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    • 17 hours, 40 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 17 hours, 43 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I had ketones thrn I am sick. If mid to large I wd call my endo or if also vomiting or dehydrated from diarrhea. I wd go to the ER
    • 18 hours, 57 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 18 hours, 58 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 19 hours, 5 minutes ago
      KSannie likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 19 hours, 7 minutes ago
      Patricia Dalrymple likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 19 hours, 21 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I increase my basal and insulin ratios if I eat until I show no longer test positive. I do only test if I have been high for a longer than usual time.
    • 19 hours, 21 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 19 hours, 43 minutes ago
      Judith Halterman likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 19 hours, 46 minutes ago
      Derek West likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 1 day, 10 hours ago
      KCR likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 1 day, 17 hours ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I have a blood ketone monitor. It works just like a glucometer.
    • 1 day, 19 hours ago
      Kathy Hanavan likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 19 hours ago
      Judith Halterman likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 2 days, 13 hours ago
      Anthony Harder likes your comment at
      Do you have ketone testing strips?
      Hi, Marty. Does your specialist have a source for that claim? It makes little sense that ketones would rise faster than BG since the metabolic pathway is much slower. If there's a source, however, I'd look further into the claim. FWIW, I've been a Type 1 for over 50 years; I can't remember the last time I tested for ketones. I possess no ketone testing strips.
    • 3 days, 16 hours ago
      Marty likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      Covers it with co pay
    • 3 days, 18 hours ago
      atr likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      It covers both. I prefer to have the the nasal version as I think it would be easier for someone else to administer.
    • 3 days, 19 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I’ve been T1D for 60 years. As a child my mother didn’t like needles or injections so she just fed me when low. In college, explained use to dorm mates and classmates would’ve been a waste of time. Now married, my wife assumed the role of my mother and doesn’t like using needles on me either. I don’t have glucagon.
    • 3 days, 19 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      Yes, always have one or two nasal glucagon kits (Baqsimi) at home in easy to reach locations (ie at bedside and special container in living area) and always keep one with me when I go out ( along with glucose tabs or other simple carbs for treating LBS.). I apparently required injectable glucagon several times as a child and needed injectable glucagon only twice as an adult, both more than 15 years ago . More recently I needed my husband to give me Baqsimi after eating a difficult to dose for, high fat meal. The experience was terrifying so I don’t go anywhere without it now.
    • 3 days, 19 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I actually have 2 non-expired prescriptions. One for Baqsimi and one for Gvoke. I have not filled either of them because they’re $500-600 each.
    • 3 days, 19 hours ago
      Lawrence S. likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      My Medicare Part D essentially doesn't cover glucagon when any form is nearly $500!
    • 4 days, 10 hours ago
      Amanda Barras likes your comment at
      Do you have a non-expired glucagon prescription?
      Same here. Been as low as 19 (struggling with a vacuum cleaner bag and refused to let it win) but was still able to swallow food. I did used the “red needle” as my husband refers to it once when I went low but was scheduled for surgery and couldn’t eat or drink anything. Only once in 26 years. Fortunate.
    • 5 days, 5 hours ago
      Karen Newe likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 18 hours ago
      Natalie Daley likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 18 hours ago
      atr likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
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    How concerned are you right now about affording your next order of T1D supplies?

    Home > LC Polls > How concerned are you right now about affording your next order of T1D supplies?
    Previous

    If you wear both an insulin pump and a CGM, how often do you put both devices on the same area of your body? (ex: pump site and CGM in the same section of your abdomen, both on the same arm, etc.)

