Me and My Money…a child’s story of diabetes

M&M Cover 300 small

Copyrighted in 2012, Me & My Money…a child’s story of diabetes, took two years to write…

From birthing thoughts, jotting ideas, typing a manuscript, carrying a daily journal, contacting an illustrator,  building the manuscript, proofreading and editing again and again and again and…you get the idea…this dream came to fruition.  It had do be done.  There is no other book like it — as far as my research goes — that reflects, mimics, or encourages diabetic children, T1Ds.  The book is now available to the general public in paperback form.  Celebrate!!

Submitting to a marketable world with a targeted audience, networking, promoting, speaking, through the main character, Kali with her dog, Money, brings attention to the increase of diabetes in animals – up 300% this past decade!

Through the wonderful insightfulness of illustrator Amy Pichly-Meyer who is responsible for the clarity of expression with the cover design, along with all 37 colored  illustrations, this book was built for you.  I am thankful for her friendship and abilities.

Briefly, the main character, Kali, is presently a fourth grader.  She was diagnosed with diabetes at the age of two.  Her rapid growth with blooming and wizened independence results from learning how to take care of herself.  Wayne, a best friend, knows her very well and together they embark on adventures through Wayne’s hobby, their separate and shared responsibilities, mutual friends, and more.  But Kali cannot forget her special pack!  She must carry this with her everyday, everywhere.

This book, along with the recent publication of Me & My Money Too…a child’s story with diabetes, are tools to understanding this disease.  Minute-by-minute self-care is introduced and forthcoming in this illustrated, easy-to-read chapter book, 104 pages long, appropriate for 8 years olds and available at Amazon.com in paperback edition as well as Kindle e-readers.   Local bookstores carry copies as well as local libraries with requests.  Please enjoy the following Chapter excerpts…

Chapter 1, Book One

Due to keeping up with my chores, I occasionally have some change in my pocket.  That’s because my parents give me a weekly allowance that I can spend when I want.

“Make sure you spend wisely,’ Dad says.  I’m not quite sure what “spend wisely” means, but I think I do okay with what I have.  For instance, one of my friends from school, Wayne, asked me to go to the hobby store one Saturday afternoon.  Because it is school summer vacation time, we could go almost any time, depending on our parents.  However, Saturday’s are best.

Wayne and I go way back, to kindergarten.  He is the only red-head kid in our whole grammar school, never mind our fourth grade.  He’s a full blown carrot top with thick hair in wavy curls.  This makes him real easy to spot in a crowd.  The girls in our class like Wayne more than the boys do.  I think this is because he has good manners and is polite.  It is either that or his clear sky blue eyes that sparkle.  Even his eyelashes are orange, matching his hair.  Most girls I know like blue eyes.  I never thought about it much.  My eyes are dark brown to match my light brown and blonde streaky hair.

Wayne is a pale looking kid.  Most of the time, the only color on Wayne’s face is because of his tannish-brown colored freckles.  I swear, if he didn’t have freckles, he would be white as a ghost!  I tease him about that, pretending that I can’t see him sometimes.  We laugh.  He blushes all red and pink.  It’s funny to see.  Wayne is shorter than I am — for now.  He teases me about my long brown hair — so flat, so straight and thin.  “There’s nothing to your hair,” he tells me as he quickly flicks it in the air.  “You don’t even have to brush it.  Your hair just hangs there off your fat head,” he often tells me as if I need to be reminded. 

I think Wayne is jealous of my straight hair.  Brushing his hair is a struggle because it is very thick.  Mine is a lot easier because it is stick straight.  He hates when his mother brushes his hair because “she always pulls it out of my head,” he told me one time.  “And you have a chubby little pug-nose.  Not like my pointy one at all,” he compares.  “But you get a tan in the summer.  I don’t tan, I burn.  It’s awful,” he explains.  That is true.

One summer that I remember, his mother covered his face and arms with white suntan lotion so  he wouldn’t get burned while playing with me in my back yard.  He looked so funny.  That stuff made him smell like the beach.  I laughed at him.  He didn’t like that.  And after a while, the suntan lotion disappeared.  But we stayed friends.  He wears that stuff all the time.  Sure, I use it too, but when I forget to rub it on my skin, I don’t get too worried.

“I guess you look like your father,” I told him because I think he does.  “I look like my mother,” I said.  And that’s okay with me because my mother is beautiful.  My Dad’s okay looking — for a Dad.  Sometimes he has a moustache.  Mom told him to shave it off because it made her sneeze when they kiss.  Eeeuu!  Sneezing and kissing, yuck!

“Kali,” my mom called up the stairs.  “Wayne is on the phone for you.”

“Okay.  Thanks.  I’ll get it up here,” I told her.

“Hi Wayne.  Wassup?”

“Hey.  Can you come to the train store with me today or what?  I’m looking for a certain model train engine and I think the Viking Hobby Store will have it.”

Well, I have no particular interest in model trains, so I knew I wouldn’t buy anything but I would go along with him anyway.  This is a wise decision.  After all, he is my very best friend.  Very best friends do things for each other whether we need to or like to or not.  It was Saturday morning anyway.  Cleaning my room could wait until I got back.  I was thinking, planning.

“Mom, Dad, is it okay with you if I go to the hoppy store with Wayne today?  He thinks he found the perfect train engine for his set.  He wants me to go and help him check it out.”

“I don’t mind.  Is your room picked up?” Mom asked.

“Not all the way yet, Mom,” I replied.  “I can finish when I get back.  All I have to do is fold my clothes and put them away.  A load of my socks and some t-shirts are still in the dryer.”

“Well, all right.  Did you ask your father?” Mom wanted to know.  “And don’t forget to take a snack and some juice boxes with you.”

“I know.  I already have a pack of peanut butter nabs in my sack with some water.  I don’t know where Dad is.  I thought he was in the kitchen with you.  Maybe he’s in the garage.”

“Okay,” continued my mother.  “If you don’t see your father on your way out, I’ll tell him.  If you do, please remind him that we’re going shopping today.  Oh, are you and Wayne taking your bikes or walking?”

“I think we’ll walk.”  And out the back door I went.

Chapter 2

Wayne lives four houses away from me.  I took the short-cut over to his house through a wildflower field.  I often come here to pick my mother some flowers.  I like to pick flowers for her.  There are all kinds of wildflowers in this field: yellow ones, pink ones, purple ones with yellow centers.  I don’t know the names of these flowers, I just know they are pretty and Mom likes them.

