1 2 3

Thursday, January 7, 2010

[Type-2-Diabetes] Digest Number 3859

Messages In This Digest (24 Messages)

1a.
Re: HELP! confused about it all.. From: Holly Shaltz
1b.
Re: HELP! confused about it all.. From: bairdkelly11
2.
snowshoeing and glucose From: Holly Shaltz
3a.
Re: Holly, A1c thoughts From: Holly Shaltz
3b.
why the "pre-diabetes" label, etc From: Jude
3c.
Re: why the "pre-diabetes" label, etc From: sharon osborn
3d.
Re: why the "pre-diabetes" label, etc From: AnaLog Services, Inc.
3e.
Re: why the "pre-diabetes" label, etc From: Steve Yarbrough
3f.
oh oh, more health care insurance ranting..... From: Jude
3g.
Re: why the "pre-diabetes" label, etc From: Jude
3h.
Re: why the "pre-diabetes" label, etc From: sharon osborn
3i.
Re: oh oh, more health care insurance ranting..... From: sharon osborn
3j.
Re: oh oh, more health care insurance ranting..... From: AnaLog Services, Inc.
3k.
Re: oh oh, more health care insurance ranting..... From: Tiamat
3l.
Re: oh oh, more health care insurance ranting..... From: Terry Shimmins
3m.
Re: oh oh, more health care insurance ranting..... From: Tami
4a.
Re: Metformin Overdose (Rx error) From: Donna
5.1.
REMy meet with the Diabetes Nurse in my local Medical Health Centre From: Wee K Chew
5.2.
Re: REMy meet with the Diabetes Nurse in my local Medical Health Cen From: Holly Shaltz
5.3.
daily carb totals and Gliclazide From: Jude
6a.
Dex4 Glucose Bits - Michael :) From: Wee K Chew
7a.
Re: Holly, role of exercise in A1c levels, etc. From: Holly Shaltz
7b.
Re: Holly, role of exercise in A1c levels, etc. From: Amal
8.
New HgbA1C result  and Medical STEROIDS From: Tricia

Messages

1a.

Re: HELP! confused about it all..

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Wed Jan 6, 2010 6:15 am (PST)



Christie, for sure you're in a tough spot! I'm
glad you at least have health insurance of some
sort - and sounds like your kids are healthy!
Amazing, all those February birthdays :)

In your shoes, knowing what I know now about
diabetes (but again, I know nothing about thyroid
disorders), I would insist upon a referral to an
endo if I were in your situation. You have the
right to see a specialist if one is needed, and
with your thyroid alone, seems like an endo is
most definitely a necessity!

Since it can take a while to get an appointment,
in the meantime I would splurge on Gretchen
Becker's book, _Type 2 Diabetes: The First Year_,
to explain the basics of T2 diabetes. It helped
me be a much more informed patient right from the
start. And as soon as possible I would splurge on
Dr Bernstein's _Diabetes Solution_. This book
spells out the approach to diabetes treatment that
has helped me, and many others, tremendously. I
would seriously consider asking a good friend or
close relative with more money than I have, to buy
one of these books for me as a gift, if I felt I
couldn't afford either (but they're not terribly
pricey in the quality paperback format).

I note here I have a hard time spending money on
*myself* for what seems like non-necessities, and
my sister bought me Becker's book, DH bought
Bernstein's. Having read them, I do feel they are
very important for the diabetic, with Becker's
book being my first pick for someone
newly-diagnosed. Bernstein's book is great for
those who have been doing this for a bit but
aren't seeing the progress they want from the
standard treatments. Today, I see both books as
necessities and would spend money on them in a
heartbeat if I needed to replace them.

I would also tell my doctor I want a referral to
the local diabetes classes, and I would do
whatever is necessary to take those classes. Do
you have a friend who can babysit, and then you
can return the favor as payment? Or do something
else in exchange? Having been a
below-poverty-level mom with young kids myself, I
know there's lots of options if you think in terms
of bartering, even though it can be logistically
challenging to juggle sometimes! :)

I would buy a kitchen timer (under $10), and a
scale ($10 for a cheap spring-type scale, and it's
quite good enough), and find or buy a spiral
notebook or 3-ring binder, or even just a legal
pad. The timer I set to remind me to take meds
and to exercise (mine's running right now, with 40
minutes to go til exercise time :) The scale is
for weighing my foods (with measuring cups as
needed as well), and the notebook or binder for
keeping track of all that. If you have a printer
and money for paper, I'll be happy to send the
form I print for each day, if you think that would
help.

With or without a form, I would be tracking the
time I eat at, what/how much I'm eating, and until
I got a BG meter and test strips, how I felt at
various times afterwards. I would also *write
down* that I'd taken my meds, and at what time.
For me, this provides a sort of accountability -
only to myself, no one else reads it, but that's
OK, whatever works <g> And I'd write down what
exercise I got.

Being in S CA, where it never snows anyway :), can
you go for walks? My Diabetes Nurse Educator told
me that exercise works the best on a T2 body when
taken 1 1/2 hours after beginning a meal. I have
found that to be quite true for my body, even now
after losing weight. Set that timer as soon as
you start eating, no matter what interruptions you
get in the meal with the kids :)

Then, when it goes off, put the kids in a stroller
and go for a walk together. It can be slow or
fast or in-between - even a slow, short walk helps
with managing both BGs and mood. Truly,
honest-to-goodness, you will be *amazed* at how it
helps the way you feel, physically, mentally, and
emotionally! Just like the health professionals
have always told us! <g>

If a walk truly isn't going to work, then DANCE
with those kids to music! OK, a slow dance to
start with :) It doesn't matter. The point is to
move those big muscles more than normal. Start
however small you have to - for me, it was just a
walk to the end of the driveway and back, maybe
500 feet altogether. That was all I could do the
first few days, but it wasn't long before it
improved tremendously.