    Next

    Before you were diagnosed with type 1 diabetes, did a healthcare provider tell you that you had prediabetes, or inform you that you had elevated blood glucose levels?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    " At T1D Exchange, we’re proud to announce our Medical and Research Advisory Team — an accomplished group of leaders in endocrinology, research, and quality improvement. Together, they are redefining what’s possible in type 1 diabetes (T1D) care through rigorous data analysis, innovative research approaches, and real-world implementation. Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. By leveraging data to scale best practices, the goal is to drive meaningful, measurable change across clinics and communities.  “Our advisors will help to extend our impact — whether through QI strategy, research innovation, funding opportunities, or new data-driven solutions,” said Walton. “We want to take what’s working at individual centers and spread that as broadly as possible.”   He added, “As a Collaborative, we’re also focused on advanced population health strategies such as exploring predictive data models to identify risks earlier and intervene before complications even begin to happen.”    The power of the T1D Exchange Quality Improvement Collaborative  Central to this work is the T1D Exchange Quality Improvement Collaborative (T1DX-QI) — a nationwide network of clinics working together to improve care through shared data, benchmarking, and evidence-based practices.  “I’m thrilled to serve as a Medical Advisor for T1D Exchange, because I’ve seen firsthand the impact this network can have on patient care,” said Dr. Nestoras Mathioudakis. “T1D Exchange is the premier organization for quality improvement in type 1 diabetes, with unparalleled assets like a large EHR database and robust patient registry.”  He added that he is excited to apply his expertise in EHR research and big data analytics to generate real-world evidence across diagnosis, management, and outcomes.  Dr. Viral Shah echoed that perspective, reflecting on T1DX-QI's evolution: “I have been involved with T1D Exchange since its early days and have had the privilege of witnessing how it has transformed the quality of diabetes care across the United States. I’m delighted to return as a Medical Advisor.”  He emphasized the importance of accelerating impact. “I look forward to working closely with the team to accelerate the evidence generation and to help translate these insights to improve patient care.”   Dr. Jenise Wong highlighted the visible impact of T1DX-QI on the delivery of care. "I’m truly honored and grateful to be working with T1D Exchange as a Medical Advisor. T1DX-QI is a remarkable resource for centers that are using continuous process improvement to improve the quality of care for people living with diabetes.”  “Diabetes centers working with T1DX –QI have done amazing work using QI methodology to make care accessible and equitable for all people with diabetes,” she said. “It’s inspiring to be a part of a collaborative in which centers have been creative and thoughtful with initiatives to address individual and systemic challenges to care, improving clinical outcomes as well as the patient experience."  Looking ahead, Dr. Sherr highlighted the opportunity to build on the existing strong foundation. “I’m very excited to be working as a Medical Advisor for T1D Exchange,” she said. “It’s a privilege to help shape what comes next for a group that’s already doing such impactful work.”  “Sharing what’s happening in clinical practice, benchmarking across centers, and understanding outcomes is how we figure out what’s working, what’s not, and where we go next,” she said.      The future of T1D care   With this team’s vision and expertise, T1D Exchange is positioned to accelerate progress in T1D care — bridging research and real-world practice to drive meaningful, measurable impact.  Together, we look forward to advancing innovation and improving outcomes for everyone affected by type 1 diabetes.   "

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    28 Comments

    1. Retired and glad

      Good Medicare Advantage plan insurance!

      3
      5 years ago Log in to Reply
    2. Sahran Holiday

      July 1 my insurance CIGNA changed the vendors for DME and raised prices. The vendors Express Scripts and Edgepark are incoherent, careless. I pay 19% of my net salary for employer provided health coverage. Switching the end of this year.

      1
      5 years ago Log in to Reply
    3. Gerald Oefelein

      With traditional Medicare my pump and CGM supplies are covered as Part B Durable Medical Equipment with Medicare paying 80% and my CIGNA supplemental insurance paying the remaining 20%.

      1
      5 years ago Log in to Reply
    4. George Lovelace

      Just a little concerned with possible Medicare changes

      1
      5 years ago Log in to Reply
    5. Karen Maffucci

      Since I have been on Medicare on May 1st it has been extremely stressful and financially challenging. The costs may force me to go back to multiple shots a day.

      3
      5 years ago Log in to Reply
    6. Lawrence Stearns

      For the time being, I am getting the supplies I need that are covered by Medicare and my supplemental UHC insurance.
      However, I’ve gone through two Dexcom receivers that stopped working. Medicare will not pay for another for 5 years. I bought a new telephone so I could use the Dexcom G6 app. The app kept losing the transmitter signal and didn’t work properly.
      Otherwise, cost is not currently my major concern. My currently problems is getting my supplies (CGM) on time from Edgepark.

