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Redux is great for managing client state: it allows data to be synchronized across the whole app, reduces prop drilling, and makes it easier to understand when state changes occur.

Server state is a different story. Sure, it’s nice to have data available everywhere in our app, which is why we tend to fetch data from the server and dump it into our Redux store. But because our client application doesn't own that server data, it’s hard to know when it has become stale. And what if multiple components trigger calls to fetch the same data? How do you dedupe requests? How do you decide when to refetch?

Why We Switched to React Query for Managing Server State

Redux is great for managing client state: it allows data to be synchronized across the whole app, reduces prop drilling, and makes it easier to understand when state changes occur.

Server state is a different story. Sure, it’s nice to have data available everywhere in our app, which is why we tend to fetch data from the server and dump it into our Redux store. But because our client application doesn't own that server data, it’s hard to know when it has become stale. And what if multiple components trigger calls to fetch the same data? How do you dedupe requests? How do you decide when to refetch?

Below, we’ll dive into how we’re using React Query at Alto to solve these problems and achieve separation of client and server state.

The Old Way: Fetch Server Data and Store It in State

Historically, we would fetch data and set the response in our React component state.

fetchUser(params) {
 this.setState({ isLoading: true });
 
 return getUser(params)
   .then(({ data }) => {
     this.setState({
       isLoading: false,
       user: data.user,
     });
   })
   .catch(() => {
     toaster.toast({ title: 'Something went wrong...' });
     this.setState({ isLoading: false });
   });
}

To make that data accessible from other components, we’d set that data in the global Redux store. This works fine, except that you have to manage your own loading state, the logic for when and when not to make the request, updating the store when mutating data on the server, and knowing when data is stale.

The React Query Way: Fetch and Cache Server Data

With React Query, fetching data and using that data is more declarative.

const { data, error, isLoading } = useQuery(
 // This is our Query Key, which is unique per query so that React
 // Query can manage the cache for us.
 ['user', { userId }],
 
 // This is our Query Function that actually does the data fetching.
 // We can use anything we want: built-in fetch, axios, etc.
 fetchUser({ userId }),
 
 // This query will not execute until the userId exists.
 { enabled: !!userId },
);

Here, we define our query for a user with a Query Key and a Query Function. The Query Key is unique per query, so React Query can manage our cache for us, and if any part of the Query Key changes, the query will automatically fetch new data. In this example, if the user ID changes, the query will fetch new data for that specific user and store that data in the cache.

Naming is hard, but caching is harder. React Query gives us caching of server data out of the box with cache invalidation and request deduping. If we use this same query with the same Query Key in another component, it'll check the cache: if the data is already there, React Query will simply return it, avoiding extra network requests!

Additionally, useQuery runs wherever you use it — no more fetching data when a component mounts. You just use the query and display the data when it’s ready. The cherry on top? The query returns status updates by default, so we don’t need to store isLoading in component state all the time.

Three Optimizations We Get With React Query

When we rebuilt Alto Connect, our web app for healthcare providers, we found impactful benefits in using React Query to help us manage server state instead of using Redux. Alto Connect provides instant access to patient and prescription information and enables messaging with the pharmacy. Because healthcare providers need to quickly switch between patients and clinics, caching data is important to provide a delightfully fast experience. Apart from the cache, what other optimizations do we get by using React Query? Below are a few that helped us.

Once we’ve queried for some data, it gets entered into our cache, so we can utilize that cached data when using the same query in a different component or when fetching new data for a stale query in the background.

React Query is configured with aggressive but sane defaults and considers cached data as stale. Stale queries will always query for new data when the following criteria are met:

The query is optionally configured with a refetch interval

The fetching for new data when the browser window or tab is refocused is especially useful because the healthcare providers using Alto Connect often switch between multiple browser tabs. If there’s an update to a task, status, or message while they’re checking a patient’s medical chart, it will be immediately reflected in the UI when they come back to Alto Connect.

