Diabetes Self-Management Blog

OK, all Gomer Pyle references in my title aside — or, for those of you who know it better from the end of Pink Floyd’s song “Nobody Home” from The Wall, all Pink Floyd/Gomer Pyle references aside — I have some musing to do on my durable medical equipment.

I’m a person with Type 1 diabetes. I’m insulin dependent. And I use an insulin pump. When it comes to health insurance, I am one of the “haves.” I have great insurance coverage. I have an employer-paid plan that covers 100% of all of my diabetes-related health-care costs when it comes to prescription medicine and diabetes supplies (doctor visits require a $15 co-pay).

And I have supplies-eyes that are bigger than my needs. See, I’m human, so I want and need. During my first year or so with diabetes, I knew I wanted — and needed — to get a handle on my self-management and maintain my blood glucose as close as possible to 120 mg/dl to bring my HbA1c down. Therefore I wanted to test my blood glucose about ten times per day, and my endocrinologist prescribed that many test strips.

I also knew, once I received my insulin pump, that I wanted to change my infusion sets and cartridges on time every time, and they told me I needed to use the alcohol wipes and skin-prep wipes and site dressings. So I did so. Religiously.

My diabetes medical supply provider automatically sends me a new box (or boxes) of supplies roughly every 40 days, so I didn’t have any worries. Everything was pretty much at my house when I needed it.

These days, however, I’m a seasoned diabetes veteran. My average for testing-per-day has dropped to about six or seven blood glucose checks. For the insulin pump and its accoutrement, I’m able to stretch things out more than I used to. I will fill up the insulin reservoir with enough insulin to get me through four — maybe five — days, rather than the every-three like it was recommended I do. I will push an infusion set for four or five days, too (I don’t think I’ve gone much longer than that); and I do this in part because, yeah, I’m sometimes lazy and the site changes are a pain, but also because I’ve yet to have any infection from leaving sites on longer. I haven’t experienced any problems from stretching the supplies’ duration. (And if you want to speculate about manufacturers’ recommendations for frequency of materials change and how much of it is for health safety and how much of it is for more use and more profit, feel free.)

Sometimes I use the skin-prep wipes when I change the infusion set. Sometimes I don’t. I use the surgical dressing, however, by cutting it into a larger circle than my infusion set and then cutting a little circle within that, then pasting that over my infusion site to keep it more firmly affixed to my body. Yet for both of these products, I use less than ten each per month. But how many come in a box each time they send me new products? Fifty. Each.

And lancets? Don’t get me started. Lancets, lancets, lancets. They’re everywhere. And because I don’t even use the type of lancets they now send me — instead I use, and love, my Accu-Chek Multiclix, for which I have 90 boxes on hand — I’m accumulating thousands of lancet needles I’ve no need for. (Oh, and if you wonder why I’m getting lancets I don’t need? Long story. Told them not to send. They still send. And it goes back to my laziness and not correcting their error.)

So what to do with all of these supplies? Well, there’s iPump.org for the supplies. For my insulin? Well, I never end up with extra insulin, but there’s a list of places to donate insulin, too, at iPump.org. I’m sure an Internet search can turn up dozens of other places to donate, as well.

But have I donated any of my supplies? No. Will I? I don’t know. I want to. But then again, I worry about the “what-ifs.” What if something happens and I lose my insurance and can no longer receive the great coverage I have? What if, by donating and continuing to knowingly receive more supplies than I’m currently using, I’m committing some type of low-grade insurance fraud? And what if I did contact my medical supply company and changed the quantity of some of the items? If I lower the number of something (say, for example, the number of test strips), then if I want to or need to, in the future, increase the number of tests I perform daily, will they allow it? And even if they do, do I want to spend the time necessary to jump through all of the hoops, go through all of the phone calls and the inevitable confusion between doctors and insurance providers and supply companies?

No. No, I do not.

So instead I’ve kept the status quo and continued to accumulate diabetes goods on the ever-expanding medical-supply shelf in my closet (it’s expanded into a dresser drawer now, too).

