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Sai Akunuri had a choice: keep his life-saving diabetes device, or pay his mortgage. He chose the latter, but now he’s afraid to sleep at night.
In April, Akunuri woke up paralysed and sweating, barely able to lift his finger to tap his sleeping wife for help. It was his latest hypoglycaemic episode, a potentially deadly medical emergency that can occur when a person’s blood sugar drops to dangerously low levels.
Akunuri used to have a continuous glucose monitor (CGM), which tracked his blood glucose level and sounded an alarm if it dropped too low. The device would wake him if his level dropped overnight, when nearly half of all hypoglycaemic events occur.
The toll of managing his diabetes adds up. Frequent pin-prick tests – sometimes multiple times a day – add to the strain of working two jobs to make ends meet and support his family, meaning less time with his 11-year-old daughter.
“I need to sacrifice something for them – so I sacrifice the CGM,” he said.
CGMs are subsidised for everyone with type 1 diabetes, who either access it free or for a co-payment of about $32 a month.
For people with insulin-dependent type 2 diabetes, like Akunuri, and people with type 3c and gestational diabetes, CGMs are not subsidised, and they can cost hundreds of dollars a month, or between $2000 and $4000 a year.
Diabetes Australia group CEO Justine Cain said access to CGMs for people who use insulin was critically important.
“This is life-changing technology,” she said. “We’ve got people who are finger pricking four plus times a day, having to inject insulin before every meal – a physical load, it’s a mental load, and it’s exhausting.”
Almost one in 20 Australians live with type 2 diabetes, and a quarter of them require insulin therapy.
Ahead of the last federal budget, Diabetes Australia recommended that access to subsidised CGMs be expanded to include several high-priority groups, such as people with insulin-requiring type 2 diabetes who are healthcare cardholders, Aboriginal and Torres Strait Islander peoples, people under 21, and people planning pregnancy.
These groups equate to about 16,000 people. If every person in this cohort accessed a fully subsidised device at $2700 per year, it would cost the government about $43 million annually.
The federal government’s 2024 diabetes inquiry recommended subsidising CGMs for an even larger group, including everyone with insulin-dependent type 2 diabetes, type 3c diabetes and gestational diabetes, equating to about 352,000 people, and costing an estimated $950 million annually.
Cain said expanded access was a “step-by-step process” given the tight fiscal environment. But, she said, CGMs were “not nice to have – it’s absolutely necessary for people who live with diabetes”.
In a statement, a federal government spokesperson said it was “committed to supporting Australians with diabetes and their families”.
A recent study found wider access to CGMs could lead to improved patient outcomes and reduce pressure and costs to the Australian healthcare system. Diabetes-related complications like emergency visits, hospitalisations and GP treatment cost the healthcare system an estimated $7.3 billion annually.
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