Access to insulin, social networks help people with diabetes

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This post first appeared on U of U Health website.

More than 37 million Americans, or about one in nine, live with diabetes. Although incredible progress has been made in treating the disease, patients still lack the care, education and support they need to treat their disease. Basically, insulin prices have increased 10-fold over the past decade, with the cost for some patients approaching $10,000 a year for the life-saving drug.

PHOTO CREDIT: Charlie Ehlert/U of U Health

Michelle Litchman, Ph.D., medical director of the Intensive Diabetes Education and Support (IDEAS) program at U of U Health.

When Michelle Litchman, Ph.D., medical director of the Intensive Diabetes Education and Support (IDEAS) program at U of U Health, began her medical career as a nurse, she could not have known that she would continue to devote herself to meeting the needs of people with diabetes. She later decided to go back to school to become a nurse practitioner specializing in diabetes care so she could develop long-term relationships with the patients she saw. Now with a Ph.D. in nursing, her research focuses on the intersection of diabetes, digital health technology and health disparities.

In her role as a nurse practitioner at the Utah Diabetes and Endocrinology Center, Litchman has observed the difficulties patients face in obtaining their medications. “One day at the clinic, a patient described to me that he bought a trash bag full of diabetes supplies from someone he met in an online classified ad,” Litchman said. “This exchange took place in a parking lot.”

To learn more about these black market interactions, Litchman began exploring online diabetes communities, where she read about people’s struggles to get medications and others’ offers of help. To quantify these interactions, Litchman and his team conducted a national survey and found that while 93% of respondents had health insurance, more than half pledged to donate, exchange, borrow, and purchase diabetes medications and supplies from each other.

The results of Litchman’s investigation were covered by NPR’s Science Friday, The doctors, CNN and others.

In addition to his research into the underground insulin market, Litchman tirelessly advocated for the passage of the bill from the Utah State Legislature, HB0207which became law in April 2020. The bill increases insulin access by capping copayments at $30 and allows emergency prescription refills.

In addition to paying for insulin, Litchman says many newly diagnosed patients find it difficult to make time to visit the many specialists who support people with diabetes, including psychologists, dietitians and nurse practitioners. Thanks to a to agree of the Larry H. and Gail Miller Family Foundation, Litchman and her IDEAS program team run “boot camps” where patients and their supportive care partners meet in small groups with multiple specialists in a single day. .

The IDEAS boot camps have had encouraging results, including improvements in patients’ A1C (average blood sugar) levels, reduced burnout, and increases in self-care behaviors such as self-monitoring. blood sugar, medication compliance, healthy eating and exercise.

Litchman and the IDEAS team have since adapted the one-day boot camp for different audiences. One version is offered through telehealth sessions to English-speaking and Spanish-speaking immigrants and refugees in rural populations. Another version provides intervention via sign language and closed captioning for deaf adults, one in four of whom are diagnosed with diabetes in the United States.

“It’s especially important to me because my mom and five other family members are deaf, and I’ve seen how the healthcare system has let them down time and time again,” Litchman said. “Access to the diabetes education, care and prescriptions you need to be successful can make all the difference.”

The video below was filmed at an event for U of U Health Partners, both produced by Ben Tomlin, University Advancement.

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