March 15, 2013

Some Random Thoughts on ADA's Guidelines

Year after year after year, we get similar guidelines from the American Diabetes Association. Occasionally we get something of value, but most of the time people with diabetes are hard pressed to learn anything new or have the guidelines in their favor. Most of the time they make it more difficult for people with diabetes to believe they are doing things for them or that there is any attempt to make life easier.

Back in 2003, ADA made a statement in their guidelines that insurance companies took to mean that only three blood glucose tests per day were sufficient for insulin dependent people. Since then all we have heard is platitudes and we will correct this. To this, I say malarkey! Has the insurance industry raised the number of test strips they will reimburse? No! And, this year my research has indicated some concern, but no promise of increased numbers of test strips that will be covered by insurance.

Also, I notice that the ADA is doing nothing for the type 2 people on oral medications that would like to be able to test more regularly than twice a day or even those on no medications. If these people are not able to test on a consistence basis, they are operating in the blind and cannot be sure that they are doing the right things to manage their diabetes. This is criminal in the way type 2 diabetes patients are treated.

Is the ADA so in bed with Big Pharma and the USDA that they bring more harm to patients by limiting testing supplies, education, and support for people with diabetes? Is this done to put more type 2 patients on insulin and to keep patients from knowing that the USDA line of nutrition is not as healthy for people with diabetes as claimed. Without testing more than once or twice a day, all we can look for is trends and rely on an A1c two times per year, which is not sufficient to maintain good diabetes management.

Some people are fortunate they can afford the extra testing supplies and are able to keep their blood glucose levels in the near normal range. Some purchase test strips as they can afford them to use for extra checking or for times when they are having problems. Those that cannot afford extra testing supplies have to rely on their doctor for assistance if they will even go to bat for them.

Then with the shortage of certified diabetes educators for education, it is no wonder that people with type 2 diabetes get discouraged. Many of the elder generation do not have access to computers to find information online about diabetes. Others also do not have access to computers except at libraries, which limits their access. This is more reasons that doctors need to utilize patients as peer workers and help spread the education. Community organizations need to work to bring people with type 2 diabetes together to give education where possible. It is doubtful that the American Association of Diabetes Educators (AADE) will even consider working with non-trained diabetes peer mentors, peer-to-peer workers, or other lay people.

I will have more on this in another blog. It is clear that the majority of people with type 2 diabetes are not receiving the education that they should. The people with type 2 diabetes are clearly not demanding the services that should be available to them. The ADA is very much discriminating against people with type 2 diabetes, contrary to the platitudes issued yearly as guidelines.

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