Tag: humalog

My Thoughts on *That* Insulin Cap News

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Just over a week ago, Eli Lilly announced a 70% reduction in price for its most commonly prescribed insulins that resulted in a cap of patient out-of-pocket costs at $35 or less per month.

This news was huge and spread like wildfire across the diabetes online community. And for good reason – it’s something that so many people with diabetes have needed to happen for a very long time. Most reactions I saw were that of complete and utter joy and relief. I’ll admit that’s what I felt at first, too, until I saw the more displeased responses that directed additional frustration and rage at Eli Lilly for not taking this action sooner, or reducing the cost of insulin to make it free altogether. Those posts got me thinking.

I’ve had time to reflect and gather my thoughts on the matter, and I think I land somewhere between thrilled and bummed, myself.

This news is absolutely something to be celebrated, as it will undoubtedly assist people who struggle to afford insulin with astronomically high price tags. This is an issue that I’ve spoken about on the blog before, and while I feel very fortunate to never have personally struggled with affording my own insulin (though I’ve certainly complained about out-of-pocket costs in the past), I’ve read countless stories about individuals in the United States who’ve had to take drastic measures in order to obtain this life-saving medication. So this news is wonderful, for sure, but it also feels a little too late.

Is this response from Lilly induced by the pressure that they’ve felt from diabetes advocates in the last several years? Is it a genuine call to action to other insulin manufacturers to follow suit and slash prices? Is it all just some sort of PR stunt? My suspicion is that it’s a mixture of all three, and while this feels like a victory for now, I don’t think that I will personally be satisfied until all people with diabetes are able to get insulin for free – no bottom line, no gimmicks, no nothing other than access for all.

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A T1D Christmas Craft

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This post was originally published on Hugging the Cactus on December 16, 2020. I’m sharing it again today because this was a fun and festive (if not messy) craft that I did with an insulin vial that I saved. Currently, I have about a dozen or so empty insulin vials set aside and I’m wondering what kind of craft I should do next…

I love Christmas, crafting, and some might argue that I love T1D (that’s mostly false, but when you’ve got a chronic illness, you’ve got to learn how to love some aspects of it…otherwise, you’ll be miserable).

So I recently *attempted* to combine all three of these things and do a little DIY project with an empty insulin vial.

And I learned a few things along the way…

  1. I do not recommend messing with a glass vial without safety glasses, gloves, and a trash can nearby. I was lucky enough to avoid any major glass breakage, but some did happen, and I could totally see this craft getting wicked messy and potentially ouchie without taking the proper precautions.
  2. Insulin vials are stable AF…they are not meant to be tampered with.
  3. Glitter cannot be directly injected into an insulin vial. Period, bottom line, don’t even try it.

Okay, so now that I’ve got my disclaimers/lessons learned out of the way, let me tell you why I decided to fill an empty insulin vial with gold glitter.

For years, I’ve seen DIY projects floating around online involving old diabetes supplies. They range in the level commitment and skill involved, but there’s no questioning the creativity of our community when it comes to recycling supplies we’d normally throw away after using.

One project that I’ve seen over and over again is transforming an empty insulin vial into a Christmas ornament: Simply stick an ornament hook into the insulin vial’s rubber top, hang it on a Christmas tree branch, and bask in its beauty. I decided to take this concept to the next level by putting gold glitter into the vial because insulin is often referred to as “liquid gold” within the diabetes online community. What better way to represent that than to make it appear as though the contents of a vial were truly liquid gold?

In order to do this, I set aside a vial once I was finished with it/sucked every last drop of insulin out of it. Then, I made a sad attempt at combining glitter with water and using an old syringe to transfer it to the vial (needless to say, I had no luck). So I came up with a new strategy: Pierce the rubber stopper and try to funnel glitter in…and that didn’t work. It became evident that I’d have to remove the top entirely, so using my nifty new toolkit that my father just purchased for me (thanks, dad), I set about the task. I used a razor to carve the rubber stopper up and out, and then pliers to get the metal maroon covering off completely. I broke off a small piece of glass in the process – whoops – but using those tools did the trick for me…all I did after that was take the cap from a new vial of insulin and glued it to the top of the glitter vial to ensure most of its sparkly contents would remain inside.

