Mtengo Woyang'anira Matenda A shuga 2: Nkhani ya Shelby

Zamkati

• Mtengo wa kusintha kwakukulu pamoyo
• Mtundu wa shuga wa 2 ukupita patsogolo ndipo momwemonso mtengo wake
• Mtengo wokwera kusunga ma inshuwaransi
• Kulimbana ndi kusintha komanso kukwera mtengo
• Kulipira mtengo wa chisamaliro
• Kumenyera chithandizo chotsika mtengo

Thanzi ndi thanzi zimakhudza aliyense wa ife mosiyanasiyana. Iyi ndi nkhani ya munthu m'modzi.

Shelby Kinnaird ali ndi zaka 37, adapita kwa dokotala kuti akamuwonetse. Dokotala wake atalamula kuti akayezedwe magazi, adazindikira kuti kuchuluka kwa shuga m'magazi ake kunali kwakukulu.

Monga aku America, Shelby adapanga mtundu wa 2 shuga - mkhalidwe womwe thupi silingasunge bwino kapena kugwiritsa ntchito shuga kuchokera pachakudya, zakumwa, ndi magwero ena.

Koma kukhala ndi matenda a shuga a mtundu wachiwiri sikumangokhala kuphunzira kuphunzira kusamalira shuga wamagazi. Kulimbana ndi mtengo wa vutoli - kuchokera kumalipiro a inshuwaransi, ma copay, ndi mankhwala mpaka njira zamoyo monga masewera olimbitsa thupi komanso chakudya chopatsa thanzi - zimabweretsa zovuta zapadera.

Poyamba, Shelby atazindikira, mtengo wake udali wocheperako ndipo makamaka umakhudzana ndikupanga zisankho zatsiku ndi tsiku. Dokotala wa Shelby adamupititsa kwa wophunzitsa za matenda a shuga kuti amuthandize kuphunzira momwe angathanirane ndi matenda a shuga amtundu wachiwiri, pogwiritsa ntchito zakudya, masewera olimbitsa thupi, komanso kusintha kwina pamachitidwe.

Mothandizidwa ndi aphunzitsi ake a shuga, Shelby adayamba zizolowezi zatsopano zatsiku ndi tsiku.

Anayamba kutsatira chakudya chonse chomwe amadya, pogwiritsa ntchito njira yodziwika kuti "njira yosinthira," kukonzekera chakudya chomwe chingamuthandize kuti azikhala ndi shuga wambiri.

Anayamba kuchita masewera olimbitsa thupi, akumapita kokayenda tsiku lililonse akamaliza ntchito.

Anafunsanso abwana ake ngati angayende pang'ono. Zinali zovuta kutsatira chakudya chopatsa thanzi komanso kuchita masewera olimbitsa thupi poyenda momwe amagwirira ntchito.

M'chaka choyamba chodziwika, Shelby adataya mapaundi osachepera 30 ndipo shuga yake yamagazi idatsikira pamlingo woyenera.

Kwa zaka zingapo zotsatira, adakwanitsa kuthana ndi kuchuluka kwa shuga m'magazi pogwiritsa ntchito njira zotsika mtengo zokhazokha. Pakadali pano, ndalama zake zinali zochepa. Anthu ena omwe ali ndi matenda a shuga amtundu wa 2 amatha kuthana ndi vutoli popanda mankhwala kwa zaka zingapo kapena kupitilira apo. Koma pamapeto pake, ambiri amafunikira mankhwala kuti asunge shuga m'magazi awo.

Popita nthawi, dotolo wa Shelby adawonjezera mankhwala amodzi kenako ena kuntchito yake.

Zotsatira zake, mtengo wake wokhala ndi matenda ashuga udakwera - poyamba pang'onopang'ono kenako modabwitsa.

Mtengo wa kusintha kwakukulu pamoyo

Kumayambiriro kwa zaka za 2000, zaka zingapo atamupeza, Shelby adakumana ndi zosintha zingapo zazikulu pamoyo wake.

