Editorial - Type 1 Diabetes and access to treatment – The perspective of a student with

diabetes in Bucharest

Authors: Stănciulescu Andreea, student of University of Bucharest, Faculty of Biology,

Biochemistry, year II

The essential constituents of a type 1 diabetes treatment scheme are insulin and blood
glucose tests. Insulin can come in the form of insulin pens (disposable pens or reusable pens)
or insulin pumps, whereas blood glucose levels can be monitored using single-use test strips
and/or insulin sensors.

Most prescriptions in Romania are written and given to patients physically. However,
at some hospitals the procedure is different: patients can ask to receive their insulin prescription
and several medical documents (such as medical certificates) via e-mail, in the form of
printable PDF documents. Patients can take the printed insulin prescription to a specialised
pharmacy in order to get the treatment for the next 3 months. Using a medical certificate
students with diabetes can obtain medical scholarships, which are independent from the
academic performances of the student. Patients can also obtain disability certificates which
make them eligible for financial help from the state. It is also important to note that quarterly
medical tests (such as HbA1c level) are thorough and free.

The online system presented earlier is a particular case and also a privilege, but a large
number of patients would benefit from it if it would be adopted in more medical institutions.
There are cases of patients who are not able to receive their medication on time because of
bureaucracy, long waiting times, large number of patients with similar problems and lastly the
inability of the medical institution to send the prescription online. The current pandemic makes
access to treatment even more difficult, hence online prescriptions should be used as an
alternative to the physical, written ones.

In Romania, patients with type 1 diabetes can receive blood glucose sensors and insulin
pumps for free. Every three to four months they would receive about fifteen Medtronic sensors.
Each sensor lasts between seven and ten days, compared to single-use normal test strips. Blood
glucose sensors are helpful because they reduce the cost of monitoring blood glucose levels
and they also allow for a continuous monitoring of BG levels.

Type 1 diabetes is a burden which can greatly affect the patients mental state as well as
their social and professional lives. Managing diabetes is a tough job which gives one no break
and therefore often leads to chronic stress and fatigue, which can also result in neglection of
one’s own health. In school, due to lack of breaks or time, I often skipped meals and corrected
the blood glucose with small amounts of insulin. Skipping meals is not a healthy practice for
anyone, let alone a diabetic person.

Work-related stress can lead to unbalanced diabetes, but unbalanced diabetes can also
affect one’s performance at school and work. One time I came home after a long day of work
and forgot to take my regular insulin dose, which led to high blood glucose levels during that
night. Other times, in a similar context, I got an insulin overdose because I forgot I had already
injected it. An insulin overdose is a serious threat, as it can lead to dangerous blood glucose
variability. Diabetic patients need to adapt and learn how to properly manage their health, but
that does not mean that employers, professors or peers can be insensitive to the diabetic
people’s needs (as I have seen a few times).
Conclusion:

In Romania, at least in Bucharest, treatment for type 1 diabetes is easily accessible. The
impact of type 1 diabetes on social life and on the mental state of the patient is predominantly
negative, but it can be reduced through communication, information and patience.