2023-11-14 05:43:29
Thousands of Quebecers suffering from type 1 diabetes must manage their disease with the means at hand, due to a lack of public funding for insulin pumps. These very expensive devices are reimbursed by health insurance in several other provinces, including Ontario.
“If you are diagnosed with type 1 diabetes before the age of 18, the RAMQ reimburses the pumps for the rest of your life,” explains Rémi Rabasa-Lhoret, endocrinologist at the Montreal Clinical Research Institute (IRCM). “But from the age of 18, this is not the case. This is a problem, because the disease appears more and more often in early adulthood, for reasons that are difficult to explain. »
The proportion of type 1 diabetes diagnoses that occur following the age of 18 has increased from 20% to 50% in 20 years, according to this IRCM researcher. “Many patients who do not have private insurance have to buy second-hand pumps,” he explains. The pumps replace the syringes with which patients traditionally inject insulin.
A new pump costs $7,000. Private insurance authorizes its replacement following a certain time, often four years, according to the Dr Rabasa-Lhoret. “Those who replace their pump sometimes resell the old one. You can find them for $1000 to $1500. There is also the problem of private insurance which ends when you retire. I have retired patients who pray their pump won’t break. »
PHOTO TAKEN FROM THE MONTREAL CLINICAL RESEARCH INSTITUTE WEBSITE
The Dr Rémi Rabasa-Lhoret, endocrinologist at the Montreal Clinical Research Institute
Another problem: you cannot use the pump manufacturer’s software if you bought the pump second hand. Patients then use “free software [open source] », specifies the Dr Rabasa-Lhoret, but they have difficulty finding endocrinologists who agree to follow them. “Many of my colleagues are worried regarding their professional liability, because this free software is not approved by Health Canada,” says Dr.r Rabasa-Lhoret. I’m one of the only ones in Montreal [à prendre ces patients]. »
“It gives me a lot more freedom for my activities”
Ingrid Fontes, a young mother in her thirties who works in administration in a hospital, is one of the patients of the Dr Rabasa-Lhoret which uses free software, even if it has private insurance. “The software links the pump to the blood glucose sensor,” she says. It gives me a lot more freedom for my activities. » Mme Fontes is a runner – she has previously run a marathon.
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PHOTO JOSIE DESMARAIS, THE PRESS
To recharge her pump, Ingrid Fontes first takes insulin in a vial.
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PHOTO JOSIE DESMARAIS, THE PRESS
She then puts the insulin into the pump.
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PHOTO JOSIE DESMARAIS, THE PRESS
To remove air bubbles in the pump, Ingrid Fontes must activate it with the software on her phone.
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PHOTO JOSIE DESMARAIS, THE PRESS
Ingrid Fontes puts the recharged insulin pump back on her arm.
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PHOTO JOSIE DESMARAIS, THE PRESS
On the right you can see the device with the manufacturer’s software, which Ingrid Fontes does not use because she prefers free software.
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In September, the Quebec Diabetes Association called for pumps to be funded for adults with type 1 diabetes, an autoimmune disease that hinders insulin production.
The Minister of Health, Christian Dubé, limited himself to saying that the file was being studied, citing the “significant” sums involved.
Since 2011, insulin pumps have been funded for people who are diagnosed with type 1 diabetes before the age of 18. In 2022, the National Institute of Excellence in Health and Social Services (INESSS) has recommended that this be the case for diagnoses received in adulthood as well.
Longer life expectancy
Could funding for all cases of type 1 diabetes open the door to funding for type 2 diabetes, which is nine times more common? “No, because we can control type 2 diabetes well with medication,” says the Dr Rabasa-Lhoret. Type 2 diabetes, a risk factor for which is obesity, is caused by the body’s improper use of insulin.
Insulin pumps are also not reimbursed for gestational diabetes.
Healthy life expectancy for diabetics increased by 10 years thanks to systems linking pumps to blood glucose sensors through software, says Dr.r Rabasa-Lhoret. “With injections by the patient, they have to make 200 to 300 decisions per day related to the management of their diabetes. But with this system, it drops to 20 to 30 decisions per day. » This disease can cause damage to the eyes, nerves, kidneys and brain, in addition to falls and fractures.
Learn more
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- 10 %
- Proportion of diabetes cases that are type 1
SOURCE: Diabète Québec
- 1,2 million
- Number of Quebecers who suffer from type 1 and 2 diabetes
SOURCE: Diabète Québec
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