After I met Wayne on the front porch of his house, we proceeded to walk to this particular ‘train store’ as he calls it.  It is really a hobby store that has lots of other things of interest besides trains.  I’ve been in there with one of my older cousins.  She was looking for some particular, special types of paint brushes made with camel’s hair.  I thought that was cool — paint brushes made out of a camel’s hair!  There are small glider planes in this store with hand-held motor devices; there are different kinds of wood burners and wood carving tools; there are even lots of different colored rubber fish bait things — lures.  I liked those because they are shiny, squishy, and they squiggle.  Things that would attract a fish — go figure!  Wayne had been going on about a certain model train engine he saw in here a while ago.  It took him weeks and weeks to save up his allowance money to buy it.

“Hey, before we walk too far, is your insulin pump filled up?” Wayne asked.  “I hope it doesn’t beep like crazy while we are out.  I would hate to have to leave early so you could fix it.”

“Yes, it’s fine.  I filled it up with insulin yesterday morning and changed the needle site.  We are good to go!”  I planned this on purpose.  I knew he would ask.  I am diabetic.  Wayne knows.  Among many other things, I do take care of myself and my diabetes.  I have to test my blood sugar levels many times each day.  Diabetes is a disease that causes me not to digest food properly.  Because of that, I wear an insulin pump.  I used to have to take insulin shots before I got the pump.  Having the pump is much easier.  An insulin pump squirts insulin into my body, automatically, a tiny bit at a time.  A “squirt” is maybe the size of a pencil tip or the size of a period at the end of a sentence.  My parents had to give me insulin shots before I learned to give them myself.  I still keep syringes handy, in case the pump breaks down for whatever reason.  This is called having “Plan B” which is important. 

Read more of Kali’s young life with diabetes in “Me & My Money…a child’s story of diabetes.”  Available at Amazon.com.

Beauty in the Virginia Hamptons

Beauty in The Virginia Hamptons (RE: NCPA “Beautiful World” Anthology 2023) A. K. Buckroth

Virginia is for Lovers.” As a recent resident to Virginia, I have seen this popular statement in one form or another throughout numerous retail areas here. Bumper stickers, refrigerator magnets, jigsaw puzzles, baseball caps, etc., are colorful and quick attention getters, money makers and conversation pieces. Such items are inexpensive for a tourist’s memory and/or collection. 

Totally different from the affluent Long Island New York Hamptons, the Virginia Hamptons are shared with working class, numerous military citizens and their families. The area has been known as the United States’ epicenter of military ventures. Diversity of the human race is abundant and apparent. I have never seen such an explosive mixture of ethnicities in one place.  

When first hearing the “lovers” phrase as a pre-teen in 1969, I lived in Massachusetts and my imagination ran away with naughty visualizations of naked people running around on “nude” beaches up and down the east coast. I never saw any of this. The slogan, however, came about in 1969 with the recognition of “baby boomers” along with that generation’s hullabaloo to get listened to by “the establishment”, also known as government entities for one reason or another. For one, I think the end of the Vietnam War remained fresh in many minds and contributed to free thinking with ideas of ‘free love’. “All you need is love” became a national mantra through vocalist John Lennon. The ‘hippie movement’ further enhanced such aspirations.

The Commonwealth of Virginia continues to use the “lovers” slogan as a retail business marketing tool. Evidently it continues to work by attracting curiosity seekers – especially the ever- present working-class and business entrepreneurs – to this state’s numerous waterways and its soft sanded limitless ocean fronts. I have seen walkers, joggers and runners on these shores – oftentimes with a dog or two – enjoying such activities. Not me. I enjoy sitting at the water’s edge listening to the ocean’s sounds. The scent of the salty ocean breeze is calming and  peaceful to me.   

The Virginia Hamptons are no longer limited to former thoughts of their being a bastion of societal elitism if they ever were. Recalling a childhood memory, my adult female family members (mother, aunts, and their lady friends) occasionally spoke of dreams abo visiting the New York Hamptons. Overhearing a conversation as the adults lay in chaise loungers on a covered back patio in a humble, Cape Cod rental cottage, the subject of New York came up with an expressed desire of taking a trip to the New York Hamptons. It ended up being an idea, nothing more.

The front path to this particular Cape Cod rental cottage had been decorated with colorful seashells having pretty hues of faded pink and light green. Along with the shells, different sized pieces of sun-bleached driftwood also adorned the pathway to the main door. I found it all to be absolutely charming.

However, the purported escapade to any one of the two New York Hamptons ─ Southampton and East Hampton of Long island, New York ─ remained a dream. They spoke of seeing a movie star if they were to go there, maybe a financier or a ‘fat cat.’

So, I wondered. My young imagination thought a ‘Hampton’ to be a place, a tangible piece of land with prodigious iconic homes having lots of gleaming windows overlooking the Atlantic Ocean, with large manicured lawns, and swimming pools; perhaps indoor pools, as well; and a gardener, a maid-or two, and of course, a cook. 

I didn’t blame the ladies for their dream. Eight children aged four to 17 with four adults in a two bedroom cottage with one full bathroom helped mental imagery to wander. The cottage rental price, split four ways, helped this particular excursion to be affordable in the summer of 1970. Overcrowded, sure, but cozy, happy, and their togetherness made it warm-spirited.

I liked the sunny summers on Cape Cod. I became familiar with walking to the beach with my siblings and cousins. We continued our adventures by locating a simple local general store that offered modest, yet necessary items such as toothbrushes and two types of tooth pastes, toilet paper, one brand of canned coffee grounds, sodas, bread, and plenty of different candy choices on display at the front counter. I could not fathom the adults wanting their summer dreams to change. However, my concerns were not addressed or even asked for.

The women in this fanciful group, aged 35 to 45, spoke of the wardrobes required to strut about a New York Hampton town ─ beach wear during the day affording cool comfort, showing skin in all the right places with open-toe sandals displaying painted toenails. Large framed, brightly colored sunglasses with a matching scarf, perhaps, or a floppy rattan hat, completed their attires. Sexy. Sexy to them. Comical to me. They laughed at each other and made fun.

However, I think they forgot they were on Cape Cod, and not New York.

Their evening dress on Cape Cod included a spaghetti-strap mid-length or full length dresses showing off their newly tanned (often sunburned) legs, feet, shoulders, bare necks and collar bones. They wanted to be there, to go “out”, to socialize wherever “there” lead them out the door. The shoes, purses and hair accessories matched their “evening costumes” with perfection. We children were left at the cottage in front of the television.

These single older women, including my mother, her sister and two of their friends, giggled and shared dreams while getting ready. It was fun to listen to until we youngsters were told to “go outside!”

However, we could still hear their chatter on the other side of the cottage walls. So, we chuckled and laughed aloud at them until we found another adventure to keep us occupied.