Anasiyana ndi mwamuna wake woyamba. Anasamuka ku Massachusetts kupita ku Maryland. Anasiya ntchito yanthawi zonse ndikugwira ntchito yaganyu, ndikubwerera kusukulu kukaphunzira kapangidwe kazofalitsa. Atamaliza maphunziro ake, adasiya kampani yopanga mapulogalamu a mapulogalamu komwe adagwirako ntchito kuti ayambe bizinesi yake.

Moyo udayamba kukhala wotanganidwa - ndipo adavutika kuti azitha kuyang'anira matenda a shuga.

"Zosintha zambiri pamoyo zidachitika nthawi yomweyo," adatero, "ndipo matenda ashuga, poyamba, anali omwe ndimawafuna kwambiri, kenako ndikuganiza, 'o zinthu zili bwino, ndikuchita bwino,' mwadzidzidzi, zimatsikira pang'ono pamndandanda. ”

Mu 2003, kuyezetsa magazi kudawonetsa kuti shuga yake yamagazi sinalinso momwe amafunira. Pofuna kumuthandiza kuti achepetse shuga, adokotala adamupatsa mankhwala a metformin, omwe amamwa pakamwa kwa zaka 2. Metformin imapezeka ngati mankhwala achibadwa pamtengo wotsika kapena ngakhale kwaulere.

"Sindidawonongepo ndalama zoposa $ 10 pamwezi," adatero Shelby.

"M'malo mwake, pomwe ine [pambuyo pake] ndimakhala ku North Carolina, kunali golosale kumeneko yomwe inkapereka metformin kwaulere," adapitiliza. "Ndikuganiza kuti mankhwalawa akhala akugwiritsidwa ntchito kwanthawi yayitali, ndiotsika mtengo kwambiri, zili ngati tikakupatsani metformin kwaulere, mubwera kuno kudzapeza zinthu zina."

Mu Meyi 2020, adalimbikitsa kuti ena opanga metformin awonjezere kutulutsa ena mwa mapiritsi awo kumsika waku US. Izi ndichifukwa choti mulingo wosavomerezeka wa khansa yotenga khansa (wothandizira khansa) udapezeka m'mapiritsi ena a metformin. Ngati mukumwa mankhwalawa, itanani woyang'anira zaumoyo wanu. Adzakulangizani ngati mupitiliza kumwa mankhwala anu kapena ngati mukufuna mankhwala atsopano.

Mtundu wa shuga wa 2 ukupita patsogolo ndipo momwemonso mtengo wake

Mu 2006, Shelby adasamukira ndi Cape Hatteras ndi mwamuna wake wachiwiri, zilumba zingapo zomwe zimayambira kumpoto kwa North Carolina kupita ku Atlantic Ocean.

Panalibe malo osamalira odwala matenda ashuga kapena akatswiri azamaphunziro am'deralo m'derali, chifukwa chake adadalira dokotala woyang'anira chisamaliro choyambirira kuti amuthandize kuthana ndi matenda ake.

Anapitilizabe kumwa metformin tsiku lililonse, kudya zakudya zopatsa thanzi, komanso kuchita masewera olimbitsa thupi pafupipafupi. Koma patadutsa zaka zingapo, adapeza kuti njira izi sizinali zokwanira.

"Ndinafika poti mukuganiza kuti mukuchita zonse moyenera, ndipo ngakhale mutadya chiyani, shuga wamagazi umakwera," adatero.

Pofuna kuchepetsa kutsika kwa shuga m'magazi ake, adokotala omwe amamusamalira makamaka adamupatsa mankhwala akumwa otchedwa glipizide. Koma zidamupangitsa kuchuluka kwa shuga m'magazi ake kutsika kwambiri, motero adasiya kumwa ndipo "adalimbikira kwambiri" pazakudya zake komanso zizolowezi zolimbitsa thupi kuti asunge shuga m'mwazi wake.

Shelby ndi mwamuna wake atasamukira ku Chapel Hill, North Carolina, mu 2013, anali akuvutikabe kuti athetse shuga. Dokotala wake watsopano woyang'anira wamkulu adamutumiza kwa katswiri wazamaphunziro.

