The Bitter Life of 'Sugar' Patients: Will the State Hear the Residents Suffering from Type 1 Diabetes? 0 18

Quiet, Treacherous, Terrifying

Let’s clarify, as having been at the picket near the Saeima, it became clear that few understand the depth of the problem without facing it directly. There are two types of diabetes: Type 1 and Type 2.

• In Type 2 diabetes, cells lose sensitivity to insulin (insulin resistance); this is often related to age-related changes, an unhealthy lifestyle, etc., and here medications, injections, or sometimes just diet can help.

• In contrast, Type 1 diabetes affects children and young people. It is an autoimmune disease in which the pancreas does not produce insulin at all.

The disease can literally destroy the body, causing irreparable damage to all vital organs. Hypoglycemic and hyperglycemic comas, blindness, cardiovascular and renal failure, amputations — this is far from a complete list of the risks faced by patients with this treacherous disease if treatment is absent or improperly administered.

A person with Type 1 diabetes faces daily, hourly questions hanging over them like a sword of Damocles: do they urgently need a dose of insulin? Or conversely, have they overdosed? Do they need to eat something sweet as quickly as possible to avoid fainting?

Therefore, constant monitoring of blood sugar levels — at least 5-6 times a day — is a matter of life. Throughout the day, they must repeatedly prick their finger to get a drop of blood on the test strip, obtain data from the glucometer, calculate the necessary dose of insulin, and administer it using a special "insulin pen."

And so it goes for a lifetime; one can only guess what it’s like to work, study, and lead an active lifestyle under these conditions...

A Dream of the Unattainable?

Fortunately, medical technologies are constantly advancing. To ease the lives of people with Type 1 diabetes, a wonderful combination of two devices (plus accessories) was invented a quarter of a century ago: a continuous glucose monitoring sensor and an insulin pump. The sensor attaches to the body and continuously displays blood glucose levels on a phone screen, while the pump continuously delivers insulin under the skin through a thin tube, allowing for much more precise dosing than using a regular "insulin pen."

Thanks to the sensor and pump, a person with Type 1 diabetes can lead a lifestyle that is almost indistinguishable from that of a healthy person. This is not only a matter of comfort but also of health and life.

All would be well — but it is very expensive. As the participants of the picket stated, the set (pump, sensor, insulin reservoirs, connecting tubes) costs its owner about 300 euros a month on average. It is clear that the average Latvian with a salary just above the minimum cannot afford such expenses. And if Type 1 diabetes affects more than one family member — even more so.

In EU countries (including Lithuania and Estonia), such sets are provided to all residents with Type 1 diabetes at the state's expense. In Latvia — only to certain groups: pregnant women and patients who have undergone amputations due to diabetes. Additionally, sensors are reimbursed until the age of 18, and insulin pumps until the age of 24.

However, unlike state support, the disease does not disappear after the age of 24. According to the Latvian Diabetes Association, the number of people with Type 1 diabetes who do not receive state-funded technologies is 5,878. Of these, 3,089 are of working age.

"Life is Not Sweet, Where is the Money for Our Sensors?"

The chant that the participants of the picket shouted in unison echoed through the Old Town. It was followed by others — directed at both politicians and specifically at Health Minister Hosam Abu Meri. The picketers — people with Type 1 diabetes and their supportive friends and relatives — held placards whose content reflected the same thought: ALL residents have the right to a normal life, and if technical means have been invented to ensure such a life, the state MUST find the funds for it. For everyone, not just for specific groups.

Realizing that this would require significant funds, the participants of the picket presented their arguments — which must be acknowledged as very weighty. For example, statistical data indicating that thanks to the use of sensors and pumps in managing Type 1 diabetes, there is:

• 49% fewer hospitalizations;
• 39% fewer hypoglycemic and hyperglycemic comas;
• 56% fewer cases of ketoacidosis;
• 51% less risk of hypoglycemia;
• 42% lower mortality from cardiovascular diseases;
• 45% fewer deaths from other diabetes-related complications;
• 75% fewer cases of hypoglycemia.

In other words, fewer instances requiring inpatient treatment, fewer emergency calls — the savings on direct costs are evident. And there are also indirect costs — disability, disability pensions, the need for social support...

The picketers emphasized: equipped with the necessary technical "gear," a person with Type 1 diabetes can make a significant contribution to the country’s prosperity. So even if we set aside the purely human aspect (which should not be disregarded in a civilized society), and consider only the economic factor, providing people with the necessary devices for maintaining health is PROFITABLE for the state.

A Question of Priorities

It was interesting to observe the reaction of the deputies who were heading to another session of the Saeima that day. Some rushed past the picket, clearly indicating that they were preoccupied with something much more important. Some stopped, expressed sympathy, demonstrated familiarity with the problem (though confusing Type 1 and Type 2 diabetes) and agreed that this issue could and should be resolved — it just requires correctly setting priorities in the state budget...

But who and how soon will start setting them? Who will finally analyze how rationally taxpayer money has been spent — and for years? Is there really a need for a huge administrative apparatus in a relatively small country, especially given the current development of digital technologies? Perhaps savings could be made by cutting funding for some NGOs and funds, the usefulness of which for residents is, to put it mildly, quite vague? Or finally establish PERSONAL financial responsibility for the squandering of public funds?

Clearly, such a "revision" could reveal where state expenditures could (and should!) be cut. And then there would surely be enough funds — not only for sensors and pumps for people with Type 1 diabetes but also for much more.