We also set a refetch interval for our queries involving messages. In the old app, we used WebSockets to enable real-time messaging. Although it’s possible to integrate WebSockets with React Query, we opted for a polling solution instead. Because our app isn’t a real-time messaging application, and we don’t need messages to show up immediately, we set a refetch interval on our messages query to poll for new messages every 30 seconds.

const { data, error, isLoading } = useQuery(
 ['user', { userId }, 'messages'],
 fetchMessages({ userId }),
 {
   // This query is disabled from automatically running if we don’t have a userId
   enabled: !!userId,
 
   // Refetch every 30 seconds
   refetchInterval: 30000,
 
   // Continue to refetch while the tab/window is in the background
   refetchIntervalInBackground: true,
 },
);

This is where the enabled option, which disables a query when it evaluates to false, is particularly powerful. We can pause polling for messages if we route to another page and we know that we won’t make any unnecessary requests if there isn’t a valid userId. We don’t have to worry about closing any socket connections or manually clearing an interval.

Most web apps have some sort of navigation menu, and if you already measure or understand your user behavior, you can prefetch data before users even navigate to a different page. Custom hooks makes it easy to expose a function to prefetch data:

export const usePrefetchUsers = () => {
 const queryClient = useQueryClient();
 const prefetchUsers = async () => {
   await queryClient.prefetchQuery(
     ['users'],
     fetchUsers,
   );
 };
 
 return { prefetchUsers };
};

We prefetch queries when users mouseover or hover over a navigation item so that when they navigate to the next page, the data is either actively being fetched or is already in the cache waiting.

We’ve been talking a lot about queries, but what about mutating data? Mutations, in contrast to queries, are imperative. While queries run automatically when we use them, we need to fire a mutation method in order to run mutations. And in order for our user experience to feel snappy, we can optimistically update the cache and then invalidate it after successfully executing the mutation. useMutation gives us some nice side-effect handlers to deal with every stage of the mutation lifecycle. Now when the user sends a message, that new message is immediately reflected in the UI and we keep the data in sync by invalidating the cache and refetching the messages.

With Redux, we needed to build out solutions to each challenge of managing server state. React Query, on the other hand, gives us those tools right out of the box. We no longer need to worry about when to invalidate or fetch new data, making the user experience more predictable — and the developer experience more enjoyable.

Resources for Affording HIV Medication

The HIV treatment and prevention landscape continues to evolve, with many effective medications. Antiretroviral therapy (ART), the frontline treatment for HIV since 1997, is a combination of medications that lower the amount of HIV in your bloodstream. When taken as prescribed every day, ART can help individuals with HIV achieve and maintain an undetectable viral load. As a result, more than half of all those living with HIV in the U.S. are not at risk of transmitting the virus to others.

On the prevention front, PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%.

For many individuals, cost is a barrier to both starting and continuing to take ART and PrEP as prescribed. Fortunately, HIV prevention medication and treatment continue to become more accessible, with generic PrEP options and expanded health insurance coverage of PrEP and ART. In addition, the following resources, including patient assistance programs and copay savings cards from medication manufacturers, can help reduce the cost of HIV treatment and prevention medication.

Read on to learn more about eligibility for these programs, and revisit our previous post on state-funded PrEP drug assistance programs.

Many pharmaceutical companies have patient assistance programs (PAPs) to offset the cost of prescription medications for individuals without insurance or with insufficient insurance coverage. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead, which offers the PAP outlined below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including PAPs.

Gilead's Advancing Access® Patient Assistance Program

Gilead's Advancing Access Patient Assistance Program provides medication free of charge to individuals without insurance who meet program eligibility criteria. There are several ways to learn if you are eligible:

Call 1-800-226-2056 (Monday-Friday, 9 am to 8 pm EST)

Print the enrollment form and submit it via fax

Copay savings cards from pharmaceutical manufacturers can help offset the cost of prescription medications for individuals with insurance. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead or ViiV Healthcare, which offer the copay savings cards below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including copay savings cards.

Gilead’s Advancing Access copay savings card

Gilead also offers a copay savings card for individuals with insurance to reduce the cost of copays. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

Learn more about program eligibility and terms and conditions.

The ViiVConnect Savings Card Program helps eligible individuals with commercial insurance save on copay costs for select ViiV Healthcare medications. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

If you do not have insurance coverage of prescription medications, contact 1-844-588-3288 to learn about additional financial assistance opportunities from ViiV.

Created to help individuals living with chronic health conditions access the treatment they need, the PAN Foundation offers financial assistance for medication costs, copays, and insurance premiums.

Learn what financial assistance you are eligible for.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Learn more about program eligibility and the application process.

