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October 10, 2005

Hyperglycemia and DKA, Other

Question from Newport, Tennessee, USA:

I am 25 years old and have had type 1 diabetes since I was 14. I have no health insurance and no job because I have so much pain in my feet from neuropathy. I am in and out of the hospital so often with DKA that when I have a job, I don't keep it for long. Disability has been denied me and I can't afford to see a doctor. I had to go to the hospital Emergency Room recently to get a prescription for insulin because I ran out and had no other way to get it. I live with my grandmother, who is on a fixed income, and she had to scrape enough money together to buy me a bottle of insulin. I don't know what I'm going to do for my next bottle. Do you have any suggestions for me?


I would encourage you to meet with a social worker, or someone that helps patients with financial assistance, at your local hospital. Maybe you would be eligible for your state’s Medicaid insurance. Also, maybe you can apply for free care at your local hospital. Also, the insulin companies do have patient assistance programs for people without insurance where you can apply for free insulin on a temporary basis, although you do need a doctor to sign off on the applications. For more information on the Lilly patient assistance program, you can call 1-800-545-6962. For Sanofi-Aventis, you can call 1-800-221-4025. And, for Novo Nordisk, you can call 1-800-727-6500.

Additional comments from Dr. Jim Lane:

I empathize with your position. I know it is tough without the money to pay for the medications and supplies. However, you have to find someone who can help as the diabetes does not care whether it is treated or not. First, have you had contact with a social worker in your area? They would have contacts with clinics where there is low or minimal charge for care and access to low cost diabetes supplies. They may also be able to help you with the disability and Medicaid systems. In many metropolitan areas, there are low cost clinics with students and nurses that are supervised by physicians as part of an educational system. You may want to see if any of these are available in your area. Several of the insulin companies have pharmaceutical assistance programs. You may be eligible for these. The most important thing is go out and try to find the resources. You will have to be your own advocate as there is no guarantee someone will do it for you. Best wishes. I hope you can find yourself some good care. It won’t be easy but it is so important. Good care carries with it the potential of having the painful neuropathy treated more successfully and this may help you to keep a job that carries benefits and support.

Additional comments from Dr. David Schwartz:

A key, I think, will be to make an appointment with the medical social worker at the hospital that you frequent.

Other options include a “free-health” clinic, which is in many communities. Check this out in a community near you. And, you should contact your state’s medical school and their Division of Diabetes/Endocrinology. See of they have an outreach clinic near your community.