"Ndinapita kukaonana ndi katswiri wazamagetsi ku malo awo a shuga kumeneko," adatero Shelby, "ndipo adati," Osadzimenya, ichi ndichinthu chopita patsogolo. Chifukwa chake, ngakhale mutachita zinthu moyenera, zidzakupezani. '”

The endocrinologist adalamula mankhwala ojambulidwa otchedwa Victoza (liraglutide), omwe Shelby adagwiritsa ntchito ndi metformin ndi njira zamoyo zochepetsera shuga yake yamagazi.

Poyamba, amangolipira $ 80 patsiku lililonse la Victoza la masiku 90.

Koma pasanathe zaka zochepa, izi zitha kusintha kwakukulu.

Mtengo wokwera kusunga ma inshuwaransi

Shelby atapezeka ndi matenda ashuga, adayang'aniridwa ndi inshuwaransi yothandizidwa ndi olemba anzawo ntchito.

Atasiya ntchito kuti ayambe ntchito yodziyimira payokha, adalipira kuti asunge inshuwaransi yake yakale kwakanthawi kochepa asanagule payekha inshuwaransi. Panthawiyo, kupeza inshuwaransi yazaumoyo kungakhale kovuta kwa iwo omwe ali ndi matenda ngati matenda a shuga.

Kenako Affordable Care Act (ACA) idakhazikitsidwa mu 2014 ndipo zosankha zake zidasinthidwa. Shelby ndi mwamuna wake adalembetsa dongosolo la Blue Cross Blue Shield kudzera kusinthana kwa ACA ku North Carolina.

Mu 2014, adalipira $ 1,453 pamwezi pamalipiro ophatikizika ndipo anali ndi banja lomwe limagulitsidwa pa $ 1,000.

Mu 2015, izi zidasintha. Ndalama zomwe amapeza mwezi uliwonse zidatsika pang'ono, koma mabanja awo omwe adalumikizidwa pa intaneti adalumphira $ 6,000. Atasamuka kuchokera ku North Carolina kupita ku Virginia kumapeto kwa chaka chimenecho, ndalama zawo zidapitilira $ 1,251 pamwezi - koma ndalama zomwe adapeza zidakwera kwambiri, ndikuwonjezeka mpaka $ 7,000 pachaka.

Monga banja, adapeza ndalama zochepa pomwe mwamuna wa Shelby adakhala woyenera ku Medicare. Malipiro ake enieni anafika pa $ 506 pamwezi, ndipo ndalama zake pa intaneti zimachotsedwa $ 3,500 pachaka.

Koma kusinthasintha kwamitengo sikunayime. Mu 2016, malipiro apamwezi a Shelby adagwa pang'ono kufika $ 421 pamwezi - koma ndalama zake zapaintaneti zidakwera $ 5,750 pachaka.

Mu 2017, adasamukira ku Anthem, ndikusankha pulani ndi $ 569 pamwezi ndi kuchotseredwa pa intaneti kwa $ 175 zokha pachaka.

Ndondomeko ya Anthem ija idapereka inshuwaransi yabwino kwambiri yomwe adakhalako, adatero Shelby.

"Nkhaniyi inali yodabwitsa," adauza Healthline. "Ndikutanthauza, sindinapite kwa dokotala kapena kukalandira chithandizo chamankhwala chomwe ndimayenera kulipira kamodzi [chaka] chonse."

"Chokhacho chomwe ndimayenera kulipira chinali mankhwala," adapitiliza, "ndipo a Victoza anali ndalama 80 masiku 90."

Koma kumapeto kwa 2017, Anthem adasiya kusinthana ndi ACA ku Virginia.

Shelby adayenera kulembetsa dongosolo latsopano kudzera pa Cigna - inali njira yake yokhayo.

"Ndinali ndi chisankho chimodzi," adatero. "Ndidapeza pulani yomwe ndi $ 633 pamwezi, ndipo ndalama zanga zidachotsedwa zidali $ 6,000, ndipo thumba langa linali $ 7,350."

Pamunthu aliyense, inali njira yotsika mtengo kwambiri kuposa inshuwaransi yathanzi iliyonse yomwe anali nayo.

Kulimbana ndi kusintha komanso kukwera mtengo

Pansi pa pulani ya inshuwaransi ya Shelby's Cigna, mtengo wa Victoza unakwera 3,000 peresenti kuchoka pa $ 80 mpaka $ 2,400 pamasiku 90.