Your financial well-being is our priority

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make ART or PrEP as affordable as possible. In addition to automatically applying coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to make it as easy as possible to stay on track with treatment, and our dedicated HIV support team is here to answer any questions you may have about ART or PrEP. Reach out any time via phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

It’s understandable to feel overwhelmed after receiving a diagnosis of chronic obstructive pulmonary disease (COPD) — living with a chronic lung disease brings changes to many aspects of life. Many people don’t realize that the condition is highly treatable, and that there are things you can do to slow the progression of COPD. To help you better understand and manage your COPD, let’s take a look at five common misconceptions surrounding this lung disease.

Misconception About COPD

Chronic obstructive pulmonary disease refers to a group of progressive lung diseases. The two primary diseases under this umbrella are chronic bronchitis and emphysema. Most people with COPD have both conditions, but it’s possible to have just one.

Chronic bronchitis and emphysema affect the lungs in different ways. Chronic bronchitis causes inflammation in the airways leading to your lungs, which leads to a chronic cough and increased mucus. Emphysema destroys your lungs’ fragile air sacs, or alveoli, obstructing airflow. When alveoli become damaged, the lungs cannot fully expel air carrying carbon dioxide out of the body, so some of it remains trapped in your lungs. Oxygen-rich air is then blocked from entering the lungs, which causes gradually worsening shortness of breath.

COPD may not be curable, but it is highly manageable. There are many treatment options that can ease symptoms and improve your quality of life, while also preventing the condition from progressing into a more advanced stage. In addition to lifestyle changes, COPD treatment may consist of medications, supplemental oxygen therapy (typically used for COPD caused by emphysema), and surgery in more advanced cases.

Medications commonly used to treat COPD include bronchodilators, which relax the muscles around the airways to make breathing easier, and inhaled corticosteroids, which reduce inflammation in the airways and prevent COPD exacerbations, or flare-ups.

Other medications may be used to treat exacerbations or more severe cases of COPD, including oral steroids and phosphodiesterase-4 inhibitors.

3. After a COPD diagnosis, it’s too late to quit smoking.

There is never a bad time to stop smoking and quitting is the most important thing you can do to manage COPD. Since COPD is a progressive lung disease, symptoms gradually become more severe over time. While it’s true that you cannot reverse the damage to your lungs caused by smoking, you can prevent COPD from progressing into a more advanced stage by maintaining healthy lifestyle habits. In fact, many people with early-stage COPD are able to regain near-normal lung function after quitting tobacco use. Even if your COPD has already progressed to a more advanced stage, quitting smoking will help reduce symptoms and prevent flare-ups and other health complications.

If you are having trouble quitting, ask your doctor for smoking cessation resources. They may be able to prescribe nicotine replacement therapy to help with withdrawal symptoms and cravings. Watch our webinar for more on the role of smoking cessation in COPD treatment.

The lung damage caused by COPD can affect other areas of the body. The condition can increase your risk of developing heart disease or having a heart attack. It may also lead to pulmonary hypertension, a condition characterized by high blood pressure in the arteries that transport blood to your lungs. The risk of these potential health complications is one reason it’s so important to get an early diagnosis, and to follow the treatment plan your doctor recommends in order to slow progression.

People with COPD are also more likely to contract the flu or pneumonia — and to have more intense symptoms of these illnesses — so as part of your COPD treatment plan, stay current with your yearly flu and pneumonia vaccines.

Quite the opposite — regular physical activity is key to maintaining a good quality of life and living healthily with COPD. While it may seem counterintuitive to exercise when you’re short of breath, physical activity can make it easier to breathe in the long run by strengthening your respiratory muscles.

It’s important to take it slow and practice gentle exercises that don’t overexert your lungs. Your doctor can help you determine appropriate activities based on your experience of COPD.

You may also benefit from a pulmonary rehabilitation program, which helps many people with COPD manage their condition and improve their quality of life. Pulmonary rehabilitation is an outpatient exercise and education program where physical therapists, dietitians, and other healthcare professionals share breathing techniques, nutritional advice, exercise recommendations, and other strategies for living with COPD.

Let Alto Pharmacy support your COPD treatment

We’re here every step of the way to help you manage COPD symptoms and get the medications you need, with free same-day delivery and easy-to-use medication management reminders in our app.

And our team of pharmacists are always here to answer your questions by phone or in the Alto app. Reach out any time through in-app messaging or by phone at 1-800-874-5881.

We are honored to announce that for the second year in a row, Alto Pharmacy has been recognized by Forbes as one of America’s Best Startup Employers. This award celebrates our commitment to employer reputation, employee satisfaction and growth.

