Question about insulin use

[Finn]

They might cost you a bit more as a one-time purchase

My reusable pen was given to me by the diabetes clinic for free. I don't know if that's always the case, but I didn't have to buy it.

 

[Finn]

Hi @Finn, great to find someone else in Germany! I feel reassured about the news that the Libre 3 is mainstream in Germany. It's the one my endocrinologist here gave me, and I've been worried about where to get the next batch of sensors from. I'll just ask my Hausartz.

I know the German healthcare system more intimately than I would like, as I was seriously ill about a decade ago. The clinical care is terrific, but once you enter hospital, it gets very fragmented. If you end up dealing with different departments, they don't necessarily communicate as they should. I very much enjoyed the three-week Kur they sent me to!

A friend of mine has two sons with Type 1 and she tells me I can probably qualify for a Schwerbehindertenausweis and get a tax deduction for being disabled! I love a good tax deduction. She says she spoke to someone official who told her they consider insulin-dependent diabetes a disability because you have to spend so much mental power every day monitoring it.

Anyway, I expect to come back to you with many questions! I return to Germany at the end of this week, and that's when this adventure begins in earnest.

Good luck!

Here are a few thought and some things I thought of after my last post, basically everything I tried to Google when I was diagnosed:

I bought glucose tabs in the UK on a holiday and found them to be waaay different to glucose tabs in Germany. I find the ones here much better than the ones in the UK. The UK ones taste chalky and have a weird flavour in my opinion, but the German ones are pretty good I get Dextro Energy tabs in citrus, 'multivitamin' (tastes like tropical fruit) or blueberry. They're usually less than €2 for a three-pack at Rewe, Edeka, DM, etc (usually by the tills).

When people in UK talk about treating lows with x-number glucose tabs, the UK tabs have different number carbs in them. The square, individually-wrapped Dextro Energy tabs have .5KE in them (5g carbs). The smaller Dextro Energy ones have .2-.3KE (2-3g carbs).

I'm not sure if your Hausarzt would be able to prescribe a CGM. All my diabetes-related prescriptions have been first given by my endo, so it might be something a Facharzt needs to initiate.

I had no problems getting approved for CGMs and my pump. There was no hassle with insurance - my Diabetesklinikum sent off all the paperwork and I got approval letters after a few weeks for each one. I'm not sure if that's common with all insurance companies but it was certainly easy. My endo said if insurance ever denied my coverage for a new piece of tech, she would talk to them and get it approved. 🙂

When I need a prescription from my endo (who is a few towns over) and I don't have an appointment coming up, I can send an email with my prescription requests, then visit them during office hours. If it's my first visit that quarter, I need to give them my Überweisung (from my Hausarzt) and show my AOK card to pick up my prescriptions. It might vary state to state, but I'm in BW and every quarter, I need a new Überweisung from my Hausarzt for my endo, and a new Rezept from my endo for my CGM.

CGMs and pump supplies are filled by a supplier, so the Rezept is posted to them (by you) and they ship you the supplies once a quarter. Everything else comes from the Apotheke. Sometimes the Apotheke doesn't have something in stock, but they get it in the next day.

My Diabetesberatung told me to dispose of sharps in a hard plastic container, like a juice or soda bottle, tape it shut and throw it in the normal bin. The pharmacists at the Apotheke confirmed that. I don't feel comfortable with that so I buy sharps bin (Entsorgungsbehälter, Medibox brand is common here) from the Apotheke. If you're on MDI, a small one (1L) would last ages.

When I travel, my endo has a form letter she prints off that has my info and boxes I can tick for what I am travelling with (in multiple languages). It's stamped and dated and they want to give it to me as close to my trip as possible. It was free. It sounds like people in the UK sometimes need to pay for travel letters, but they are free here, or at least at my clinic.

I'm happy to help with any other questions. Things do vary state to state and doctor to doctor, but I would have found it very helpful to have an idea of what to expect when I was diagnosed. Germany does some things very differently and Google isn't always helpful when you want German-specific info, but in English. 🙂

I'll take a look at the Schwerbehindertenausweis. If I qualify for a tax deduction, I might as well take it! Insulin-dependent diabetes certainly does take a lot of brain power! 🙂