Other Problems in Diabetes Management

These problems in diabetes management can be completely out of your control. The medical insurance industry which follows very closely the actions of Medicare can really hamper the management of diabetes.

First, even though Medicare has small programs when they reimburse doctors for screening elderly patients for diabetes, the medical insurance industry will not. In addition, the medical insurance industry and Medicare will not reimburse for expenses that do not diagnose diabetes. If the HbA1c is less than 6.1 or less than 126 mg/dl, blood sugar reading, insurance will not pay for prescriptions and anything relating to the potential advice that could help you prevent or delay the onset of full diabetes. This is the sad part of our insurance industry.

Then in the area of testing strips, most insurance companies are limiting them to just two per day that they will reimburse for. A few are even getting bolder and limiting the number to 50 test strips per month for people on oral medications. This makes learning what different foods do to your blood glucose levels very expensive after diagnosis and until you have gained confidence in the foods that you may consume.

This also is true when you add new foods or have unusual times like eating out a lot when it would be wise to know what the foods are doing to your blood glucose levels. This is why I can understand people that have a creep up in A1c's. We are being forced by our insurance to not manage our diabetes and maintain daily controls.

This in turn encourages doctors to discourage testing and doing what is necessary to manage our diabetes. The doctors then say that the A1c give us a quarterly reading to tell us how we are managing. I say this is not good enough. By being able to test as needed, we can more readily see how a food is affecting our blood glucose so that we can change the serving size or eliminate the food from our menu.

If a person is on insulin, there are a few more strips, but sometimes not enough. For those that are on oral medications, make sure that you know whether the medication can cause hypoglycemia. For oral medications alone, the amount of test strips should be allowed an increase, and medical insurance should cover them.

To me, Medicare and the medical insurance industry actions are counter intuitive and more harmful for patients than practicing a little preventive medicine. Granted there are always those individuals that will never manage diabetes and give the rest of us headaches because they have participated in the surveys that the medical insurance companies send out showing that there is little or no need for larger numbers of test strips. The medical insurance companies also find them for the studies to back their cutback of testing supplies.

This is making it harder and more difficult for those that wish to tightly manage their diabetes to accomplish this unless they are able to afford the additional test strips out of their own pocket.