How I Spent My Summer Vacation

I am a Type 1 diabetic. It was diagnosed on my 40th birthday. My case is unusual. My blood sugar can jump from 2 mmol to 28 mmol while I am sleeping. This is not the sort of diabetes that can be managed by diet and exercise, although that doesn’t stop me from trying. I wear an insulin pump. My blood sugar is monitored by pin pricks of blood, hand-applied to test strips fed into a glucometer.

The target range for blood sugar is 4 to 6 mmol. Spend too much time outside this range and the unattended excess sugar goes on a crime spree attacking bodily organs. The information from the glucometer calibrates my dose of insulin. Without insulin I will die. The pump provides a steady drip of insulin through a straw that feeds directly into my body, and on top of that, I must bolus additional insulin to match every carb consumed, every time I eat.

The role of the insulin is to push the blood sugar back into the target range and keep it there. In my case, it is failing, more often than not. So we try additional meds to support it. While they sometimes help with the blood sugar range problem, they cause others, like chemically burning my skin off in patches, from the inside out.

Last week, I learned as I was picking up my test strips at the drug store that I had reached my annual insurance coverage for this prescription. It is July. Through the pharmacist, I learned that I cannot get more of them until January. I am testing on average about 15 times per day. Uninsured, my strip supply costs nearly $400 per month. I have a private insurance plan that costs me approximately $300 per month through my incorporated company to cover these expenses.

I am good with money and budgeting. My spending is in line with my priorities. This is not the kind of surprise I like in July with five months left in the calendar year. What I learned: 1) Check your insurance limits in December and plan your spending for the following year accordingly. 2) The Ontario government considers up to 3000 pin pricks per year reasonable. 3) A reasonable person would conclude that I have reached my pin prick limit for the year, in July. It’s erroneous, but there is small joy to be had in it. Pin pricks are aversive, and they hurt for a split second. You never just get used to them.

In the short term, I have put myself on a little test strip vacation. This is short sighted, and common sense will eventually prevail. For the most part I can judge my blood sugar to be too high from the pressure on the back of my eyes or to be too low from the stars I am seeing.

Rather than get angry, I did some reading and made some phone calls. It would seem that the current insulin pump is no longer meeting my needs. This is a reasonable conclusion. The technology has advanced since I was equipped and I can offload some of the decision making.

My insulin pump can be replaced by one that does continuous glucose monitoring for me, and after speaking directly with my insurance company, it sounds like this is something they might be willing to provide for me. Paper chase to follow. And no more pin pricks when it’s done.

I have pin-pricked my finger more than 25000 times.