Shelby sanali wokondwa ndi kukwera mtengo, koma adawona kuti mankhwalawo amugwirira ntchito. Amakondanso kuti zimamupindulitsa paumoyo wake wamtima.

Ngakhale kuti panali mankhwala ochepetsa mtengo, anali ndi nkhawa kuti amabwera ndi chiopsezo chachikulu cha hypoglycemia, kapena shuga wotsika magazi.

"Ndingadane kupita ku mankhwala ena otsika mtengo," adatero Shelby, "chifukwa amatha kupangitsa kuti magazi ashuke magazi, chifukwa chake uyenera kuda nkhawa za otsika."

Adaganiza zokhala ndi Victoza ndikulipira mtengo.

Akadakhala kuti alibe mwayi wopeza ndalama, akadapanga lingaliro lina, adatero.

"Ndili ndi mwayi kuti ndimalipira $ 2,400 pamankhwala," adatero. "Ndikumvetsa kuti anthu ena sangathe."

Anapitilizabe kumwa mankhwalawa mpaka chaka chatha, pomwe womupatsa inshuwaransi adamuwuza kuti sangaphimbe mankhwalawo - konse. Popanda chifukwa chachipatala, wothandizira inshuwaransi adamuwuza kuti sizingakhudze a Victoza koma zithandizira mankhwala ena, Trulicity (dulaglutide).

Mtengo wokwanira wa Trulicity udakhazikitsidwa $ 2,200 pamasiku 90 aliwonse operekera mu 2018. Koma atamugulira deductible ya chaka, adalipira $ 875 pa kukonzanso kulikonse komwe kudagulidwa ku United States.

Opanga "Makhadi Osungira" amapezeka ku Trulicity ndi Victoza, komanso mankhwala ena, omwe angathandize anthu omwe ali ndi inshuwaransi yazaumoyo pamalipiro. Kusungidwa kokwanira kwa Trulicity ndi $ 450 pamasiku 90. Kwa a Victoza, ndalama zosungidwa kwambiri ndi $ 300 patsiku la 90.

M'mwezi wa Disembala, Shelby ndi mwamuna wake adapita ku Mexico ndipo adayimitsidwa ndi malo ogulitsa mankhwala kuti amufanizire. Kwa masiku 90, mankhwalawa anali pamtengo $ 475.

Kunyumba, Shelby adayang'ana mtengo wa omwe adamupatsa inshuwaransi ya Trulicity ya 2019. Atayika mankhwalawo m'galimoto yake kuti agule pa intaneti, mtengo udafika $ 4,486.

Tsopano, sindikudziwa ngati ndizomwe ndimalipira, "adatero Shelby," chifukwa nthawi zina kuyerekezera kwawo sikuli kwenikweni [kulondola]. Koma ngati ndi choncho, ndikuganiza ndikuyenera kutero - sindikudziwa. Sindikudziwa ngati ndilipira kapena ndisamukira kwina. "

Kulipira mtengo wa chisamaliro

Mankhwala ndi gawo lotsika mtengo kwambiri la mtundu wapano wa 2 wothandizira matenda ashuga a Shelby.

Koma si ndalama zokha zomwe amakumana nazo posamalira thanzi lake.

Kuphatikiza pa kugula mankhwala ashuga, amagwiritsanso ntchito aspirin wakhanda kuti achepetse chiopsezo cha mtima komanso kupwetekedwa mtima, ma statins kuti achepetse magazi m'magazi, komanso mankhwala a chithokomiro kuti athetse hypothyroidism.

Nkhani zathanzizi nthawi zambiri zimayenderana ndi matenda amtundu wa 2. Pali kulumikizana kwapafupi pakati pa vutoli ndi hypothyroidism. Matenda amtima, monga matenda amtima, sitiroko, komanso cholesterol m'mwazi, ndizofala kwambiri kwa anthu omwe ali ndi matenda amtundu wa 2.