Alto Pharmacy Announced as One of Forbes Best Startup Employers for the Second Consecutive Year!

When Alto’s founders set out to transform the pharmacy experience, they outlined a vision whereby our work could improve the quality of life for everyone who needs medicine. Through this foundation grounded in helping people, we have built a company culture centered in care, inclusion, and impact. 

We are honored to announce that for the second year in a row, Alto Pharmacy has been recognized by Forbes as one of America’s Best Startup Employers. This award celebrates our commitment to employer reputation, employee satisfaction and growth. 

This recognition follows Alto Pharmacy's recent admission as a Great Place to Work-Certified™ company – awarded based on employee feedback and a rigorous assessment of Alto’s culture and benefits. Given the impact we strive to make on the communities we serve, we are humbled to share this most recent recognition alongside other accolades over the past year, including: 

The Healthcare Technology Report: Top 100 Healthcare Technology Companies of 2021 

The Healthcare Technology Report: Top 25 Consumer HealthTech Executives of 2021

The Healthcare Technology Report: Top 25 Women Leaders in Consumer HealthTech of 2021

These recognitions and achievements are only made possible through the hard work and dedication of the entire Alto team. If you are passionate about shaping the future of pharmacy, join us as we deliver our industry-leading pharmacy care to millions of people across the country.

For the full employers list and an overview of the selection methodology, head to the Forbes site.

There are more than 25 million individuals in the U.S. living with asthma, including more than 5 million children. While most asthma cases involve the same common symptoms — shortness of breath, chest tightness, and wheezing — day-to-day life with the condition can vary significantly from one person to another. Not only is there a wide spectrum of the severity and frequency of symptoms, but there are also different types of asthma with distinct causes and triggers. (They are not mutually exclusive, so it’s possible to fulfill the diagnostic criteria for more than one type of asthma.) Here’s what to know about the main types of asthma, including important treatment considerations.

Understanding the Different Types of Asthma

Asthma is a chronic respiratory condition in which the airways in your lungs become narrow and inflamed, often leading to difficulty breathing. There are several different types of asthma: allergic asthma, non-allergic asthma, nocturnal asthma, occupational asthma, cough-variant asthma, and a related condition called exercise-induced bronchoconstriction. While there is variation among these asthma types with respect to causes, triggers, and treatment options, there are also some similarities, including the core symptoms of asthma such as coughing, wheezing, chest tightness or pain, and shortness of breath.

Some people with asthma experience intermittent flare-ups while others have symptoms the majority of the time, or persistent asthma. Persistent asthma can be categorized further as mild persistent, moderate persistent, or severe persistent depending on the severity of symptoms.

Allergic asthma is the most common form of asthma, accounting for about 60% of all asthma cases in the U.S. It occurs when an individual’s immune system interprets substances such as household dust mites, pet dander, or pollen as harmful and releases antibodies that ultimately lead to inflammation in the airways. Allergic asthma frequently involves allergy symptoms like nasal congestion, a runny nose, and itching in the eyes, nose, or ears in addition to core asthma symptoms. There is often a genetic component.

Read When to See a Healthcare Specialist for Allergy Treatment

10-33% of all individuals with asthma experience symptoms caused by triggers other than allergies including a history of smoking or exposure to secondhand smoke, respiratory infections, pollution, cold weather, humidity, and exercise. This is referred to as non-allergic asthma. It often develops later in life in comparison to allergic asthma. As part of the diagnosis process, your healthcare provider will rule out allergies as the cause of your asthma symptoms.

60% of all individuals with persistent asthma also experience nocturnal asthma, a type of asthma in which symptoms worsen at night. Those with nocturnal asthma frequently have their sleep interrupted as a result of coughing, wheezing, or chest tightness. There are many factors involved in the development of nocturnal asthma including smoking; dust or other allergens; and other illnesses or health conditions such as the cold, flu, sinusitis, gastroesophageal reflux disease (GERD), and sleep apnea. Your circadian rhythm and nightly fluctuations in the hormones epinephrine and histamine are also believed to play a role.

Since your daytime breathing can’t be used to diagnose nocturnal asthma, your doctor may ask you to test your breathing at home or participate in a sleep study to confirm a diagnosis.

Occupational asthma occurs when you are exposed to chemicals in your work environment that affect your respiratory function and breathing such as paint, cleaning products, mold, fungi, or dust. 11 million individuals in the U.S. are exposed to an occupational asthma-linked substance at their workplace. Workers who may have a higher risk for occupational asthma include bakers, farmers, metal and plastics workers, woodworkers, and those who work in manufacturing.