Glamorous beauty is in the mind, I mean the eye, of the beholder.

The particular Hamptons of the Commonwealth of Virginia consist of seven cities: Hampton Roads, Newport News, Norfolk, Virginia Beach, Portsmouth, Chesapeake, and Hampton. These women were unaware of the Virginia Hamptons.

Hampton Roads is the specific name of the land and water masses that exist within each separate city. If I were asked “Where do you live in Virginia,” I could answer “Hampton Roads, specifically the city of Chesapeake.” Therefore, I have become aware that Hampton Roads is an inclusion of each city surrounded by rivers, an embodiment of coastal Virginia. Each city is known as a “Hampton Roads region.” Unfamiliar with such an ideal, I am familiar with its worldwide economic impact which is tremendous. Bridges and more bridges with connective railroad tracks in-between each city encompass a visitor’s journey; and don’t forget a map.     

Newport News, another metropolis of Hampton Roads, is trodden with a naval history dating back to the 17th century. I have found this city to be a visual mixture of antiquity and modernism. Confusing, perhaps misunderstood. The Mariner’s Museum sparks my interest and could perhaps entice me to visit Newport News.    

Unbeknownst to me until living here, NATO (North Atlantic Treaty Organization) became headquartered in Norfolk, Virginia, in 2021. After more than 50 years of being a European entity, it has found a home in the Commonwealth of Virginia.

Virginia Beach is basically an independent resort city boasting an expansive shoreline with beach-front properties. Full of hotels, restaurants, boardwalks and boutiques, the Chesapeake Bay Bridge attracts much attention. I found it to be quite amazing. For one, it is over four miles long. There are no exits, of course. It is ominous and amazing, similar to an amusement park ride.  The fee for me to cross it when I did was $4.00. I have also spent time walking under the bridge when visiting Virginia Beach’s beach. It is very impressive.

Portsmouth, to me, is a dense, diversified city ─ an overcrowded place. Through my brief visits there, I found it encumbered by concrete structures ─ mostly tall apartment buildings. Unimpressed at first, I found the Norfolk Naval Shipyard ─ located in Portsmouth ─ to be just the opposite. There is a historic and active U.S. Navy facility located in Portsmouth with a small park demonstrating in-ground memorial placards explaining certain ships and the activities of U. S. Navy sailors involved in various battles. Presently, the admirable behemoth Battleship Wisconsin is docked there, offering self-guided tours for under $20.00. 

There are approximately 20 miles of land between each city. These land masses are intersected by rivers, creeks, streams and estuaries leading to the Atlantic Ocean. In order to cross from one side to another, bridges are a necessary accessibility. In fact, there are 90 bridges in Chesapeake alone, six of them are drawbridges. I know because I live in Chesapeake and have been amazed while driving from point A to point B, having to cross a couple of them.

I remain terribly confused with the highway system and avoid it as much as possible. The enmeshed routes from one Hampton city to another and the closest to me are as follows: I-64 with the “Hampton Roads Bridge and Tunnel (HRBT)”; I-664; route 17; I-264; route 58; route 164; route 13; route 168 and more. The routing system is endless. Each routing number has a letter behind it: either an N, S, E, or W depending on where you or I want to go. U-turns are ever-popular.

Due to the continual infrastructure updates of each of these highways, and others, my opinion and experience of driving through orange traffic pylons, orange-and-white-striped-traffic-control-barrels, white painted lane changes and merges is horrific. I prefer to drive ten miles out of my way to get to where I need to be. In that way, my blood pressure can maintain its normalcy as I enjoy the views of grassy or forested Virginia suburbia.

The nearby blue Gilmerton Bridge is a huge drawbridge, spreading one mile east to west over the Elizabeth River; a solid steel/metal conglomeration of riveted beams and concrete, with four lanes for automotive vehicles, and a vertical height restriction of 16’.

I have been awestruck seeing that necessary metal monster move up and down allowing sailboats, tugboats, fishing vessels, barges, etc., to pass unencumbered. The smooth flowing Elizabeth River gives way with a sense of ease and calm while waiting the 20 minutes for the bridge to reopen to traffic. Such visible strength is one price to pay for commerce. It amazes me.

Multiple times a day that bridge is overcrowded with vehicles, big and small, wanting to get to the other side. This road, Military Highway North, leads me home and further into Chesapeake. If chosen, drivers may continue on to Portsmouth, Norfolk, and/or Virginia Beach.

I have also frequented the Deep Creek Drawbridge which is the name of my immediate neighborhood. When people ask “Where do you live.” I say “Deep Creek,” and they know exactly what I am referring to. This drawbridge crosses the Great Dismal Swamp Canal. It consists of a narrow two-lane passage, north to south, and is much smaller than the Gilmerton span.

Great Bridge has a fantastic historical venue as regards the American Revolution and Virginia’s resident Patriots of 1775. In short, within an hour of battle, the Patriots overtook 100 British red-coated troops occupying this area to be free of British rule. I learned all this through a free tour of the outer grounds at the “Great Bridge Battlefield & Waterways Museum” where this battle took place. I stood in the exact place where shots were fired.

In this area of the East coast of America’s world, not only do the bridges support transportation and commerce, but railroads are vastly commonplace. For instance, under the Gilmerton Bridge are daily operable railroad tracks traversing north to south with an uncountable amount of boxcars stacked two high. The trains lug their multiple containers from Norfolk, through Chesapeake, into North Carolina and beyond. So, after waiting for the bridge to come down, the first road to get me home has me (and others) halted at a railroad crossing. Feeling greatly agitated, there is nothing to be done but sit and wait – again.

Geez o peet! It’s a good thing I have crackers in the car with a water-filled thermos at all times; two items I will not leave home without!

“Virginia’s vast system of scenic rivers, salty tidal bays, quiet inlets and streams provide opportunities for canoeing and kayaking enthusiasts to leave the world behind, have an adventure of their own and explore nature on its terms.”

Personally, a simple walk on the beach is fine for me.

In addition, the rich and lengthy history of these Hamptons is centuries old and worth learning about this part of a beautiful world.  

Although a newcomer to this state, confusion continues to abound my mind. Yet all the Hampton regional cities and their numerous activities offered in, on and at the Atlantic Ocean is, simply, why Virginia is for Lovers.       

Colorful Sparks in the Night

Colorful Sparks in the Night (NCPA Anthology Submission April, 2024)

by A. K. Buckroth

As I became a new resident to the Deep Creek/Great Bridge neighborhoods of Chesapeake, Virginia in late 2021, temperatures were apt to remain steady for days at a time in the  27°F to 40°F. These temperatures were not so different from California U.S.A. However, they lasted longer and gave me an unwelcomed feeling.

