Last week, the province announced $6 million in expanded diabetes supports for young Manitobans with Type 1 diabetes.
The funding will establish programs to fund advanced glucose monitors and insulin pumps for people 25 and under. Manitobans that meet the program’s criteria will be eligible to receive insulin pumps at no up-front cost, and advanced glucose monitors will be covered under the Manitoba Pharmacare Program once their out-of-pocket deductible is met, much like blood glucose test strips.
Diabetes awareness activist Trevor Kirczenow explained the significance of the inclusion of continuous glucose monitors (CGM) — a type of advanced glucose monitor — under the new coverage.
“A CGM […] measures blood sugar levels and it communicates a new reading to the user every five minutes,” said Kirczenow.
“I think sometimes people who aren’t as familiar with the condition think that it’s more about convenience […] There’s definitely the quality-of-life factor, but even with all the finger pricking in the world, you just cannot come close to the quality of information that you get from a CGM.”
Insulin pumps have been provided to eigible children under 18 since 2012 through the Manitoba Pediatric Insulin Pump (MPIP) Program. The province said the eligibility criteria for the MPIP Program will largely remain for those aged 18 to 25 with the new programs.
“An insulin pump […] can replace the need for multiple daily injections of insulin, so if you don’t have an insulin pump and you’re insulin-dependent, that means you’re sticking yourself with a needle many times per day,” Kirczenow said.
Kirczenow’s son is Type 1 diabetic. He struggled with needles until got his pump.
“It was really sad because there were healthy foods that he loves that he would say no to because he didn’t want the needle,” Kirczenow said.
“This kid loves apples, and we would ask him, ‘Matthew, do you want an apple? Do you want a snack?’ And he would kind of think about it and say no, and then after he got his insulin pump that just completely turned around.”
Insulin pump supplies and blood glucose test strips will remain covered under Manitoba pharmacare. Advocates like Kirczenow remain frustrated by the cost.
“The insulin pump supplies can cost a few hundred dollars per month and a CGM costs about $300 per month,” Kirczenow said.
“When you compare the cost of this to, say, the cost of dialysis […] I really think that the province should pay for the preventive supplies. Overall, in the long term, that will be better for our health system.”
Ally Amedick is a 24-year-old health-care worker and Type 1 diabetic on the verge of aging out of the program.
“I have maybe about a year, year and a half left until I will, once again, not have any coverage,” she said.
“Specifically for the insulin pump, it means that maybe I have five years left with the pump and past that I have to self-pay […] The cost of a pump is [between $6,000 and $8,000].”
“Looking forward, it feels like I’m going to sort of drop off a cliff when I turn 26.”
Amedick is critical of the eligibility requirements the province has put in place.
“You have to have your A1C results under a certain number in order to qualify, and you have to have three separate results that are usually about three months apart in order to qualify. So, we’re sort of disqualifying people that may need it the most, those people that have maybe the least control of their diabetes currently and could most benefit from these devices,” she said.
“I’m very thankful for the coverage. It’s a step absolutely in the right direction but there’s just so much work left to do.”
Jen Dyck is a 31-year-old mother of two with Type 1 diabetes. Because of her age she has been too old to qualify for two insulin pump programs in a row.
“I think when the public hears the news, like the big amount of money, it’s really great, but what they don’t realize is programs have been cut and then there’s nothing put in place for people like me,” said Dyck.
“We can’t save for our future, we’re stuck.”
Dyck explained that having the tools to control her blood glucose had positive impacts on her family as well.
“It’s very important when you’re pregnant that your sugars are well controlled. If they aren’t, either miscarriage or birth defects are common,” she said.
“I have two kids and I paid out of pocket for all my stuff. I managed to keep my sugars perfectly well controlled with those two devices and it paid off. I had two very healthy pregnancies.”
The program including advanced glucose monitors under Manitoba pharmacare will come into effect on Sept. 28 and expanded coverage for insulin pumps will come into effect in November.