These things do cost a little money and a little
time, but they will help insure you won't end up
like your father - who is, BTW, just 4 years
<ack!> <VBG> older than I am! I'm very, very
sorry he's not treating his diabetes in a more
healthy way. Learn from his example, take the
bull by the horns, bite that bullet, and there
won't nobody be able to keep you down!

On the brain fog / depression side of things -
again, I don't know about thyroid issues, but
diabetes is well known for creating that kind of
problem. When you lack energy, don't feel good a
lot of the time, feel like you're going downhill,
can't think straight, and on top of all that, are
diagnosed with a major disease, well golly, who
wouldn't be depressed?!?

If you can take a few positive steps toward
controlling your diabetes, even before you see an
endo, then I'm willing to bet you'll start feeling
better, emotionally, physically, and mentally. If
not, when you do talk to your new endo, mention
your depression and anxiety - it's frequent in
newly-diagnosed diabetics, and she/he will know
who to refer you to.

Finally, you have the right to have your diabetes
- and your thyroid issues - taken seriously by
your health care provider. You have the
responsibility to take it seriously yourself,
which includes getting a HCP who will support your
desire to get healthy. Yes, there are obstacles -
we each have challenges getting the care we need
and adjusting our attitudes to make that care the
top priority. Let that wonderful family of
February kids help motivate you :)

Hugs,

Holly in MI

1b.

Re: HELP! confused about it all..

Posted by: "bairdkelly11" bairdkelly11@yahoo.com   bairdkelly11

Wed Jan 6, 2010 10:21 am (PST)




Christie,

I'm just going to put my little bit in:

I was diagnosed with hypothyroidism 6 years ago, presenting with extreme cold sensitivity, and exhaustion (I didn't have the other symptoms, such as weight loss and hair loss). I went on Synthroid and improved greatly within about a month. Last spring I was diagnosed with Type 2 diabetes, and by following a low-carb diet, have lost 50 lbs. so far, without feeling deprived. In fact, the weight has come off so easily as to be almost effortless.

While everyone is different, it is possible to lose weight with thyroid disease.

I understand that your life circumstances are challenging, but I wanted to give you my little bit of encouragement. And listen to Holly (MI), she knows what she's talking about!

Kelly in Texas

--- In Type-2-Diabetes@yahoogroups.com, Holly Shaltz <holly@...> wrote:
>
> Christie (thanks for the name - it's the same as
> my DIL's! :) writes:
>
> <<Every doctor I seem to get, although they have
> very little knowledge of thyroid issues think they
> could handle my thyroid issues without an
> endocrinologist. >>
>
> Umm, you've had severe thyroid disease for over 15
> years and you're not under the care of an endo? I
> don't know much about these things, but that seems
> odd to me. Are you in an area where there aren't
> many endos? There's only 4 that I've been able to
> learn of, in the northern third of the lower
> peninsula of Michigan, where I live, with 3 of
> those 4 being 70+ miles away, but I've still
> gotten an appointment with one.
>

2.

snowshoeing and glucose

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Wed Jan 6, 2010 6:18 am (PST)



Is there anyone on the list experienced with
snowshoeing? I'm going to do that at a friend's
tomorrow for the first time. I'm looking forward
to figuring out a way to be active *outside* in
the winter, but I'm concerned about managing my
BGs during it.

I can take glucose tablets and put them in an
outside pocket to get at pretty easily. But I was
thinking it would be smart to have my meter along,
and I'm not sure how to keep it warm enough (it
will probably be in the low 20s), or for that
matter, get my fingers warm enough to test while
outside.

Any tips from those who do winter sports?

TIA,

Holly in MI
who grew up in TX and has never been on snowshoes
in her life :)

3a.

Re: Holly, A1c thoughts

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Wed Jan 6, 2010 6:56 am (PST)



Thanks for the link, Amal :) I had read I think
basically the same press release in the ADA
magazine a week or so ago.

But it kind of makes my point: even though
they've lowered the the A1C they acknowledge as
"diabetic", it's still way over my current A1C.

"The new guidelines call for the diagnosis of type
2 diabetes at A1C levels above 6.5 percent, and
prediabetes if the A1C levels are between 5.7 and
6.4 percent."

And then, just a bit later, it says "Generally,
people without diabetes have an A1C level of less
than 5 percent."

HUH? What about those with an A1C between 5 and
5.7? And what about their precious category of
"prediabetes"? If they're over 5, doesn't that
mean they're "properly" diabetic? Sheesh!

The other thing that bothers me is someone can
have a nice, low A1C, and yet be suffering serious
BG swings, with resulting damage to the body, to
get that A1C. Or, by the previous guidelines of a
fasting BG only, someone fairly early in the
disease progression, like my sister, can have a
great fasting BG for *years* while the A1C,
weight, and complications creep up.

I think it needs a series of tests - A1C, fasting
BGs, post-prandials after carby meals at the very
least - to get a better idea of who is diabetic
and who isn't. Each of these alone provides only
a partial picture of what the BG is actually doing.

And the info needs to get down to the level of the
PA and the Nurse Practitioners to do much good.
I'd be willing to bet they're the ones most likely
to see early diabetes, and diagnose it or not, for
the vast majority of Americans, anyway.

