Medical Community Turns Against People with T2 Diabetes

On December 13, Catherine Price posted a blog on why you should be depressed about the government's attitude toward diabetes. Whether you are a person with type 1 diabetes, or type 2 diabetes, you owe it to yourself to read it. She listed it as part 1 and I will wait for part 2. In the meantime, I will write my blog about the actions of our medical community and how they are turning against people with type 2 diabetes, especially those not on insulin.

This started in June 2013 and earlier if you listen to ADA's Dr. Robert Ratner. He is quoted back in December 2012 as saying people with type 2 diabetes, not on insulin, did not need to test. He is the tip of the proverbial iceberg of the problems now presenting to people with type 2 diabetes. Next, we have Dr. Alan J. Garber of the AACE who believes people with type 2 diabetes and not on insulin need only rely on A1c tests.

If you think I am angry, you are right. Next, the Society of General Internal Medicine (SGIM) and their “Choosing Wisely” choice of "Don't recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.” This was in early September. Next, was the AACE entry in “Choosing Wisely” saying almost the same, but allowing for testing for oral medications that cause hypoglycemia.

Now in December, we have the Oregon's Health Evidence Review Commission (HERC) limiting test strips for people with type 2 diabetes. If it had not been for DiaTribe this may have been even worse. DiaTribe at least alerted their subscribers and the Diabetes Online Community about the intention to stop test strips for people with well-managed diabetes.

Then we also hear some of the remarks by members of the HERC and this is very indicative of the attitude of many doctors - “More knowledge for patients is not always better…”, “Lay people just don’t understand these issues…” To this, I ask if the doctors are going to make themselves available 24/7 to answer questions from people with diabetes. Since I know they will not do this, we as patients with diabetes do need to take action and oppose every attempt to limit testing supplies.

This means the battle is on with the Centers for Medicare and Medicaid Services (CMS), many state medical groups and especially the groups mentioned above that only want people with type 2 diabetes operating in the dark. All these supposedly medical professionals want to do is cause harm and have the complications to treat for steady income.

If the medical community really wanted to reduce medical costs, they would do some education, work more diligently to help diabetes patients, and actually encourage people with diabetes to manage their diabetes.

The doctors now have shown their true colors and we know that we cannot depend on them. They openly declare that diabetes is progressive and that the complications will develop. We know that we need more information, but many of the studies and clinical trails continue to be put behind the pay wall where most cannot afford to see them. Even the ADA and AACE are making things more difficult for people with diabetes, and especially people with type 2 diabetes.

Internists Blow It in Choosing Wisely

I will attempt to stay away from ranting, but this Medscape article did get me going and I will never understand why the Society of General Internal Medicine (SGIM) chose to make this choice. I can only guess they want to keep the diabetes epidemic in full out advancement.


I know from David Mendosa and his blog here that most doctors believe that diabetes is progressive. This is their shame then and they deserve being told this. I know that diabetes can be halted and kept at bay for many years. Each person is different in their abilities, but for the SGIM to take this stance, means that I no longer have faith in their side of the practice. I will say that having a diabetes clinic for my diabetes and being on insulin does make a difference for me.


I just feel very sad for the other diabetes patients on oral medications because of what they will face in the days and months ahead by being kept in the dark about their blood glucose levels. They will not be taught about self-monitoring of their blood glucose and what the readings mean. They will not be able to obtain testing supplies to have any guidance for managing their diabetes.


This means that diabetes will become progressive for them and they will have no knowledge of how they are doing to even manage diabetes. The complications will develop more quickly and become worse quicker. They will probably spend more time in the hospital and help elevate the medical costs everyone is trying to reduce. This is a sad day for people with diabetes.


We in the diabetes online community can only hope and pray that many will come to the internet to learn about diabetes and see some of these blogs and wonder why they are not being told to test. I know that I will continue to promote testing, encourage veterans to apply for assistance from the Veteran Affairs, and be able to learn about testing and test.


Several of my fellow type 2's in our peer-to-peer support group are now emailing me to find out what is going on and they have scheduled a meeting for this Saturday. As of the last email, we now have four support groups that are planning to attend plus two doctors. The room has been reserved to accommodate everyone and this may be quite a discussion. Makes me happy that my blog here got everyone alerted to what is happening.


Tim and I have been in conversation about this and the otherMedscape article here that I have not finished my blog on.

Urgent - Internists Blow It in Choosing Wisely Points

Dr. Robert Ratner, chief scientific and medical officer for the ADA that says, “Many people with type 2 diabetes who are on medications don't need to do home glucose monitoring at all," in talking about oral medications must be celebrating big time now. The Society of General Internal Medicine (SGIM) released their list of not always necessary, tests or procedures.


Topping their list is, "Don't recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.” This means that patients will not receive any education and will be operating in the dark to manage their diabetes. This also means that insurance will not pay for any testing supplies.


We think the diabetes epidemic is bad now, but wait until the full effect of this takes place. Diabetes complications will cost our healthcare system dearly. We complain about Medicare only covering one test strip per day now. Just wait until test strips become more expensive and patients on oral medications are operating in the blind and not able to know what their blood glucose levels are.


Think of the deaths caused by hypoglycemia, the trips to the emergency department because the patient cannot test or goes into a coma from hypoglycemia. Angry, HELL YES, I am angry. This is one of the most idiotic things to do to patients with type 2 diabetes. We don't need less, in this case no testing supplies, but should be receiving more test strips.


Now I wonder if doctors or endocrinologists will even go to bat for their patients to receive more test strips to learn what foods are doing to their blood glucose. This is a horrible blow to the diabetes epidemic and confirms that doctors don't care about diabetes. They just want patients to develop the complications so they have something to treat and don't want patients that become knowledgeable to stop the progression to the complications.


More on this when I have more time to think and get my anger under some semblance of control.