The icy rain and frequent snow flurries affected my attitude in a bad way.  

Knowing my frame of mind had to improve, feeling like a wet rag would not help a thing. My former happy disposition did not want to deal with being a grumpy ol’ woman.

The coldest temperature I witnessed so far in Virginia had been 13°F. That was outside this particular day. I do not know what the temperature had been inside this 20 year old, one-story house. The thermometer did not work. This meant the heater/furnace did not work. Three days before Christmas the comprehension of this fact made my language abominable indeed.

The 45’ moving truck had been hired and paid for with a delivery date of today. I looked forward to seeing all the things I did not sell before leaving California: a solid oak dining table with its six upholstered chairs; a matching glass, wood and mirrored hutch; an antique travel trunk where I stored multiple blnkets and home-made afghans; and stuff, lots of stuff. Otherwise, I would have gone to a hotel – if I knew of a decent one – and stayed the night. Not only did I not know the area well, I did not know anyone. So, I stayed “home”.

Before 7PM, I began making more than a few emergency phone calls to prospective area HVAC businesses to get this generator working. These calls led me nowhere but having to leave messages. Such a PITA (Pain In The Arse)!

I decided to bake some bread to warm up the place through the electric oven. I became very happy that it worked. A good sign for sure. The scent of baked bread alone helped to uplift my spirit and warm the kitchen. No, I did not want to sleep on the floor in the kitchen no matter how warm that room became. As my thinking apparatus thawed a little, I remembered I had brought some electric heaters, three in fact.

I dug out the three different electric heaters that had been stored in a back room. Thank goodness I had them. Not too crazy about having to sleep with them continually running, I truly had no choice. One I set up outside the bathroom sure to keep that room warm. Another I set up at one end of the hall to disperse heat toward the kitchen. For cautious sake, I did not plug in the third. Two became my limit.

In a bad mood, tired, maybe a little hangry, I needed to go to bed. I fully clothed myself in sweatpants, a t-shirt under a sweatshirt, woolen knee socks, and another two queen-sized flannel blankets for my person did not put me in a warm, cozy, “welcome to your new home” good mood.

Yes, my bed is always set up comfortably but I could not sleep. Sure. I laid down on it but did not sleep well with the thought of those heaters causing a possible fiery problem. So many bad ‘n sad stories I have heard about using such machines in an effort to stay warm….

The following morning, my doorbell loudly awoke me. Who the heck and what the heck? at 7:25AM?

Slowly looking through the window of the solid wood front door, I asked “Who is it?”

“I’m Dan from Rescue Air Services. We got your voice message last night and I was sent out to take a look.”

“Okay,” I responded through the door window.

Not caring about my appearance, I opened the door into the living room, continuing to clutch the blankets to my chest. I was cold. Horribly cold. Chilly willy goose-bumps on the legs cold.

After he entered, I sure─as─heck closed the door. Brrrr….

“What’s the temperature this morning?” I asked as I looked at his dark brown winter beaniecovering his ears. His multi-pocketed work pants enveloped thick-soled black shoe-boots. His thick, warm looking, grey zip-front jacket with a hoody told me he was indeed a service man. Besides, the upper right shoulder label on his jacket read “Rescue Air Services” in bright red letters. I felt okay when letting this strange man into my home.

“When I left the shop at 7:15 this morning, it was 32 degrees. Supposed to be up to 38 degrees today.”

“Oh My Gosh!” I stated. Is this typical?”

“Yes ma’am. It sure is. You’re not from around here, are you?”

“Nope. From warmer, California.”

A pause took hold of him. Looking at me with a slight grin or smirk, I could just about read his mind. Sure, this conversation could have continued, but I needed to scramble for a hot cup of coffee and he needed to check out the broken heater.

Breaking the silence, Dan asked where the heater was.

“In the attic, I said.“That’s where the sputtering and clanging comes from when I turn it on. I sure hope there are no ghosts up there.” He chuckled.

“I have to go get my ladder. Once I see its location and check it out, I’ll need to bring in my tool box. Would you please turn on the thermostat?”

“Sure can,” I responded and did so immediately. By the time he returned with his eight foot aluminum ladder, a hissing sound became added to the banging and clanging. WTH I’m thinking. What is this going to cost?

This lightweight, young man made countless trips up and down that ladder. I envied his energy.

Anxious to hear his report, I paced the kitchen and living room with a filled coffee cup I hand. After an hour and a half, his verbal report proclaimed “broken band blah blah replace parts blah blah blah to get some [usefulness] out of the existing system or get a new one.” I didn’t quite understand everything he was saying. In the end, he made it work. Happiness overwhelmed me but became overshadowed with uncertainty in the future.

Carrying his ladder to his brightly labeled company work truck, then his tool box, he re-entered my home once again but with a yellow invoice in hand. He explained what he replaced, what he fixed, along with the possibility of needing a new system. $450.some odd cents later, the heater began doing what a heater is supposed to do.

Unplugging each of the electric heaters, I finally climbed into my now-warm bed and slept for at least six hours. Sleep last night befitted an impossible effort, more of a task.

Awaking in the early evening, I was hungry. Very hungry. And for good reason having slept all day as needed. The contents needed for a fried egg sandwich and a glass of orange juice were readily available in my refrigerator. That particular appliance came with the house.

Yesterday, I plugged in and set-up the Keurig. I’ll be okay. 

As always, I felt better after eating.

Wandering through the house looking at the multiple moving boxes, I wanted to locate the Christmas Decorations. They were neatly piled in the back room near the back door. Having found them, my happy spirit awoke. However, not only did the Christmas storage items light my heart, but there were Christmas lights hanging on the back of the houses across the deep creek swamp 20 yards from the back of my house.

Looking out the back door window, I was in awe. Eight large, two-story homes had been engulfed in multi-colored Christmas lights. Their roof rims, their windows, their pergolas that I could see had each been covered in strings of beautiful lights. Overwhelmed and speechless, I felt welcomed to the neighborhood. Tears actually welled in my eyes.

The following Christmas these decorations did not appear. I hope to see them again. I hope to contact one of those neighbors across the swamp and learn of the story. In the meantime, I like to think the decorations were for my eyes only. So sweet. So lovely.

There is always a spark of hope. Something to light up your life.

Yearning for Spring

It’s that time of year again.  Wetness from day-after-day of rain, colder termperatures, an ugly and constant muddiness, a consistent and persistent cloudy sky.  In sixteen days of this past mont, I saw the sun twice.

 Becasue I work at home, my two dogs have become my salvation to get ouside.  Otherwise, I would not go out at all.  Well, besides them and having to go to the grocery store.

