As diabetics, we are all well aware of fast acting insulin and the vital role it plays when it comes to keeping us alive and upright, but for those newly diagnosed diabetics (type 1 and type 2), Insulin is secreted by the beta cells in the islets of Langerhans in the pancreas, a small organ between the stomach and liver. This hormone regulates the sugar levels in the human body. When the pancreas stops secreting insulin, it results in hyperglycemia which is a common and lethal symptom of diabetes.
There are several rapid acting insulin brands, and as a type 1 diabetic, I am extremely reliant upon fast acting insulin, Novolog in particular. When discussing a topic over on The Organic Diabetic Facebook page, we got onto the subject of all the negative side effects associated with insulin and blood sugar regulation. So for all you newly diagnosed type 1’s, lets take a peek at some of the most dangerous side effects associated with fast acting insulin. Also, what drives the cost of insulin and are there programs to help defer the costs? Lets take a closer look!
Diabetes And Insulin:
Less common, but potentially more serious, is generalized allergy to fast acting insulin, which may cause rash (including pruritus) over the whole body, shortness of breath, wheezing, reduction in blood pressure, rapid pulse, or sweating. Severe cases of generalized allergy, including anaphylactic reaction, may be life threatening. Localized reactions and generalized myalgias have been reported with the use of cresol as an injectable excipient (preservative to keep insulin potent).
Fast Acting And Hyperglycemia:
Hyperglycemia, diabetic ketoacidosis, or diabetic coma may develop if the patient takes less fast acting insulin than needed to control blood glucose levels. This could be due to insulin demand during illness or infection, neglect of diet, omission or improper administration of prescribed fast acting insulin doses.
A developing ketoacidosis will be revealed by urine tests which show large amounts of sugar and acetone. The symptoms of polydipsia, polyurea, loss of appetite, fatigue, dry skin and deep and rapid breathing come on gradually, usually over a period of some hours or days. Severe sustained hyperglycemia may result in diabetic coma or death.
Fast Acting Insulin And Lipodystrophy
Long-term use of fast acting insulin, can cause lipodystrophy at the site of repeated insulin injections or infusion. Lipodystrophy includes lipohypertrophy (thickening of adipose tissue) and lipoatrophy (thinning of adipose tissue), and may affect insulin absorption. Its extremely important to rotate insulin injection or infusion sites within the same region to reduce the risk of lipodystrophy.
Rapid Acting Insulin And Hypoglycemia:
Per the American Diabetes Association, hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels, usually less than 70 mg/dl. However, it is important to talk to your health care provider about your individual blood glucose targets, and what level is too low for you.
Hypoglycemic symptoms are important clues that you have low blood glucose. Each person’s reaction to hypoglycemia is different, so it’s important that you learn your own signs and symptoms when your blood glucose is low.
The only sure way to know whether you are experiencing hypoglycemia is to check your blood glucose, if possible. If you are experiencing symptoms and you are unable to check your blood glucose for any reason, treat the hypoglycemia. Severe hypoglycemia has the potential to cause accidents, injuries, coma, and death.
Fast Acting Insulin And Injection Sites:
Reactions at the injection site (local allergic reaction) such as redness, swelling, and itching can happen. If you keep having skin reactions or they are serious, talk to your healthcare provider. Do not inject insulin into a skin area that is red, swollen, or itchy.
If you are pregnant, breast feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Do not use the insulin if you notice anything unusual in the appearance of the solution, such as cloudiness, discoloration, or clumping.
Cost Of Insulin:
While people are all up in arms about the rise in cost of EpiPens, have you taken a look at what has happened to insulin over the past couple of years?
According to a 2015 Bloomberg report, when it comes to insulin, some brands, including Humulin R, Levemir, and Lantus, have increased in wholesale price by more than 160 percent in the past five years! Not only that…
Co-pays or coinsurance percentages are also rising to meet the increased cost. Endocrinologist Kasia Lipska, MD, MSH, assistant professor of medicine at the Yale School of Medicine, has numbers to back that up. In her 2014 Journal of the American Medical Association study on the use and out-of-pocket costs of insulin for people with type 2 diabetes, she found that among the commercially insured population that her team analyzed, out-of-pocket costs for insulin increased by 89 percent from 2000 to 2010.
Per Dr Lipska:
“I see a lot of patients in my clinical practice who cannot afford the insulin they are taking,” she says. “I have to work with them and discuss the financial implications of using one versus the other, because it really matters. Sometimes it’s between taking the insulin and paying their bills.”
This is very unfortunate, but as we’ve all become pretty accustomed to, insulin can be expensive.
Per consumer reports, if you’re one of the 6 million Americans with diabetes relying on insulin as part of your management protocol, you could be paying out-of-pocket costs anywhere from $120 to $400 per month, according to a 2016 New England Journal of Medicine commentary. Insulin such as Lantus and Levemir have seen significant cost increases, according to a recent trend report by pharmacy benefit manager Express Scripts.
One reason for the high prices is the lack of generic options for insulin, in turn, we are now stuck having to search around to find affordable options.
If you don’t have health insurance or are without drug coverage, you can always look into applying for a patient assistance program (PAP). There are nonprofit organizations such as NeedyMeds that can help. You can also find some additional programs that offer free or low-cost insulin as long as you meet the eligibility requirements by talking to your endocrinologist. Those are usually based on your insurance status, income, and diagnosis.
You might also qualify for a diagnosis-specific program that can help you save on syringes, pumps, and other diabetes supplies. Pharmacists are also a great resource and can help you find a PAP that meets your financial needs.
Also, as with most medications on today’s market, prices can vary depending on where you fill your prescription. Try Walmart, where you can get Novolin N for just $25, says Jeremy A. Greene, M.D., Ph.D., associate professor of medicine and the history of medicine at Johns Hopkins University School of Medicine and co-author of the NEJM commentary.
“Walmart has the cheapest insulin in the country. They use their distribution muscle to demand a much lower price.”
You can also check with Walgreens, where fellow diabetics have found Novolin N priced as low as $64. Costco is also well worth a try, especially if you’re a member. People have reported that Costco pharmacies in New York and New Jersey said it would cost $130 for Novolin N.
You can fill prescriptions at Costco without being a member, but membership can bring the out-of-pocket price down to just under $100, so definitely something worth checking out if your a Costco member!
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