I think someday soon I’ll ship some supplies off to iPump. Really. I will.

Do you send off your extras? What do you do, those of you fortunate enough to have this problem? Sit on ’em? Throw ’em out? Use all of them?

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Comments
  1. It’s a continuous, internal struggle for me too. Sometimes I’m in a hoarding mood, and sometimes I’m in a purging mood. I too have fears that I’ll someday “run out”, whether by losing my job and/or insurance coverage. So sometimes I hoard, and allow the local medical supplier to send me more than I know I’ll need. And other times, the box in my closest gets so ridiculously full that I call and tell them “Stop the auto refills. I’ll call you when I need something”. Right now I have had autorefills turned on for my test strips for a while, and just asked that autorefill commence again for my infusion sets. But, I have three unopened cartons of insulin cartridges, so I won’t be needing any for a while. The problem with not having things on auto refill, though, is that I get into the mindset that “I have a ton of everything” and then I go to replace something and find it’s virtually out, so I have to raid my cache of supplies at work to last until I can get a refill.

    Another point is that infusion sets and cartridges will never expire, so perhaps it makes more sense to hoard those than it does strips. But, since I know I’ll only be on the Cozmo for a limited time longer, there’s still a limit on how many supplies are actually worth hoarding.

    Lancets: I am still using the same couple of cartons of them that I left home with when I moved out of my parents’ home ten years ago. I only change lancets when they get very very dull, which for me is about once every 2 months or so. “Bad diabetic! Tsk tsk.” Too bad for the lancet-makers. On the other hand, I move my infusion set at least every 48 hours, sometimes more often, which I know is significantly more than average. But, I get big pools of insulin built up under the sets, and blood in the canula, if I let it go much more than that.

    I’ve never heard of iPump. I’ll have to keep them in mind. There’s a lady who posts on the local freecycle from time to time asking for blood strips of any type. I gave her some unexpired strips from a meter I no longer own once. I’m not sure what her story is.

    Posted by Aaron |
  2. I am a Type 1 diabetic using an insulin pump + CGMS with pretty good insurance coverage. I also hoard supplies. I’m always worried about losing my job, my coverage, or having to switch to a different plan that is not as good as my current one. Before I started using the sensors I was testing 12-18 times a day. I am hypo unaware and testing is the only way I knew what was going on. When I started using CGMS last year I kept my strip prescription the same. I get 4 boxes of infusion sets every 90 days and I do change them religiously every 3 days. I don’t have many bad sets so those extra boxes started to pile up. I did have Minimed stop sending reservoirs ages ago because I fill mine (300 units) completely and use it until it’s empty, while still changing the cannula every 3 days. Not too long ago I gave away lancets that were really, really old (for a friend’s cat). I change my lancet just a few times a year.

    I have a very good stockpile of sets, reservoirs & test strips. I sometimes feel guilty about it, and I did give away some several months ago to an uninsured pumper on a forum I frequent. Still, I don’t want to give away much. I remember not having insurance for the first 11 years of having TYpe 1. I was 19 when I was diagnosed and had just aged off my father’s insurance. I paid for everything out of pocket even after getting insurance, because my original plan had no pharmacy benefits. It just covered doctors & lab tests. I’m afraid of being back in that position - no insurance or the minimum.

    I’ll continue to keep my extras but probably could be persuaded to part with *some* on an emegency basis.

    Posted by Liz |
  3. What if tomorrow never comes for you. Today could be your last day. You had the opportunity to contribute to those who may not be able to obtain the supplies that you have just sitting around. You have been given a blessing to be a blessing. Go NOW and be a blessing you may not have this chance later.

    Posted by Laverne |
  4. No wonder insurance coverage is getting so expensive and so many have to do without. Co pays are going to continue to go up. Send back or donate what you don’t need. I have a co pay on my meds. How much has your stockpile really cost you?