Yep, I have a case of log-cabin fever with a touch of the doldrums.

Are you feeling that way?

Not to be inappreciable with nature, I know some geographic areas are lots worse than mine – weather-wise.  For instance, I have lived many many years on the East Coast of the continental U. S. A. and do not miss that weather!  Although I do miss watching snow-falls and ice skating, I do not miss the cold temperatures (the lowest I have personally experienced was negative 23 degrees below Fahrenheit!).  Nor do I miss the areas’ summer humidity.  Having lived a few months in the south-eastern U. S., the humidity was so heavy that I contracted a fungal discoloration and disorder in my skin!  I was medically told to treat that condition with Head & Shoulders shampoo, of all things.  Are you familiar with that?  I had to “smurf up” every day until it disappeared.  

I need a physical ‘re-birthing’ with some sunshine.  Spring allows me that grace.  Summer is another story in this area of northern California where I reside.  Having witnessed day-upon-day of temperatures above 105 degrees fahrenheit (the highest I lived through was 118 degrees), I think and remember the winter cold.  Autumn is a welcome reprieve and my favorite time of year.

On and on we go. 

How are you and your area’s weather?

Fun Facts: Thomas More

Thomas More

From Wikipedia, the free encyclopedia

Jump to: navigation, search

For other uses, see Thomas More (disambiguation).
Saint Thomas More

Thomas More Signature.svg
Portrait by Hans Holbein the Younger (1527).

Martyr
Born 7 February 1478, London, England
Died 6 July 1535 (aged 57), London, England
Venerated in Roman Catholic Church, Anglican Communion
Beatified 1886, Rome by Pope Leo XIII
Canonized 19 May 1935, Rome by Pope Pius XI
Feast 22 June (Roman Catholic Church)
6 July (on some local calendars and in the Anglican Communion)
Attributes dressed in the robe of the Chancellor and wearing the Collar of Esses; axe
Patronage Adopted children; Ateneo de Manila Law School; civil servants; Diocese of Arlington; Diocese of Pensacola-Tallahassee; University of Malta; University of Santo Tomas Faculty of Arts and Letters; court clerks; lawyers, politicians, and statesmen; stepparents; widowers; difficult marriages; large families

Sir Thomas More (7 February 1478 – 6 July 1535), also known as Saint Thomas More, was an English lawyer, scholar, author and statesman. He is also recognised as being a saint within the Catholic Church. During his life he gained a reputation as a leading Renaissance humanist, an opponent of the Protestant Reformation of Martin Luther and wrote long treatises opposing William Tyndale and others who wished to see the Bible translated into the English language.  For three years toward the end of his life he was Lord Chancellor.

More coined the word “utopia” – a name he gave to the ideal, imaginary island nation whose political system he described in Utopia, published in 1516. An important counsellor to Henry VIII of England, he was imprisoned and executed by beheading in 1535 after he had fallen out of favour with the king over his refusal to sign the Act of Supremacy 1534, which declared the king to be the Supreme Head of the Church of England, effecting a final split with the Catholic Church in Rome. More was beatified by the Catholic Church in 1886 and canonised, with John Fisher, in 1935. In 1980, he was added to the Church of England calendar of saints.

Fun Facts: Andrea Doria (for which I was named)…

From Wikipedia, the free encyclopedia

Jump to: navigation, search

Andreadoria02.jpg
The SS Andrea Doria
Career Civil Ensign of Italy.svg
Name: Andrea Doria
Owner: Italian Line
Port of registry:  Italy
Builder: Ansaldo Shipyards of Genoa, Italy
Launched: 16 June 1951
Maiden voyage: 14 January 1953
Identification: Code Letters and radio callsign ICEH
ICS India.svgICS Charlie.svgICS Echo.svgICS Hotel.svg
Fate: Capsized and sank on 25 July 1956 after colliding with the MS Stockholm
General characteristics
Class and type: Andrea Doria class ocean liner
Tonnage: 29,083 GRT
Length: 213.80 m (701 ft 5 in)
Beam: 27.50 m (90 ft 3 in)
Installed power: Steam turbines
Propulsion: Twin propellers
Speed: 23 kn (42.60 km/h)
Capacity: 1,221 passengers
Wreck Location
Discovered: Yes
Discovered by: Peter Gimbel and Joseph Fox
Discovered when: 27 July 1956
Wreck depth: 190-260 FSW
Position: 40°29′30″N 69°51′0″W / 40.49167°N 69.85°W / 40.49167; -69.85

SS Andrea Doria was an ocean liner for the Italian Line (Società di navigazione Italia) home ported in Genoa, Italy, most famous for its sinking in 1956. Named after the 16th-century Genoese admiral Andrea Doria, the Andrea Doria had a gross register tonnage of 29,100 and a capacity of about 1,200 passengers and 500 crew. For a country attempting to rebuild its economy and reputation after World War II, Andrea Doria was an icon of Italian national pride. Of all Italy’s ships at the time, Andrea Doria was the largest, fastest and supposedly safest. Launched on 16 June 1951, the ship undertook its maiden voyage on 14 January 1953.

On 25 July 1956, approaching the coast of Nantucket, Massachusetts bound for New York City, Andrea Doria collided with the eastward-bound MS Stockholm of the Swedish American Line in what became one of history’s most infamous maritime disasters. Struck in the side, the top-heavy Andrea Doria immediately started to list severely to starboard, which left half of her lifeboats unusable. The consequent shortage of lifeboats might have resulted in significant loss of life, but improvements in communications and rapid responses by other ships averted a disaster similar in scale to the Titanic disaster of 1912. 1660 passengers and crew were rescued and survived, while 46 people died as a consequence of the collision.[1] The evacuated luxury liner capsized and sank the following morning.

The incident and its aftermath were heavily covered by the news media. While the rescue efforts were both successful and commendable, the cause of the collision and the loss of Andrea Doria afterward generated much interest in the media and many lawsuits. Largely because of an out-of-court settlement agreement between the two shipping companies during hearings immediately after the disaster, no determination of the cause(s) was ever formally published. Although greater blame appeared initially to fall on the Italian liner, more recent discoveries have indicated that a misreading of radar on the Swedish ship may have initiated the collision course, leading to some errors on both ships and resulting in disaster. However, the news that the crew had abandoned the passengers to their own fate dealt a marketing blow to the Italian Line it found hard to recover from.[citation needed]

Andrea Doria was the last major transatlantic passenger vessel to sink before aircraft became the preferred method of travel.

“Hey, I’m Speaking Here!”

