• Home
  • Archive
  • Türkçe

    • Diabetes and Living in Japan as a Student / Professional

    Tue 05 December 2023 diabetes / t1dm / t2dm / type 1 / type 2 /

    1. Introduction

    Hi,

    I am Ayberk. As of December 2023, I am a PhD Student living in Tokyo/Japan. I also live with Type 1 Diabetes for the last 5 years. I was thinking for a very long time about starting this blog since I first found out that I will be receiving the MEXT Scholarship and coming to Japan. As for us diabetics, moving-out to a foreign country is literally a matter of life and death which requires a thorough planning regarding how to register for an insurance plan, how to get prescriptions (mainly for the insulin) and what are the financial outcomes. When I learnt that I will be going to Japan, the first thing I did was to try to figure out those and my Japanese language skills were far from sufficient.

    Unfortunately, I was not able to find any English resources on the matter. Knowing that making a mistake will have dire consequences, all I could think of was contacting the student office of my university where they told me that they will help me ONCE I arrive.

    I have been regularly contacted by newcomers about diabetes management in Japan for some time now. So, I decided that it would be a great first topic to start the blog. Please note that the following are my own personal experiences and I am not certified to provide you with neither legal nor medical advice. I hope it helps. I also included a TL;DR for those who are short on time.

    2. Before coming to Japan

    As stated by the Ministry of Health, Labour and Welfare of Japan, you are allowed to bring up to 1 month supply of injectable medicine and syringes/injection apparatus [Source]. If you desire to bring more than the specified amount you are required to do a procedure called "Yunyu Kakunin-sho". However, this procedure requires some time and given that my university will answer my questions, I decided that I don't need do this procedure.

    Before my departure, I prepared an English letter stating "The aforementioned person has Type 1 Diabetus Mellitus condition due to having following A1C and (insert other related blood test results) and he requires the following medicine (insert the list of basal/bolus insulin pens and needles I use for a month)". I took that letter to my local family clinic and get a prescription for my monthly insulin, plus my doctor's seal on the bottom. Although this step was not necessary, Insulin with cooling blocks in your bag will occupy a lot of space which might attracted some unwanted attention. I thought that this letter + official prescription may come handy If I am selected for random inspection at the customs when I arrive to Japan. Turns out I was actually right about preparing those as I have been indeed selected for the random inspection during my first arrival. They asked about my insulin pens and I showed them my prescription and the letter from my doctor which justified the medicines I brought and they allowed me to enter the country.

    For the record, I prefer to carry my insulin at the cabin with me under room temperature. Because, temperatures at the luggage area may decrease to subzero levels during your flight which may cause damage to them.

    3. First Week in Japan

    So you came to your new dormitory or apartment in Japan. The first thing you will do is to register your new address to the ward office responsible for your area (Shibuya-ku, Meguro-ku etc.). When you go to the ward office you will be first asked to present your resident card (zairyu 在留カード, given at the airport) and any documents given to you by your school/company/houselord stating that you are indeed living at that address. Then, they will process you and print your current address at the back of your resident card.

    After this procedure, the next thing you should do before leaving the ward office is to register for the National Health Insurance and apply for your National Health Insurance Card. The personnel would surely direct you to the relevant area for this application. It is a pretty straightforward process.

    If you are a student, don't forget to mention that you are a student and (assuming you are not working in the Japan at the time you have arrived) you don't have any regular income in the current fiscal year. This will provide a significant reduction on your insurance premiums. I am not exactly sure how do they calculate it; but, my premiums are around 1,700 yen ($11.5) at the time I type this.

    After you complete your application, they will give you a temporary document that indicates you enrolled into National Health Insurance which you can show to the clinics and hospitals (as a temporary measure). Your insurance card should probably arrive in the following 10 days.

    National Health Insurance is very important as it basically reduces all of the medical expenses including doctor visits, tests and medicine into 1/3rd of the original prices. If I am not mistaken, it is also mandatory to enroll. So don't forget to apply.

    4. First Visit to Doctor

    Well, you are still using your backup insulin and your National Health Insurance Card (i.e. hoken-sho 保険証) has just arrived. At this point, I contacted the student office of my university and explained to them that I require monthly insulin prescriptions. Luckily, they found a endocrinologist at a nearby university hospital who can speak English. They arranged an appointment with the doctor and I went there when the time comes. When you admit, the hospital will ask your National Health Insurance Card, Resident Card and ask you to fill some forms to get your medical history.