I also think they need to ditch that "pre
diabetes" category. Diabetes is a continuum, for
T2s. You don't go to bed one day non-diabetic and
wake up the next "pre" or "full-blown" diabetic!
(In fact, it strikes me for the first time - I
wonder if that concept of "pre" and "full-blown"
diabetes isn't influenced by the fact that T1s
practically do go to bed non-diabetic and wake up
the next morning diabetic? Hmmm...) The pancreas
of a T2 can be working harder and harder for
*years* to keep BGs normal before it finally can't
keep up anymore and diabetes can finally be
diagnosed by the rules, even these revised
guidelines. IMO, every person who starts to gain
weight, no matter whether there seems an obvious
reason or not, needs to be strenuously assessed
for diabetes, and watched for it regularly afterwards.

Just my take.... as someone who tried to get
diagnosed in the early 80s, with every symptom of
"full blown diabetes" except weight loss, and
couldn't get taken seriously. 25 years of misery
later, diagnosed with an A1C of 11.1.

Holly in MI

3b.

why the "pre-diabetes" label, etc

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Wed Jan 6, 2010 7:46 am (PST)



--- In Type-2-Diabetes@yahoogroups.com, Holly Shaltz <holly@...> wrote: <snip> I also think they need to ditch that "pre diabetes" category.>>

My theory is that the currently used pre-diabetes diagnosis is insurance industry driven. By having the docs label patients within a certain fasting glucose range as pre-diabetic, the insurance companies can put limits on how many test strips they'll pay for those patients, how many diabetes education classes they'll pay for, how many trips to the nutritionist they'll allow each patient, and whether or not they'll pay for CDE appointments for education and teaching about testing, etc.

And if you doubt it, just think about it... imagine the millions, if not billions, of $$$ the health ins. industry *doesn't* have to pay, just by providing the docs and their insurance billing staffs a nice, neat pre-diabetes diagnosis insurance code, delaying labeling the patients as true diabetics. I think this is short-sighted at best and downright inhumane at worst-- to withhold payments for the very things that will keep those patients healthy, out of the hospital, and needing fewer drugs long term, just for some kind of short term addition to the bottom line, well... no one ever said the insurance lackies were smart, I guess. Sigh.

<snip> The pancreas of a T2 can be working harder and harder for *years* to keep BGs normal before it finally can't keep up anymore and diabetes can finally be diagnosed by the rules, even these revised guidelines>>

Most of the time the T2's pancreas makes plenty of insulin, especially in the early years, but the body's cells' insulin resistance makes it impossible to be used. Type 2 and Insulin Resistance and Glucose Intolerance are all synonymous terms, after all. It's complicated, since everyone is at a different age and in a different stage of their condition; it is true that pancreases can completely dry up and stop producing insulin in some cases, but that ol' insulin resistance is the real culprit, no matter what else is going on. At least this is my rudimentary understanding.

Judy D.

3c.

Re: why the "pre-diabetes" label, etc

Posted by: "sharon osborn" shaross8@gmail.com   osborn.sharon

Wed Jan 6, 2010 8:28 am (PST)



> My theory is that the currently used pre-diabetes diagnosis is insurance industry driven. >>
> Judy D.

Hiya, I am "new", although old, 57yrs. old, Female, diagnosed
November. Fasting 166, triglycerides 985. I did not have a doctor,
and no insurance, although I've worked all my adult life, never a job
with 'benefits'. Every year I do go to my ARNP for pap, etc., and she
spotted the sugar problem this year in a moment of epiphany, thus
saving my life, set up an appt. with a dr., forcing me to go. As soon
as the Dr. a very pleasant woman, found out I had no Ins, she cut way
back on tests. I had to ask her please to include thyroid, t-4/t3.
However, to my surprise, everything is 'discounted', when I pay cash.
It leads me to believe that ins. companies must charge a whack just
to process-or because they can. Something's fishy, there, imo. The
lipid test is only $20, the blood panel went from $335 to $235, and
the initial office visit went from $336 to a $171 credit, which was
used on the second visit. I've had specs for a very long time,
although didn't need them regualrly until the last few years, but
eyeballs are of the utmost importance, so I went to my opthamologist
and yay, no retinopathy. That price went from $175 to $140 for cash.
Everywhere says that Diabetes is the single most expensive chronic
disease, but I always think of all the insurance companies who have
huge private agendas. A big, fat middleman.
sharon in walla walla, wa

3d.

Re: why the "pre-diabetes" label, etc

Posted by: "AnaLog Services, Inc." analog@logwell.com   sydlevine

Wed Jan 6, 2010 8:30 am (PST)



It nay be even more insidious that you suspect. These pre-diabetes labels may follow individuals in much the same way a true diabetes diagnosis does. That is to say, the coding may affect insurance availability and cost.

----- Original Message -----
From: Jude
To: Type-2-Diabetes@yahoogroups.com
Sent: Wednesday, January 06, 2010 10:46 AM
Subject: [Type-2-Diabetes] why the "pre-diabetes" label, etc

--- In Type-2-Diabetes@yahoogroups.com, Holly Shaltz <holly@...> wrote: <snip> I also think they need to ditch that "pre diabetes" category.>>

My theory is that the currently used pre-diabetes diagnosis is insurance industry driven. By having the docs label patients within a certain fasting glucose range as pre-diabetic, the insurance companies can put limits on how many test strips they'll pay for those patients, how many diabetes education classes they'll pay for, how many trips to the nutritionist they'll allow each patient, and whether or not they'll pay for CDE appointments for education and teaching about testing, etc.