As many as 90% of individuals with asthma experience respiratory symptoms during physical activity — a subcategory of asthma known as exercise-induced bronchoconstriction (EIB). Exposure to airborne irritants including smoke, pollution, and pollen and/or to cold, dry air may contribute to symptoms.

There is much variation in individual experiences of EIB symptoms. Some individuals begin to have difficulty breathing right when they start exercising while others have more noticeable symptoms shortly after they return to a state of rest. Symptoms quickly disappear in some cases but last up to 24 hours in others.

If you have symptoms of exercise-induced bronchoconstriction, it’s important to stay active. Rather than avoiding exercise to prevent an asthma flare-up, speak with your healthcare provider about your asthma treatment plan and look for forms of exercise with an appropriate level of intensity.

In some cases, a dry cough is a symptom of cough-variant asthma. This type of asthma is more common in children than adults. It can be difficult to diagnose since a dry cough is also linked to other health conditions. If your cough wakes you up at night, worsens in cold, dry weather or after exposure to allergens, or occurs after exercise, you may have cough-variant asthma.

30% of all individuals with cough-variant asthma eventually develop classic symptoms of asthma. The goal of treatment for cough-variant asthma is to prevent the condition from progressing into a more severe form. Inhaled corticosteroids, which reduce inflammation and swelling in the airways, are the frontline treatment for cough-variant asthma.

All types of asthma can be managed with a combination of asthma medications, healthy lifestyle habits, and additional preventive measures to avoid triggers. However, given the spectrum of severity of symptoms — and the variety of asthma triggers — there isn’t a one-size-fits-all approach to treatment. Your doctor will advise you on the most effective treatment plan for your individual needs. 

If you have mild asthma, you may only need quick-relief rescue medications to manage acute symptoms. Albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) and Levalbuterol (Xopenex HFA®) are common quick-relief asthma medications. They may be taken via inhaler or nebulizer.

If you have moderate to severe asthma, you may need long-term maintenance medication in addition to a rescue medication for flare-ups. There are two main types of long-term asthma control medications:

Inhaled corticosteroids including Flovent® HFA and Qvar Redihaler® 

Combination inhalers that contain both corticosteroids and long-acting beta agonists (LABAs) including fluticasone and salmeterol (Advair Diskus®); budesonide and formoterol (Symbicort®); mometasone and formoterol (Dulera®); and fluticasone and vilanterol (Breo Ellipta®)

If you have allergic asthma, your doctor may also recommend over-the-counter or prescription allergy medications such as oral antihistamines (Claritin®, Allegra®, Zyrtec®), decongestants  (Afrin® and Sudafed®), and corticosteroid and cromolyn nasal sprays. While these medications can help you avoid allergy-induced asthma attacks, they are not a substitute for classic asthma medication. If you have nocturnal asthma, your doctor may recommend adjustments to the timing of your dosages to help you experience a better quality of sleep.

To learn more about asthma medication and management, read A Guide to Common Asthma Medications.

Alto Pharmacy is here every step of the way to make it easy to manage your asthma symptoms. Our team of pharmacists is available to answer questions about your asthma medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your asthma treatment plan.

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between outside germs and healthy cells and mistakenly attacks various tissues and organs throughout the body.

What is an autoimmune disease?

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between germs and the body’s own cells and mistakenly attacks various tissues and organs.

There are more than 80 of these conditions, with variation in the affected area of the body; some of the most common autoimmune disorders involve the joints and muscles, digestive tract, nervous system, and skin. There is also significant variation in day-to-day life with autoimmune disorders. Some, like type 1 diabetes, require daily management, while others may have periods of intensified symptoms known as flare-ups. In all cases, there are treatment options that can reduce discomfort and help you experience a better quality of life. Here’s what to know about the most common types of autoimmune disorders.

Causes and symptoms of autoimmune disorders

Many autoimmune disorders do not have a specific known trigger, but the following factors may play a role in the development of certain conditions.

Genetics — some autoimmune disorders such as lupus and multiple sclerosis run in families and likely have a genetic component.

Sex — of the 23.5 million Americans living with an autoimmune disease, 78% are women. Specific autoimmune disorders that are more common in women than men include rheumatoid arthritis, psoriasis, celiac disease, inflammatory bowel disease, lupus and multiple sclerosis, among others.

