Strangely enough my post on reddit is still up, but now none of my comments show up... Here's what I posted:

There are major problems with the health system in the US. However, having insulin-dependent diabetes does not have to be expensive.

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I'm writing the following in hope that others who are on insulin or know someone who is will see it and find it useful. I wish someone told me this stuff years ago -- public perception and reality are greatly at odds here.

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In almost every state (except Indiana, I think) you can get both slow acting (NPH) and regular insulin over the counter. At Walmart it goes for $25 / vial which lasts more than a month for me. You don't need to be on any health program or state plan to get that price. No paperwork or questions.

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Typically people with diabetes will be prescribed newer insulin analogs which are not available over the counter and are extremely expensive. The analogs are designed to be slower acting or longer acting (depending on the type) than older generation insulins which are available OTC.

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However, regular human insulin can be made faster acting by doing an intramuscular injection (instead of a subcutaneous injection). This is most recommended when on a keto diet--which lets you minimize the amount of fast acting insulin you'd need to inject at any given time (on the order of like 1 or 2 units at most).

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The older generation slower acting insulins (insulin isophane aka NPH) can be made slower (comparable, effectively to the newer slower acting insulins) by just splitting the injection into 2 spread throughout the day instead of one large injection once per day. I've maintained the same glycemic control on these cheaper insulins as I had on the newer ones and I've been doing this for years.

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Syringes are cheap and many states also do not require a prescription for them. Syringe exchange programs, while not ideal, can be used as a last resort.

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Test strips can be purchased at a rate of $0.19 per strip at walmart. I go through 5 or so a day.

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It frustrates and saddens me to read about people not being able to afford insulin. Not only does it not have to be that way, it isn't that way. And that makes this all the more tragic.