And if you doubt it, just think about it... imagine the millions, if not billions, of $$$ the health ins. industry *doesn't* have to pay, just by providing the docs and their insurance billing staffs a nice, neat pre-diabetes diagnosis insurance code, delaying labeling the patients as true diabetics. I think this is short-sighted at best and downright inhumane at worst-- to withhold payments for the very things that will keep those patients healthy, out of the hospital, and needing fewer drugs long term, just for some kind of short term addition to the bottom line, well... no one ever said the insurance lackies were smart, I guess. Sigh.

<snip> The pancreas of a T2 can be working harder and harder for *years* to keep BGs normal before it finally can't keep up anymore and diabetes can finally be diagnosed by the rules, even these revised guidelines>>

Most of the time the T2's pancreas makes plenty of insulin, especially in the early years, but the body's cells' insulin resistance makes it impossible to be used. Type 2 and Insulin Resistance and Glucose Intolerance are all synonymous terms, after all. It's complicated, since everyone is at a different age and in a different stage of their condition; it is true that pancreases can completely dry up and stop producing insulin in some cases, but that ol' insulin resistance is the real culprit, no matter what else is going on. At least this is my rudimentary understanding.

Judy D.

3e.

Re: why the "pre-diabetes" label, etc

Posted by: "Steve Yarbrough" medtexsteve@gmail.com   csy1846

Wed Jan 6, 2010 8:55 am (PST)



Diagnostic groupings are based on medicare's ICD-9 (soon to be 10) codes,
they are adhered to by most insurance companies and if a doctor wishes to be
paid for his services his billing for medicare and insurance is submitted
based on those codes, the doctor must document in the pt. medical records
the supporting testing and history which are subject to review by the payor.
Yes ICD codes do effect benefits somewhat,, if you don't like your insurance
benefits you can shop for a different policy, of course if your employer
provides insurance then you may have no choice. Everything a doctor
prescribes, office visits, Rx's, tests and consults are driven by the coding
and if the coding is deemed in error they do not get paid until they get it
fixed.

On Wed, Jan 6, 2010 at 9:46 AM, Jude <peridotjude@yahoo.com> wrote:

>
>
> --- In Type-2-Diabetes@yahoogroups.com <Type-2-Diabetes%40yahoogroups.com>,
> Holly Shaltz <holly@...> wrote: <snip> I also think they need to ditch
> that "pre diabetes" category.>>
>
> My theory is that the currently used pre-diabetes diagnosis is insurance
> industry driven. By having the docs label patients within a certain fasting
> glucose range as pre-diabetic, the insurance companies can put limits on how
> many test strips they'll pay for those patients, how many diabetes education
> classes they'll pay for, how many trips to the nutritionist they'll allow
> each patient, and whether or not they'll pay for CDE appointments for
> education and teaching about testing, etc.
>
> And if you doubt it, just think about it... imagine the millions, if not
> billions, of $$$ the health ins. industry *doesn't* have to pay, just by
> providing the docs and their insurance billing staffs a nice, neat
> pre-diabetes diagnosis insurance code, delaying labeling the patients as
> true diabetics. I think this is short-sighted at best and downright inhumane
> at worst-- to withhold payments for the very things that will keep those
> patients healthy, out of the hospital, and needing fewer drugs long term,
> just for some kind of short term addition to the bottom line, well... no one
> ever said the insurance lackies were smart, I guess. Sigh.
>
> <snip> The pancreas of a T2 can be working harder and harder for *years* to
> keep BGs normal before it finally can't keep up anymore and diabetes can
> finally be diagnosed by the rules, even these revised guidelines>>
>
> Most of the time the T2's pancreas makes plenty of insulin, especially in
> the early years, but the body's cells' insulin resistance makes it
> impossible to be used. Type 2 and Insulin Resistance and Glucose Intolerance
> are all synonymous terms, after all. It's complicated, since everyone is at
> a different age and in a different stage of their condition; it is true that
> pancreases can completely dry up and stop producing insulin in some cases,
> but that ol' insulin resistance is the real culprit, no matter what else is
> going on. At least this is my rudimentary understanding.
>
> Judy D.
>
>
>

--
Steve Y.
3f.

oh oh, more health care insurance ranting.....

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Wed Jan 6, 2010 9:10 am (PST)



--- In Type-2-Diabetes@yahoogroups.com, "AnaLog Services, Inc." <analog@...> wrote:It may be even more insidious that you suspect. These pre-diabetes labels may follow individuals in much the same way a true diabetes diagnosis does. That is to say, the coding may affect insurance availability and cost.>

Oh, I'm sure of that. And god knows who has access to these so-called "private" bits of info. I very rarely see conspiracy anywhere, since I refuse to think that way, but you know what, I see Big Brother in action in the whole health care mess-- they've got us so over a barrel, we really are in the barrel with the pickles. Sigh.

My family has new health ins. as of Jan. 1. Had a telling conversation with the insurance billing person at the home health care agency that supplies my CPAP and oxygen concentrator I have to have for my sleep apnea. She told me they bill the insurance nearly $200 every MONTH for the oxygen concentrator-- I haven't checked recently, but the darned things only cost like $800 to buy. After 4 years of them paying $2400 a year for that one item of medical equipment... gee, can we say FUBAR? Yep, I knew we could.

Judy D.

3g.

