Two weeks ago, I happily sacrificed my study week at uni to attend the OzDAFNE course at Diabetes Australia – Vic. Granted, I probably worked myself into the ground the week while trying to finish all my assignments. But it was mission accomplished! (sorta), which meant I could tackle the course with one less worry on my mind. So what is OzDAFNE exactly?
Day 3 – Share your most memorable diabetes day.
I remember the initial panic of sitting in my endo’s office and being told that the tablets weren’t working. We needed to move onto injections. I was really upset because I had been working extremely hard while being on the tablets and being told that I needed to go on insulin made me feel defeated. I think this is something that most people with type 2 diabetes experience when they start on insulin. That feeling of guilt and anger at yourself for not doing enough.
Yet there was a part of me that knew, subconsciously, that I had done everything I could. I woke up at the crack of dawn every weekday to head to the gym to do either a spin or bodypump class. They were all intensive classes that left me sweating like a mushrooms that haven’t been stored in a paper bag (possibly the worst analogy ever?). I was obsessive over what I ate and reduced my portion sizes dramatically. I felt like I was starving myself at one point. I knew this wasn’t a lifestyle I could sustain. But was there more I could have done to prevent going on insulin, or even diabetes altogether?
We hear it everywhere – that type 2 diabetes can be prevented with a healthy lifestyle with healthy eating. We’ve grown up with it – that it’s our fault we have type 2 diabetes because we haven’t looked after myself. But I never expected to be diagnosed with type 2 diabetes at 19. When I’ve been physically active and eat fairly well. I did a pretty damned good job of looking after my health at that age, when most of my friends were out partying, clubbing and drinking. I couldn’t comprehend why or how this was happening. Sometimes, genetics just sucks!
I guessed how I felt came through because my endo reassured that I was doing an amazing job on my part but my body is just stubborn. The insulin will just help make things easier for me and manage my sugars much better too. There was no point in working myself to the ground just to manage my sugars and let diabetes dictate my life. And I agreed. I was given the choice between starting on a Mixtard twice a day or Basal/Bolus four times a day. And what happened next felt like a major turning point for me. Instead of having my endo determine what regime I was going to do, I sat up a bit straighter and said confidently ‘Let’s try having it twice a day and if it the numbers still don’t budge, we can do four times a day.’
Did I just have a say in my diabetes management? Did I just choose to go insulin? This endo is so sneaky! He immediately sat back, smiled and said alright let’s do it.
It’s been three and a half years since I started on insulin and I’m now on the basal/bolus regime and I haven’t looked back since. My Hba1c took a dramatic dive from the high 9s to 6s since starting insulin and I’m much more relaxed with the things I eat. It has taken me a long time to stop feeling the guilt and anger of my diagnosis and accept the fact that I do have diabetes (whatever the type may be). I can’t do much about it but to move on, manage it the best I can now and live my life to the fullest! To diabetes dictating lives, Ashley says no! (Cringe factor of a 100 for that corny statement!)
Day 2 – If you could petition anyone, organisation or project, what change would you ask for?
Funny enough, I am currently petitioning the National Diabetes Service Scheme (NDSS) for equal healthcare access for everyone living with diabetes. Now, just because I’m petitioning them doesn’t mean I am disgruntled with them. Without the NDSS in place, the majority of people living with diabetes would not even be able to afford the medication to keep us alive. Things like insulin, oral hypoglycaemic agents, needle tips, syringes and test strips are all heavily subsidised by the NDSS, which is a government initiative and run by Diabetes Australia. In that sense, I am eternally grateful that we have this in place so we can afford the basic necessities of living with diabetes.
However, when it comes down to subsidies for pump consumables, that’s a different story. There are certain criteria individuals have to meet before being eligible for pump consumable subsidy. The criteria listed for eligibility is listed here. They’ve covered just about every category of diabetes in there – except for type 2. There’s a blanket ban for people with type 2 diabetes who are currently using insulin to manage their condition. What’s the reason for this blatant discrimination? Here are some of my theories:
People with type 2 diabetes are generally managed by tablets or lifestyle changes.
While this is true for most people with type 2 diabetes, keep in mind that there is an increasing number of young adults that are being diagnosed with type 2 diabetes. Although they may be initially responsive to tablets, they may decide that insulin therapy would suit them better down the road. Particularly for ladies who are thinking of starting a family, we would most certainly be needing insulin to cope with the crazy hormones. How handy would being on a pump be while you’re planning for that baby, to get on top of the BGLs and not worry as much during the pregnancy about having multiple needles? One less thing to worry about!
On top of that, not every case of type 2 diabetes is due to poor lifestyle changes. Sometimes, it just happens because it’s within their genetics. Diabetes is not always black and white. Some people don’t fall clearly within a specified group. Let’s take me for an example. Because they’ve eliminated me from the type 1 category, their only other option is to put me in the type 2 category. This is despite the fact that I’ve always been a healthy weight, physically active, and non-responsive to tablets. I started insulin therapy two years into my diagnosis. Does that sounds like a typical type 2 scenario to you? Although I have finally convinced an endo to change this for me, there may be many others in my situation out there.
Providing us with a generous subsidy for the basic things we need is a luxury. I know of many people in other countries who have to ration their strips because they are only allowed so many per month. How do they expect us to be vigilant in managing our diabetes when we are rationing medical supplies because we can’t afford more? So I’m grateful for NDSS in the regard that we have our basic needs covered and I acknowledge that this is also very costly to our government. Although improving quality of life for us may not be on their high priority list, what about improving diabetes management to reduce the risk of complications down the track? From my understanding, it’s much more costly to manage a complication, particularly if we need to be admitted into hospital and with the limited availability of hospital beds, this is a huge issue for us at the moment. And there is evidence in the literature that insulin pump therapy is the preferred option to help achieve good glycaemic control to reduce the risk of complications. Isn’t prevention better than cure?
At the end of the day, the percentage of people living with type 2 diabetes who are on insulin are quite small. I’m guessing that the percentage who would be appropriate for insulin pump therapy would be smaller. So, I don’t see why a blanket ban is quite necessary.
What do you think?
If you would like to support this petition, you can add your name to the list here and I would be very grateful and thankful!