On a good day, living with type 1 diabetes (T1D) is a lot. For my son, diagnosed with T1D over a year ago, a quick trip to the store, to school, or down the street means checking to make sure his blood sugar isn’t too low or too high before getting in the car; ensuring his bag — which is always with him — contains carb-appropriate items for low blood sugar, emergency medication for extreme blood sugar highs, extra insulin, test strips and a lancet to prick his finger in the event his continuous glucose monitor (CGM) stops working, an extra pump and the device to control it; and that he’s wearing one of his emergency id tags if god forbid he should pass out anywhere in between home and his destination. A plane trip means double and triple of all of those items and more. And, a global health pandemic like coronavirus? Well, that’s just so extra.
TID is a supply-heavy disease. As anyone living with T1D can attest, we have extras of everything at all times, and then some. But, trying to stock up in the midst of a pandemic isn’t easy. We received additional insulin in batches as the pharmacy was unable to fill our prescription in full at once. We’re still waiting for syringes, typically a one-day prescription fill that is going on two weeks.
To stay within blood sugar ranges, low carb diets are generally the norm for T1D folks. Think lots of vegetables, eggs, cheese, and meat. Anything white — flour, sugar, etc. — is often the kiss of death for blood sugar, sending it sky high no matter how much you exercise, eat low carb, or young/old you are. To self-quarantine means not as much fresh vegetables; dry goods like nuts along with pasta made out of edamame, black beans, lentils, and anything but flour; and cauliflower rice. Lots of it. Our freezers are filled with frozen meat, loaves of low carb bread, and vegetables, with refrigerators filled with more meat, eggs, and cheese. Why? Because going to the store or food delivery adds an extra layer of complication: with reports coming out that kids are not immune to the coronavirus, do we put our immunocompromised son at risk by going to the grocery store?
Should he contract the virus, it’s not as simple as taking medications to treat the symptoms. Any illness makes managing T1D more difficult. And, T1D can be exacerbated by medication used to treat the symptoms of common illnesses. Over-the-counter medications affect blood glucose levels — many contain sugar, which increases high blood glucose levels. Others cause blood sugars to lower, which could lead to an immediate life threatening situation, or interfere with insulin delivery as well as CGM data delivery.
It’s not without notice that this massive global health scare is occurring against the backdrop of the Affordable Care Act (ACA), and the 10th anniversary of the passage of this important law. The ACA extended health coverage to more than 20 million people and ensured that the more than 50 million people with preexisting conditions — including my son and others with T1D — can no longer be denied coverage. Without question, the ACA has made coverage better and/or more affordable for millions in this country.
Indeed nothing makes the need for broad health care coverage clearer than a public health emergency like the coronavirus pandemic. By giving millions access to affordable health care, the ACA has made our families and communities healthier and better able to confront this crisis: the more people with ready access to medical care, the safer it is for all of society.
Yet, within this moment, President Trump is supporting a lawsuit to repeal the ACA, brought by 18 Republican attorneys general and 2 Republican governors, threatening health care when Americans need it most. It seems obvious that in the midst of a medical emergency, it would be a terrible time to take health care away from 20 million people.
When Americans and those with pre-existing conditions — particularly immunosuppressed folks at risk of being able to fight the coronavirus — are in urgent need of health care, this administration is actively working to undermine the ACA. The immorality of such an effort is so extra, and it’s not lost on us health care voters.