July 31, 2012

Type 2 Diabetes May Be Diagnosed Late

This physician has it right and knows what he is saying. Type 2 diabetes is often diagnosed late. Timothy Lyons, MD, does not point the finger at patients like many doctors are prone to do, but also points an equal responsibility at the doctors. Dr. Lyons is presently Director of Research of the Harold Hamm Diabetes Center in Oklahoma City and has experience as a researcher and a clinician.

Dr. Lyons has some strong suggestions for earlier detection, and I am in complete agreement with his suggestions. His suggestions will not be popular with the medical insurance industry that does not believe in prevention, just illness treatment.

His first suggestion is that routine screening should occur after age 45, or at younger ages for those that are overweight, have a family history of diabetes, and those who are not Caucasians. He then states, "I personally think that everyone by age 30 should know what their fasting glucose is." This is an aggressive proposal, but could help prevent many cases of diabetes. This could be the wake-up call many people need.

I sincerely wish that Dr. Lyons had been available to me in the years before my diagnosis and that I had been routinely tested after age 45 as I might have been able to prevent diabetes. I do have diabetes history on my mother's side of the family, but not a lot of her side of the family ended up with diabetes. My brother was able to manage with diet and exercise until cancer forced the issue.

Dr. Lyons also states that even when diabetes is diagnosed, many primary care physicians may not have the time to adequately examine patients. He also emphasized that prevention, early detection, and good long-term management are keys to defeating the diabetes epidemic.

The point that most doctors fail to cover is the availability of testing supplies for the fasting blood glucose that they talk about wanting. To-date Medicare and the medical insurance companies will not cover meters and test strips for people without diabetes. Then after diagnosis, testing supplies are limited because of many studies funded by the National Institutes of Health and Medicare. Medicare followed by the medical insurance industry in lock step has continuously reduced to number of test strips available to people with type 2 diabetes. Anyone with prediabetes or that does not have diabetes is not eligible for insurance reimbursement for meters and test strips.

This is the problem with Dr. Lyons suggestion of everyone by age 30 and over knowing what their fasting blood glucose reading is, as many people will not be able to obtain testing supplies with the Centers for Medicare and Medicaid Services (CMS) standing in the way. Until we can push the medical associations and other professional groups working with people with type 2 diabetes to object to the studies, it will continue to be an uphill struggle. By encouraging the manufactures of meters and test strips to up the amount of education and do scientific studies for people to obtain the correct amount of testing supplies, suggestions like those from Dr. Lyons will not become a reality.

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