Friday, 26 February 2010

10 Things I Wish I Knew When I First Got Diabetes

10 Things I Wish I Knew When I First Got Diabetes

1) You can adjust your insulin to your diet rather than adjusting your diet to your insulin.

Most diabetics follow a fairly structured diet and insulin regimen when it comes to managing their diabetes. This offers them the best opportunity to consistently keep their blood glucose levels within an acceptable range.

I, as I do with many things in life, decided to head down a different path. I manage my diabetes with a sliding scale of insulin that I adjust to the number of carbohydrates consumed on a per meal basis. Yes this does mean that I take a shot of insulin every time I eat but it also means I can eat a full plate of pasta one night and 16 ounce steak the next. Or I can eat lunch at noon on Monday and three on Tuesday.

The flexibility this offers far outweighs the slight pain of taking one or two extra shots of insulin per day. In my case it also leads to better overall control of my blood sugar.

2) You can order 3 months worth of prescriptions at a time which saves a ton of money.

After leaving the hospital and or being diagnosed with diabetes you head home with a pocket full of prescriptions and an assumption that your local pharmacy is your best option as it was for pain relievers after your last root canal. This is not the case with many if not all of your diabetes prescriptions.

Personally I take two types of insulin, Humalog as a short acting insulin and Lantus as a long acting insulin. At Walgreens using my current insurance provider it cost $12 per prescription for approximately one month worth of Humalog and 3 months worth of Lantus.

About a year later I realized that same insurance company, and every insurance company I have had since, offered a mail order prescription service where you could get a much larger prescription supply for the same cost or less than what you paid at your local pharmacy. Additional benefits to this method include prescriptions being mailed directly to your home or work, Doctors being able to write a years worth of prescriptions at one time, and the ability to order refills online.

In my case I received a three month supply of Humalog and six month supply of Lantus at $8 dollars per prescription. Not a huge savings but every little bit helps, especially in this economy.

3) There are a ton of options when it comes to choosing a glucose monitor, test strips, and needles.

Along with the pocket full of prescriptions you will likely also have a fairly lengthy supply list to purchase as well. If you are anything like me you will head out and purchase whatever brands and products you were exposed to at the hospital. This usually occurs for one of two reasons. One you are under the impression that whatever the hospital was using has to be the best option for you, or two, you are as unaware as I was to the large number of choices out there for diabetes management products.

The following are just a few of the products I would investigate and try out multiple options on before settling on a long term product. There are huge savings to be found depending on brand and where you purchase your supplies.

Blood Glucose Monitor and Test strips - Test strips can vary from $1 per test strip to $.30 per test strip depending on brand and quantity ordered.

Lancets - Lancets are offered in many different lengths and gauges. You can go a long way in limiting your discomfort by choosing the correct lancet.

Syringes and/or pen needles - Similar to lancets needles are offered in a wide variety of lengths and thicknesses. I personally go with the thinnest and shortest needle available. 3/16th of an inch in length and 31 gauge for thickness.

Alcohol swabs - Pretty cheap anywhere you shop but you might as well get the best deal available.

4) Choose your Dr. and any other members of your health care team wisely.

Choosing your health care team is one of the most important decisions you will make after being diagnosed with diabetes. You want a team consisting of not just competent professionals but also of people you feel 100% comfortable with. There are many sensitive issues you will discuss all of which require total honesty between you and your doctor.

Did you cheat on your diet? Do you smoke? How often do you consume alcohol? How often do you exercise? To receive the best health care possible you need to be upfront and honest about these and many other questions. If you pick the right team you will be able to provide them with the information to create a diabetes management program that gives you the best chance to life a long complication free life.

5) If managed properly being diabetic can actually improve your health.

This is one of those, get out what you put in, situations but I honestly believe being diabetic for the past 13 years has actually improved my overall health. Because of diabetes I exercise more, eat better, and drink less. I do know a few diabetics out there who neglect their diabetes but for me I decided to head down a different path.