And voila, here’s the end result:

Despite the glass breaking off, this DIY came out better than I expected.

As I held the glittery vial in front of my Christmas tree for a few photos (if I didn’t take pictures, then it didn’t happen), it occurred to me that there’s a strong likelihood that many families will have to make a difficult choice this holiday season: Give a special gift to a loved one, or use that money to pay for insulin instead. Or even more seriously, to have to choose between making this month’s mortgage/utilities payments, or getting life-saving medication.

The thought shook me, as nobody should have to make a choice like that ever.

And so I thought of something to add to my Christmas wish list: affordable insulin for all.

My Pharmacy Mailed Me a Broken Vial of Insulin. Here’s How I Handled It.

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As soon as I opened the package, I knew something was wrong.

The contents of said package were five vials of insulin – my regular 90-day supply. On the surface, nothing seemed wrong. They arrived in their usual styrofoam cooler that was taped shut. After removing the tape, I saw four ice packs next to the plastic packaging containing the insulin vials; again, this was all expected.

When I picked up the plastic package and used scissors to cut it open, though, a pungent odor greeted my nose.

A medicinal, harsh, familiar scent…the smell of insulin.

Upon further investigation, I discovered that one of the five cardboard boxes encasing the vials was totally damp to the touch. Gingerly, I opened it from the bottom flap, which was sticking out slightly due to the wetness. That’s when I saw the shattered insulin vial: Somehow, the bottom part of the vial had broken, spilling and wasting all of its contents.

I wish that smell-o-vision was a thing, because OMG…the smell coming from this was STRONG.

I was shocked. In all my years of diabetes, nothing like this had ever happened to me before!

I didn’t really give my next step a second thought: Immediately, I jumped on the phone with Express Scripts, which is the mail order pharmacy that I use for my insulin and some other medications. I spoke with and explained the issue to a customer service representative, who connected me with a technician that promised a replacement vial would be mailed to me at no additional cost to make up for the broken one. I asked if they needed me to send the broken one back to them, but I was reassured that it wouldn’t be necessary because I had called them so they could document the incident.

My issue was resolved, just like that, in fewer than 15 minutes. While it was annoying to have to take time out of my day to figure that out, I’m very happy that I got a replacement quickly and easily. But really, where was quality control on this one?!

Insulin is expensive, as we all know. And to see that a perfectly good vial full of it was rendered useless due to defective packaging was a major punch to the gut, indeed.

But this reminded me of the importance of being proactive whenever I suspect something is wrong with any of my diabetes supplies…when in doubt, do something about it.

3 Things I Want the World to Know About Insulin

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See that tiny glass vial in the below image? Can you believe that the contents of it are extremely precious?

Can you believe that, at approximately $9,400 per gallon, insulin is ranked as the sixth most expensive liquid in the world?

It’s kind of crazy, right? But besides knowing that insulin is priced outrageously, there’s actually a few other things that I think the world should know about insulin.

Ethan Zohn_ A Survivor Contestant Who Inspires-2

  1. Not all insulin is created equal. Just like diabetes, insulin exists in various forms. Besides liquid insulin, there’s also inhaled insulin (Afrezza). And some people with diabetes may even take oral medications that are designed to help increase the effectiveness of insulin that they either receive via injection or produce on their own. There’s brand-name insulin produced by several drug manufacturers (the big three being Eli Lilly, Novo Nordisk, and Sanofi) as well as generic versions of the drug…but that doesn’t mean that generic insulin works just the same as brand-name insulin for all people with diabetes. Insulin is complicated and different types work better for different people.
  2. Insulin is incredibly sensitive. Take one look at the vial in the above photo and tell me that the insulin inside it is safe at all times. Nope, it sure isn’t! Besides the packaging being super fragile, people who rely on insulin must also be careful to keep it at the proper temperature at all times. All it takes is dropping the vial once or leaving it in an unstable environment for the insulin to be rendered useless, potentially wasting a few hundred dollars. It’s as volatile as it sounds.’
  3. Taking too much or too little insulin is dangerous and life-threatening. For some people, there can literally be a life-or-death difference between one unit of insulin. Too much can cause blood sugar to plummet and a person can experience severe hypoglycemia that may result in shock. Too little insulin has the opposite effect: A person will experience hyperglycemia that can have ranging consequences, some that are minimal/temporary, others that are very serious. That’s why precision is so important when dosing for insulin; on top of that, nobody wants to waste a single drop of the stuff because it is so expensive. But this is what many people with diabetes need in order to survive.