“Good Morning and Happy New Year once again!  My name is A. K. Buckroth, author of “My Diabetic Soul – An Autobiography.”  Thank you for inviting me here this morning.  IHOP (International House of Pancakes) sure is a different place to host a speaker.  You all go ahead and eat your breakfasts while I talk at you.  My topic, as some of you many know, is diabetes….”

I use a a version of that line when promoting my book during a Book Speak/Book Signing.  As an Independent Author, marketing this item is not only constant but quite difficult with little tangible reward.  I do it alone.  I do not have a team of people routing for me and selling the item nor collecting payments.  I do that.  As a sole-proprietor, I do it all, down to cleaning the toilet.  That is just the way it is.  I am cost-effective and efficient, personable and candid; a realist and an idealist; humorous and sarcastic.  

An upcoming speaking engagement needs your review.  I am to present myself and the book in front of 20 – 30 other published or unpublished authors.  The setting is literally in a local IHOP restaurant.  It’s  a writers club.  This certain club has been in existence for over 90 years, having obtained elite and highly respected credentials.  I am honored to have been invited.

I am not naive to public speaking engagements.  I have participated in many over a course of seventeen years.  However, this particular scope of concern is not the topic of my purpose – diabetes – but presenting the subject matter to people while they are eating some of the most highly carbed and saturated fats available to mankind.  Visualize this: while the 20 – 30 people in the audience conference room literally eat breakfast, I’ll be standing at the head of the table discussing the whats, wheres, whys, whos, hows, how tos, and how muches that is involved with this disease.

I’m nervous.  The date for this event is two days away.  After a self-introduction, I’ll begin with a biref definition of diabetes: “In the plainest and  simplest of difinitions, diabetes means a person cannot digest food.  I am not a medical professional in any way, means, shape or form.  I am a diabetic.  I am proud to report that I have successfully lived with this disease for over fifty years.  I need to stress to you that diabetes does not have to be a death sentence.  It is up to you – non-diabetics and diabetics alike – to learn about the intricasies of your bodies.  This book is a blueprint for not only your health, but for everyone around you.  It is full of knowledge, references, and hints for your well-being.” 

Sound good?  I don’t know. 

The demographics of the audience are middle-aged and older.

 

 

 

Needles be Gone for Type One Diabetes Patients

 

 

 

 

 

 

 

 

 

 

Project Researcher: Yo Suzuki, Ph.D. – J. Craig Venter Institute

Project Description

Success will bring more NIH funding and could eliminate needles!
Insulin delivery using infusion pumps can be effective for treatment of T1D, but it does not completely protect T1D patients from the long-term effects of the disease or enable a normal non-diabetic lifestyle. Diabetes research has focused on using insulin-producing cells isolated from cadavers or made from stem cells in T1D patients. While some of the research has yielded promising results, nothing yet has radically changed general approaches to treat patients.

Our approach is to give bacterial cells that naturally live in our body the ability to function like our insulin-producing cells, to synthesize insulin when blood glucose levels are high to maintain proper glucose levels in T1D patients. In the proposed project, we will establish the feasibility and safety of this approach by making bacterial strains with this function and testing them in mouse systems. If successful, our research will form the basis for a bacterial treatment that can circumvent the struggle of injected insulin therapy and the issues regarding the rejection of transplanted human cells.

 

 

 

 

 

 

 

 

 

 

Project Details

An important ingredient of our study is a set of bacteria recently discovered to naturally reside deep within the human skin, in a layer previously thought to have only human cells. This layer of the skin contains blood vessels and is, therefore, suitable for implanted cells to monitor blood glucose levels and release insulin for systemic distribution. These bacteria do not cause problems in our body. Unlike transplants, they do not trigger host immune response. Unlike insulin pumps, they can enter this deep layer of the skin without puncturing the skin!

Advances in biology now enable making changes to DNA, the genetic material, in these bacteria. Our team at the J. Craig Venter Institute is at the forefront of these advances to produce safe and beneficial bacteria. To make the deep-skin bacteria function like insulin cells, we will introduce a gene into them for making a version of insulin. Bacteria cannot make native insulin by themselves, but there is a type that can be made in bacteria and is as effective as native insulin. We will also introduce a DNA piece containing three genes for making a glucose sensor to control insulin production in the bacteria.

It is critical that insulin-producing bacteria do not infect healthy individuals. Therefore, we will install a mechanism to prevent the bacterial cells from spreading beyond the designated host. We will then paint the mouse skin with our bacteria and see if blood glucose levels drop.

This critical proof-of-concept experiment will tell us if this skin bacteria-based approach has promise and deserves continued support. If we are successful, we will have experimental data that will attract additional funding from the NIH. Establishing a system that can be tested in actual T1D patients will involve many rounds of experimentation and improvement. For example, our future bacterial cells will have more sophisticated safety features. However, tools needed for this approach are already available in basic form. Moreover, the eventual product may be superior to any other products under development. Therefore, we strongly feel that the work needs to be started now toward determining the viability of this approach. Your support could help revolutionize T1D therapy.

 About Me (Yo Suzuki)

Hello, my name is Yo Suzuki. I am an Assistant Professor at the J. Craig Venter Institute. Our institute is known for its expertise in reading and writing genomes, blueprints for life. When writing genomes, our focus is to design and build beneficial microbes. I have been engineering microbes for 11 years, and finally, a connection is made between my skills and the opportunity to contribute to curing type I diabetes. The goal of this project is to create a bacterial strain that can respond to glucose and produce potent insulin analogs in a mouse. Our long-term goal will be to develop an engineered bacterial strain as a surrogate for beta cells in T1D patients. If we are successful, we will have a microbial treatment that circumvents the struggle of injected insulin therapy and problems with a transplant approach. Our project is the first and critical step toward this long-term goal. Our approach is innovative, but many tools to enable this approach are already available, including harmless bacteria that enter the skin in a non-invasive manner and live in a layer of skin appropriate for glucose sensing and insulin administration. Our tools to control these bacteria will only improve. Therefore, we have to start the work now to test the viability of this promising approach. Your support is greatly needed and appreciated.

PROJECT UPDATES

Update on 4-11-18  (6 Month Progress Report)

Executive Summary

The purpose of this project is to test to see if skin bacteria that respond to glucose levels and produce insulin can be engineered and introduced into laboratory animals to reduce their blood glucose levels, as a precursor to establishing engineered skin bacteria as painless substitutes for glucose sensors and insulin pumps. During the first six months, we made rapid progress and established genetic tools for engineering skin bacteria. This accomplishment sets the stage for the second phase of the project where expression modules for insulin genes and regulatory mechanisms for sensing glucose will be developed.

Productivity

The work performed is summarized under the aims proposed for the project.

Aim 1. Establish genetic engineering tools in selected deep skin bacteria.