Re: why the "pre-diabetes" label, etc

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Wed Jan 6, 2010 9:17 am (PST)



--- In Type-2-Diabetes@yahoogroups.com, Steve Yarbrough <medtexsteve@...> wrote:<snip> Everything a doctor prescribes, office visits, Rx's, tests and consults are driven by the coding and if the coding is deemed in error they do not get paid until they get it fixed>

Hey, no way was I blaming the docs for trying to get paid. After all, they have to adhere to the insurance guidelines if they want reimbursement.

My only point was that by inventing a "pre-diabetes" code, the insurance co.s feel they can justify reduced benefits. I'm sure they see that as strictly a business decision, bottom line stuff. Unfortunately, the fallout from that coding can be compromised education and home testing, etc, for folks in the early stages of the disease, which is unfortunate in the extreme.

Judy D.

3h.

Re: why the "pre-diabetes" label, etc

Posted by: "sharon osborn" shaross8@gmail.com   osborn.sharon

Wed Jan 6, 2010 10:23 am (PST)



That is to say, the coding may affect insurance availability and cost.

Exactamundo. As soon as I said the words, "I have no insurance",
there was an immediate distancing from the Dr. She wouldn't even give
me scrip for more than 2 BG readings a day. Foo. The next visit the
first thing she asked was if I had gotten Ins., yet. My reply, "Now
that I am diagnosed, who *would* insure me". It costs more for Ins.
than just pay-as-I-go. The eyeball Dr. was *very* concerned, but he
did say Obama may have all that fixed soon<g>. I told him I'll just
stay healthy until medicare, only a few more years after all... I
*do* have private hospital for any possible surgery and a great little
rider that takes a percentage off any drugs, so. I've paid it for
30ish years, and the one time I used it for carpal tunnel, it went up
from $35 quarterly to $372 quarterly. So I paid for *that* little
doodad many times over(!) One good thiing about not having Ins. I
toed the line *immediately*. Reading everything and adhearing to
protocol. Dr. had nothing to say, and the CDE classes are
exhorbitant, $190 per 2hrs., so I figure I know about as much as they
do, by now, although I might consider them in the future. My
step-daughter-in-law, in Spokane, is one, so she has given me all the
paperwork guidlines, I'm so lucky, eh.
sharon in walla walla, wa US

3i.

Re: oh oh, more health care insurance ranting.....

Posted by: "sharon osborn" shaross8@gmail.com   osborn.sharon

Wed Jan 6, 2010 10:24 am (PST)



>>She told me they bill the insurance nearly $200 every MONTH for the oxygen concentrator-- I haven't checked recently, but the darned things only cost like $800 to buy. After 4 years of them paying $2400 a year for that one item of medical equipment... gee, can we say FUBAR? Yep, I knew we could.
>
> Judy D.

And boy, it's that way with every little thing. Taking care of my
ancient auntie, she had total coverage Ins, and I mean total. She
needed a potty chair-one example-for which she was charged $30 a
month. This had been going on for some time when I started going over
to get her meds down her, breakfast cooked, etc., and I immediately
went to the thrift store and got one exactly like it, in excellent
shape, for $20. There is so very much bloat in the system. Why.
sharon o' walla walla, wa

3j.

Re: oh oh, more health care insurance ranting.....

Posted by: "AnaLog Services, Inc." analog@logwell.com   sydlevine

Wed Jan 6, 2010 11:51 am (PST)



I had an interesting experience with sleep apnea. When I went on heavy duty diuretics after my stay in the hospital, the sleep apnea disappeared. The doctors seemed surprised, but I did find some reference to it on the web. The sig other is now the only one who snores around here!

----- Original Message -----
From: Jude
To: Type-2-Diabetes@yahoogroups.com
Sent: Wednesday, January 06, 2010 12:10 PM
Subject: [Type-2-Diabetes] oh oh, more health care insurance ranting.....

--- In Type-2-Diabetes@yahoogroups.com, "AnaLog Services, Inc." <analog@...> wrote:It may be even more insidious that you suspect. These pre-diabetes labels may follow individuals in much the same way a true diabetes diagnosis does. That is to say, the coding may affect insurance availability and cost.>

Oh, I'm sure of that. And god knows who has access to these so-called "private" bits of info. I very rarely see conspiracy anywhere, since I refuse to think that way, but you know what, I see Big Brother in action in the whole health care mess-- they've got us so over a barrel, we really are in the barrel with the pickles. Sigh.

My family has new health ins. as of Jan. 1. Had a telling conversation with the insurance billing person at the home health care agency that supplies my CPAP and oxygen concentrator I have to have for my sleep apnea. She told me they bill the insurance nearly $200 every MONTH for the oxygen concentrator-- I haven't checked recently, but the darned things only cost like $800 to buy. After 4 years of them paying $2400 a year for that one item of medical equipment... gee, can we say FUBAR? Yep, I knew we could.

Judy D.

3k.

Re: oh oh, more health care insurance ranting.....

Posted by: "Tiamat" tiamat99@comcast.net   lulamoon99

Wed Jan 6, 2010 1:47 pm (PST)



Yes indeed. So much so that a local group began a 'savings club' where people could donate no longer needed medical equipment: crutches, potty chairs, walkers etc. These are then given away free to whoever.
Mb start one in your neighborhood--anybody.

Tia

> ancient auntie, she had total coverage Ins, and I mean total. She needed a potty chair-one example-for which she was charged $30 a month. This had been going on for some time when I started going over to get her meds down her, breakfast cooked, etc., and I immediately went to the thrift store and got one exactly like it, in excellent shape, for $20.
> sharon o' walla walla, wa

3l.

Re: oh oh, more health care insurance ranting.....

