Insulin Rationing

INTRODUCTION:

Insulin is a hormone produced in the pancreas, which regulates the amount of glucose in the blood. Insulin is a drug most commonly used to control blood sugar levels in people who have insulin- dependent diabetes. Diabetes is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine. Insulin list prices in the United States have increased dramatically over the past decade. Insulin prices are higher in the US than any other country. The insulin prices in the US are eight times higher than in 32 high-income comparison nations combined.

WHAT IS INSULIN RATIONING:

Rationing insulin is the act of skipping insulin injections or not taking enough in order to prolong each dose. People with diabetes do this because they cannot afford enough insulin to take full doses everyday. Rationing insulin is dangerous and should not be attempted. Insulin rationing is widespread among people living with type 1 diabetes. Many countries lack financial support systems for those with type 1 diabetes who struggle to afford insulin and other diabetes care costs.

STATISTICS:

• 30% of 500 people with Type 1 diabetes were rationing insulin due to high cost according to an informal survey by the organization Beyond Type 1
• 66.2% of all respondents in the 2018 T1 International Patient Survey said that they do not receive any kind of support to help cover their diabetes costs.
• 26% of people who have diabetes around in the US rationed their insulin at least once in 2018.
• 25.5% of patients at the urban clinic at Yale reported insulin underuse related to cost, including using less insulin than prescribed, not filling a prescription, or stopping it.

CONSEQUENCES OF INSULIN RATIONING:

Diabetic Ketoacidosis (DKA):

When the body doesn’t have enough insulin in the bloodstream to allow blood sugar (glucose) into cells, blood sugar levels rise. The body turns to another source of fuel for energy and it begins to break down fat. This causes the release of compounds called ketones into the bloodstream. Ketone build up in the blood makes the blood more acidic. This is diabetic ketoacidosis (DKA). DKA can cause severe dehydration and leads to kidney damage, brain swelling and brain damage, stroke, heart rhythm problems, fluid build-up in the lungs and respiratory failure. One can lose consciousness, go into a coma and die in a short amount time. The body also produces more glucagon, adrenaline, cortisol and growth hormone as your body attempts to regulate itself.

SOURCES:

1. Harrar, W., Gentile, J., Vieira, G., Nilsen, M., & Amy Hess Fischl, M. (2019, January 16). Insulin Rationing: What It Is and Why It’s So Dangerous. Retrieved November 25, 2020, from https://www.ontrackdiabetes.com/live-well/diabetes-management/insulin-rationing-what-it-why-its-so-dangerous
2. Gathering Evidence on Insulin Rationing: Answers and Future Questions. (n.d.). Retrieved November 25, 2020, from https://www.ajmc.com/view/gathering-evidence-on-insulin-rationing-answers-and-future-questions
3. Team, P. (2018, November 14). The Deadly Consequences of Insulin Rationing. Retrieved November 25, 2020, from https://www.pasadenahealthcenter.com/2018/11/16/deadly-consequences-insulin-rationing/
4. High insulin costs are killing Americans. (2020, April 13). Retrieved November 25, 2020, from https://rightcarealliance.org/actions/insulin/