What: As a lifelong type 1 diabetic (T1D), I am no stranger to the outrageous cost of living with type 1 diabetes in the USA. Insurance companies are not on our side, often forcing us to pay egregious amounts in order to stay alive. It is time to send a message to insurance companies and politicians in the US: type 1 diabetes is devastating enough without the financial burden you force on us.

Why: Type 1 diabetes is not a disease that is self-inflicted. Sometimes it's hereditary, while others may have suffered a sickness that led to type 1 diabetes. It is still considered a rare condition in the US, with less than 200,000 new cases present per year; however, every single one of us knows the financial struggle we face having this "rare" disease. 

Recently, the cost of insulin has (finally) been lowered. (Did You Know: some T1Ds are still forced off of the insulin that works for them by their insurance company?) However, insulin is useless without a means to inject it. Yes, we can revert back to the "original" T1D care by manual, multiple daily injections (MDI) and several daily finger pricks, but through the invention of continuous glucose monitors (CGMs) and insulin delivery systems (IDs), T1D care has been revolutionized. Some T1Ds prefer MDI, whereas some would not only prefer, but also need the assistance of these devices. Shouldn't the choice belong to the individual, and not belong to whichever choice is more affordable?

CGMs, as the name suggests, continuously monitor blood glucose levels in the body, and eliminate the need for multiple daily finger pricks. IDs, as the name suggests, deliver insulin via a tube placed beneath the skin. IDs essentially pick up the job that the pancreas lost. They deliver hourly basal rates to continuously keep our glucose levels in check, and users can deliver boluses that cover food or high blood sugar levels. There are different types of CGMs and IDs, and many IDs and CGMs are compatible, working together to deliver treatment. Both of these types of medical devices are life-saving and medically necessary.

Life-saving medical equipment, such as continuous glucose monitors and insulin deliver systems, cost us so much out-of-pocket, WITH insurance, that many of us cannot afford day-to-day expenses. I, personally, have had to consider whether I should pay for food, rent, or groceries, or if I should pay for my monthly prescriptions. It comes down to that so often: what can we afford given our condition?

Greedy insurance companies consider CGMs and IDs "durable medical equipment", meaning they only consider them to be enhanced-quality-of-life devices rather than life-saving and necessary medical devices, thereby forcing T1Ds to pay enormous out-of-pocket expenses for access to these devices. An example of our costs will be included at the bottom of this petition.

As T1Ds, we need to see our endocrinologist every 4-6 months (if that care is affordable), and we obtain prescriptions for CGMs and IDs through our endocrinologist, who agrees that these devices could save and better our lives. 

When I was around 13-years-old, I suffered two hypoglycemic-induced comas. Hypoglycemia occurs when blood sugar levels are too low, which can cause unconsciousness and, if left untreated, death. My parents found me both times, and I was given a glucagon shot to raise my blood sugar levels. Had I had access to a CGM back then, these medical emergencies would never have happened.

However, my case is not the worst. Hyperglycemia (high blood sugar) can be more dangerous than low blood sugar, and can cause diabetic ketoacidosis (DKA), a condition that, also left untreated, can result in death. I, personally, do not know a single T1D who has not experienced DKA. It is a terrifying experience: no matter how much insulin you deliver, nor how much water you drink, sometimes blood sugar levels just won't come back down. We are told to go to the ER for DKA; however, you don't need to be a T1D to know how expensive an ER visit can be. 

These emergencies alone should be proof enough of the necessity for CGMs and IDs. 

How: We T1Ds need your support - whether you yourself are T1D, have a loved one suffering from the disease, know someone who is suffering from it, or empathize with our cause - to help us lower the cost of our treatments. We did not do this to ourselves, and should not be forced by insurance (or anything else) to pay extortionist prices in order to live. Please help us by signing this petition so we can kickstart the change we need by bringing this cause to the attention of our politicians and all 50 states themselves. Change needs to happen... Let's make it now! 

Example of cost: Here is a website that breaks down the benefits, downfalls, and cost of a popular CGM, Dexcom. From this article:

"Rough retail costs per year without any insurance factored in are:

• a total of $1,200 for Dexcom G6 transmitters (each lasts 90 days, so four transmitters per year)
• a total of $4,800 for a box of three Dexcom G6 sensors (each sensor lasts 10 days)

$4,800 for a box of three sensors. That's $4,800 EVERY 30 DAYS. Consider an insurance company that pays only 60% for "durable medical". That's still $2000 EVERY 30 DAYS, WITH INSURANCE and not including the monthly premium/deductible. 

Did You Know: Dexcom's 2018 revenue was $1.03 BILLION 

IDs are even more costly than that. 

Why I started this petition: I am a member of several T1D support groups on social media, and I see post after post from struggling T1Ds, parents of T1Ds, or partners of T1Ds who simply cannot afford their medical devices. They are scared because they don't know what would happen without them. It could be a parent of a child suffering from T1D afraid of what might happen during the night if their child can't use a CGM. Or a terrified partner afraid they might wake up to their T1D loved one passed away in their sleep because they didn't have their CGM. Or a T1D who is suffering physically, mentally, and financially because they are forced to pay outlandish prices for their life. Or a T1D considering the unspeakable because they can't handle the mental struggle alongside the financial burden. 

I can testify to the extent of the expenses we face in the US. When I turned 26 and had to get my own insurance, I was told by my insurance broker that Medica's Applause Gold C "was the best for my condition". The monthly premium was $440 (I qualified for a tax credit, that lowered it to around $320) and the deductible was raised every single year. In the beginning of the year, I'd pay hundreds of thousands for my much-needed prescriptions - and this was before the price of insulin was lowered. During the first few months, I would have multiple panic attacks over the cost I'd be forced to pay in order to keep myself alive. It was unbearable, and I, many times, considered suicide. I couldn't even pay my vehicle payments during some months (thank you to my parents for helping me during these awful times). 

From the bottom of my heart, I thank you for considering signing this petition and what it would mean for the lives of so many of us.

I will leave with this statistic from the American Diabetes Assocation:

• up to 7% of deaths in individuals with type 1 diabetes are a result of suicide.