Obesity — being overweight or obese may increase an individual’s risk of developing rheumatoid arthritis or psoriatic arthritis.

Smoking — research suggests a connection between cigarette smoking and lupus, rheumatoid arthritis, hyperthyroidism, and multiple sclerosis.

Medications — some medications including blood pressure medications, statins (which are commonly used to treat high cholesterol), and antibiotics may increase a person’s risk for certain autoimmune disorders. Consult with your doctor about medication side effects if you have concerns.

While exact symptoms and treatment options vary by condition, as explained in more detail below, there is also some overlap. Fatigue, joint pain and swelling, rashes and other skin issues, digestive issues, and swollen glands are common signs of a variety of autoimmune disorders.

Most autoimmune disorders do not have one single test to confirm or rule out a diagnosis. With the majority of these conditions, the diagnosis process involves several steps including a physical exam and multiple tests.

If you have potential symptoms of an autoimmune disease, a common first step is an antinuclear antibody (ANA) test. This is a blood test that checks for antinuclear antibodies, the type of antibodies that attack healthy cells. If you have a positive ANA result, your doctor will likely recommend additional tests to identify the specific autoimmune disease.

A negative ANA test does not necessarily mean that you do not have an autoimmune disease. If you have negative ANA results, your doctor may recommend additional tests for other antibodies or inflammation markers depending on your symptoms. Tests used to diagnose autoimmune disorders include:

An erythrocyte sedimentation rate (ESR) test — which examines how quickly your red blood cells sink to the bottom of a test tube — may be used to diagnose rheumatoid arthritis and lupus. Higher rates of settlement may indicate inflammation.

A c-reactive protein (CRP) test — which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver — may be used to diagnose rheumatoid arthritis, lupus, and inflammatory bowel disease.

A rheumatoid factor (RF) test checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.

Depending on your symptoms, your healthcare provider may refer you to one of the following specialists:

A rheumatologist who treats autoimmune disorders of the joints and muscles including rheumatoid arthritis and lupus.

A gastroenterologist who treats autoimmune disorders of the digestive system including Crohn’s disease, celiac disease, and ulcerative colitis.

An endocrinologist who treats autoimmune disorders of the endocrine system including Graves’ disease and Hashimoto’s thyroiditis.

A dermatologist who treats skin-related autoimmune disorders including psoriasis.

Common autoimmune disorders and treatment

These are some of the most common types of autoimmune disorders affecting individuals in the U.S. Symptoms, treatment, and diagnostic tests vary by condition.

Rheumatoid arthritis occurs when your immune system attacks the lining of your joints, causing pain and inflammation throughout your body. It is a progressive condition, and getting an early diagnosis and staying proactive about treatment can help prevent more severe damage to your joints.

Several medications may be used to reduce the pain and inflammation caused by rheumatoid arthritis, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®); acetaminophen (Tylenol®); and Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®). In addition, avoiding or reducing your intake of sugars and refined carbohydrates and gluten can also help reduce inflammation.

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®) and injectable biologic DMARDs like etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®) are often prescribed to slow tissue damage.

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, so individuals with type 1 diabetes cannot produce any insulin and rely on daily insulin therapy to manage their blood sugar.

For more information on managing type 1 diabetes, read our previous blogs:

What’s the Difference between Type 1 and Type 2 Diabetes?

How to Live with Type 1 Diabetes at Any Age

Psoriasis is a skin disorder that occurs when inflammation caused by an immune response causes new skin cells to grow too quickly. It is characterized by thick patches of skin covered with white or silver scales, also referred to as plaques. There is a genetic component, and psoriasis often runs in families. 

Many individuals with psoriasis experience periodic flare-ups. While not all psoriasis flare-ups can be attributed to a specific cause, skin injury, stress, and cold weather are common triggers.

There are a variety of treatments for psoriasis, including steroid creams; anthralin (Drithocreme HP® and Zithranol®), an anti-inflammatory medication; moisturizers; UV light therapy; vitamin D3 ointment; and vitamin A creams.

Systemic lupus erythematosus (SLE), the most common type of lupus, affects many different parts of the body including the skin, joints, kidneys, brain, and heart. Common symptoms include joint pain and swelling, severe fatigue, and rashes. Without effective treatment, lupus can lead to other health complications over time, including blood clots and inflammation of the heart or kidneys, and increase your risk for a heart attack or stroke. Getting diagnosed early and starting treatment as soon as possible is critical to managing lupus.

