (some closer to the U.S. than you think), there is a problem getting insulin to children.

Lack of access to insulin remains the most common cause of death in a child with diabetes (Gale, 2006). The estimated life expectancy of a child who has just developed diabetes could be less than a year in some areas (Beran et al, 2005). Many die undiagnosed, others through lack of insulin or lack of expert care. In some countries, expert care is available but resources are limited and so early and serious complications frequently lead to death in young adulthood. – IDF

We know that insulin is expensive in the United States, but for some families in the world, the cost of insulin is more than a family will make in an entire year. And you know what can change that?

Us. 

roseFor the past few years, the Spare A Rose, Save A Child online campaign has helped to raise funds for the International Diabetes Federation (IDF)’s Life for a Child campaign.

Life for a Child began over a decade ago and gives donor funds directly to diabetes centers around the world, getting children insulin, test strip supplies, and care to help these children live… and laugh.

How Can You Help?

Valentine’s Day is coming.

Flowers are pretty. Chocolates are nice. Perfume smells lovely (Sometimes.)

But flowers wither. Chocolates get eaten. Perfume wafts away into the air.

You deserve more than that. 

Five dollars.

The cost of a single rose. Or a very expensive piece of chocolate. Or a few spritzes of perfume. (Or even that teddy bear that gets purchased at the gas station on the way home.) Five dollars gives a child with diabetes in an underdeveloped country a month of life.

Let those who love you know that you’ll take one less rose. One less piece of chocolate. Skip the spritz. You want them to give five dollars (or more) to the Spare A Rose, Save A Child campaign.

You can have them donate once or… they can remind you that you are loved throughout the year with a monthly gift to the program. You get a sweet acknowledgment and the knowledge that you are helping people all over the world hear a child laugh.

Want to get your office in on the action? Done. Easy-peasy-give-insulin-to-kids-squeezy.

Your donation is tax-deductible. (So, for those of you who are romantic AND financially savvy… you can say I love you and write it off. It’s still sexy.)

What About People YOU Love?

And of course, think about the people YOU love. You can donate in their name, then print out this card (or the other one) to let them know you love them more than roses.

You love them more than life itself. 

Click here to give life for a child. 

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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.)

Right now, you’ll see a glaring absence of blood glucose monitoring supplies. Every link I researched ended with a dead end. Roche/Accu-Chek does offer a free Aviva or Nano meter on their site, but there are no programs currently offered for free/discounted strips. If this changes, I’ll let you know. (And not five minutes after posting this, Megan helped our community by giving us our first program for test strips/meters. That’s what community is all about!)

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

Eli Lilly

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

  • You must be a U.S. resident.
  • 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)
$36,000 $48,000 $60,000 $72,000 $84,000 $96,000 $109,000 $121,000
Alaska $44,000 $59,000 $75,000 $90,000 $105,000 $120,000 $136,000 $151,000
Hawaii $41,000 $55,000 $69,000 $83,000 $97,000 $111,000 $125,000 $139,000

 

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.

GlaxoSmithKline

Avandia may be available at a reduced cost or for free. Unfortunately, the qualifications are not listed. You must call 1-866-GSK-FOR-U (1-866-475-3678).

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.

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

  • There are several limitations to this program. Review the application for all the restrictions.
  • You must be a U.S. citizen.
  • Patients must have a household income less than 200% of federal poverty level.

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 offers a prescription assistance program for Januvia.

  • 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 $46,680 or less for individuals, $62,920 or less for couples, or $95,400 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.)

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, 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. 

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.

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.)

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 Hurts

1441012_62476745Diabetes hurts.

I’ve never heard anyone describe injecting insulin as graceful or gentle.

The needle bears down onto unblemished skin that begs to not be pierced. Nerves scream in anticipation as the metal bores underneath, invading the sacred temple of the body and pushes the very cells that give me corporal nourishment. It sears and brands the skin around it, leaving a physical scar behind as a permanent reminder of what I must do to stay alive.

If I told a stranger that I hurt myself on purpose daily, they would recommend psychological counseling immediately.

