On August 6, 2019, the following article went viral on the internet: “Diabetic groom-to-be” dies after taking cheaper insulin to pay for wedding.”
Please read the article as it was presented. When you are finish reading, what is the take away message?
After the article I will discuss how the media mis-represented his cause of death and cast a negative light on much less expensive insulin that is offered without prescription through Walmart.
It really made me uncomfortable and then angry to read this article as it presents a total false impression of what happened. Because of price gouging by insulin companies, many people who REQUIRE INSULIN TO LIVE can safely use a different type of insulin without prescription with Reli On Brand insulin available at Walmart. If you must change to Reli-On’s blood glucose meter and strips, feel safe to use them. But do so under the guidance of your health care provider! This insulin is not the same as newer insulin analogs like Humalog or Novolog.
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DIABETIC GROOM-TO-BE DIES AFTER TAKING CHEAPER INSULIN TO PAY FOR WEDDING.
By Hannah Frishberg August 6, 2019 | 2:24pm |
When Josh Wilkerson turned 26, he aged out of his stepfather’s private health insurance and he was unable to afford his nearly $1,200-a-month insulin.
He began rationing his pricey prescription brand, before a doctor recommended taking ReliOn, an over-the-counter brand sold for $25 a vial at Walmart.
“It didn’t work for his body,” his mom, Erin Wilson-Weaver, tells The Post. Her son died June 14, and she’s still in mourning — but determined to advocate in his memory.
Known as “human insulin,” ReliOn requires more time to become effective than the “analogue” insulin that Wilkerson had previously been taking — but, at one-tenth of the price, it was more affordable for the northern Virginia dog kennel supervisor, who was earning $16.50 an hour.
“When it comes to type 1 diabetes, people are facing unthinkable decisions — between the costs of living and their very lives,” Wilson-Weaver writes in a post for a diabetes advocacy blog full of similar posts about those lost to Type 1 diabetes after being unable to afford insulin.
“We figured: Hey, it’s $25. We can do that, and we’ll just work with it and try to do the best we can,” Wilkerson’s fiancée, Rose Walters, 27, tells the Washington Post. Walters, also a Type 1 diabetic, began using the cheaper insulin as well last winter.
The pair also had to switch to an over-the-counter brand for their blood glucose meters to keep medical prices within their budget.
The couple — among the 30 million US residents living with diabetes — planned for a rustic barn house wedding in October, and hoped to save money for it with the more affordable, if less effective, medication.
Wilkerson’s mom was concerned — she had lost her father to Type 1 diabetes complications when he was just 38, and this wasn’t the first time insurance complications had prevented Josh from getting the medical attention he needed.
Still, after graduating high school, Josh lost his childhood insurance coverage, and his troubles began. “He couldn’t afford the maintenance or supplies for his insulin pump, so he had to make the switch back to syringes,” Wilson-Weaver writes in a blog post. When his health care changed, “Josh’s health and life really began its downward spiral.”
When Wilson-Weaver told Josh she was worried, though, Wilkerson reassured her. “Don’t worry, mom,” he wrote her in a Facebook message after she sent him an article about a man who had died after rationing his insulin.
But she was right to worry: While Walters was fine, Wilkerson was experiencing stomach problems, mood swings and high blood sugar in response to the ReliOn.
In June, when Walters was staying overnight at the kennel for a week while his boss was away, his symptoms proved fatal.
On his second night sleeping there, Wilkerson and Walters were Face-Timing before bed when he complained of stomach problems but promised to take his insulin before signing off, WaPo reports. In the morning, when Walters called his phone and he didn’t pick up, she became worried. She rushed to the kennel to discover that Wilkerson was unconscious on the floor.
“I just remember smacking him on the face, saying, ‘Babe, wake up. You have to wake up,’” says Walters.
Wilkerson had suffered multiple strokes and was in a diabetic coma, his blood sugar 17 times what’s considered normal. “The staff at the hospital had never seen a blood glucose reading as high as Josh’s before,” says Weaver-Wilson.
