Minister Jung Eun-kyeong of the Ministry of Health and Welfare visited the CGV movie theater in Yongsan-gu, Seoul, on the afternoon of the 20th. She went to watch the film "Sugar" with people living with Type 1 diabetes.
Diabetes is broadly classified into Type 1 and Type 2. Type 1 diabetes is a condition in which the pancreas does not secrete insulin, requiring lifelong external insulin for survival, while Type 2 diabetes is a condition in which the body's response to insulin declines or insulin secretion is relatively insufficient, making blood sugar control difficult.
◇ After the controversy over a mother of a child with diabetes importing a continuous glucose monitor
Sugar is a film starring actor Choi Ji-woo that tells a story about Type 1 diabetes, produced based on the account of Kim Mi-young, head of the Korea Type 1 Diabetes Association.
In 2017, Kim, who has a child with Type 1 diabetes, brought in a continuous glucose monitor from overseas to check the child's blood sugar in real time. Kim shared the device with association members. The Ministery of Food and Drug Safety determined there were suspicions of importing and selling an unapproved medical device and of manufacturing and selling it, and reported Kim to prosecutors. As this action became known, public debate widened over patient access and the appropriateness of medical device regulations.
Type 1 diabetes is a chronic disease in which no insulin is secreted from the pancreas due to abnormalities in the immune system. It can occur in all age groups and requires lifelong insulin administration and blood sugar management. Patients must measure blood sugar and inject insulin several times a day and are constantly exposed to life-threatening situations such as hypoglycemic shock.
Even so, it has often been misunderstood as a "lifestyle disease" or dismissed as a matter of personal management. As a result, patients and families have faced institutional blind spots and social prejudice across health care, education, and care.
When it became known that Kim had been reported to prosecutors on suspicion of importing and selling an unapproved medical device, patient groups and online parenting communities criticized it as excessive regulation of actions taken for patients' right to survive. In June 2018, prosecutors deferred indictment for Kim, and the government prepared a regulatory reform plan to simplify procedures for importing medical devices for self-use.
Kim Mi-young said, "At the time my child was diagnosed, there was almost no social attention to Type 1 diabetes and the management environment was poor," and added, "I still can't believe our story has been made into a film."
◇ "pancreatic impairment" system to take effect in July
The Ministry of Health and Welfare revised the Enforcement Decree of the Act on Welfare of Persons with Disabilities in December last year to recognize "pancreatic impairment," in which the pancreas does not secrete insulin, as a type of disability. Accordingly, starting July 1, a system will also be implemented to provide necessary services to people with Type 1 diabetes who are recognized as having pancreatic impairment.
Once registered for pancreatic impairment, a person may qualify for activity support services through a comprehensive disability service needs assessment and receive disability allowances based on income level, medical expense support for persons with disabilities, and public utility fee and tax benefits.
The ministry explained that, regardless of whether the underlying condition is Type 1 or Type 2 diabetes, a person may be recognized as having pancreatic impairment if they meet the "severe blood sugar management impairment" status set out in the notice.
However, a diabetes diagnosis itself is not recognized as a disability. Chronic and severe endocrine dysfunction of the pancreas must be confirmed through medical tests and treatment progress.
According to the ministry, disability registration is allowed only when endocrine dysfunction of the pancreas persists despite more than six months of intensive insulin therapy (multiple daily injection therapy or use of an insulin pump).
C-peptide levels are used in the determination. C-peptide is a substance secreted when insulin is produced in the body and is an indicator for evaluating the body's insulin secretion capacity. When insulin is injected from outside, this level does not increase.
Under the government's criteria, a person is determined to be a "person with a severe disability" only if certain conditions are met, such as a C-peptide level measured at a plasma glucose concentration of 140 mg/dL or higher being less than 0.6 ng/ml, or a spot urine C-peptide/creatinine ratio being less than 0.2 nmol/mmol.
Minister Jung Eun-kyeong said, "We are well aware of the demand to expand insurance coverage related to medical devices such as insulin pumps and continuous glucose monitors," and added, "We will continue improving systems so that we can provide the services needed for people with pancreatic impairments."