Tuesday, February 17, 2009

Health insurance prescription coverage changes

I just got a letter from our health insurance company today stating that their special program for diabetic prescriptions is ending. This program made prescriptions really affordable by putting all diabetic prescriptions in the tier with the cheapest copay.

The change is most likely due to the fact that another, bigger health insurance company recently took over our original provider. I'm sure this is only the first of many ways they'll find to wring a little extra money out of us.

I know from experience that many of my medications will not be in the generic tier once they end the program on March 1. Instead I'm willing to bet my bill for three months' worth of prescriptions is going to double. The expense was difficult enough to cover some quarters — do they have any concept of how this is going to affect many people?

Of course, they don't care. As my husband said sarcastically when I told him, "Oh, but people with chronic medical conditions always have tons of money laying around. That's why they have to charge you more."

Thursday, February 5, 2009

Campaign against reusing syringes

Apparently, there's enough of a problem with nurses reusing plastic syringes — just snapping on a new needle — that there is a campaign forming to speak out against the problem.

The problem is that some nurses thing that as long as you use a sterile needle every time, there is no problem of transmitting disease. This simply is not true. The plastic syringe can transmit disease just as easily as the needle.

This shows how important it is to be in charge of your own diabetes management if you are ever in the hospital. You can — and should — request that you control your insulin regimen. After all, you know more about your body and how it reacts to insulin, sugar, etc. than some doctor who has never met you before!

If you can't be the one in charge of your insulin shots, be sure to confirm with every nurse, every time, that the entire syringe is sterile. It's sad that we have to think about these things while we're in the hospital, but honestly, it's better to harass a few nurses than to wind up with hepatitis C — or worse!

Monday, February 2, 2009

Diagnosing diabetes using an A1c

This article made top headlines today: Doctors are beginning to use the A1c test to diagnose type 2 diabetes.

I think it makes sense to use this test as a diagnostic test. After all, the usual diagnostic tests for diabetes only tell you what the person's blood glucose is doing at that time, while an A1c test effectively tells you what it's been doing for the past three months.

In fact, this makes so much sense that I can't help but wonder why doctors just now thought of it!

Of course, the article fails to mention that A1c test results tend to vary in what they actually mean, depending on the lab your doctor's office uses. The same A1c from two different labs may translate into different average blood glucose levels, in other words. So a 7 from one lab might be the same as a 6 from another — a fact the article ignored with its blanket statement, "People who don't have diabetes typically have about a 6 or less reading."

What I found especially interesting about the article is that it mentions there are no clear standards for diagnosing type 2 diabetes. What exactly does that mean? That we don't understand the disease as well as we would like? That the whole "prediabetic" thing is a bunch of hooey? Or does it simply mean that the fasting blood glucose and the oral glucose tolerance test simply aren't very good at indicating whether a person has type 2 diabetes — and therefore why the A1c test is needed to help diagnose the condition?