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Sugar Diabetes: not a sweet life

The state took upon itself the task of providing the insulin-dependent part of the population with medication. This is a commitment that cannot be neglected, with people’s lives in the balance

The physician Aretaeus of Cappadocia  in the II or III century BC described the illness in the following way: “a terrible affliction, not very frequent among men, being a melting down of the flesh and

limbs into urine. Patients cannot stop making water in unending torrents, like through an open pipe. Life is short, unpleasant and painful, thirst unquenchable, and one cannot stop them either from drinking or making water. If they stop drinking for a while, they experience dryness in the moth, the skin and mucous glands become dry.”   Every fiftieth Ukrainian suffers from sugar diabetes.

And just as many people are at risk of this illness but don’t have any inkling of this. Just under half the patients are insulin-dependent. The state has committed itself to provide the medication, however as in the majority of cases, these people have become hostages of officials determining their fate. And if Americans think that this is not an illness, but a way of life, in our country a sugar diabetes diagnosis is taken as a sentence.

An elderly lady basically driven to despair rang the editorial official.  With second group disability status and suffering from sugar diabetes, she had come up against the problem of finding insulin, vitally important in her type of illness.

She agreed to be interviewed, but wanted to remain anonymous. “You understand, if you write my name in the newspaper, the clinic will just eat me alive, I can’t cope with that”.  Over three months Anna Mykhailivna (as we’ll call her) has not been able to receive the necessary medication from her doctor. Although in 1999, after the Presidential Decree № 545/99 from 21.05.1999  on a comprehensive program “Sugar Diabetes”, the state took upon itself the task of providing the insulin-dependent part of the population with medication. Given that the dose and medication are specific for each patient, the transfer from “ones own” to an “alien”, that is different medication, can be quite problematical. “When the doctor prescribed a type of insulin, I was assured that there would be no problem with getting it. I don’t understand why I have to beg for medicine from the doctors. It’s humiliating!  After all the state committed itself to provide diabetes patients with their insulin treatment. At all levels they claim that the money for buying the medication is there, but for some reason the medicine isn’t!  After traipsing around different offices, they gave me “Khumodar” instead of “Pharmasulin”, and it makes me unwell. The sugar leapt up in my blood, and for three weeks I haven’t been able to eat anything except porridge. In the regional hospital they tell me to buy the medicine in the chemist, but it’s very expensive. And what can you buy on a pension of 370 UH? I don’t know who to turn to for help. I phoned both the city department of health, and the head of the regional state administration – the management is never there! They’re either at a meeting, or ring after 12, then after 2. A blank wall of incomprehension all around”.

What she told us in no way matched the assurances of the heads of different levels. After all it hasn’t been more than a couple of months since at the regional level they reported on their monitoring of the implementation of the program “Sugar Diabetes”. At state level no problems at all were observed with providing insulin!

The Chief Endocrinologist of the Ministry of Health Professor Volodymyr Pankov in his address stated that “Everything is fine with insulin”. – He noted that the implementation of the program “Sugar Diabetes” was under the personal control of the President of Ukraine.

“I can say that today the insulin problem in Ukraine is resolved – the state is on a centralized basis providing for the insulin needs of all regions (up to 85-90%, with the rest from local budgets). More than 2 million people in Ukraine have sugar diabetes. More than 7,000 patients live in Chernihiv. The register in the Chernihiv region has 21,376 patients. Nobody is protected against sugar diabetes. The illness does not depend on age, nationality or party affiliations. If diabetes has already developed, it is impossible to restore the insulin-producing cells. Attempts to transplant the pancreas (or the insulin-producing cells) are taking place, but they cannot yet be called successful. Therefore the main components in treatment are diet and the injection of insulin. At the present time it remains a mystery why the pancreatic gland cells are destroyed, and why this happens with some and not others. Yes, heredity plays a certain role in 1st type diabetes, but there is virtually no direct passing from parents to children of the illness. Therefore those with diabetes (or with relatives afflicted) can have children”., Ludmila Zakharevych, regional children’s endocrinologist.

The problem with insulin provision has not affected children or pregnant women. All 192 children and 8 women are provided with medication. Each has their means for self-regulation and two syringes for injecting the medicine. In the children’s regional hospital there Is a “Sugar diabetes school” where children, through games, learn how to live with the illness. From 6 years children already monitor their own blood sugar level and inject themselves.

Ludmila Borisivna considers that children need to be told and given training about the illness.  Monitoring ones condition is vital in treatment of the illness. “If you don’t tell them, in a couple of months the patient will be back, but this time in a horizontal position! If the illness is neglected, there are complications for the heart, eyes, legs, kidneys and there can be hypoglycaemia or a diabetic coma, and then you can’t do without insulin”

And on this subject the chief endocrinologist of the region Vera Voinypovych told us:

“People cry, sob, swear, whatever you like. .. The situation with insulin at present is different. The Minister has taken purchases upon itself but the tender has been postponed now for the third time! We can’t say that there isn’t  any insulin. We have a month’s supply. And even if the insulin we can administer differs from the one the patients are used it, that doesn’t mean that it’s bad, the insulin meets the standards. The state provides 80% of patients with insulin, and the other 20 get it from local budgets. All the districts buy insulin treatment, but there’s no money in Chernihiv for this! There was never such a situation in the city. The city always have money, subsidies. This has happened for the first time. I still hope that in the near future the situation will improve. On Saturday 28 October I’m going to Kyiv. The Minister is gathering us together and perhaps some decision will be taken. After all, it can’t go on like this!

When we were going to press:

The situation with provisions of insulin remains unresolved. If the Ministry “closed” the issue on “children’s” insulin, for adults the periods for purchases remain unclear. The tenders carried out have ended up in court disputes and proceedings. To resolve the issue, the Regional hospital has decided to announce by itself a tender for buying insulin.


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