Posted by: "Terry Shimmins" xquid79@yahoo.com   xquid79

Wed Jan 6, 2010 4:34 pm (PST)



My VFW post loans out crutches, canes, shower stools, wheelchairs, walkers to members who need them for themselves or family.   Found a website a year ago that offers donated wheelchairs and power scooters to those who need them - lifenets.org.    My mom needed a a power chair to get around.   Now she REALLY needs one.  Medicare/Medicaid was giving her excuses for 5 years for not getting one and 3 weeks after requesting a scooter on this website, we had a donor.   All it cost was the gas money to drive from S. Wisc. to the Chicago Northern suburbs and pick it up.

________________________________
From: Tiamat <tiamat99@comcast.net>
To: Type-2-Diabetes@yahoogroups.com
Sent: Wed, January 6, 2010 3:47:06 PM
Subject: Re: [Type-2-Diabetes] oh oh, more health care insurance ranting.....

 
Yes indeed. So much so that a local group began a 'savings club' where people could donate no longer needed medical equipment: crutches, potty chairs, walkers etc.  These are then given away free to whoever.
Mb start one in your neighborhood- -anybody.

Tia

> sharon o' walla walla, wa

3m.

Re: oh oh, more health care insurance ranting.....

Posted by: "Tami" vze1k0d8@verizon.net   hummycherub

Wed Jan 6, 2010 5:50 pm (PST)



They bill my insurance company $300 a month for my o2 and 27 dollars for a nebulizer that every month i call and say I dont have that one anymore. I had to buy one out of pocket because they said medicare wouldnt pay for another one if it wasnt atleast 5 years old.
4a.

Re: Metformin Overdose (Rx error)

Posted by: "Donna" sdbmshad@yahoo.com   sdbmshad

Wed Jan 6, 2010 1:40 pm (PST)



Brian,
I know here in South Carolina they have to keep a copy of it. The State can and does audit the pharmacy when someone complains about constant mistakes.
You could call the state board and ask them if the pharmacy is required to keep the scripts and for how long.
In South Carolina they are required to keep them (or at least an electronic copy of them) for a prescribed number of years (I don't remember the exact amount). They are also required to obtain a copy and not just a verbal order. They have different lengths of times according to the type of prescription. I do know this to be true as it was part of a court case that I sat on a jury for. We had to listen to all the information about the different classes of medications and the procedured the pharmacy's had to go through. It was kind of enlightneing really.
I have also gone back to my pharmacy when they made a mistake on the Lantus pen the dr wrote. I had argued with my pharmacist about it twice on the day he filled it. I didn't think it was right so I went to another pharmacy and asked and was told by 2 pharmacists there that there was a mistake and to go back to the filling pharmacy. I changed after pharmacist as this was thier third mistake including putting the wrong doctor on a script!
I think NC goes along the same lines as SC. At least it did when we lived in Charlotte. And Walmart does it the same across the board. If it's done at one it's done at all (from what the 800 number told me). My little brother works for them in CA and has told me that the pharmacy get's it's orders from Corporate. They are suppose to be licensed in every state.
On another note.... The Endo's in my area have not impressed me. They refuse to talk with the family even when one has been told they are diabetic (need's a referal). We stay with our Internist! She's great! She knows alot about diabetes and all of our ailments. She does a fantastic job and has no problem finding a specialist as need. She went to the extent of finding a Gastrointerologist for my husband from the country he is from so he would be more comfortable. Now that is service!
I hope things get worked out for you.
Take care
Donna

--- In Type-2-Diabetes@yahoogroups.com, brian cooper <brianevans_99@...> wrote:
>
>
> Donna,
>
> Thanks for your suggestions. It may be that the Walmart pharmacy I'm using here in NC has to keep records, but I think that would vary by state. The FDA (theoretically) regulate drugs/etc, but state pharmacy boards license pharmacists, and may, as far as we know, also set standards and requirements for operation of pharmacies. (I may call our state board in Raleigh.)

5.1.

REMy meet with the Diabetes Nurse in my local Medical Health Centre

Posted by: "Wee K Chew" wee@weekhiong.plus.com   wee_khiong

Wed Jan 6, 2010 1:54 pm (PST)



"Hi, Wee :) Did you see your doctor on Tuesday?
What was the result? I hope those lows are a thing of the past! Holly in MI"

I told the Diabetes Nurse my Doctor told me to stick with Gliclacide despite the lows I was having pre-Christmas time shopping with my DD.
I explained extensively that when I was first diagnosed of this condition, I was put on 1g Metformin(twice a day).
But in June, last year my HBA1C was 7.5.
Doctor prescribed 80mg Gliclazide, the aim was to bring HBA1C to under 7.0.
In mid Oct 2009, HB1AC was 6.6.
Obviously, it had done the trick.
At this point I have not cut any of my Carbs down yet.
I only started cutting down Carbs just before Xmas & experienced some lows which I didn't expect.
No one had warned me that's what will happen and it caught me by surprise.

"why prompted you to want to cut down on carbs?", she asked curiously and smile :)
I told her I have been talking to the Diabetic Dietician Nurse where I work and I was asking why my PP BGs are so high.
The Diabetic Dietician Nurse then told me that I was eating too much carbs and showed me the correct portion size to eat.
She explained that my Diabetic condition is not able to handle the amount of carbs I was use to and that I had to make a new change in the portion size.
So, I had to listen as I know little about Diabetes and this person was saying something to me that sounded logical.(She smiled).

