Recently there was a story about a diabetic who died because he couldn’t afford his insulin. And the hurricane news brought other stories up about people needing insulin, and a preparation thread.
I wanted to address the survivability issue when someone can’t afford their prescriptions or loses insurance coverage or is far from home with no meds.
This is not a recommendation on ideal treatment. This is what keeps you alive for less than $50.
Both ReliOn Novolin N (NPH) insulin and ReliOn R insulin are available from Walmart for $24.88 per vial WITH NO PRESCRIPTION. Syringes are also available with no prescription.
R is a mealtime bolus insulin, but slower than the current popular rapids. NPH is a medium length basal.
As a treatment example - a shot of both NPH and R in the morning, the R is slower than current rapids, so it would cover both breakfast and some of lunch. The NPH starts to come in around lunchtime, and helps with lunch and also helps cover dinner. A little more R with dinner, along with the NPH that is remaining from the morning will cover the dinner. And a little NPH at night covers you through the night.
Lose insurance? In a strange city with no access to anything? No prescription? $50 keeps you alive.
@Sam, this is somewhat related to your prep thread, but a bit of a tangent. Merge or keep separate, whatever you think is best.
The reason I wanted to post this is because of that guy who died from not having insulin and no insurance. The whole thing is crazy.
I mean, I know people are bashing R and NPH, but jeeze, if you don’t have anything else, it really can keep you alive. No matter what city you find yourself in, no script or anything, as long as you can get your hands on $50, you can stay alive.
Yes I completely agree… it’s silly to me that every time we mention using it in life and death scenarios the knee jerk response is immediately negative… we’re not suggesting it as a first choice best option (although many people in the world consider it theirs) we are presenting it as a way to survive
Agreed. Definitely good information for anyone - we just never know what can happen, as we found out many times in the past, and most recently with what’s going on in Texas, this information may be the difference between life and death if we ever find ourselves in one of these disasters.
I totally agree, R and NPH may not be ideal but they sure beat the alternative.
I have not experienced using these insulins but I’m certainly not proud, i would use them in a heart beat. I look at things from a T2 perspective and to me it seems that for someone that only does basal insulin NPH would work nicely if spread out a few times a day. For a T2 like me that needs both basal and bolus I think I could manage in the same fashion as a T1 on these insulins but with a higher dosage due to my insulin resistance.
I haven’t used them either-- although I absolutely keep a decently large stockpile of R, NPH, and 70/30 (which also doesn’t require an rx) on hand… on a different forum I tried to tap ito the brains of some old timers who could outline a decent baseline protocol for disaster usage and didn’t get very far although @drbbennett did give me some tips. I’d really love to see some experienced guys who dosed for years with R and NPH outline a simple staying-alive in WW3 outline for R and NPH…
I’d also be willing, as FUDs self appointed secretary treasurer, as we grow, to maintain a stockpile of R and NPH available to any of our members in any type of emergency. It’s a non prescription item so I see no conflicts in that regard (hope I don’t get banned for saying that)… we’d have to work out some logistics but I think it’s a really good idea and I’m willing to dedicate some personal resources to making it work
I believe the limited shelf life is largely a regulatory myth. I can certainly tell you I have an apartment sized refrigerator full of largely expired insulin that I have no intention of ever discarding… as a Good Samaritan providing emergency non rx meds to others I don’t think I’d have to either…
Even if I did have to discard to keep within date-- at $25/ vial who cares?
I spent 13 years on R (later Humalog) and NPH, but I don’t think my regimen was that great (two to three shots a day). I had “okay” control (A1c in the 7% range) but that came at the price of one or two serious lows (requiring assistance from others) on average each year. If you’re interested in this type of regimen, I’d pick up an old book about Type 1 diabetes published in the '80s or '90s (I haven’t read it, but maybe something like this). However, I think there are probably better ways of using these insulins to approximate a basal-bolus regimen and reduce the risk of serious lows than many of us used back in the day, such as using four shots of NPH to approximate a flat basal rate and a shot of R at each meal, or something similar.
I seem to be failing to get this concept across— in this scenario, the goal is avoiding short term death, not shooting for a sub7 A1c… we are not looking for perfect protocol-- looking for avoiding death in most simple terms possible in horrible emergency scenarios
Yes, but the goal is to avoid death from DKA and death from hypoglycemia, right? The problem with the R and NPH insulin is that the peaks and valleys created by a two- or three-shot-a-day regimen caused extreme highs and extreme lows, but not much in between. My A1c may have been around 7%, but I was hitting 25 mmol/L and 2 mmol/L most days. So in order to get any semblance of stability, especially in a situation where you don’t have an exactly fixed and consistent schedule in terms of exercise and meals (something the traditional R and NPH regimen relied heavily on), you would have to use these in some approximation of modern insulin regimens. Others may disagree with me, but that’s my opinion based on my experience.