Lupus treatment varies depending on the severity of symptoms and which part of the body is affected. Other-the-counter NSAIDs and oral corticosteroids including prednisone (Deltasone®, Prednicot®) may be used to treat joint pain and stiffness. Antimalarial medications including hydroxychloroquine (Plaquenil®) are often prescribed to reduce pain and inflammation, prevent flare-ups, and treat rashes.

Inflammatory bowel disease refers to several autoimmune diseases that affect the digestive tract including Crohn’s disease, which involves any part of the small or large intestine, and ulcerative colitis, which involves the colon, rectum, or both organs.

Common symptoms of both Crohn’s disease and ulcerative colitis include diarrhea, abdominal cramps, bloody stools, fever, fatigue, loss of appetite, and weight loss. Many individuals with these conditions experience periods of time without symptoms, also known as remission. Treatment options include the following:

Antidiarrheal and anti-inflammatory medications such as oral 5-aminosalicylates and corticosteroids

Immunomodulators, a group of medications that act on the immune system to reduce the inflammation that causes Crohn’s

Biologics, a group of medications that are derived from antibodies and used to prevent inflammation in more severe cases, such as adalimumab (Humira®), golimumab (Simponi®), infliximab (Remicade®), tofacitinib (Xeljanz®), ustekinumab (Stelara®), and vedolizumab (Entyvio®)

Other common autoimmune diseases include:

Multiple sclerosis, which affects the nervous system

Addison’s disease, which affects the adrenal glands

Graves’ disease, which affects the thyroid gland in the neck

Celiac disease, which affects the digestive tract

Living with any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in the treatment of autoimmune diseases and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

To learn more, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Millions of individuals with type 1 and type 2 diabetes need insulin every day to keep their blood sugar levels in a healthy range. In recent decades, it has grown increasingly difficult for many to access this life-saving medication, as insulin prices continue to rise.

Managing the Costs of Insulin

Millions of individuals with type 1 and type 2 diabetes need insulin every day to keep their blood sugar levels in a healthy range. In recent decades, it has grown increasingly difficult for many to access this life-saving medication, as insulin prices continue to rise. Take a look at these recent statistics:

The cost of insulin increased by an average of 14% every year from 2012 to 2018.

In 2017, insulin accounted for 20% of all diabetes-related healthcare spending before rebates and discounts and 6.3% after rebates and discounts.

In a 2018 survey on insulin affordability conducted by the American Diabetes Association, 39% of the respondents reported an increase in their insulin costs between 2017 and 2018.

Rising insulin costs can significantly impact an individual’s ability to manage their health. 27% of those surveyed by the ADA said that insulin prices affected how much of the medication they could buy or use. Missed insulin doses can lead to serious health complications including diabetic ketoacidosis.

While insulin access remains a critical issue for many Americans with diabetes, lawmakers have recognized the urgency of lowering insulin costs. In November 2021, the U.S. House of Representatives passed the Build Back Better Act, which caps out-of-pocket copays for insulin at $35 per month. The legislation has yet to pass in the U.S. Senate, but President Joe Biden recently reaffirmed his commitment to lowering insulin costs — and prescription medication costs more broadly — as part of his domestic agenda.

In the meantime, there are a variety of resources to help you manage the costs of insulin, including patient assistance programs and copay savings cards from insulin manufacturers. Here’s more on eligibility for these programs.

The Lilly Cares® Foundation Patient Assistance Program

The Lilly Cares Foundation Patient Assistance Program provides free insulin and glucagon products for individuals who have Medicare Part D or no health insurance coverage and meet certain income requirements.

Learn more about program terms and conditions and the application process.

The Novo Nordisk® Patient Assistance Program

The Novo Nordisk Patient Assistance Program provides insulin and other diabetes medications at no cost to individuals who have Medicare or no health insurance coverage and whose total household income is at or below 400% of the federal poverty level.

Sanofi Patient Connection provides Sanofi medications including insulin at no cost to individuals whose total household income is at or below 400% of the federal poverty level.

The Lilly Insulin Value Program offers all Lilly insulins at $35 per month to individuals with commercial health insurance or no health insurance coverage. Download the copay card here.

Sanofi offers a copay savings card for those with insurance as well as the Valyou Savings Program for those without insurance, which offers Sanofi insulin at $99 per month. Learn more about Sanofi savings opportunities.