He died five days later. He was 27.
“The saddest thing was, when he was diagnosed, and until he was 18, his insurance provided him the best and newest care available,” Wilson-Weaver says, calling his death “absolutely” preventable.
His death illustrates the worst-case scenario for thousands of people living with diabetes in the US, the Independent reports. With analogue insulin prices nearly tripling since 2002, doctors have begun recommending the cheaper version as a stopgap — a strategy endorsed for “some patients” by the American Diabetes Association.
During the government shutdown in January, one federal worker was also forced to ration her insulin, living through the extreme fear and discomfort as she could no longer afford her copay for more.
In May, the governor of Colorado signed legislation capping insurance co-payments on insulin to $100 a month to prevent such tragic fates as Wilkerson’s.
Last month, the Trump administration announced it will create a way for Americans to legally import lower-cost prescription drugs from Canada.
In the near future, scientists may even be able to replace insulin altogether for those with Type 1 diabetes: Researchers are rapidly working toward creating insulin-producing cells, essentially curing the disease.
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DIANE KRESS REPLIES:
After reading this article, I got the impression there was something wrong with much less expensive Reli-On insulin. This older type of insulin costs 25.00/vial and is sold without prescription at Walmart. That is 10 times less than the newer rapid and long-acting insulin analog prescriptions. Walmart also sells a Reli-On blood glucose meter and strips for cost savings for anyone with diabetes.
Yes, using the newer analog insulin is preferable for many people. Insulin pumps require rapid acting analog insulin. It begins to work almost immediately. Rapid acting insulin can be used to normalize high blood glucose occurring from carb consumption, during illness, during times of stress, when fighting an infection/virus, when taking certain medications.
The newer analog insulin can also be used in vial/syringe or in convenient pre-filled insulin pens. When choosing to use multiple doses of insulin to control Typed 1 diabetes, people are usually prescribed a long-acting analog insulin dose at bedtime and use rapid acting insulin to cover the blood glucose rise from carbohydrates they will have at a meal or to normalize blood glucose that is running high even before a meal.
The newer insulin analogs are wonderful. With their use, and with knowledge of how the insulin works and how the carbohydrates in food, increased stress, illness, and pain impact blood glucose, people with type 1 diabetes can have the very best blood glucose control. Their carbohydrate intake does not have to be the same for each meal. Rapid acting insulin analogs begin to work within a few minutes of injection.
Unfortunately, the pharmaceutical companies who produce the newer insulin analogs have raised the cost to consumers to in-affordable prices. A person with type 1 diabetes who must take insulin to survive, but is without health insurance, is between a rock and a hard place. A person with type 1 diabetes requires insulin to LIVE. They cannot take a pill to normalize blood glucose; their life depends on taking insulin.
For many people, Walmart’s Reli-On non-prescription insulin is amazingly affordable and enables them to lead a normal life with diabetes while decreasing the risk of diabetes complications and death that can occur when not taking adequate insulin.
Please be aware that there is nothing wrong with Reli-On insulin or blood glucose meters….but using this insulin requires INSTRUCTION from the endocrinologist, health care provider, internist, NP, PA, CDE
You should never switch your type of insulin without medical guidance…Human insulin and Analog insulin work VERY DIFFERENTLY.
Granted, Human insulin won’t enable the wonderful blood glucose results that can be attained with analog insulin. But it’s far better to work with Human insulin than to ration analog insulin for affordability while risking your health or life.
When Mr. Wilkerson was covered under his stepfather’s health insurance, he used insulin-pump therapy. The pump uses analog rapid acting insulin that works almost instantaneously. The pump dispenses this rapid acting insulin in small amounts over 24 hours via a program set to match a person’s typical daily insulin needs. If blood glucose runs high during the night, insulin can be programmed at a higher rate for the evening only. If low blood glucose is a problem in the afternoon, the insulin rate can be decreased for the afternoon. If a person wants to consume a higher carb dinner, they can program the pump to release insulin to match the carbs they will eat. Pumps are phenomenal technology, but they are very expensive, especially without adequate insurance.
