We always like to hear from Diabetes Community friends overseas, and now we are thrilled to share a guest post by Jochen “Joe” Gaiser over in Germany.
I had the chance to meet Joe if we both journeyed to Las Vegas this March for its first-ever Diabetes UnConference, although admittedly he has the “farthest travel award” because he arrived all the way in Stuttgart, Germany, his lifelong hometown where Porsche and Mercedes happen to be located. Joe was diagnosed more than two years before, and now works as chief financial officer of a tiny, technical biotech company (no link to diabetes).
Today we are pleased to listen to his POV on diabetes technologies, the DOC overseas, and all that has changed during his years. Take it away, Joe!
A Guest Post from Jochen Gaiser
When I was diagnosed at age 18, my physician promised me during our first meeting that we’ll have ice cream collectively at the end of next week following the first “installation” of my T1. If I could have ice cream, diabetes could not be that bad after all, I thought.
Over 20 years after she’s still my diabetes physician and I have learned a great deal from her. I also now know that diabetes may be challenging bargain every second day and sometimes really bad. To deal with this, I try to stay curious and learn every single bit about this disorder that’s possible.
The Internet and especially the DOC (Diabetes Online Community) help a great deal in doing so, even across oceans and borders. Kerri Sparling’s blog post at SixUntilMe made me aware of the DiabetesUnConference at Las Vegas in March and it was soon clear to me that I wished to attend even though I live in Germany roughly 6,000 miles off.
I had the chance to attend some diabetes encounters earlier in Germany — that the largest was T1Day at Berlin in January with more than 300 T1Ds. It had been held that the day following a seminar for diabetes healthcare professionals. The massive audience — and likely also the German tendency to be distanced at least at the start — made it even more challenging to connect personally. In the afternoon, when smaller focus groups worked on various topics, private connections where made but never at the way I experienced it in Las Vegas during DUnCon.
Germans have a tendency to observe that the U.S. as a way ahead in technical issues. So I was not surprised to find out that you have a wider choice of pumps. T-Slim and Asante Snap (RIP) haven’t been accessible here. But the Animas Vibe was accessible in Europe long before you had the chance to get it, and Abbott FreeStyle Libre Flash Glucose Monitor is driving the German DOC crazy since summer 2014.
Abbott did a fantastic job in marketing. They encouraged bloggers to get a weekend to test drive the unit in real life long before it had been released. Patients were allowed to blog a bit about what happened, but no product particulars. So nearly the entire DOC was eager to listen to news of its own official launch, so much so that Abbott had to close its own online shop for new registrations shortly following the Libre went available. Demand was far higher than they expected — even though the Libre isn’t covered by health insurance and must be compensated entirely out of pocket.
Libre is a “CGM mild,” as we consider it, as it has no alarms. Alerts are the main reason for me to have a Dexcom. So it felt like attempting Libre might be a step back for me.
But my impression is that Germans have a tendency to be settled when it comes to where they live and what they have generally than Americans are, so perhaps that equates to less furor for the latest brassy diabetes tech too. No evidence for this, just my impression.
The differences are even more astounding, since Germans are utilized to health insurance covers what is required and there is no huge additional cover aside from the insurance contribution. German health insurance covers insulin and supplies whilst T2s utilizing no insulin need to pay to get BG strips themselves. Most others get up to 200 strips per month.
It’s a fact that physicians are afraid health insurance organization will take recourse against them if they prescribe longer — meaning that the physicians would need to pay for the strips from their own pocket. Somehow physicians believe that there is legal regulation to never prescribe more than 600 strips per quarter — even though there is no such official rule and they likely have nothing to fear.
I never had problems with that, as I just tested 4-5 times a day before I utilized CGM. Other T1s get 600 strips out of their diabetologist and try to acquire additional prescriptions from their family physician.
To acquire an insulin pump has become more and harder during the past years as insurance companies try to save money. In the old days you simply needed a prescription using a tiny justification and you’re done. Nowadays insurance companies need three months’ worth of diabetes logbook data and a few applications are denied if they don’t have a blood spots — as they see that the deficiency of blood for a indication that the logbook entries have been made up (!) Like in the U.S., approval is only given if the authorities see “medical necessity,” meaning that the patient is struggling with dawn occurrence or other issues that cannot be solved with injection therapy. So that the individual needs to prove that they are doing poorly so as to acquire a pump; simply aiming for higher quality of life is no more an accepted reason.
CGM isn’t supplied by general health insurance in Germany — even though several extremely isolated individual scenarios. So patients pay from their own pocket and are utilizing DIY solutions to decrease cost. Examples of these DIY alternatives are , developed by Stephen Black in the U.S. (saves $1.000 as no Dexcom receiver is required) or individual replacement of Dexcom transmitter batteries.
The German DOC
With the aid of companies involved in diabetes, the German-speaking DOC is attempting to get closer together instead of posting and working at an array of individual websites. One of the greatest ideas was that the introduction of portals amassing individual diabetes blogs and publishing the various posts at the same website (i.e. one portal assembles 62 distinct blogs at the moment). So it is extremely easy for readers to discover new blogs and find out more. And it reduces the number of RSS feeds in my phone, as I needed to add so many new ones following my trip to Vegas.
The ability of the world wide web has given us, and helped create diabetes much easier to live with in several ways.
Oh, and to not overlook: My doc and I never left it to have that ice cream together (but I must confess we had some yummy pasta and pizza!)
Thank you for sharing this, Joe! We expect to see you at the next year’s Diabetes UnConferences in Las Vegas or Atlantic City, and look forward to seeing you round the Global DOC.
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