Novo Nordisk offers savings cards that reduce copays for a variety of insulin products. Get more details here.

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your insulin and other medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to simplify your diabetes management, and our dedicated diabetes support team is here to answer any questions you may have. Get started or learn more about Alto, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

For many individuals, the journey of living with type 2 diabetes starts early. Once referred to as adult-onset diabetes due to its prevalence among middle-aged and older Americans, the condition has become more common in children, adolescents, and young adults, due in part to growing childhood obesity rates. While some aspects of type 2 diabetes management, like glucose monitoring and healthy lifestyle choices, are important for all age groups, other parts of treatment may change with time. Here’s a snapshot of what type 2 diabetes may look like at each stage of life and tips for living with the condition.

Managing Type 2 Diabetes at Any Age

All type 2 diabetes treatment plans include healthy eating, frequent physical activity, and blood sugar monitoring regardless of age. Depending on a child or adult’s blood sugar levels and overall health, they may also need diabetes medication or insulin therapy to supplement these lifestyle changes. In addition to insulin, two other diabetes medications may be used to treat type 2 diabetes during childhood: metformin, an oral medication, and liraglutide, an injectable medication.

Younger children will need assistance with blood sugar monitoring, and if your child takes insulin, they will also need help with insulin administration. It’s important that teachers or other school staff are able to provide support during school days. Make sure that someone at the school is prepared to administer glucagon if your child’s blood sugar falls below a healthy range (known as hypoglycemia).

Inform your child’s teacher and/or other school staff of your child’s type 2 diagnosis before classes begin. Be sure to discuss daily treatment needs like blood sugar monitoring, insulin therapy, or other medication needs, as well as how to spot the signs and symptoms of low blood sugar. The American Diabetes Association (ADA) has resources that can help you start these conversations.

Living with type 2 diabetes as a young child can be emotionally challenging. It often helps to build connections with other children who are on the same journey. Explore programming for children with type 2 diabetes, like the ADA’s summer camps.

If your child is overweight, their doctor may recommend that you focus on slowing weight gain rather than losing weight since they are still growing. Follow your doctor’s recommendations and look for simple but impactful changes, like swapping carbohydrate-rich foods for a snackable fruit or vegetable, or trading soft drinks and fruit juices for water.

Whether you’ve had type 2 diabetes since childhood or are newly diagnosed, living with the condition as a young adult requires you to take an active role in the management of your health. It’s important to build a relationship with a care team that you trust to avoid any gaps in your treatment. Depending on your treatment plan, you may also have to learn about the logistics of filling prescriptions, ordering diabetes supplies, and coordinating with your insurance company.

Taking on additional responsibilities and navigating life more independently doesn’t mean that you’re completely on your own in managing your diabetes. If parents or another relative previously helped you with blood sugar monitoring, scheduling doctor’s appointments, or other aspects of care, use them as a resource during this transitional period as you become more confident managing your health. You may also want to expand your support system by working with a certified diabetes educator or connecting with other young adults living with type 2 diabetes.

Make sure you understand how other health issues can affect diabetes. For example, the common cold or flu can impact your calorie intake and blood sugar levels, so it’s important to be prepared to manage other illnesses. Alcohol safety is also extra important when living with type 2 diabetes, as alcohol is a factor in your blood sugar levels. For those taking insulin, be mindful of how alcohol use affects insulin therapy.

Build a diabetes care team you trust. In addition to seeing a primary care physician for general health issues, search for an endocrinologist who specializes in diabetes treatment.

Familiarize yourself with all aspects of managing type 2 diabetes, from navigating health insurance to monitoring blood sugar. Consider working with a certified diabetes educator. These are healthcare professionals with extensive knowledge of the condition who can offer individualized support. You can also search for a diabetes education program.

Find opportunities to connect with other young adults learning how to manage type 2 diabetes, like the Beyond Type 2 community.

The progression of type 2 diabetes varies significantly by individual. While many individuals are just beginning the journey of living with the condition in their 30s or 40s, diabetes management may feel like second nature for those who were diagnosed at an earlier age. It’s also possible for a person’s treatment needs to evolve at this stage of life. If lifestyle changes and other medications are effective, you may be tapering off of insulin. Conversely, you may need to begin taking additional medications, such as insulin, in order to manage your diabetes even more effectively. As always, follow your care team’s recommendations for your specific needs.

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