It has been my experience with most diabetics that we are significantly more knowledgeable about nutrition and our bodies than your average individual. Some of this is by choice and some of it is out of self preservation.

In order to adequately care for your diabetes, you will need to learn the nutritional information of foods you eat, limit your intake of sugar and carbohydrates, maintain a regular exercise schedule, and have regular blood tests and eye exams. All of which will hopefully lead you down a long diabetes complication free life.

6) Diabetes as a pre-existing condition pretty much eliminates any chance of being accepted into a private insurance plan.

Hopefully this is something that changes with one of the many health care reform bills being discussed in Washington but since there is no guarantee change will happen I will discuss this topic anyway.

If you are diabetic and have insurance through your employer, the insurance company is required to admit you to their coverage under what is usually called "Guarantee Issue Insurance". What this means is if a health insurance plan is described as "guaranteed issue," it means that applicants cannot be turned down for coverage based on their health status. Most job-based group health plans offer coverage on a guaranteed issue basis.

That being said, if you decide to leave your employer's insurance coverage and seek an individual health insurance plan you are in for an uphill battle. I was considering leaving my current job a few years back and looked into private insurance. At the time I was 24 with no diabetes complications or other health risks, and a non-smoker. I applied to 10 different individual health insurance plans and was rejected by every single one on the basis of my pre-existing condition.

At this point, at least where I live in Illinois, any diabetic attempting to secure a individual health insurance police with in all likelihood be denied. As I mentioned this will potentially be changed with the upcoming health care legislation that the Obama Administration is trying to have passed this year.

Most, if not all, of the legislation being proposed included provisions that all applicants must be granted insurance regardless of any pre-existing condition they may have.

Here's hoping....

7) Not all carbohydrates are digested the same way.

This is one topic I would cover more with your doctor or dietitian as they will be able to guide you much better than I. What I can say is different types of carbohydrates are absorbed into the body in different ways and over different periods of time. With that certain foods will have a bigger impact on your blood sugar even though the total carbohydrate count may be the same.

8) Diabetes increases your risks for.......

This topic is not meant to scare you but rather should be considered a word of caution that diabetes should be taken seriously. Even a person with well maintained diabetes is at greater risk for health complications as you can see from the facts below.

• Diabetes is the leading cause of new cases of blindness among adults ages 20 to 74.
• People with diabetes are 40 percent more likely to develop glaucoma.
• People with diabetes are 60 percent more likely to develop cataracts.
• Adults w/ diabetes have heart disease death rates about 2 to 4 times higher than adults w/o diabetes.
• Diabetes is the leading cause of kidney failure, accounting for approximately 44 percent of new cases.
• More than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes.
• Periodontal, or gum, disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.

9) Candy or fruit snacks work just as well as glucose pills.

This one is pretty much self-explanatory but if you are in a pinch and suffering from hypoglycemia (low blood sugar) eating or drinking anything with sugar or carbohydrates will usually correct the problem. The trick it to only have a few skittles, life savers, or fruit snacks to raise your blood sugar to the appropriate level and not eat too much and end up with hyperglycemia.

I usually have a small bag of skittles or fruit snacks stashed away wherever I am. Good places to keep them include your desk at work, purse, gym bag, car, and your backpack or briefcase.

10) There are no carbohydrates in certain types of Alcoholic beverages.

When I first started drinking I was under the impression there was no way I could both enjoy myself as every college student should, and maintain my diabetes at the same time. After discussions with my doctor I was informed I could do both fairly easily by making smart choices when I did decide to drink. Keeping in mind that my Dr. stressed on many occasions that alcohol and diabetes should be combined only in moderation we came up with a list of drinks that were to some degree diabetes friendly. For more information please consult your Dr. or diabetes educator.

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1 comment:

  1. Diabetes today is a major problem in the UK and in the rest of the world; the treatment of which costs millions of pounds for which purchasing medical insurance for diabetics is a good solution.