Team:Lethbridge/HP Patients
Patient Perspective
We sought to understand how diabetes affects those in our community. In Canada, diabetes mellitus reportedly affects approximately 7.3% of the population and disproportionately affects households with lower incomes, acting as a mechanism of societal inequality (Stats Canada 2017). As such, with the intent of making a product that democratizes insulin supply, we made it a priority to engage diabetic patients in the design process.
Our main takeaways from interviewing diabetics in our community was that having diabetes can be incredibly expensive. Type I diabetics often need constant maintenance of their blood glucose levels, requiring insulin pumps, glucose monitors and insulin injections. Although the pumps and monitors can make life easier, requiring less injections, they are also expensive (cost an average of $6 000 - $7 000 (Diabetes Canada 2019)), expose patients to infection, and can still cause pain to the patient. In addition, some insurance companies consider pumps unnecessary for some patients so many of them have to pay out of pocket. The insulin pumps also provide challenges for diabetics being able to enjoy outdoor activities, where one patient stated “There is a constant risk of infection that you need to be aware of, especially while camping.”
Without pumps, diabetic patients are dependent on insulin injections, which is also more common for treating type II diabetics. These can not only be painful, but can cause damage to tissue and produce anxiety in the patient. A pharmacy technician we interviewed mentioned that a diabetic patient came in seeking advice on administration after showing the technician their needle related bruising all around their abdomen. This was confirmed by nearly every other patient we interviewed. This led us to believe that an oral insulin was necessary for improving the quality of life of diabetes patients as well as an insulin alternative that is affordable, especially for lower income families.
(Accessed from wikimedia commons)
With all of these challenges, there is also a unifying issue, and that is simply the cost of insulin medication. Many diabetics have to temporarily forego insulin to pay for basic necessities. The cost of insulin can be as high as paying rent in some cases, yet the success of good health outcomes in diabetic patients is predicated on being able to maintain a proper medication regimen.
In order to democratize insulin supply, we also wanted to learn what diabetes patients consider the best way to supply insulin. It appeared most vehemently that a direct to consumer model is one that addresses diabetes patients’ concerns regarding the ease of overdosing on insulin and also the ease of taking too little. This led us to pursue a photobioreactor design for pharmacies to be able to produce and distribute insulin directly, making dispersal more widespread and less costly, but also regulated and measurable.
The state of affairs for diabetics can be summarized by the fact that many Americans need to travel to Canada and Mexico to purchase life saving insulin at a lower cost that citizens of Canada and Mexico already struggle to afford (Reuters 2019). This has been described as an insulin crisis and is one where we hope Algulin can make a difference.
References
Diabetes Canada https://www.diabetes.ca/
Statistics Canada. 2018. Health Facts Sheet: Diabetes. Government of Canada. https://www150.statcan.gc.ca/n1/pub/82-625-x/2018001/article/54982-eng.htm
Reuters T. 2019. “American caravan arrives in Canadian 'birthplace of insulin' for cheaper medicine.” CBC News. June 2019. https://www.cbc.ca/news/canada/london/insulin-prices-united-states-canada-caravan-1.5195399