Not every needle insertion is a hot branding, but when you must, without fail, do this tortured dance for the rest of your life, knowing that you have endured over three decades of this, it begins to ache deeply. Even with smaller needle gauges and shorter lengths, no one has ever gleefully clapped hands and asked to be mutilated for their health.

Diabetes hurts.

Over and over, a lancet finds its target somewhere on a finger, slicing into the same tender skin that strokes my daughter’s hair as she drifts off to sleep. It’s become rote at this point, a slight turn of the head at the same nanosecond that the button is pushed to draw blood. A sting, temporary, to decide on the dosage of the drug that will keep me alive but could also render me unconscious or dead. That sting, several times a day, over time, is a weight that drags me to the bottom of the ocean, gasping desperately in my dreams.

Too much insulin and diabetes hurts. It starves brain cells and prevents me from making rational choices. The throbbing between my eyes competes with the violent contractions of my limbs to squeeze out the last vestiges of glucose within my muscles. My throat constricts, choking on the words needed for help.

Too little insulin and diabetes hurts. Toxic sludge sloshes through my veins, spewing poison into every organ and damaging the beautiful body my soul holds, shutting down the potential of a long life and health. The complications build an ugly monument where the delicate framework of what I am once stood.

The guilt crushes you, despite your best efforts of controlling what is uncontrollable. The questions of why build to a deafening roar. Labs slam your body into a corner, even when the results are expected. It infiltrates and infects those around you who love you and can’t live in your body or take the burden from you.

You may accept this disease. You learn to live with it, try to tame it, keep it in check and at bay. You talk about it, claim it, share your thoughts with those who understand.  But it bites and scratches and never relents. It will sink its viper fangs into you and not.let.go.

No one said it would be easy. I knew it would be hard.

But no one told me when I was diagnosed that diabetes hurts.

 

 

 

Accidentally Untethered…

1439534_15304554In the fifteen years of insulin pumping, I have been “off the pump” once for less than a day. (The child birth protocol forced me onto an insulin I.V. drip for about 12 hours.) I’ve been incredibly fortunate in that I’ve never had a pump fail.

The “untethered” regimen is extremely interesting to me, especially as our plans for the summer include frequent trips to the hot beaches, but not yet. It’s not time yet. My insertion set, however, had other plans in the middle of the night.

I accidentally untethered myself during sleep. At 3am, I awoke to my Dexcom beeping, but after looking at it with one eye, I can only assume that it had been beeping for a while. That arrow was reaching for the sky, and I had that sinking feeling that it was going to be a tough day ahead.

I checked my blood sugar, knowing that I wouldn’t like what I was going to see… and I wasn’t surprised. 406. That would explain the sandy desert in my mouth, but not the smell of bandaids. (Insulin smells like bandaids. Yick.) I got up and looked down at my insertion set site… it was still adhered to my body, so I gracefully tiptoed like an elephant into the kitchen to grab a vial of insulin to inject my correction bolus, ignoring the odor of eau de bandaid.

The cool water only temporarily parched my tongue. The injection stung as the needle sunk into my arm. And then I realized…

The insertion set was still adhered to my body, but the cannula had sneakily pulled out in my sleep. I must have rolled back onto the adhesive after I pulled it out.

Well, isn’t this a fine mess you’ve gotten us into, Ollie?

I hate inserting a new site without warming up my skin per a long, hot shower, but sleep… I wanted sleep… And so, barely awake, another needle slid into my body and in five minutes, I was back in bed, correction bolus, new insertion set, and a Dexcom that felt unloved because I had ignored it.

Less than five hours later, my blood sugar was 184. Two hours after that, I clocked in at 52 mg/dl.

Even when you think you are doing everything you can to stay within range, sometimes life unthethers you and the smell of bandaids fill the air.

The next time I untether, I’m going to actually use a long acting insulin. I hear that works a little better than what I did.

 

Monday Morning Musings…

1427584_81613555I took a little blogging break last week. It wasn’t intentional; I had other things cooking on the burners and gave them the time that was due to them. In the end, it all goes in the same pot, but it was strange to not write. (And that’s the extent of my chef metaphors.)

