With all the turmoil caused by COVID-19, the fear of not knowing what comes next or how bad this may become, there is significant comfort in feeling prepared for the worst. Living with a disease that requires daily medication brings a new level of trepidation; what if I run out of medication? What if my preferred medication isn’t available? What if I’m too ill to get to the pharmacy to pick up my medication?

Living in Hawaii means we are dependent on daily shipments from overseas for our food, supplies and medicine. If our island becomes quarantined – talking about worst case scenario here – or if the shipments are delayed due to illness or quarantine on the other end, we are essentially cut off. Residing on a tropical island does have its perks of course. We are surrounded by a bounty of wild growing avocados, mangos, guavas, bananas, fish and wild pigs, just to name of few. Many people here live off grid with solar power and catchment for water. We can garden year around due to lack of severe weather, so access to food is not as threatening as it could be given the seclusion of our islands. The access to medication, however, has the potential to be a major concern.

Stocking up on meds is not a simple thing. Health insurance makes it near impossible to acquire extra supplies so often times paying cash becomes the only other option – that is, if the medication is available sans prescription. Insulin dependent diabetics do have that luxury. We can purchase supplies over the counter (OTC) with out a prescription, but the cost of insulin is exorbitant. If you have the cash, great! If not, let me share my strategy with you.

In almost 30 years of living with a diagnosis of DM Type 1, I have spent far too little of that time in excellent control. My ravenous sweet tooth and emotional eating have made maintaining an optimal hemoglobin A1C a constant challenge. But amidst the ups and downs, weight fluctuations, diet experimentation and fitness fads, I have learned quite clearly what works for my body, and what doesn’t. I have discovered when I loose weight, my insulin needs decrease. When I am using less insulin, I am more sensitive to what I use. So in order to decrease my insulin requirement and thereby slowly save my insulin, I cut way down on my carbohydrate intake. Processed carbohydrates such as bread, cereal and pasta pack the heaviest punch and raise my blood sugar the most, for the longest duration, so that’s the first thing to go. Conveniently, cutting back on the carbs also helps me to slowly loose weight, thereby decreasing my need for the long acting insulin. This is a very gradual process and will not save a massive amount, but it will help.

Along with the processed carbohydrates, I also cut back on starchy vegetables and fruit. I do not eliminate these foods completely because there is a great deal of benefit in them and their impact on my blood sugar is much less significant if taken in in moderation. The sugar has got to go though, no getting around that. The candy, sugared dried fruit and alcohol are out.

Exercise plays a huge role in my plan as well. My longs days at work and the importance of enough sleep has limited my opportunities for long work outs so I catch what time I can for a walk, some lunges, pushups, the spin bike and a run when I can. This is not only important for the more obvious reasons; cardiovascular health, etc – but also because it speeds up my metabolism and thereby decreases my need for insulin.

While my insulin needs decrease, my body becomes leaner and stronger, and my overall health improves, my insulin prescription does not change. I am able to save, or stock up if you will, on my insulin. Yes, insulin expires, but not nearly as quickly as the pharmaceutical companies would have you believe. And I speak from experience here, not medical expertise. Over time insulin looses its effectiveness but does not spontaneously expire, become poisonous, or any such nonsense. So in the event I find my self using insulin 2 months or 2 years past its expiration date, I would test my blood sugar more frequently and make adjustments initially til I’m sure it is having its desired effect.

I will also be sure to buy an extra generic glucometer and test strips (Longs), glucose, and if possible and extra bottle of insulin OTC as finances permit.

When this whole COVID-19 mess blows over and becomes another seasonal illness that gets included in on our annual flu shot (one of my favorite predictions), I will have learned from the experience. But to my fellow diabetics, wash your hands and take your vitamins – being immunocompromised, we are at higher risk for getting sick. It couldn’t hurt to be prepared. Okay, that was my PSA.

Be well friends.