Ndalama zamankhwala ndi zachuma zamtundu wa 2 shuga zimawonjezera. Shelby wagulanso mazana azipangizo zoyesera chaka chilichonse kuti aziwunika kuchuluka kwa shuga m'magazi tsiku lililonse. Nthawi zina, amapeza zotsika mtengo kugula zoyeserera pamashelufu, m'malo mogulitsa inshuwaransi yake. Chaka chatha, adapeza mayesero aulere kwaulere posinthana ndi kuyesa kwa woyendetsa ndege wowunika watsopano wa glucose.

Posachedwa, adagula chowunikira mosalekeza cha glucose (CGM) chomwe chimatsata magazi ake mosalekeza popanda mizere yoyesera.

"Sindinganene zabwino zokwanira," a Shelby adauza Healthline. "Ndikuganiza kuti ayenera kungopatsa mankhwalawa kwa aliyense amene akudwala matenda ashuga, ndipo amafunikiradi inshuwaransi."

"Sindikukhulupirira zomwe ndikuphunzira," adapitiliza, "kungoti nditha kuwona graph ya komwe shuga wanga wamagazi wakhala tsiku lonse."

Chifukwa Shelby satenga insulini, wothandizira inshuwaransi yake sangaphimbe mtengo wa CGM. Chifukwa chake adalipira $ 65 mthumba kwa owerenga omwe, komanso $ 75 yama sensa awiri aliwonse omwe adagula. Chojambulira chilichonse chimakhala masiku 14.

Shelby adakumananso ndi zolipiritsa komanso zolipirira ndalama kukasankhidwa kwa akatswiri ndi mayeso a labu. Pofuna kuthandizira ndikuwunika matenda ashuga, amapita kwa katswiri wazokhudza matenda opatsirana pogonana ndipo amagwiranso ntchito magazi pafupifupi kawiri pachaka.

Mu 2013 adapezeka kuti ali ndi matenda a chiwindi osagwiritsa ntchito mowa (NAFLD) - vuto lomwe lingakhudze anthu onse omwe ali ndi matenda ashuga amtundu wa 2. Kuyambira pamenepo, amapitanso kukaonana ndi akatswiri a chiwindi chaka chilichonse. Wakhala akuyesedwa maulendo angapo a chiwindi ndi mayesero a elastography a chiwindi.

Shelby amalipiranso mayeso am'maso apachaka, pomwe dokotala wake amayang'ana ngati ali ndi vuto la kuwonongeka kwa diso ndi kuwonongeka kwa masomphenya komwe kumakhudza anthu ambiri omwe ali ndi matenda ashuga.

Amalipira m'thumba kuti azisisita mwezi ndi mwezi komanso magawo a yoga pawokha sabata iliyonse, zomwe zimamuthandiza kuthana ndi kupsinjika ndi zomwe zingayambitse shuga yake yamagazi. Zosankha zotsika mtengo zilipo - monga makanema aku yoga kunyumba komanso kupuma kozama - koma Shelby amachita izi chifukwa zimamugwirira ntchito.

Kusintha kadyedwe kake kwakhudzanso ndalama zomwe amawononga mlungu uliwonse, chifukwa zakudya zopatsa thanzi nthawi zambiri zimawononga ndalama zochepa kuposa zakudya zochepa.

Kumenyera chithandizo chotsika mtengo

Mwa njira zambiri, a Shelby amadziona kuti ndi mwayi. Mkhalidwe wake wachuma ndi wolimba kwambiri, kotero sanafunikire kusiya zinthu "zovuta" kuti amuthandize kuchipatala.

Kodi ndingakonde kuwononga ndalama zanga kuchita zinthu zina, monga kuyenda, chakudya, ndi galimoto yatsopano? Zachidziwikire, ”adatero. "Koma ndili ndi mwayi kuti sindiyenera kusiya zinthu kuti ndikwanitse."

Pakadali pano, wapewera zovuta zazikulu kuchokera ku matenda ashuga.

Mavutowa atha kuphatikizira matenda amtima ndi kupwetekedwa mtima, kulephera kwa impso, kuwonongeka kwa mitsempha, kuwonongeka kwa masomphenya, mavuto akumva, matenda akulu, komanso mavuto ena azaumoyo.