      2
      5 years ago Log in to Reply
      1. Bob Durstenfeld

        Call, Dexcom, there is a simple setting on your phone that fixes the lost signal.

        2
        5 years ago Log in to Reply
    7. ConnieT1D62

      I answered “A little concerned”. Am on Medicare with a fairly decent Advantage plan, but am in the donut hole so things are bit more pricey. I wish they would just get rid of the donut hole nonsense and evenly distribute reasonable payments across the entire 12 month period so senior adults with T1D can plan and budget accordingly. Our spending needs don’t change when we reach the “donut hole”; in fact because T1D is an ongoing expensive health concern we often reach the donut hole by mid-year and then we are stuck with having to pay more for what we need to stay alive.

      5
      5 years ago Log in to Reply
    8. Eadie Laro

      My greatest concern is receiving my supplies at the appropriate time.

      4
      5 years ago Log in to Reply
    9. Mary Dexter

      Negotiating the coordination of doctor’s office, insurance company, and third-party DME is stressful. Their stories don’t jive so I wonder who is lying or if anyone is telling the truth. Tuesday everything is fine; then Friday 4PM I am told my order cannot be shipped, and this pattern repeats week after week until just before I will no longer be able to use my CGM because my transmitter will expire or I won’t have sensors, and then they relent. I get my stuff, but the next time I need stuff, the cycle begins again.

      4
      5 years ago Log in to Reply
    10. Natalie Daley

      Although we have reasonable retirement earnings, my copay for insulin despite Medicare and bridge insurance is over $700 every other month. I’ve stopped eating lunch, which eliminates a dose of novolog and lowers my Tresciba. I’ve lost 25 lbs over the years, lowered my A1C. If I get hungry, I have a non-carb snack such as nuts or coffee with a splash of milk.

      1
      5 years ago Log in to Reply
      1. Kristine Warmecke

        There are other’s who do the same. I’m one of them.
        If it weren’t for the cost of my Novolog, my Medicare Advantage plan would be awesome. They cover none of it though, because it’s not on their formulary & I am allergic to Humalog.

        5 years ago Log in to Reply
    11. Bob Durstenfeld

      Supplies have been part of or budget forever. That does not mean they are affordable. We give up other things.

      2
      5 years ago Log in to Reply
    12. Tom Caesar

      It costs me roughly $14 per day for supplies, mainly towards insurance that covers CGM, pump, and insulin needs. My prescription insurance has a $400 yearly deductible and my first vial eats up most of that, no help from medicare. After that the price drops to $25 per vial until the doughnut hole pushes it up to $100. Try to get samples from my Dr each visit. Having diabetes for over 50 years the total cost is enormous! PS had very poor service from Edgepark, US Medical so much more organized.

      5 years ago Log in to Reply
    13. Anthony Angel

      Due to a “surgery” I had due to diabetic retinopathy my copay and out of pocket have all been met. So I am good at least til the end of the year.
      .

      1
      5 years ago Log in to Reply
    14. Sjoymex

      Right now I’m blessed with great insurance and a full time job. However in the past I have had to either go without, minimize the amount of supplies used, or even sell belingingdms in order to afford insulin, strips, etc.

      5 years ago Log in to Reply
    15. Mick Martin

      Not at all concerned as I live in the United Kingdom of Great Britain and Northern Ireland so do not have to pay anything for my diabetes supplies. (They are paid for by our NHS (National Health Service), which is financed via direct taxation of all working people.

      1
      5 years ago Log in to Reply
    16. Sadie Robinson

      I am concerned because the supplies to maintain safe levels of blood glucose are expensive on a fixed income. Those of us that try to keep up with the technology have struggles.

      5 years ago Log in to Reply
    17. Henry Renn

      I’m in Medicare. If I had to pay for majority of supplies I’d have to go back to MDIs.