And now I sit with a large amount of caffeine, thinking about the good things that are happening in the diabetes world. In no particular order…

The Power of Community

According to an unofficial total (but from a source I trust), the Spare a Rose, Save a Child campaign raised…drumroll, please… $26,519. That’s a lot of insulin. That’s a lot of love. That’s a lot of lives that will be saved because the Diabetes Online Community raised their voices as one. I am in awe of the power of this community. For those who shared the message, thank you. For those who donated, thank you. (And it’s not too late to give a rose… )

StripSafely

Just because we’re not shaking the gates in person doesn’t mean that we aren’t working on ensuring blood glucose meter accuracy isn’t on our minds. Larry Ellingson has a guest blog post over at StripSafely.com, asking us all to join him in calling for congressional oversight of meter accuracy. I had the pleasure of meeting Larry at the DTS meeting in September, and I’m glad he believes as we do: whatever it takes to make sure we stay healthy and safe.

Think meter accuracy is not important? Larry gives another statistic that scares me (and it should scare you, too!):

 A second survey confirmed that 27 percent of patients with type 1 diabetes had experienced health problems due to inaccurate blood glucose meter readings.

The FDA can only do so much at this point. It’s up to us to rally together to bring Congress the news: we need their help. Bennet and I will be putting together some points that you can use when talking with your representatives soon.

It’s an i-port Advance

Medtronic announced the i-port Advance, an “all-in-one” injection port. For those who take multiple daily injections, it basically takes the place of injecting into different places… and into the injection port. You insert the i-port Advance and for the next 72 hours, you inject into the port.

Injection ports aren’t new. I remember using an injection port years ago. (I don’t remember why. It was probably a sample or two to see if I liked it, but obviously I didn’t care for it, because I didn’t use it for long.) If you have needle phobia, it’s a great way to ease the fear of having to inject more than once a day. If you micro dose fast acting insulin for optimum control, this may be a great way to avoid seven or eight injections each day.

There was a study done in 2008 about the impact of insulin injections on daily life and the results didn’t surprise me much. The study showed that out of 500 subjects, 29% of them stated that injecting insulin was the hardest part of their diabetes care. Fourteen percent of the subjects said that insulin injections have a negative impact on their life. So… obviously there’s a need to help alleviates some of the negativity. The i-port Advance is one way to do so.

The Future of Glucagon

For anyone carrying around that red hard case in the bottom of a bag or a purse or next to your bed, you will nod your head when I say this: Glucagon is a pain in the ass. (Sometimes literally.)

The Glucagon Emergency Kit has been around for quite a while, but unless you’re with someone who knows how to use it, it’s useless. If you pass out, the last thing a stranger will do is rifle through your bag looking for something to help you. Even if you’ve shown a friend or a work colleague how to use it, when push comes to shove (or push comes to drop on the floor), it may be too complicated.

True story: I would give a little primer about my glucagon emergency kit to my staff. New team member = pull it out and go through the motions. I would end every discussion about glucagon with this: “Call 911 first. Then attempt to inject me.” Then the discussion would be who would draw the short straw to do this. I trusted my team, but knew that glucagon was a last resort.

These days, I’m hopeful that glucagon will be available in an easier delivery mechanism - and perhaps even not by injection! Mike Hoskins over at DiabetesMine has a great article about Next-Gen Emergency Glucagon, in which he discusses the big issue: stability of glucagon. (Currently, once mixed, it’s good for 24 hours. After that, pfftt.) But even more exciting? This:

Assessment of Intranasal Glucagon in Children and Adolescents With Type 1 Diabetes - Yes. It’s a clinical trial that currently is recruiting kids for an intranasal dose… Could this be more awesome? Nope. I am hoping that this is what’s in store for all of us. I’d be much happier giving a primer about: Hold this up to my nose and squirt. Wouldn’t you?

By the way, there’s also a trial for adults: Effectiveness and Safety of Intranasal Glucagon for Treatment of Hypoglycemia in Adults. You can get a little more info here: Evaluate the Immunogenicity of a Novel Glucagon Formulation. The company behind this is AMG Medical, Inc. out of Canada. I’m eager to see the outcome of these trials!

So, as I sit here this morning, I’m buzzing with excitement (or is it caffeine) with hope for the future. What are you excited about?