    Posted by airborne mom |
  5. I had a similar situation. My wife and I are T2. My elderly mother was recently moved to a nursing home after her home care by my sister became overwhelming.

    My sister sent me some of the diabetic supplies (test strips, lancets, etc.) that were left, since the nursing home furnishes all of my mother’s supplies and she thought that we could made use of them. We use different meters and have more lancets than we needed already.

    I literally spent weeks trying to find an organization, group or charity to donate them to. I tried my local health dept, Red Cross, and others recommended by the ADA. Finally I found a diabetes educator at a very large hospital that said that she could use them.

    It can be frustrating. I only wanted some fairly expensive supplies to go to someone who needed them.

    Posted by Phil |
  6. I am not as fortunate as you are, but I have switched to different supplies and had left overs of the other one and I donate them back to my endocrinologist and the diabetic nurse to give out to newly diagnoised patients. All my supplies are still sealed and the insulin is a full bottle with the seal still on it.

    I too wear an insulin pump and have recently changed from a 45 degree insertion needle to 90 degrees and no longer use a particular type of insulin which I bought just prior to the insulin pump so the seal is still intack.

    Posted by Janet |
  7. I wish I had that problem! I am on our state’s version of Medicaid which does NOT cover any testing supplies. I can’t even afford a new meter and test strips and have yet to find any place that I can get those for free even though I am on SSI. I have had to go without testing for some time now. I asked my endocrinologist if she knew of any way for me to get the supplies I need; she did not know of any.

    Posted by rivka |
  8. Way to go, airborne mom! i agree!
    I have underpaid work, no health insurance except what my county hospital offers; been there for 5 years. The diabetes clinic i interface w/ had me sign a medicare form so that my doctor visits, supplies, are paid for that way.
    i can understand the hoarding-been there.
    I agree w/ airborne mom that getting more supples than we need increases insurance costs for some one-usually the insurance companies that charge more; the clients try to use them less because they can’t afford the costs - a vicious cycle.
    I sympathsize w/ rivka.
    Rivka, do you have access to the internet? there are diabetic websites that suggest where to log into to get low cosT(really low cost testing supplies. I gather that being on SSI pays for montly expenses and there is very little left for diabetes supplies?
    what brand of meter do you have now? how old?
    maybe I can help somehow.

    Posted by misskitty3 |
  9. For Meters - check the ads for your local drug stores and even the super markets for meters. I don’t know where you live - I live in Central Florida and the ads have meters on sale all the time and a lot of the time there is a coupon with it to get the meter for free - either an instant rebate or mail in rebate. If they aren’t free alot of times you can find them at sale prices of about $20 or so.

    Also check your coverage - you may find if your doctor writes a script for the meter, strips, and lancets you can submit the receipt and get reimbursed for the cost of the meter,and/or maybe get a discount on the cost of your strips and lancets.

    Also this magazine - Diabetes Self Management ran an article roughly 4 months ago? that listed Foundations and organizations you could contact for free diabetic supplies - it was very informative.

    Posted by Suzanne |
  10. Hi Suzanne,

    Thanks for your comment. I believe the article you are referring to is “Diabetes and the Downturn: Getting Care During Tough Times,” which can be found here.

    Thank you for your interest in Diabetes Self-Management.

    Sincerely,
    Diane Fennell
    Web Editor

    Posted by Diane Fennell |
  11. my son is 30 years old it took him for ever to get a pump and now he has no ins please if someone has extra pump supplies please let us have a few tubes and any thing eles you will give us we can’t buy these and i worry abount him useing the tubes and things to long one tube cloged up on him the other night and his sugar went to 500 so please help if you have extras,we need help asap,

    Posted by jackie |
  12. we are asking for your help with any supplies

    Posted by jackie waldrop |
  13. Ipump.org is changing their direction and no longer has anything posted on donations.

    Posted by Nelson Murry |

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Living With Diabetes
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The Foibles of Dealing with Diabetes (06/17/14)

 

 

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