Zovuta zoterezi zimatha kusokoneza thanzi ndi moyo wa anthu omwe ali ndi matenda ashuga, pomwe zimawonjezera ndalama zawo kuchipatala. Kafukufuku wa 2013 adapeza kuti azimayi omwe amapezeka ndi matenda ashuga amtundu wa 2 azaka zapakati pa 25 ndi 44, pafupifupi mtengo wapakati pazachipatala pochiza matendawa ndimavuto $ 130,800.

Pakafukufuku, ndalama zokhudzana ndi zovuta zimakhala pafupifupi theka la mtengo wake wonse. Izi zikutanthauza kuti kupewa zovuta izi kumatha kukhala kosunga ndalama.

Pofuna kuthandiza kuzindikira za mavuto azachuma omwe anthu ambiri omwe ali ndi matenda ashuga amtundu wa 2 amakumana nawo, Shelby adakhala loya wopirira.

"American Diabetes Association imathandizira china chilichonse chaka chilichonse chotchedwa Call to Congress mu Marichi," adatero. "Ndidakhala nawo awiri omaliza, ndikupitanso mu Marichi. Ndiye mwayi wouza opanga malamulo anu nkhani ngati izi. "

"Ndimagwiritsa ntchito mwayi uliwonse wothandiza kuti osankhidwa anga adziwe zonse zomwe timakumana nazo," adaonjeza.

Shelby amathandizanso kuyendetsa magulu awiri othandizira anthu omwe ali ndi matenda amtundu wa 2, kudzera kubungwe lotchedwa DiabetesSisters.

"Ndi gulu chabe la anthu omwe akukumana ndi zomwe mukukumana nazo," adatero, "ndikulimbikitsanso komwe mumapereka ndikutenga madera amtunduwu kwakhala kopambana."

"Ndikuganiza kuti aliyense amene ali ndi matenda amtundu uliwonse ayenera kuyesa kupeza gulu longa ili," adatero, "chifukwa limathandiza kwambiri."

• 23% adati anali ndi chiyembekezo.
• 18% adati akuchita zolimbitsa thupi zokwanira.
• 16% adati ikuwongolera zizindikilo.
• 9% adati kugwiritsa ntchito mankhwala ndizothandiza.

Chidziwitso: Maperesenti amatengera kafukufuku wa Google wokhudzana ndi mtundu wa 2 shuga.

Nazi zinthu zina zomwe mungapeze zothandiza:

• 34% adati ndikudya zakudya zabwino.
• 23% adati anali ndi chiyembekezo.
• 16% adati ikuwongolera zizindikilo.
• 9% adati kugwiritsa ntchito mankhwala ndizothandiza.

Chidziwitso: Maperesenti amatengera kafukufuku wa Google wokhudzana ndi mtundu wa 2 shuga.

Kutengera yankho lanu, nayi njira yomwe ingakuthandizeni:

• 34% adati ndikudya zakudya zabwino.
• 23% adati anali ndi chiyembekezo.
• 18% adati akuchita zolimbitsa thupi zokwanira.
• 16% adati ikuwongolera zizindikilo.

Chidziwitso: Maperesenti amatengera kafukufuku wa Google wokhudzana ndi mtundu wa 2 shuga.

Nazi zinthu zina zomwe mungapeze zothandiza:

• 34% adati ndikudya zakudya zabwino.
• 18% adati akuchita zolimbitsa thupi zokwanira.
• 16% adati ikuwongolera zizindikilo.
• 9% adati kugwiritsa ntchito mankhwala ndizothandiza.

Chidziwitso: Maperesenti amatengera kafukufuku wa Google wokhudzana ndi mtundu wa 2 shuga.

Nazi zinthu zina zomwe mungapeze zothandiza:

• 34% adati ndikudya zakudya zabwino.
• 23% adati anali ndi chiyembekezo.
• 18% adati akuchita zolimbitsa thupi zokwanira.
• 9% adati kugwiritsa ntchito mankhwala ndizothandiza.

Chidziwitso: Maperesenti amatengera kafukufuku wa Google wokhudzana ndi mtundu wa 2 shuga.

Kutengera yankho lanu, Nazi zinthu zina zomwe zingakuthandizeni: