Originally published August 2019
Some people die every day because they don’t have access to something they need. Especially if you travel outside of the US. If you investigate, there is often a string of reasons contributing to their lack of access to something they need. So while none of us expects a fellow human to be perfect, survival and its first world, distant cousin we call “thriving” often demands a solid succession of wise decisions. We should be encouraging each other to make good decisions and I include the medical community when I say this.
The Diabetes Online Community often says that people die just because of a lack of access to insulin because of the prices of insulin. It’s a bit more complicated. This story has been oversimplified. Obviously, the prices of insulin are a huge contributing factor, but since prevention of more people ending up this way is of key importance, I think that talking about the other reasons which may have played a role is crucial. For example, these people who died because they couldn’t afford insulin, did they not have family or friends or a church community they could lean on? Did they have the latest smartphone or a nice car? Did they get in over their heads financially? Did they struggle to keep constant employment for some reason? Was it due to poorly managed blood sugars? Were those due to choosing to eat foods that make it really hard to manage blood sugars?
In other words, did their life choices help make them this vulnerable?
Some in the DOC will ask how these cases happen and often, community members shoot back saying that it does no good to question and that suggesting that their personal decisions played a role is just WRONG. Well, I beg to differ.
I think it could absolutely help someone to question this. Someone who could be next might be reading and may make a determined push in their life to make themselves less vulnerable. We should never minimize the power of wise personal decisions. They often make all the difference.
Of course, these stories are awfully tragic but I do question how each might have been preventable, too. Why? Because my daughter and I have type 1 and that makes us pretty vulnerable as a family unit with crappy health insurance and one income. So to best protect ourselves, my family has to think through possible safety nets and situations very carefully. We can’t afford certain things nor to engage in certain behavior or take certain risks. People tell me I should take a vacation because there is a bit of money in the bank. No. That money exists as a cushion to the realities of life–one with two type 1s in it.
Life is rife with consequences for everyone, especially those most vulnerable. One of the saddest things to me about type 1 diabetes is how vulnerable it can potentially make a person. No it’s not “fair” but life isn’t fair so what I would recommend any type 1 to do is strive to make careful decisions and to try to find ways to insulate themselves from further vulnerability, and simply do what is in their best interests, even if that means going without something else like a smartphone or a vacation or a nice car or cable TV or new clothes, etc. There are exceptions to everything but surely most of us can minimize the chances that we will end up like these sad cases?
Obviously, insulin prices are horrible (believe me I know, I pay twice over). However, each of us is probably responsible and smart enough to figure out how to survive if we focus and carefully prioritize while we work for improved affordability.
Here’s my plan against death and destruction from type 1 due to a lack of insulin under normal circumstances (not talking about a zombie apocalypse with a lack of electricity or a shortage of supplies or something–Lord help us all in that scenario):
My family already eats a very low carb diet which works best with R insulin for meals. On top of this my daughter and I also use a basal insulin and fast-acting for corrections. What if I can’t afford the basal and fast-acting? The plan is to use R and NPH for $50 a month to survive and be more disciplined than ever. It’s better than death and I’m also positive we can do it to achieve much better glucose control than most who have access to all the latest insulins plus a CGM and a pump. How to afford very low carb food? I would pretty much live off of tuna and sardine cans, I’m sure. It would suffice for a difficult period of time.
It also helps to keep friend and family ties, if possible. The more people to help you in a pinch, the better. Staying healthy usually saves money, so doing what one can now, today, to take great care of health and type 1 will pay off big time later on.
I’ll do all I can to prevent anything hurting me or my family. I suggest you do what you need to do to ensure your well-being, too. Don’t let excuses and a lack of priorities get in the way of your survival. After all, surviving and working to improve things is always the best way to honor those who didn’t make it.