    When I first visited the doctor, they checked my current blood glucose and conducted a detailed blood and urine test to verify that I have Type 1 Diabetes in which you will get your results on your next visit. Still, during the first consultation I just explained to my doctor that I use this amount of bolus insulin (e.g. Novorapid) and that amount of basal insulin (e.g. Lantus) and the type of needle tips I want. He quickly prescribed them and gave me an appointment for the next month's visit

    The cost of my first hospital visit was around 15,000 yen (100$) due to management costs for enrolling me into regular diabetes care. One good thing about Japanese Health System is that you don't have to pay for your finger prick strips as they provide a monthly supply of 150 strips, finger prick needles, and alcohol wipes for free forever. They also gave me a brand new blood glucose monitor set (a Japanese brand device that shows the results in 5 seconds and has Bluetooth support, say good bye to your old devices). These are all included in that initial 15,000 yen.

    Plan B: I never tried this but an alternative is to go to a medical clinic near your area. The doctor at the clinic can also prescribe you with the amount of insulin you need. However, I don't know the specifics. I am not sure if you can get a blood glucose monitor, routine tests and other supplies via this method.

    5. Pharmacy

    In Japan, if you have a prescription from a doctor, you have to take it to a pharmacy in 4 days (not business days). Say you get your prescription on Saturday, even in case where there is a national holiday at Monday, you are obligated to take it to a pharmacy of your choice by the end of Tuesday latest. In case you fail, you have to extend your prescription by going to your hospital/clinic again.

    When visiting a pharmacy for the first time, they will hand you a short form about your medical history and ask you to fill it. They may also ask you about whether you want a notebook for recording your medicine which is optional. It is not like you have to go to the same pharmacy all the time. It is just a procedure to get to know you. You can buy your medicine from various pharmacies, but each time you visit a new pharmacy, you have to fill that form. After that you can give them your prescription and get your medicine.

    It usually takes about 1-3 days to get your insulin in Japanese pharmacies. They will let you know about it after they process your prescription. The moment you deliver your prescription, you fulfill the 4 day requirement. You don't have to receive your medicine during that 4 days. So feel free to visit the pharmacy whenever your medicine arrives.

    The cost of insulin in Japan is not the best of the world, but it is definitely managable. These numbers may differ but just to give you an idea:

    WITH National Health Insurance

    WITHOUT National Health Insurance

    The cost of insulin significantly differs with respect to type and brand. Japan also has local brands that produce many types of insulin which are equivalent to above brands.

    6. Monthly Visits to Doctor

    Every month, your physician will start to conduct routine blood and urine tests to check your glucose, keton levels, A1C, liver-kidney values and so on. Japanese doctors are very careful about your well-being and it is good to have routine check-ups.

    Then, you will get your prescription and the date for your next appointment. To give you an idea, my monthly hospital expenses are about 6000 yen. National Health Insurance allow you to see your doctor every 4 weeks. So, you will have to wait at least 4 weeks to see your doctor again.

    I always try to keep an extra suppyle

    7. Continuous Glucose Monitor (CGM) and Insulin Pumps

    I personally only use insulin pens and finger pricks to check my blood glucose. So, I won't be able to provide details. However, here is what I know:

    8. Closing Notes

    I believe the above information covers most of the medical cycle of a diabetic patient living in Japan. In my honest opinion, Japan has a very good, patient-oriented health system for diabetics. Having the monthly check-ups instead of semi-annual ones greatly helped me to manage my diabetes and mental well-being due to being aware of how I am doing.

    To help your financial planning, you can roughly use the following to estimate your monthly diabetes related expenses. Add an additional 6000 yen for the first month.

    Cost of Monthly Diabetes Management = 1700 yen (Insurance for Students) + 6000 yen (Doctor, Tests, Supplies) + Number of Bolus Insulin Pens (i.e. Novorapid) x 300 yen + Number of Basal Insulin Pens (i.e. Lantus) x 500 yen

    Well, I guess that was all for now. I wish you all have a great and healthy stay in Japan.

    If you have any questions feel free to contact me. See my personal website for contact information.

    TL;DR:

    on the top