      5 years ago Log in to Reply
    18. Ahh Life

      The costs referenced by most here are the direct peel-off-the-dollar-bills to pay someone costs. However, as we’re learning about crypto currency, money in the digital age does not have to be foldable.

      The cost that everyone hints at but never explicitly mentions is the “time costs” of the American medical system. The time spent waiting on the phone; the time spent talking to medicare; the time spent talking to secondary insurance; the time spent talking to MD’s; the time spent talking to CGM vendors; the time spent talking to pump vendors; the time spent talking to pharmaceutical companies; the spent talking to local drug stores.

      Now multiply all those times together, since in each and every case someone is on the other end of the phone with you. They waste time calling each other trying to get “the other guy” to pay for something.

      I do not know what your time nor mine is worth. But you could estimate the physician’s time, the insurance guy’s time, etc. etc. When all is said and done, it amounts to a time tax. It doesn’t appear to have a monetary value, but, boy, does it cost a lot. ¯\_( ͡❛ 益 ͡❛)_/¯

      5 years ago Log in to Reply
    19. Janice B

      As others have stated above coverage of care and supplies is very dependent on the particular insurance plan people are on. Right now I am covered well, but through out my 25 years I have had many different company supplied insurance plans some of which were so expensive I was struggling to pay for MID.

      5 years ago Log in to Reply
    20. Ronald Troyer

      while I’m not particularly concerned about affording it I will say that because of Medicare’s restrictions on ordering cgm supplies I’m concerned that I won’t receive them in time for my next extended time away from home. When traveling it’s especially hard to get that timing right. There should definitely be some provision for this

      5 years ago Log in to Reply
    21. PamK

      As the end of the Recovery Act comes closer I am very concerned. We have not been recalled to work yet, and finding new jobs at our ages is difficult. Not sure what we will do.

      5 years ago Log in to Reply
    22. Dorian Dowell

      Fortunately, I receive supplies and equipment via the VA. Hopefully, this doesn’t change!

      5 years ago Log in to Reply
    23. Adam Wright

      I more concerned FedEx is going to lose them again and give me the run around. The regional facility in my area is known for shipping packages by mistake across the country. There are multiple reviews stating it is the Bermuda Triangle of FedEx.

      1
      5 years ago Log in to Reply
    24. Antsy

      My supplies are affordable; I’m lucky to have great insurance. MY problem is receiving them safely & securely each time. Medtronic uses only UPS, and I learned yesterday drivers are not supposed to ring a doorbell when they leave a package UNLESS the shipper pays extra to require a signature. Now I know why they ignored the sign I’d taped on the door, asking them to ring before leaving.. I stay home when I know supplies are supposed to arrive, as we’ve had packages stolen before (including pump supplies) when we were home, despite signing up for UPS notifications. Thieves are fast here.. I think I’ve talked Medtronic into requiring a signature every time (without requiring a lengthy phone call every 3 months). We’ll see if it works. One would think getting a driver to ring a dang doorbell when they leave expensive medical supplies should be easy for the user to request, but it isn’t. If it happens again, I’ll switch to Tandem and Dexcom so most supplies will come from my pharmacy. Time for a new pump anyway…

      5 years ago Log in to Reply
    25. Wanacure

      I contribute to groups that are working to preserve and expand social security and Medicare for all. I hope at least future American generations will have single payer universal health care. There are other countries where private health insurance companies are required to be non-profit. Result? Better health care for more people at half the cost of US health care. It took organized political struggle to get social security and to finally get Medicare. Why stop now?

      5 years ago Log in to Reply
    26. NAK Marshall

      My Medicare plan is great. I am lucky. I did at one time in my career leave a job I loved at a non-profit and return to teaching in a public school for the health insurance though. At one time in my late 30’s I was on the “Colorado Health Insurance for the Uninsurable,” which cost as much just for me as the insurance we had for the 3 other members of our family.

      5 years ago Log in to Reply

    How concerned are you right now about affording your next order of T1D supplies? Cancel reply

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