If a person does not use an insulin pump, they can still use the newest analog insulin by taking a long- acting type of analog insulin at bedtime and rapid acting insulin to correct blood glucose or cover blood glucose rise from meals and snacks. When ill, when taking certain medications, when under stress, extra rapid acting insulin begins to work within a few short minutes of injection. But in and of itself, analog insulin is extremely expensive for those who use insulin for survival.
But, prior to the availability of this newer type of insulin, people used Human insulin. Perhaps you remember the names “Regular” insulin and “NPH” insulin. Regular and NPH are types of HUMAN INSULIN. Regular insulin is short acting and NPH insulin is intermediate acting insulin. These insulins have a “lag time” before they even begin to work. They also last for different amounts of time in the body. Every body is different but you take a set dose of Regular and NPH insulin (often twice a day…1/2 hour before breakfast and 1/2 hour before dinner). Regular insulin will not immediately decrease high blood glucose because of its 1/2 hour lag time. Because there are set doses of regular and intermediate acting insulin, a person’s carbohydrate intake must remain consistent at meals. It is not easy to get normal blood glucose while using these insulins as every day is different. A person may sleep in one day, skip a meal another day, overeat carbohydrate at dinner, snack between meals, have high stress one day, exercise more or less or not at all the next day. The doses of human insulin are SET DOSES.
Remember that people with type 1 diabetes have no choice as to if they take insulin or not. They can’t use oral medications to lower their blood glucose. They require insulin to live.
Although analog can provide the most flexibility and the best results, it is totally in-affordable for many people. But, it is far better to use the older type insulin than to ration analogue insulin.
The most important thing to remember if you must change from analog to human insulin is that conversion is not an equal dose change!
You will require brand new guidelines from your MD or health care provider. Although you will not require a prescription to buy the Reli-On insulin, you still NEED your MD to give you direction on your initial dosage and then titrate your insulin doses until you reach blood glucose control. You also need direction on how to treat very high blood glucose and hypoglycemia.
NEVER change from analog to human insulin without your physician’s knowledge and guidance. Your MD must prescribe your insulin dosing! (There may be a CDE, NP, or PA at the office that will help you). Your provider will initially need to see your blood glucose on a regular basis and make changes in your insulin doses until you reach acceptable readings.
So….from the article, it seems that Mr. Wilkerson went off the pump and analog insulin when his father’s insurance no longer covered him due to his age. He changed to Reli-On insulin as he could no longer afford his pump or analog insulin. (I don’t think he switched insulin to save money to pay for a wedding; we can see from his pay scale that he was priced out of his insulin of choice).
-Reli-On insulin does not require a prescription. Is it possible that he simply purchased the insulin not realizing it was so different from the insulin he had been using in his pump?
-I wonder if Mr. Wilkerson simply switched to injections without realizing how Human insulin works.
-He never took regular or NPH insulin….he started diabetes treatment on the insulin pump.
-Did he have guidance when he made the insulin switch?
-Did his health care provider even know he switched?
-Did his doctor prescribe a starting dose of insulin and then, after seeing his blood glucose results, make dosing changes as needed?
-Was he testing his blood glucose regularly?
-Was he testing more often because he was sick? Did he know what to do when blood glucose rose due to illness?
Please realize, it wasn’t the cheaper Human insulins and blood glucose strips that cost him his life. While it’s true he passed away due to damage from multiple strokes and a diabetic coma due to extremely high blood glucose….the reason his blood glucose was not adequately controlled could provide the true reason for his death.
If lack of knowledge caused Mr. Wilkerson to lose his life, it’s beyond sad.
I wonder: Why are pharmaceutical companies price-gouging on insulin?
The Metabolism Miracle 