Feet? You were lucky enough to have FEET?
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I think this is the sketch below, I love this one!
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What is it that you don’t want people to see? That most of us (but not all) had negative experiences with R+NPH and are wanting you to be prepared and proceed cautiously…? 'Cause that’s how I’m reading this thread.
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No just the bickering. It was supposed to be a thread thatd make people feel empowered and unlimited and instead it wandered off in a totally different direction
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I will join you @Sam - let me know when you are ready to start. 2% of the US market, and 80% in the UK will be right next to us.
And for the record, I’m not on a regime. Weekdays I get up and go to work. It puts me on a schedule, just like millions of others who work. Weekends, not so much. But since I choose to eat regularly and healthy, I am one of “the few.”
People - please listen to yourselves. In your offense, you don’t see your own offenses.
Curious, do you have a citation for that? I’m surprised to read it. Is getting hold of analogues in the UK as difficult as getting hold of a pump/CGM?
Unlimiteds on the thread:
I feel uncomfortable about the tone in several of the posts. This community has always been one where we all know we trust and care about others. It is disturbing to me, and I think to some who would read this thread, that this has not been true in this thread.
It is clear to me that, due to the fundamental ambiguity of forums, some posts in this thread could have been read as provocative and invited a response. I believe that nobody tried to or intended to demean anyone else. I also understand that some took offense because they felt there was ground for it.
I feel that this is a valuable thread though, that exposed strong opinions and information that is useful to many. I would like to have one of our mods lightly sanitize the thread so that we can relist it for all to read. Please let me know privately, by PM, if you disagree (or agree). If there is any disagreement with this thought, we will leave the thread untouched, and unlisted.
National Institute For Clinical Excellence recommens it for Type 2 and some Type 1 diabetics (2016) . Admittedly, it is based on NICE numbers from 2013. But keep in mind their national health determines what most people get, and they recommend the lowest cost option. Private insurance and self pay happens too.
They also don’t pay for a CGM either, I believe—am I wrong? To us, a CGM was a life changer, truly. In most senses, it seems to me PWDs are better off in the US, despite our insurance woes. For that reason, I don’t see the UK as a reference to imitate in diabetes. Mo2c, of course.
From my time there, correct. Only with private insurance which many higher income employees get as a benefit.
Should they be imitated? Maybe no, but they and many other countries have higher percentages of diabetics on nph and other “old” regimine with “acceptable” a1c’s. That would sort that out may not be as awful as we think.
UK (and others) still sells porcine and bovine insulin, too.
I’ve priced out my expenses if I were to move to the Netherlands (something I’ve seriously considered). $100 premium/month with a total of $350 expenses (this is the deductible but there is no additional cost-sharing once you have met the deductible). This article http://haiweb.org/wp-content/uploads/2016/04/ACCISS-Prices-report_FINAL-1.pdf indicates that both Tresiba and Novolog/Humalog would be covered (after paying $350 deductible). The cgm is not covered, but I’ve contacted Dexcom and they’ve quoted the cost of the transmitter and sensors in the Netherlands. Based on how often I change the sensors, I would spend about the same total amount as I spend in the U.S. for maintenance and premiums, but I would be completely covered if an emergency were to occur. In addition, if I ever were to lose my job, I could count on the same level of care (aside from the cgm) for $1,550/year.
It’s all a matter of perspective and priorities. Different countries prioritize things differently. In some ways the U.S. is better, but in some ways it’s worse.
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This, to me, is a huge plus, and one that we need to fix in the US.
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If this is true, then stick with your current Insulin regimen and don’t switch. Since, in the end, you’ll have enough money to buy whatever insulin you want even without a job and without insurance. I think a lot of us are just trying to figure out what your intent is for doing the test.
If your intent is to show wealthy individuals how this experience will “not be a big deal”, then you may succeed, since you’ve indicated you have enough money to use whatever technologies/insulins you want in the future with or without a job and with or without insurance. Since you’re a minority, “normal people” who aren’t in your financial situation would garner very little from your experiment because they “won’t have the choices you have” when they lose their job/insurance. They MAY not be able to have a CGM. They may NOT have the choices you have.
So if you sincerely want to do a test that will benefit EVERYONE, whether you have money or not, do it for a month, without any other form of technology which would be too expensive to a large majority of Americans.
I am looking forward to seeing the results of this experiment that you’re going through and I also hope you consider doing it without CGM at some point (even if just for a few days) to see if that makes things any different in your experience. When you test, think about how a large majority of Americans will be taking this Insulin and dealing with this circumstance, not how the 1%'ers would deal with it.
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Assuming we’re just talking about T1 diabetes here (since this has been what the thread is about), then the docuemtn says:
NICE recommends:[7]
Offer MDI basal-bolus insulin regimens, rather than twice-daily mixed insulin regimens, as the insulin injection regimen of choice for all adults with type 1 diabetes.
I couldn’t find anything saying that the majority of T1s use NPH. The UK system seems quite similar to what we have here in Canada, and I’d be utterly shocked if anywhere near 80% of T1s here used R and NPH. Maybe 8%…maybe…
It seems to me that people may be better off in the US if they have good insurance. Otherwise, they aren’t. I quite like our heatlhcare system in Canada. It’s not perfect, and no it doesn’t cover everything (like CGMs), but the vast majority of Canadians are happy with it.
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I can’t think that it is possible to make this work well without a CGM, though. I am guessing that doing it without a CGM is doable, but not with a very good A1c (although @Eric succeeded). To be able to make a success out of it, I think he will need to test the heck out of the day.
So I think that at least starting with a CGM makes sense, imho. If that works, then going without would be interesting, as a second stage. That is the grand slam.
Of course, these are all @Sam’s decisions 
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Agreed, I just think if he wants to do a real test that is really beneficial, then he’ll have to do it like a majority of Americans would be forced to do it; otherwise, it’s more of a “I did it, you guys suck” deal. And that wouldn’t be very helpful.
If he can provide how he’s doing things (assuming he’s successful), that would be of great benefit to many as perhaps the strategies they were using weren’t correct. But the whole point of everyone’s argument (besides Sam) was that R/NPH would be for survival only and really would suck…UNLESS you were wealthy enough to have the other perks that are necessary (such as CGM) while using it.
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I don’t think @Sam’s experiment will necessarily be a simulation of reality. Not only use of a CGM, but also the fact that he plans to start at a convenient time in his schedule and the fact that he plans to use just NPH at first before adding in R. These are advantages that people wouldn’t have in a “real world” scenario.
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Of course they are. If you’re using a cgm and you run out of insulin for whatever reason, does your cgm just go up in a puff of smoke or do you have it until you run out of supplies?
I plan to start when I’m not at work— to compare what it would be like if one were not working…
If you realized that you were going to be unable to afford analog insulins wouldn’t you figure that out at least a few days in advance of being bone dry empty and probably try to test one out for a few days before adding the other ?
How is any of that unrealistic…
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Don’t assume. A diabetic on insulin is a diabetic on insulin. Their guidelines day to stay with NPH twice a day. Another of their reports says 80% of diabetics.
I’m not going to argue. Go there yourself, and experience it firsthand.