The search for the OneTouch Delica in Australia…

Like many people living with type 1 diabetes, I am always looking for ways that will make the daily routine that tiny bit easier. Even if it is only by 0.5%. That 0.5% is better than 0.0%. A cure is probably some time away, so in the meantime, I just keep an eye out for stuff that will make each day easier than the one before. A football coach would call this “playing to the percentages and improving at the margins”.

In this particular blog post, I’m focusing on the fun of finger-pricking, which I do 10+ times a day, 70+ times a week, equating to approximately 3,700 times a year. Sure, life with the Accu-Chek Multiclix is okay, but could it be better? Even 0.5% better?

I first read about the OneTouch Delica on Six Until Me. Then I saw something on Diabetes Mine. And then on Don’t Fear Diabetes. And then on Broken Pancreas. And then on A Consequence of Hypoglycemia. I could go on – but the moral of the story, aside from the fact that I read a heap of diabetes blogs, is that A LOT of bloggers are using the OneTouch Delica lancing device.

Awesome, I thought. An alternative! I like options.

So I looked into it, only to learn that I couldn’t get a OneTouch Delica lancing device (or lancets) in Australia. OneTouch themselves, via twitter explained that the OneTouch Delica is not available in Australia, and it seems you can’t even order one via Amazon or eBay because of shipping regulations. In fact, Amazon gives me a nice little message saying “there is a slight problem with your order”. I’m not sure slight is the right term for complex importing requirements and international shipping regulations surrounding health product, but thanks Amazon.

Indeed, I can’t help but think Newman from Seinfeld has something to do with this. After all, “when you control the mail, you control information”.

In many ways, this is admittedly, a First World Problem, or FWP. But it’s a curious one. Surely it isn’t too hard to include the Delica with the OneTouch Verio IQ, which would give OneTouch not only a broader market share in terms of meters, but in terms of lancing devices as well.

I am a long-time user of Accu-Chek lancing devices, particular the Multiclix. But I don’t love it, and interested in alternatives that might do a better job. When I go to look for alternatives, there are, essentially, none. Add to that the fact that the Delica is not a new device – it has been around since 2010 – and it paints a strange picture of some things reaching Australian shores early, like the Medtronic Paradigm Veo, but some things not reaching our shores at all, like the OneTouch Delica…

Anyway, I’m off to hunt down the next 0.5% improvement.

Diabeteconomics

I found it entirely unsurpising that a recent news report on research conducted through the Jaeb Center for Health Research showed that frequent blood sugar testing was strongly associated with better diabetes management and by effect, lower HbA1c results. I also find it distressing that many people outside of Australia are faced with a cap on the number of test strips they’re allowed to use per day – effectively being prescribed a limit. Since getting my pump, I check my blood glucose about 8-10 times a day, but sometimes more, and cannot imagine being restricted.

A wise person once said to me that economics is not necessarily about money, but about values. That is, if you value something higher than something else, you will make reasonable efforts to adjust your budget accordingly to meet this valuation. I think this has some relevance to diabetes, and the sacrifices we all have to make to support the condition financially within our respective health care systems.

In Australia this is of course made easier through the National Diabetes Service Scheme, where I can get 50 Verio IQ test strips for $7.80 and there is no strict cap on strip availability. I place such value on the information that comes from regular checking, as demonstrated in the research, that I manage to incorporate this within my budget.

However, sometimes I feel like purchasing diabetes supplies is a bit like a trip to Bunnings (for those not in Oz, Bunnings is a mega home hardware store). A quick visit can quickly end up in  $150 spent on stuff for the house and garden, topped off by two sausages and a Coke Zero at the trusty sausage sizzle on the way out.

It can be surprising to see the cost add up as quickly as it does, and you never quite feel like you got everything you need.

Just the other day, I got a new batch of insulin and ordered a further $120+ worth of diabetes stuff in about 3 minutes, including pump supplies, strips and some Dex4 glucose tablets to try. But like Bunnings, it feels like I have barely scraped the surface of what I need at the moment, and further, what I value in terms of diabetes management. On top of the supplies listed above, I’m really, really due for some new sensors (I’ve talked about the benefits of CGM before). When I see my Enlite CGM sitting there unused, I feel guilty for not buying a new box, but the cost of $375 for a box of five sensors remains fairly restrictive (and I’m equally as perplexed as Renza as to why the Dexcom sensors come in at $440 for five).

Diabetes is a costly condition to live with and whilst our system is Australia has many positive aspects, and we fortunately do not have a cap on test strip supplies, it is glaringly apparent that the costs of CGM consumables need to be subsidised to enable broader usage.

Going back to “diabeteconomics”” I value the information that 10+ tests a day provides, and perhaps even more so, the data that CGMS can provide, and try to fit this within my budget as best I can. But within the current Australian parameters for access, I haven’t quite figured out how to fit regular CGM supplies in financially yet, especially given the deck isn’t going to build itself, the fence needs painting and the garden needs replanting.

Can we clone Gary Scheiner?

So last night I went along to a Diabetes Australia – Victoria event featuring one of my favourite people with a non-functioning pancreas, Gary Scheiner.

Gary is a diabetes educator with type 1 who runs Integrated Diabetes Services in Pennsylvania. Pennsylvania looks like quite a cool place. I’d like to go there. Gary is also author of the rather famous book that encourages people with diabetes to think like a pancreas, unsurprisingly called Think Like a Pancreas, and the recently released Until There Is a Cure (which I am going to use as justification as to why I need a Kindle Paperwhite. Gadgets!).

Gary was in Melbourne talking about diabetes technology – particularly insulin pumps and continuous glucose monitoring. Unfortunately he didn’t discuss the potential for Tetris to feature on upcoming pumps, but I’m sure that will feature in presentations down the track. 

I saw Gary speak on an identical topic last year, mere weeks before I got my insulin pump. I found him to be humourous, knowledgeable, perceptive but most of all, reassuring. Seeing Gary speak in 2012 reaffirmed to me why I had made the decision I had made, and filled me with confidence.

You might rightly ask  – “why did you go to see him speak when you’d essentially seen the same presentation?”.

Aside from hearing his joke about NPH/Protophane for a second time (that is, NPH standing for standing for “Not Particularly Helpful” which I completely agree with – curse you, Protophane!), I went along because Gary just gets it, and as a result, he is fascinating to listen to. 

Sure, he gets diabetes – he knows it back to front – but more importantly, he gets people with diabetes. He gets that diabetes technology needs to make our life easier; he gets that it is important for people with diabetes to be able to enjoy life; he gets that humour can be a handy tonic for dealing with what is a pretty crappy and frustrating condition; and he gets that if a miraculous cure does come one day, we want to be able to enjoy it. 

I have been enormously lucky with my diabetes care team being awesome, but I know others are not that fortunate and have quite frustrating experiences with people that don’t share Gary’s approach or technique. So in a session about diabetes technology, I couldn’t help thinking that one of the best technological advances we could get would be to create a machine that would clone Gary Scheiner.

Because he gets it. 

Power to you, Gary! 

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Image property of Bill Watterson.