Dr Ashley Ng

Day 2 – If you could petition anyone, organisation or project, what change would you ask for?

Funny enough, I am currently petitioning the National Diabetes Service Scheme (NDSS) for equal healthcare access for everyone living with diabetes. Now, just because I’m petitioning them doesn’t mean I am disgruntled with them. Without the NDSS in place, the majority of people living with diabetes would not even be able to afford the medication to keep us alive. Things like insulin, oral hypoglycaemic agents, needle tips, syringes and test strips are all heavily subsidised by the NDSS, which is a government initiative and run by Diabetes Australia. In that sense, I am eternally grateful that we have this in place so we can afford the basic necessities of living with diabetes.

However, when it comes down to subsidies for pump consumables, that’s a different story. There are certain criteria individuals have to meet before being eligible for pump consumable subsidy. The criteria listed for eligibility is listed here. They’ve covered just about every category of diabetes in there – except for type 2. There’s a blanket ban for people with type 2 diabetes who are currently using insulin to manage their condition. What’s the reason for this blatant discrimination? Here are some of my theories:

People with type 2 diabetes are generally managed by tablets or lifestyle changes.

While this is true for most people with type 2 diabetes, keep in mind that there is an increasing number of young adults that are being diagnosed with type 2 diabetes. Although they may be initially responsive to tablets, they may decide that insulin therapy would suit them better down the road. Particularly for ladies who are thinking of starting a family, we would most certainly be needing insulin to cope with the crazy hormones. How handy would being on a pump be while you’re planning for that baby, to get on top of the BGLs and not worry as much during the pregnancy about having multiple needles? One less thing to worry about!

On top of that, not every case of type 2 diabetes is due to poor lifestyle changes. Sometimes, it just happens because it’s within their genetics. Diabetes is not always black and white. Some people don’t fall clearly within a specified group. Let’s take me for an example. Because they’ve eliminated me from the type 1 category, their only other option is to put me in the type 2 category. This is despite the fact that I’ve always been a healthy weight, physically active, and non-responsive to tablets. I started insulin therapy two years into my diagnosis. Does that sounds like a typical type 2 scenario to you? Although I have finally convinced an endo to change this for me, there may be many others in my situation out there.

The money.

Providing us with a generous subsidy for the basic things we need is a luxury. I know of many people in other countries who have to ration their strips because they are only allowed so many per month. How do they expect us to be vigilant in managing our diabetes when we are rationing medical supplies because we can’t afford more? So I’m grateful for NDSS in the regard that we have our basic needs covered and I acknowledge that this is also very costly to our government. Although improving quality of life for us may not be on their high priority list, what about improving diabetes management to reduce the risk of complications down the track? From my understanding, it’s much more costly to manage a complication, particularly if we need to be admitted into hospital and with the limited availability of hospital beds, this is a huge issue for us at the moment. And there is evidence in the literature that insulin pump therapy is the preferred option to help achieve good glycaemic control to reduce the risk of complications. Isn’t prevention better than cure?

At the end of the day, the percentage of people living with type 2 diabetes who are on insulin are quite small. I’m guessing that the percentage who would be appropriate for insulin pump therapy would be smaller. So, I don’t see why a blanket ban is quite necessary.

What do you think?

If you would like to support this petition, you can add your name to the list here and I would be very grateful and thankful!