I came home after two days away to a flurry of discussion about Sunday’s New York Times article, “Even Small Medical Advances Can Mean Big Jumps in Bills.”
My knee-jerk response was to be thrilled that type 1 diabetes received above-the-fold coverage in the New York Times. Reading the profile of and quotes from Catherine Hayley felt like a fair assessment of life with type 1 diabetes, and painted Catherine not as someone who suffered from anything, but who worked hard to power through a whole lot. I wished the columnist had been more focused in her discussion (Is this article about health system economics? The cost of treating type 1 diabetes? The complications associated with diabetes as a whole?) but I am not the best person to discuss a lack of focus because … (shiny thing)
That said, the quote that really bothered me was right at the beginning:
“But as diabetics live longer, healthier lives and worries fade about dreaded complications like heart attacks, kidney failure, amputations and blindness, they have been replaced by another preoccupation: soaring treatment costs.”
Really? It’s that simple? I wish I was being dramatic, but every, single night before I go to sleep, I think about whether or not I’ll wake up in the morning. It’s not a thought I belabor, and at this point, I sometimes debate the possibility almost pragmatically, calculating insulin on board and exercise I’ve done recently, thinking about my last A1C or EKG, thinking about how 27+ years of type 1 diabetes has affected my body.
I wish financial worries were replacing others, but instead, I worry about diabetes-related complications in addition to cost of treatment. However, the trick is that these advanced treatments will allow me to worry about diabetes into proper old age, because I will live longer, and better, with access to this technology.
Devices like an insulin pump, which can precision dose my insulin and help efficiently calculate and track insulin use throughout the day, help me fall asleep with more peace of mind. Wearing a Dexcom, which alarms when my blood sugars falls out of my pre-established comfort zone, helps me fall asleep with more peace of mind. Peace of mind, when living with a complicated chronic illness, matters. These are not devices I wear because they’re “cool” or “fun.” I don’t care what colors they come in or whether or not they resemble an iAnything – I want it to work and work well. I turn to technology to help best manage my diabetes because my pancreas stopped making insulin almost three decades ago, and these advances in treatment have improved my quality of life immeasurably in some ways (emotional health) and very measurably in others (better blood sugar control).
One other quote was particularly frustrating, not because it was the study that was referenced, but because the study itself is over 20 years old:
“But that all changed after a landmark study in 1992 showed that patients did better if they maintained very tight control — keeping their blood sugar within a nearly normal range by checking it frequently and taking multiple insulin shots a day.”
Where is today’s modern DCCT? Where is the study that’s looking at the influence of insulin pumps, CGM, and insulin analogs on patient outcomes? (Please tell me this study exists – I hope it does!) We’re talking about modern-day diabetes treatments and lining these discussions with studies involving somewhat out-dated treatments. I’ve seen the benefits of pumping and CGM use on my personal diabetes management, and I can only hope that the overall PWD population sees positive outcomes in their management when given access to these technologies.
The discussion I’ve seen across the DOC and the web at-large has been enlightening, and I’m really glad to see and hear people talking about diabetes with such excitement and passion. Diverse opinions should be shared, and heard. Progress is important. Innovation matters. And in my opinion, modern-day diabetes should be treated with modern-day technologies.