Completed.

We collected six Gram-positive and three Gram-negative strains of bacteria isolated from skin samples. We determined the minimal inhibitory concentrations for nine antibiotics commonly used for genetic engineering. This test revealed that there are many strain-antibiotic combinations that can be used in our study. The Gram-positive strain Staphylococcus epidermidis ATCC12228 was the only strain tested among the nine strains for the capacity to re-enter the skin (unpublished result, R. Gallo). Therefore, we focused our resources on this strain. Gram-negative bacteria have been noted to be more proficient at proper folding of secreted proteins derived from other organisms, although there are examples where Gram-positive cells were used for making and secreting insulin. We decided to keep the Gram-negative strains as backup strains and continue to acquire genetic engineering tools for them. This marks the attainment of an initially proposed milestone (selection of strains).

We previously developed a genetic engineering approach where synthetic DNA fragments loaded with an enzyme called transposase in vitro is introduced into bacteria. Transposase facilitates the integration of DNA fragments into the genome. Because this approach is effective in a wide variety

of organisms, we tested it in the S. epidermidis strain with limited tools. To cost-effectively perform this procedure, we purified transposase and confirmed the activity of the purified enzyme. We then used the enzyme and succeeded in introducing a DNA fragment only containing a puromycin resistance gene into the S. epidermidis strain. The positive result was obtained when the DNA sample was pretreated with the lysate of the organism. The idea was that methylases in the lysate generated the methylation pattern on DNA found in the native organism so that the incoming DNA was accepted as its own DNA.

Aim 2. Implement a biocontainment measure.

In progress.

Before we engineer the capability to express and secrete insulin in the S. epidermidis strain, a mechanism for biocontainment needs to be implemented, as an organism capable of expressing human insulin would be a hazard to laboratory workers, should they become infected. We are attempting to use CRISPR genome editing to knock out the thyA gene needed to make thymidine, an ingredient for DNA, to make our bacterial cells dependent on thymidine supplied from outside and keep the cells within designated culture tubes.

Aim 3. Express SCIs in deep skin bacteria.

In progress.

Recent studies have resulted in single-chain insulin analogs (SCIs) that match native insulin in potency (Hua et al., 2008, J. Biol. Chem. 283:14703-14716). In beta cells, proinsulin is folded and cleaved to produce biologically active insulin, which consists of two peptides that are linked by disulfide bonds. Because native bacteria cannot cleave proinsulin, SCIs are essential for the strategy of cell-intrinsic and self-sufficient production of active insulin within bacteria. We are currently designing expression constructs incorporating the published SCI-57 design (Hua et al., 2008).

Aim 4. Evaluate the capacity of bacterially produced SCIs to stimulate glucose uptake in adipocytes.

Not started.

We plan to test whether the bacterially produced SCIs are biologically active by treating mouse adipocytes with the bacteria in a glucose uptake assay. We expect this work to be started as soon as the SCI-producing strains are made. We have culture cell expertise needed to prepare the adipocytes.

Aim 5. Evaluate the ability of SCIs to reduce blood glucose in mice after application of the engineered bacteria to the mouse skin.

Not started

We plan to determine if the SCI-producing bacteria can colonize the skin of a mouse to result in a reduction of blood glucose levels in the mouse. We will prepare for this work when the SCI- producing bacteria are made.

Aim 6. Implement a glucose-mediated regulation of SCI production.

Not started.

For effective blood glucose control, it is critical that SCI production be adjusted based on glucose concentration. We initially proposed to use a glucose sensor in Gram-negative bacteria, but we decided to focus on a Gram-positive strain. We will start researching mechanisms available in Gram-positive bacteria to enable a smooth transition to this phase of research.

Synergistic Activity

in this project were incorporated into a grant preproposal submitted by J. Glass (JCVI) to the Larry L. Hillblom Foundation. We have identified a suitable NIH grant mechanism (PAR-18-434) to further develop our approach. We also attended the 2017 Chemical and Biological Defense Science and Technology Conference in Long Beach, California sponsored by Defense Threat Reduction Agency. Skin biology is an important aspect of their portfolio, and we received useful feedback on our research from experts.

Update on 2-06-18

Last time I told you that I purified an enzyme called transposase to be used for facilitating a process called transformation, to put engineered DNA constructs into cells from outside. It turned out that the transformation step was still not easy for skin bacteria, but by communicating with scientists from Australia and multiple universities in the US working on related bacteria of the

The Diabetes Research Connection grant enables the critical first step toward a microbial treatment for diabetes that circumvents the struggle of injected insulin therapy. The preliminary data obtained

Staphylococcus species, I got better at the process. I started getting colonies, or dots in a Petri dish each originating from a single transformed cell. Tests confirmed that these colonies had the DNA material I introduced into the cells. With this process being established, the next step for me will be to knock out a gene (thyA gene) needed to make an ingredient for DNA, to make our bacterial cells dependent on the ingredient (thymidine) supplied from outside, so that we can keep the cells at designated sites like a culture flask (as opposed to my skin). Also, the time is right for making a DNA construct for expressing insulin to be introduced into the skin bacteria. Designing DNA constructs is what I love the most. I am grateful that your support enables us to proceed to this phase of the project.

Update on 11-22-17

 

 

µl of it costs $500, and you can use up all 10 µl in one experiment.  Therefore, I decided to make my own preparation of transposase.  I received a DNA construct containing a transposase gene that can be expressed in E. coli from a research group in Sweden.  I introduced this construct into an E. coli strain suitable for recombinant protein production.  I induced transposon production, lysed the cells, and purified the protein from the lysate using an affinity chromatography column.  I confirmed the activity of the purified transposase using a standard assay in our laboratory.  I succeeded in this process and obtained an amount of transposase worth $93,000.  Encouraged by this result, I am now tackling establishing transformation protocols for skin bacteria.

 

 

 

 

 

 

 

 

Did you know…? Facts about the Nobel Prize by author Tom Kando

1. INTRODUCTION:

     “The Nobel Prize has existed for 117 years. In that time, a total of 916 prizes have been awarded to individuals and organizations, with some receiving the Nobel Prize more than once.

     “In this article I  examine the national, ethnic and gender  composition of the laureates. I examine TRENDS over time,  and I show how the allocation of  Nobel awards  reflects the history and the evolution of the world over the past 117 years.

     “This article is not an exercise in nationalism or chauvinism. To the contrary, you’ll see that there is probably no more international population on the planet than the  body of Nobel laureates. But to demonstrate this, it is necessary to identify each laureate’s background. This is the first objective of this article. A second, and related, objective is to demonstrate the changing composition of this population and to show that the trends over time   reflect the world’s geopolitical  and cultural evolution. 