Anyway, the nurse told me to stop taking Gliclazide as from tomorrow onwards as I have already taken one this morning.
It was at 11:30 am when I saw her.
She also told me to make an appointment with the same Doctor (who saw me last)in two weeks time and ask me to come with a fully loaded Record Book of all my BGs for the two weeks. (She was already typing a letter out to the Doctor to inform him why she told me to come off Gliclazide) as I say Goodbye and walk out the consulting room.

So, Judy and Holly was spot-on when they suggested that the Gliclazide was causing my lows(and not the Metformin).
I had thought perhaps it was the Metformin but what do I know about Metformin and Gliclazide? :)

I have learned so much here :)

I looked back at all the posts as I was filing and sorting out my emails and Judy and Holly's posting is "phenomenal".
I will need to make more room for these two if they carry on as they are right now, hehe, lol :)

Sorry for the long post.
I didn't realise until now that I am nearly as good as Judy and Holly, as far as long post are concern, that is, lol :)


Wee :)
Middx, UK

5.2.

Re: REMy meet with the Diabetes Nurse in my local Medical Health Cen

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Wed Jan 6, 2010 4:19 pm (PST)



Wee writes:

<<I only started cutting down Carbs just before
Xmas & experienced some lows which I didn't
expect. No one had warned me that's what will
happen and it caught me by surprise.>>

It's always frustrating - there's SO MUCH
information out there and somehow we're always
lacking a crucial piece of the puzzle, no matter
how dedicated the medical advisors are or how many
lists we ask questions on or how many books we read.

It keeps coming back to doing those BG tests and
keeping track of the results, and then reporting
them to the doctor or whoever is keeping an eye on
us when something doesn't seem quite right. For
me, that meant several calls to my PA reduce my
dose of micronase before I finally got off it
altogether - too many lows even when I cut the
smallest pill they make in quarters.

<<So, I had to listen as I know little about
Diabetes and this person was saying something to
me that sounded logical.>>

I'm glad you had good advice! Over here, my
dietician and Diabetes Nurse Educator both
strongly disapprove of my low-carb eating, but
simply don't respond when I ask how I'm supposed
to eat the level of carbs they want (a minimum of
*240* g of carb a day!!!!) and still maintain a
reasonable BG, even if not as low as Bernstein
recommends.

<<I had thought perhaps it was the Metformin but
what do I know about Metformin and Gliclazide?>>

You can always check drugs on rxlist.com.
Although I was never able to find "Gliclazide"
there, but maybe it's a US site and that's a UK
brand name. Maybe you have an equivalent site for
UK drugs? Worth a google, I think :)

<<Sorry for the long post.>>

Not long at all! Thanks for sharing your update.
Let us know how it goes without the Gliclazide.
Keep checking your BGs after meals of measured
amounts of carbs, to see how it does.

Holly in MI

5.3.

daily carb totals and Gliclazide

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Wed Jan 6, 2010 5:08 pm (PST)



--- In Type-2-Diabetes@yahoogroups.com, Holly Shaltz <holly@...> wrote:> simply don't respond when I ask how I'm supposed to eat the level of carbs they want (a minimum of *240* g of carb a day!!!!) and still maintain a reasonable BG>>

Wow, that's a lotta carbs! When I eat all I want to, I still only eat about 150 gm of carbs a day. But 240! Just the calories that would pack on would be unbelievable, forget the impact on the glucose level. Whew.

Re: Gliclazide. Go to wiki for info at this site
http://en.wikipedia.org/wiki/Gliclazide, which says <<Each tablet contains 80 mg of gliclazide. Not marketed in the United States>>

Judy D.

6a.

Dex4 Glucose Bits - Michael :)

Posted by: "Wee K Chew" wee@weekhiong.plus.com   wee_khiong

Wed Jan 6, 2010 4:34 pm (PST)



"Wee, call your local Costco and ask. I've been a member for years and I do
NOT own a business. I just buy lots of wholesale items and repackage them
at home for personal use. Here in the US, you can go into Costco without
being a member on a 1-day pass but you must pay in cash as check writing is
limited to members only."

I have emailed them today & ask for a 1-day-pass :)

I have also made contact with a fellow colleague who has a business :)
He told me he shop at Costco and the next time he will shop there is next
month.
He is not very helpful because he did not even make a phone call to check if
they really do stock Dex4.
(That's what I would have done but hint. Hint and he still did not pick up
the phone).
So, I will have to wait and see if he will help me in the end.

Wee :)
Middx UK

7a.

Re: Holly, role of exercise in A1c levels, etc.

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Wed Jan 6, 2010 6:15 pm (PST)



Judy writes:

<<If the doc gives you insulin for this reason,
I'll eat my virtual hat. I'm just sayin'. >>

Lovely. That ol' catch 22 yet again - you're
"supposed" to eat zillions of carbs on the ADA
diet, then they won't give you the insulin you
need to keep the BGs down enough to avoid
complications. Damned if I do and damned if I don't.

I hope this particular endo is more flexible! Not
that I want to eat 200 g of carb, but 50 would be
nice - or even a full 30 most days!

<<He'd be much more liable to prescribe metformin
and/or an oral med to take with meals, like
Starlix or Prandin.>>

I had to look them up - yep, both drugs force the
pancreas to excrete more insulin. No thanks! I
won't take them if she prescribes them. I've been
there, done that, and have the lows to prove it -
and that was on the ADA diet! Not to mention they
can make the pancreas burn out faster. Mine is
already far enough gone, and I want to keep its
remaining function going!