So when you see the hashtag #Insulin4All or hear someone talking about how overpriced it is, you’ll know some of the basic characteristics about insulin that make it invaluable to people with diabetes. Perhaps you’ll be inspired to join the fight to make insulin affordable and available to all – as it should’ve been to begin with.

The Curious Case of Rotten Insulin

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I spent half of the month of August high.

NOT THAT KIND OF HIGH.

I’m talking about blood sugar here, people.

And I’m not talking about scary-high levels. I’m just referring to levels that are higher than I’d like – between 160 and 200. And I’d stay stuck right in that range, even after bolusing quite aggressively.

I chalked it up to stress – life has been a little unkind to me this summer. I also blamed it on making less-than-healthy food choices, and questioned whether I needed to seriously start thinking about taking Metformin again (even though I had a shitty experience on it).

In other words, I took the brunt of responsibility for my highs. I was angry with myself for letting my diabetes get out of my control, and was just starting to accept responsibility when it hit me that it might be something other than my body rebelling against me at play here.

As it turns out, I should’ve suspected an outside factor from the beginning. That’s because my insulin had, somehow, gone bad.

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The vial in question…it caused me a boatload of stress.

I’m still very confused about how or why it happened. My insulin had an expiration date that was like, 2 years from now. The contents within the vial were totally clear – discoloration would’ve indicated an issue – and everything about this vial of insulin looked completely fine.

It was, and still is, an utter mystery to me as to how or why the insulin spoiled.

If nothing else, the case of the rotten insulin made me wonder…why hasn’t anyone developed strips that can check the effectiveness of insulin yet?

Can somebody please get on that (and give me partial credit for helping to spark this genius idea)?

The $2,000 Mistake

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Have you ever received an email that made you stop breathing for a moment? Did it feel like time stood still as you blinked rapidly and tried to comprehend the meaning behind it?

It sounds like a dramatic overreaction, but imagine getting a notification from your pharmacy notifying you that your prescription would cost almost $2,000. That’s a big old chunk of change. The mere thought of paying that much for a supply of insulin makes my heart race and my palms sweat.

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I nearly keeled over when I saw this dollar amount.

I’m happy to report that this was a giant mistake; for whatever reason, my doctor’s office sent my prescription for Humalog to my local pharmacy, even though I explicitly told them that I use Express Scripts for my insulin orders. It was a total mix-up, and the approximately $2,000 was an amount that I would pay if I didn’t have any insurance coverage. I do, and though I’m not sure how much I’ll be paying for my insulin yet, I know that it can’t possibly cost this much.

I’m relieved that I was able to call the pharmacy and straighten this out without spending a cent of my money. But it was also a major wake-up call to a reality that many people are forced to face when it comes to refilling insulin prescriptions. It’s not fair. (That last sentence is the understatement of the century.) I can’t make any sense of it and I don’t know how many people have no choice but to fork over such a large sum of money on a monthly basis in order to live. Thoughts of those individuals and their dire situations scare me far more than navigating the world of health insurance ever could.

While I didn’t appreciate the mini heart attack this email triggered, I guess I am glad that it alerted me to the fact that I’m going to have to be aware of things like this going forward. As I figure out my health insurance costs and coverage, I anticipate more confusion, surprises, and expenses…but hopefully I can also expect/experience a pleasant discovery or two along the way.

Every Last Drop

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27 units. That’s exactly how many units of Humalog were left in my pod, and I had no choice but to literally throw them away. My pod was expired – it had been for 8 hours – and to my knowledge, 8 hours after a pod expires, it will cease working entirely.

I kept the pod on those 8 extra hours because I couldn’t bear the thought of wasting insulin.

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27 units and no choice but to throw all of them away.

It’s a strange, messed up game that I played. I was taking a bit of a risk by wearing my pod for so long after it expired. After all, it’s just a piece of technology, and it can sometimes be difficult to know whether or not it’s working properly when it’s brand new, let alone within the window of expiration. But this is the game that I have to play, along with so many other people with diabetes, because insulin is precious.

