Syringes, Pens, and Pumps

Syringes, Pens, and Pumps: New Jersey Diabetes Educator Demonstrates the Challenges of Managing Insulin Dependence

by Alexandra Maron, JD’15, Harvard Law School

Francine Grabowski demonstrates how to use insulin.

As an attendee at the New Jersey Diabetes Leadership Forum, I had the pleasure of witnessing a real, live insulin demonstration. Fran Grabowski, Lead Diabetes Educator for the Camden Citywide Diabetes Collaborative and Program Manager at Cooper Diabetes Center, went around from table to table at the Forum throughout the day showing attendees the various tools available for those with diabetes to take their insulin. A number of attendees, including myself, had never witnessed insulin intake before, so this was a fascinating part of the day. Ms. Grabowski first demonstrated how to use a syringe to give insulin, and while she noted that the needle is much smaller than it was in the past, it is still uncomfortable for those with diabetes who have to give themselves insulin at least 4 times per day. Ms. Grabowski then showed attendees the insulin pen, which has a remarkably smaller needle than a syringe, but unfortunately is no longer covered under New Jersey Medicaid. She pointed out that this is very unfortunate for those with diabetes in New Jersey because they are forced to use methods that are more time consuming and more painful. She also described the mechanism of insulin delivery systems, such as pumps and patches, which are even easier ways for those with diabetes to receive insulin; however, Medicaid also does not cover those systems. Therefore, a big take-away from this demonstration that was reiterated by many attendees is the need for more coverage under Medicaid for the tools necessary to treat and manage diabetes such as test strips, insulin pens, and other delivery systems. Additionally, Ms. Grabowski noted that there is a 76% chance that individuals who need insulin will not take it at meals when they are supposed to due to the cumbersomeness of the syringe system. If individuals with type 2 diabetes were able to use pens or other insulin delivery systems instead, then administering insulin would be easier and less time consuming and perhaps fewer people would avoid taking it. I really enjoyed the opportunity to witness insulin delivery and to hear more about the day-to-day challenges that individuals with diabetes in New Jersey are facing. It seems to me that if the insulin pens and other delivery devices were covered by Medicaid in New Jersey, then more individuals would be able to use them, which could lead to better diabetes control in the state. Because the pens and patches seem so much easier and more efficient for those with diabetes than the traditional syringe methods, those with diabetes in New Jersey could learn to treat and control their disease more effectively. Ms. Grabowski indicated that the cost of the pens and delivery systems are what prevent most individuals from using them, so by alleviating some of the financial burden through insurance coverage, more people in New Jersey with diabetes could gain access to them. Therefore, I agree with Ms. Grabowski that Medicaid coverage would drastically improve the face of diabetes control in New Jersey.