     “The single most important finding is this: From the 1920s onward, there has been an enormous outflow of brain power from Germanic and other parts of Europe to North America. This was largely caused by the rise of National Socialism and Fascism, and a huge proportion of the Nobel laureates who were  expatriates and refugees were Jewish. 

     “Additionally, I trace the gradual diversification of the Nobel Prize from a largely Euro-centric phenomenon to a worldwide one, and I examine the evolving gender  distribution of awards.

      “Finally, I provide samples of illustrious individuals and organizations who have received Nobel prizes.

             2. THE OVERALL DISTRIBUTION, AND TRENDS:

      “The most striking differences between the pre-  and post-World War Two eras are shown in table One:

                                  Table One:Comparison of Number of Nobel Prizes Awarded 
Before and Since World War Two, by Country and by Region 

Country or Area

1901-2017

Number

1901-2017

%

1901-1945

Number

1901-1045

%

1946-2017

Number

1946-2017

%

world

916

221

695

Germany

92

10%

44

20%

48

6.9%

Germany-Austro-Hungary

121

13%

57

26%

64

9%

United States

290

32%

29

13.1%

261

38%

North America

307

34%

30

13.5%

277

40%

Europe

446

49%

178

81%

268

38.5%

Japan

25

2.7%

0

0%

25

4%

Emerging World

64

7%

4

1.8%

59

8.5%

“Table One shows the sharp decline in Europe’s share of Nobel prizes – from 81% up to World War Two, to 38.5% of all awards since then.

     “Much of Europe’s dominance prior to World War Two was due to that of German-Austrian Europe.

      “Since World War Two, it has been North America, particularly the United States, which has dominated the Nobel Prize,  its share of awards  rising  from 13.5% to 40%.

        “Furthermore, there has been a five-fold increase in the percentage of prizes awarded to laureates of the  Emerging World – (Africa, Latin America and  Asia).

         “3. THE “ONE HUNDRED AND TWENTY-SIX:”

“How much does it cost to produce insulin?” By Dana Howe

So how much does it actually cost to produce insulin? And if a truly competitive market existed, how much could insulin cost per person?

Researchers from Imperial College London, the Harvard TH Chan School of Public Health, and Liverpool University set out to answer these questions with support from the ACCISS study, aiming to improve access to insulin globally. A recent study estimated the price tag associated with creating regular human insulin, analog insulin and their biosimilars.

What is a biosimilar?

Biosimilars are insulins designed to work similarly to an insulin product that already exists and has previously been licensed. This allows for lower costs of research and development, streamlined governmental and regulatory approvals, and ideally lower costs for the product.

Few biosimilar insulin products have come to market in the United States. In some instances, current insulin manufacturers have taken active steps to prevent new biosimilars from coming to market. For more on this, read “Where are all the generic insulins hiding?”.

What is a “reasonable” price for insulin?

With an active, competitive biosimilar market, this study estimated a reasonable price for analog insulins to be between $78-130 USD per person per year (except insulin Detemir, which was higher). Regular and NPH was even lower — between $48-72 USD per year. Yearly costs are based on an average dosage of 40 units per day (a World Health Organization statistic).

The numbers proposed take into account not only manufacturing costs, but many of the other variables involved in production including the cost of active pharmaceutical ingredients, cost of other ingredients, cost of vials, cost of transportation, operating expenses and the added cost of bringing a new biosimilar to market. These numbers are “competitive but profitable” to manufacturers based on experts’ analysis.

This study makes suggestions in the context of government procurement of insulin directly from an insulin manufacturer. The numbers should be interpreted as a price point for what a government might expect to pay per person per year if they were negotiating a dollar amount directly with an insulin biosimilar manufacturer.

Why am I paying so much more than $130 per year for my insulin?

Right now, there is no competitive biosimilar insulin market. Not just in the United States – anywhere in the world. This study sites the insulin oligopoly, regulatory challenges and regular incremental developments in insulin as three reasons we haven’t seen the emergence of a healthy biosimilar market. In order for the low prices suggested here to become a reality, multiple new manufacturing competitors need to enter the ring.

Not only are the big three insulin manufacturers financially opposed to biosimilars entering the market, they’ve actively taken legal steps to prevent it. In July 2017, Merck received FDA approval for Lusduna Nexvue, a biosimilar of Lantus. It has not launched in the United States because of an outstanding lawsuit — Sanofi, maker of Lantus, sued Merck for patent infringement. Just this month, Merck announced that Lusduna will not come to market because of the cost associated with getting it there.

The answer to why you’re paying so much for insulin depends on where you live, what kind of insurance you have, and a slew of other variables. The study’s authors remind us: “final prices to patients or health systems may include additional mark-ups added during the supply chain. These mark-ups will vary between countries, as they may be subject to local negotiations, regulations, and other factors. In some cases, these additional markups can be very large.”

The United States is one such case. For the majority of Americans, the insulin prices we see are not negotiated by the government but by a long list of supply-chain players. Private insurance companies, pharmacies, and pharmacy benefit managers all have a hand in negotiations that impact the list price of insulin set by the manufacturer.

The $1200 price tag a patient in the United States might see for a month’s worth of insulin reflects the total of money exchanged throughout the supply chain. Exactly how much profit each cog in the insulin-pricing machine rakes in is unclear. Between insulin manufacturers and customers, insulin passes through wholesalers, pharmacy benefit managers (PBMs), pharmacies, and insurance companies. The lack of transparency at every level makes it nearly impossible to understand the scope of the problem. Read more about the insulin-pricing machine here.

Rising costs are taking a more serious toll than ever because patients are increasingly paying the entirety of the massive price tag out of pocket every month. Health insurance plan design has changed — more people are being forced to pay full prices for the first several months of the year after switching to a high-deductible plan. That is, of course, if they are lucky enough to be insured at all.

These numbers put in sharp relief the remaining work there is to be done in insulin access globally. Less than $130 per person per year for modern insulin analogs represents an aspirational goal for a more affordable future. A future where no one dies because of a lack of access to insulin, with a competitive market made up of more than just three manufacturers, and where government regulation helps set affordable prices for insulin that everyone has access to.

TAGS:

Dana Howe

Dana was diagnosed with Type 1 at the age of 8. Driven by her T1D, Dana studied Biology and Community Health as an undergraduate and went on to complete an MS in Health Communication from Tufts University. In the past, Dana has worked as a communications specialist with major hospitals as well as small nonprofits on topics ranging from cancer to pediatric device innovation. At Beyond Type 1, Dana works to unite the global diabetes community and to inspire everyone to find how they #LiveBeyond.