Insulin keeps us alive.

Insulin is a need, not a want.

Insulin is exorbitantly expensive, so much so that it ranks #6 on a listing of the 10 most expensive liquids in the world.

With that in mind, tell me…would you feel comfortable throwing away even one single unit of it?

One could argue that maybe I could’ve tried to extract the 27 units from the old pod and reuse it in a new one – but to me, that’s an even more dangerous game to play. I have no clue whether that’s safe, or if there’s too much risk involved with germs and cross-contamination. Maybe I’m just paranoid, but when it comes to my health, I have to be.

So as much as it pained me to be unable to use every last drop of insulin, I made the only viable choice for me and disposed of 27 units of Humalog.

27 units, 16 units, 3 unit, 1 unit…no matter what the quantity is here, every last drop of insulin is invaluable.

When will we see change? Is it really too much to ask for insulin to be affordable to all?

Why I’m Afraid to Turn 26

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I’ve never been afraid of my birthday. In fact, I’ve looked forward to it every single year because of all the fun things that distinguish the occasion. I’m lucky to be able to say that each third of May of my life has been filled with celebration, gratitude, and cake – what’s not to like about that?

But this year is different for me. I’m turning 26, which means I’ll no longer be eligible for dependent coverage under my parents’ health plan. I’ll need to enroll in my employer’s plan and figure things out from there.

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I don’t want a cake or presents for my birthday this year. I’d rather affordable health insurance.

This is terrifying to me. Why?

I’ve heard the stories.

Alec Raeshawn Smith’s story sticks out to me the most. He researched his insurance options and when he realized that the out-of-pocket costs for insulin were exorbitantly high, he decided to forgo insurance because it seemed more manageable to him.

He passed away just one month after going off his mother’s health insurance plan.

His family believes he was rationing insulin in order to survive until he could afford to buy some more.

There’s nothing about Alec’s story that isn’t tragic. It’s especially sad and frightening to someone who is about to begin navigating the confusing, expensive, and ruthless world of health insurance.

I’m hoping that I never get to a point where I need to pursue the dangerous “solution” of rationing insulin. But I’m also hoping that the biggies of insulin manufacturing – Novo Nordisk, Eli Lilly, and Sanofi – wake up and realize that they’re doing more harm than good. In 1996, just one year before I was diagnosed with diabetes, one vial of Humalog insulin (which I’ve used and continue to use since diagnosis) cost $21. Fast-forward 20 years, and Humalog costs skyrocketed to twelve times the cost at $255 per vial. Why? What could possibly justify this? How could anyone say that it is right for someone with diabetes who needs insulin to survive, and who didn’t ask for diabetes or do something to cause it, to pay that much on a regular basis to stay alive?

One thing is for sure: Insulin prices CANNOT stay as high as they are. There’s simply no reason for it, other than shameless, disgraceful greed.

And that is the simple truth of why I’m afraid to turn 26 this year.

Memory Monday: Cloudy and Clear

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One Monday per month, I’ll take a trip down memory lane and reflect on how much diabetes technology, education, and stigma has changed over the years. Remember when…

…it was a thing to mix insulin?

Yup, I’m referring to the days of cloudy and clear insulins – also known as NPH and Regular, respectively (insert corny Neil Patrick Harris joke here). Oh, you don’t know what I’m talking about? This is going back at least 15 years, probably more like 20, to when short-acting and long-acting insulins needed to be mixed in order to avoid having to take two separate shots. I only vaguely remember mixing my insulins, but here’s what sticks out in my memory about the process:

  • It was always “clear before cloudy” – the Regular insulin had to be drawn up in the syringe first to avoid getting any of the cloudy insulin into the clear vial.
  • The cloudy insulin needed to be rolled between the hands before inserting a syringe into it…I can’t remember why. Maybe to help bring it to room temperature, or make sure it was adequately mixed?

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I definitely do not miss the days of filling these bad boys with two different kinds of insulin.

  • Drawing the insulins into a single syringe was nerve-wracking as hell. Precision was everything.
  • Air bubbles! They ruined everything!

I certainly don’t miss the tedious process of having to draw up insulin in such a careful, precise manner. If only I’d known how much easier an insulin pump would make my life sooner…

…but I guess that just makes me appreciate my pump more.