Nfld. & Labrador

These diabetes patients want N.L. government to cover the cost of glucose monitors. Here's why

Diabetes advocates say devices to better control glucose levels exist, but without government support, life-changing technology isn't available to everyone.

5 provinces in Canada fund continuous glucose monitors

Laura Keating checks her daughter's glucose levels on an application on her phone. (Ted Dillon/CBC)

Sitting in the stands at the Trinity Placentia Arena in Whitbourne, N.L., Laura Keating watches her daughter Clarke take a slapshot on net, then glances at her phone as Clarke skates behind the goalie.

Keating is monitoring her diabetic daughter's glucose levels using an app connected to a continuous glucose monitor that's been inserted into her daughter's arm.

Instead of pricking Clarke's finger a handful of times a day, a device called a Dexcom G6 sends a glucose reading to their electronic devices every five minutes. An alarm goes off if Clarke's glucose levels get too high or low.

It has given the Keating family control that they didn't have before, especially when Clarke is playing sports.

"Before I had the Dexcom, I would usually have to come off the ice one time every single practice so I could poke my finger to see what my sugars were," said Clarke. "I can't really imagine myself living without the Dexcom. It has helped me a lot."

Clarke Keating, right, wears a continuous glucose monitor, which allows her mother, Laura, to read her glucose levels while she is on the ice. (Meg Roberts/CBC)

With Clarke on the ice so frequently, said Keating, her levels can get dangerously low. Having juice nearby when her levels drop keeps Clarke safely in the game. 

The Dexcom is a device Keating is not willing to part with. But it's been challenging to afford.

The Newfoundland and Labrador government does not pay for continuous glucose monitors, and Keating doesn't have any private insurance.

No Atlantic Canadian province currently covers continuous glucose monitors.

Quebec and the Yukon cover continuous glucose monitors while Manitoba does so for individuals up to the age of 25, and Saskatchewan for individuals under the age of 18. The British Columbia government funds the device for those who have pharmacare coverage with certain plans.

Diabetes advocates want the Newfoundland and Labrador government to follow suit, citing benefits to patients' health and financial savings to the health-care system.

"All of the research and education in the world doesn't help people if they don't have access to the right drugs or devices when they get sick," said Dr. Seema Nagpal, vice-president of science and policy at Diabetes Canada.

"Access through public plans is essential to ensure people can get to the devices that have been shown to help them."

Paying out of pocket

On top of the other costs associated with her daughter's diabetes, Keating said it's a struggle to pay the $300 a month for the device.

"It's hard, it's really hard," said Keating. "We do collect some recycling, and that helps a little bit."

The device was also life-changing for Krista Stephens, but the benefits were short-lived. 

Her doctor put her on a new insulin pump and wanted her to use a continuous glucose monitor. However, it was a temporary device and Stephen doesn't have private insurance, so she's no longer able to use it.

Stephens is blind in one eye due to complications from diabetes and was at risk of losing vision in the other before she had access to a drug that saved the rest of her vision.

"I can't erase any of the damage that has been done, but I can prevent new complications from developing and I can slow down the progressions of the complications that I already have. And the best way to do that is to see what my numbers are all the time," she said.

Krista Stephens has diabetes and as a result developed macular edema, a condition in which fluid collects in the retina, distorting her vision. (Meg Roberts/CBC)

Advocates plead with government 

Diabetes advocate Mark Buckle, who lives in St. John's, has asked policy-makers to consider how the monitors change people's lives.

"There's a sense of urgency for this, and the longer we wait, the more complications are going to happen and the higher the health-care system costs are going to be."

Years ago, before he had coverage from his workplace for his glucose monitor, said Buckle, he woke up one morning to discover two paramedics taking him to the hospital because his glucose levels were out of control.

Between the two-day hospital stay and a full week off of work, he said, the ordeal proved to be an expensive one that could have been prevented with a glucose monitor. 

Nagpal said tighter control over glucose levels can lessen chances of amputations, heart attacks, strokes and acute-care hospitalizations. 

After experiencing the benefits of continuous glucose monitors, Mark Buckle has been asking the provincial government to cover the cost of the devices. (Meg Roberts/CBC)

She said people living with diabetes have a five- to 10-year lower life expectancy, but research has shown those who are able to manage the disease can have an equal lifespan.

It's one of the reasons she would like to show the Newfoundland and Labrador government the benefits of the devices.

About 70,000 people in Newfoundland and Labrador have Type 1 and Type 2 diabetes, according to Diabetes Canada, which estimated the direct cost of diabetes to the health-care system to be $69 million this year.

Government says benefits unclear

Newfoundland and Labrador's Department of Health and Community Services, which declined an interview request from CBC News, says it has done a thorough review of continuous glucose monitoring. But it is unclear what that review entailed.

In an email, the department said it acknowledges these approaches are safe and effective, but "it is not definitive on whether the benefits provide significantly better clinical outcomes than can be achieved through self-monitoring and traditional methods."

"As this is a costly technology, and with our province's current fiscal situation, there is a need to prioritize investments where there will be clear health impacts," said the statement.

Buckle's continuous glucose monitor is pictured on his arm. (Meg Roberts/CBC)

Laura Keating said for her family, the health impacts are obvious when her phone's alarm goes off in the middle of the night, indicating her daughter's glucose levels are in a dangerous zone.

Before getting the Dexcom, "I was afraid to go to sleep, my husband was afraid to go to sleep. [The device] really makes a difference," she said.

"People can't help that they have diabetes, they didn't ask for it. It would be great if we could just get some coverage."

Read more from CBC Newfoundland and Labrador

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