Diabetes Diet #37: Catapulted To Diabetes Advocacy

Diabetes Recipes:

Apple Cake
Pear Snack Cake
Apple & Pear Dumplings

I learned the hard way that rushing is not such a good thing when you carry along with the responsibilities of managing diabetes.   Over the years I have devised my own personal mental checklist which is safely tucked in the deep storage compartment of my mental Rolodex.   It is handy to know the litany of meter, strips, batteries, pump apparatus, vitamins and of course, insulin. The reason I mention this is that recently I was leaving for a week’s vacation and my husband picked me up an hour earlier than expected.   In a rush, I threw clothes into a backpack, grabbed a bottle of insulin from the fridge, added it to my pump and meter supplies and ran out the door.   All was fine and dandy except for that vague uneasiness of having forgotten something when rushed.

Sure enough, next afternoon when I prepared to change my (pump) site I found that I had accidentally taken a bottle of Lantus insulin instead of   Novolog, the insulin I use in my pump. How the Lantus got into the Novolog box is another story. With 10 units of insulin remaining in the reservoir, I set off in search of a pharmacy. Mission accomplished within minutes. I explained the situation to the pharmacist and handed over my drug card.   She said she could not sell me the Novolog without a prescription. I asked her to call the drug plan to verify my identity and the fact that 3 months ago they sent me 6 bottles of Novolog (for $30). She did. The company told her that according to their records I had not received insulin from them in 2 years. Impossible! In a slight frenzy, I pulled up my shirt to bare my pump and pump site to the pharmacist. Frantically, I pulled out my meter, a vial of strips and diabetes ID.   Look! Look at the baseball cap I am wearing, Diabetes Exercise and Sports Association. What other proof did she want! She said she understood and would sell me a bottle of Novolog. Whew! I still couldn’t understand why the drug prescription plan said I had not bought insulin in 2 years. But, what the heck, I was getting the Novolog and that’s all that really counted at the moment.

She put the insulin in a bag and came from behind the counter with the bill. It looked like $112.95. I knew that could not possibly be correct. Lo and behold, it was. ONE BOTTLE of LIFELINE insulin selling at $112.95! I gasped in horror. What happened to the noble theory that insulin is a lifeline drug and that once dollars spent on research anted up, there would be no (or minimal) charge from manufacturers since insulin is vital medication to the lives of type 1 diabetics. I guess my reaction revealed my age and philosophy to that baffled young pharmacist.

The story winds up with me refusing to pay the absurd amount of money for a bottle of necessity, making many phone calls all over the country and finally learning that my major medical insurance now pays for insulin, even though I send a check $30 to the drug prescription plan, Express Scripts. It seems they pass the order on to GHI, the health insurer.   But, why oh why, didn’t anybody say that in the first place. It took a couple of hours of phone work to straighten the matter out and in the end, I paid $5 instead of the $112.95 sticker price.   I walked away sad and weary, thinking of the explosion of the diabetes population (with over 1 million new cases diagnosed each year) and people who do not, for a number of reasons, have health insurance or are unable to afford medical needs. What are they supposed to do to live? My heart was heavy.

Here is what I have since learned about the basics of access and options for receiving diabetes medication and equipment.

Help for Diabetes Health

State Legislation: Every state in the USA has legislation to help people in need of diabetes care and supplies. It varies from state to state. Contact your legislative office on health care in your state’s capital. Ask lots of questions and be persistent.
Medicare: covers individuals over 65 or under 65 and disabled, or patients with End-Stage Renal Disease.
Medicaid: assists those with low incomes or limited resources.
TAA Tax Credit : helps workers who have lost their jobs or whose salaries have decreased due to increased product imports.
Prescription Assistance: Most pharmaceutical diabetes supply companies help the uninsured. Each company has specific evaluation standards for the qualification and most will send insulin or meds to physicians in 3-month increments for patients unable to pay on their own. Contact companies that supply your medication and therapies. NOTE: As far as I discovered no test strip companies offer long-range assistance. Many offer free meter and 1 free box of strips at best.
Advocacy Action Center: the American Diabetes Association’s advocacy group works to foster government relations with the diabetes community as well as advocate for assistance and funds for diabetes patients. Call your local ADA office or 800-DIABETES, or go on the website www.diabetes.org to become an advocate for action and communication on diabetes. Get involved.
Community and Local Help : Your neighborhood or local community may be able to offer some assistance and support. Ask around, call your Chamber of Commerce, hospital, clinic or churches to inquire about affiliated diabetes programs and support groups. Reach out.

Well, this column is supposed to be about food and recipes, so it’s time to meander in that direction since everybody’s probably hungry by now!

Cyber Kitchen Recipes

Since September is my birthday month, come into Cyber Kitchen to indulge in some celebration sweets that taste great and take advantage of the season’s best apples and pears.

Really Easy Really Good Apple Cake (9 servings)
1 cup whole wheat flour
½ t. ground nutmeg
1 t. each: cinnamon, baking soda
pinch of salt
3 T. sugar
3 T. butter or a favorite substitute
2 eggs
2 cups apples (Rome, Empire, Cortland), peeled and shredded
¼ cup each: finely chopped dates, confectioners’ sugar

  1. Mix dry ingredients in a large bowl and stir to combine well.
  2. In a separate bowl, cream sugar and butter to fluffy.   Add eggs and beat until smooth.   Stir in apples and dates.
  3. Gently add dry ingredients to apple mixture and stir to incorporate thoroughly.   Pour batter into a 9″ square pan that has been lightly sprayed with cooking spray and bake in 350 ovens for 45 minutes.
  4. Sift confectioners’ sugar on top, cut into squares and serve warm or cold.

Nutritional Value: 1 square = 200 cal, 7.5 fat grams, 4 grams protein, 31 carb grams, 1.5 grams fiber

Fresh Pear Snack Cake (24 squares)
½ cup canola oil
¼ cup honey
1 egg
1 cup unbleached flour and ½ cup whole wheat flour
½ cup oatmeal (not instant)
1 t. baking soda, 2 t. baking powder
1 t. of ground cinnamon, ½ t. ground ginger
1 cup low-fat buttermilk
2 cups sliced ripe sliced pears, unpeeled
1 t. each: cinnamon and confectioners’ sugar mixed together

  1. With an electric mixer, beat oil, honey, and egg to smooth and fluffy.
  2. Add remaining ingredients and stir until smooth.
  3. Pour batter into an oiled (cooking spray) 9″ x 12″ baking pan and bake in 350 ovens for 35 minutes. Cool, dust with a little cinnamon mixed with confectioners’ sugar, cut into squares and serve.

Nutritional Value: 1 square = 95 cal, 11 carb grams, 5 fat grams, 2 grams protein

Apple and Pear Dumplings (makes 8)
1 8-pack crescent rolls from the grocery
1 T. each: sugar, cinnamon
2 Granny Smith apples, peeled and sliced
½ cup of water
2 t. butter or spread

  1. Separate and stretch out the dough. Mix sugar and 1 t. cinnamon, dredge fruit into the mix to coat.
  2. Place even amounts on each piece of the dough round and shape into crescent or puff.   Place on a baking sheet.
  3. Mix water with remaining cinnamon and any leftover on the plate. Sprinkle over dumplings. Dot with butter and bake in 350° oven for about 30 minutes.

Nutritional Value: 1 dumpling = 140 cal, 17 carb grams, 5 fat grams, 2 grams protein