And I *am* still taking metformin, 1 x 850 mg
daily. I don't think it any longer makes any
difference, and I expect my PA to discontinue it
when my current bottle runs out, probably later
this month (haven't counted the remaining pills).
I have nothing against metformin except the
eczema it gives me, but if it no longer makes a
difference to my body, there's not a lot of point
to continuing it.

<<Which a hypoglycemic oral med could also cause,
if not handled right. But you wouldn't know until
you experimented with yourself.>>

The idea is that excess insulin in the system will
work on excess carbs to store fat. That's if I a)
let myself eat that many carbs (I won't :) and b)
was making or taking that much insulin (I'm not).

Shall be interesting to hear what she has to
say.... I'll be sure to report, but it won't be
til Feb 24th, so don't hold your breath :)

Holly in MI

7b.

Re: Holly, role of exercise in A1c levels, etc.

Posted by: "Amal" amal_mba10@yahoo.com   amal_mba10

Wed Jan 6, 2010 9:34 pm (PST)





--- On Thu, 1/7/10, Holly Shaltz <holly@shaltzfarm.com> wrote:
(( you're

"supposed" to eat zillions of carbs on the ADA

diet, then they won't give you the insulin you

need to keep the BGs down enough to avoid

complications. Damned if I do and damned if I don't.))*****************I do not understand why any diabetic would be deprived the right to choose insulin if he/she wishes to do so.  What if a person can achieve good control with oral medications but for a reason or another cannot tolerate any of the drugs due to other health conditions, side effects etc.  
((I had to look them up - yep, both drugs force the

pancreas to excrete more insulin. No thanks! I

won't take them if she prescribes them. I've been

there, done that, and have the lows to prove it -

and that was on the ADA diet! Not to mention they

can make the pancreas burn out faster. Mine is

already far enough gone, and I want to keep its

remaining function going!))*****************I use Prandin and it does create lows but not as severe as the other drugs (I think).  It helps with the Post Prandial BG control mainly.  I understand your case against them anyway.  Holly, have you tried any of herbal formulas?  Do you believe in them in the first place?  I know that some people think herbal is useless but I tried some during the Metformin days and they did help immensely..  In the Middle East, many diabetics take no drugs at all and rely on natural alternatives.  Best wishes on Feb 24th.Amal 

8.

New HgbA1C result  and Medical STEROIDS

Posted by: "Tricia" psimmons1219@gmail.com   psimmons1219

Thu Jan 7, 2010 4:25 am (PST)



Holly
I really do not do anything that is special to keep my glucose down. I drink almost no soda. The only time I drink any soda is when I have an upset stomach. I pour 2 ounces of regular coke in a small coffee cup and something in Coke-a-Cola helps settle my stomach. I have Crohn's disease so I have a good many upset stomachs. Probably 3 times a week.
I keep count of my carbs and try to stay between 60 and 80 carbs a day. I have lost a good bit of weight this way. I have tried very hard to cut "fast" carbs out of my diet all together. I try and keep my carbs in the fruits and grains categories. If I do have a craving I just can not get rid of after several hours I eat a couple of bites in small mouthfuls and very slowly to get rid of the craving. If I do not satisfy the craving and put the craving of for days or weeks when I do have whatever the craving is for I will eat a "bucket" full.

My exercise routine is really poor but it is the best I can do since I have trouble getting around. I have drop foot and was diagnosed a few days ago with tendonitis of the Achilles tendon. (A runners disorder) LOL. I use an exercise band for my legs and arms. I may be able to only do 2 or 3 minutes at a time if my pain is very high but I work with the band over and over through out the day. It seams to have helped a good bit. I also use a manual wheel chair when I am out of the house and this burns a lot of glucose and calories. I have to be careful not to go low when I am out in my wheelchair.

I seem to be able to increase my carbs more with ever 10 pounds of weight I lose. I can keep my same weight and keep my glucose where I want it (under 120 mg/dl) if I eat ~115 carbs a day. Since I still have more weight I want to lose I am keeping to the lower carb values.

I doubt this helps anyone but this is my life.

By the way. I am taking steroids and I just checked my glucose. It is 260 mg/dl and on the rise. I feel really sick and I am starving. I do not understand what is happening to me. I have already eaten twice my normal intake for the day and I am STARVING!!! I am also not sleeping since beginning this medication.

If you have any experience please tell me what happened to you on a dose pack. I am going to do a search on glucose and medrol dose packs when I finish this. The literature on the net is great but I am more interested in personal experience at this moment. Glucocrticoids (steroids) are one of the big reasons I am diabetic at 41. Several years ago I was overdosed on steroids. I ended up in the hospital with major complication and my adrenal glands were damages severely.

Tricia

Tricia writes:

<<My A1C result is down even more. It is 5.1%. >>

WHOOO HOOOO!!!! Wow, way to go, Tricia! That
*IS* great, especially considering the holiday
season!!!

Since we've had lots of new people on the list
lately, maybe you could share the bones of how you
manage doing that - and why you aim for a low A1C?
I'm sure some would like to hear it from someone
other than moi <g>

Holly in MI

Recent Activity
Visit Your Group
Yahoo! Groups

Cat Zone

Connect w/ others

who love cats.

Y! Groups blog

the best source

for the latest

scoop on Groups.

Yahoo! Groups

Mental Health Zone

Find support for

Mental illnesses

Need to Reply?

Click one of the "Reply" links to respond to a specific message in the Daily Digest.

Create New Topic | Visit Your Group on the Web
*** All information discussed on this list is not to be taken as medical advice but the experience of each member based on discussions with their doctors. ***

*** Please always consult with your doctor about what treatment options are best for your situation. ***

No comments:

Post a Comment