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The true COST of the Holidays

Happy holidays, and the happiest of New Years! Rachel here giving you a look into my Christmas Day. 

Today’s post is going to be a mix of a day-in-the-life of Type 1 Diabetes, and a demonstration of how expensive insulin is! I tracked my blood sugars and the insulin I used over Christmas Day, which in my family, traditionally features a lot of food, and calculated how much that insulin would cost without insurance, at market cost. I want to emphasize, however, that I am certainly not advising any particular type of management of blood sugars, especially because my Christmas had some literal ups and downs. I do not advocate this, and want us all to take the best care of ourselves possible! However, this is sometimes the reality of diabetes, and I pledge to be completely honest about my experience always!

On Christmas Day, I woke up around 9:30, and my family ate breakfast together. We had some delicious gluten-free waffles (I have Celiac Disease, so no gluten for me!) with blueberries, and sides of eggs and bacon. I was pretty spoiled that morning, I admit. It can be tricky to estimate carbs for things like waffles and pancakes, especially if they’re gluten-free because that typically means it’s higher in carbohydrates. I was 123 at breakfast, and gave myself 5.7 units. About an hour later, I tested at 161 and gave myself 2.85 units because I was snacking on some of the treats that were left in my stocking. Usually, my family sort of snacks all day on holidays, but I try to stay on top of it.

I then went to my dad’s apartment to celebrate my second Christmas, and we were watching some Christmas thing on TV while snacking. My CGM alerted me that my blood sugar was high- I have it set to alert me any time I am above 250- and said I was 276. I always test my blood sugar with a finger prick before I bolus, so I tested my blood sugar to find that I was actually 368! I was extremely shocked, because not only was my sensor very far off, but I also did not feel that high. I quickly bolused 7.825 units and stopped eating. I tend to be pretty aggressive with my high blood sugars, at least until they’re trending downwards, so about fifteen minutes later, I tested my blood sugar and it was at 406. This was the highest I had been in months, but I guess I had not been as on top of my blood sugar as usual, especially among the holiday festivities, seeing family, and playing with my very cute dog. I gave myself another 1.525 units, as directed by my pump. Thirty minutes later, I had come down to 335, and by the time we had dinner at 6:45, I was 244. Phew!! I gave myself 12.05 units for our delicious pasta dinner- again, gluten-free, of course!

I had a few more boluses later on that night for snacks and wine (don’t worry everybody, I am 21!), and ended up going low at 9:37. A lot of times, when I come down from high blood sugar, it seems like my glucose doesn’t really know when to stop lowering, but I caught it at 75, and treated with a few glucose tabs. It was definitely an abnormal day, but holidays typically are, for me.

By the end of that day, I had bolused 40.6 units, and my total basal amount (which, for me, was determined by my Medtronic closed-loop system) was 31.475 units. This is 72.075 units of Humalog total. According to Beyond Type 1, Humalog now costs roughly $300 for each vial, which contains 1,000 units (https://beyondtype1.org/the-insulin-pricing-machine/). Feel free to check my math, but that means that the market cost of the insulin I used on that ONE DAY was $21.62. I was shocked by that number, clearly, so I looked at my average total daily dose (something your pump usually can show you!) over the past 30 days, and that was 64.1 units, which adds up to $19.23 per day. That means that the market cost of my average month of insulin is about $575.

I’ll let you draw your own conclusions about that price. Personally, I am just grateful this holiday season that I have the help that I do in managing and paying for my diabetes, and that I was able to get my sugars under control to keep enjoying my holiday. I hope that we can find better ways to price pharmaceuticals, and have my own resolution to be more knowledgeable about the legislation that affects my life- and the lives of other diabetics- so directly.