Sunday, August 02, 2015

Testing Your Blood: The Importance and the Expense

Why read this post if you do not have diabetes, type 2?  Well, answer me this.  Do you know anyone with diabetes type 2?  (Click here for an explanation about diabetes type 1 and type 2.  For this post, I'm focusing solely on diabetes type 2.)  I’m guessing (especially if you are Chicana/Chicano or Latina/Latino) you will say “yes.”  You probably know a family member, a friend, a co-worker who has it. And if you have a child, know this statistic: 1 in three children born in the U.S. after the year 2000 will develop Diabetes.  Stay with me. 

Diabetes has become a widespread disease because it is exceedingly complex.  It touches all the multifarious and labyrinthine layers of our human body’s systems.  I’m talking about the cardiovascular, endocrine, respiratory, lymphatic, urinary, muscular, reproductive systems.  And because every body is unique (think fingerprint), the disease manifests itself differently in each individual.  That is why education is often lacking.  Doctors, nutritionists, diabetes cookbook authors, etc., tend to disseminate one solution to many without taking into account each person’s individual body and symptoms.  The impulse is to go for the simple, "one treatment for all" instead of taking the time to educate each patient toward a more complex and ongoing relationship with ones body, which is constantly in flux. 

So how can you truly get to know your body and/or individualize your diabetes management?  The answer lies with your blood.  Whether or not you have diabetes, your blood can tell you a lot about your health.  It can tell you if your blood glucose level is too high, too low, or stable.  It can tell you if your cardiovascular system is being compromised by plaque caused by an overabundance of glucose in the bloodstream.  You can truly become your own medical manager by becoming intimately connected with your blood.  But most people don’t know how much they can learn from a drop of blood.

Finger is pierced. A drop of blood placed on a glucose strip.  The meter then reads the glucose level.

I can’t tell you how many times I’ve talked to people newly diagnosed with diabetes who say their doctor (1) told them they have diabetes and (2) prescribed a pill (most often metformin). I ask:  did your doctor tell you what your blood glucose was, or your A1C level?  Did they tell you what metformin does?  Most often they tell me “no” and that they don’t know what a normal glucose level is or what an A1C level is.  Then they tell me the doctor simply said to cut down on desserts. 

Today roughly 80% of individuals with diabetes are not managing the disease very well, and only 20% are successful at management.  What I mean by management is that the individual is able to keep track of her/his blood glucose levels and the individual is able to self-monitor and understands what to do when blood glucose levels are too high or too low.  Often, individuals are popping a pill or injecting insulin and continuing to eat whatever they want because they haven’t received education about carbohydrates, fiber, about how foods with a high glycemic load affect glucose levels (it's not about desserts). Exercise is crucial in managing this disease but the kind of lifestyle the average person in the United States leads does not often include exercise—especially for those individuals who are working long hours, who are living in areas where walking outside is too dangerous, whose family commitments are daunting.  Individuals with diabetes can be too busy placing other family members’ needs first before their own. 

Successfully managing diabetes demands shifting priorities, redirecting commitments and, unfortunately, management of the disease demands money.  Those who are working class or poor have much less means to manage this disease. If blood monitoring could become more affordable, if diabetes education were focused on empowering the individual to understand her/his own body, I believe the percentage of those successfully managing the disease (20%) would increase. 

The key, as I’ve said, is getting to know your blood and there are tools to do that. Here’s a quick lesson:

Glucose Meters
1.     Glucose meter:  not too expensive and sometimes they can be purchased with a discount.  They range from $5 to $30 (sometimes more).  The meter will come with a lancet device and lancets which pierce the skin (usually piercing ones’ finger) to draw blood.

Glucose strips
2.     Strips:  Here’s where it gets expensive. You place the strip into the meter.  After piercing your finger, the blood (just a drop) is placed on the end of the strip (see picture). 

Placing blood on the strip

The strip is designed (with enzymes) to react to blood chemically and transform it into electricity.  The meter will pick up the electrochemical signal translating the concentration of glucose into a number which appears on the meter. Because of the science behind the manufacturing of the strip, pharmaceutical companies hike up the price of each strip.

50 Strips come in one container (over $1.00 a strip)
In her article, “Anatomy of a Test Strip,” Dr. Erika Gebel, writes, “Little test strips are big business.  At Roche’s plant in Indianapolis, giant machines work around the clock to turn out test strips, a projected 4.2 billion in 2012 alone.  And that’s just one manufacturer.”  At a little more than $1.00 per strip (that’s without insurance), one container of 50 strips is in the $60 range.  And if you are testing more than once a day, the monetary hit can be painful. This is one major reason why individuals with diabetes stop testing their blood.  Here are other reasons: (1) some strips are not as accurate as others and it can be frustrating; (2) it can be difficult to get used to piercing one's finger but lancets are getting more sophisticated and less painful. The Genteel Lancet is the latest proven easy-to-use and painless device.  It really does work, but it's not inexpensive. Here's an article about the Genteel Lancet (click here).  

An article by Amy Tenderich (published in 2007) explained that test strips actually cost 8 to 12 cents to manufacture.  Manufacturers make between 60-80% profit on strips.  Illness in the U.S. is high profit for pharmaceutical companies.  Have you ever noticed how many commercials you see on TV that have to do with pharmaceutical drugs?  Check next time.  Billboards, magazine/newspaper ads, online ads--most often are from pharmaceutical companies.  And many of them have their own glucose strips to sell.  Do you ever see any ads about educating people to get to know their bodies, to understand how food and exercise actually works to heal the body, to keep the body healthy? There has to be a way to stop sacrificing the lives of so many people in exchange for profits.  If we work toward having every individual (whether they have been diagnosed or not) learn how to become intimately connected with their own blood and body systems, I'm convinced we can prevent or help individuals with diabetes successfully manage the disease.  Our lives depend on it. 

For other posts I've written or interviews I've conducted, see below:
1. Why Diabetes is not like any other Disease
2. Talking to Young Chicanas & Chicanos/Latinas & Latinos about Diabetes
3. Diabetes on Madison Avenue
4.  Creating Art from Diabetes
5. The Body with Diabetes:  Interview with Christina Elizabeth Rodriguez

Sending all of you strong healing and positive energies!  Abrazos!

No comments: