Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change? (Thanks to Briley of inDpendence for this topic suggestion.)
The first petition I want to send out is to the insurance companies and mail-order pharmacies.
My insurance company, for some reason, lets me test 10 times a day, no questions asked. If it weren't for that, I'd probably never have found out that my blood sugar was spiking within ten minutes of eating, and then continuing to rise for hours, content with letting me sit at 180 for the length of time I sat for two or three classes. (That, by the way, it the basic reason why my endocrinologist FINALLY agreed to let me start meds, even without a high A1c.) I'm not complaining about that.
I'm complaining about the fact that the mail-order pharmacy that my insurance company uses (with NO co-pay) gives me a hard time about those supplies.
For example: I use 10 strips a day. A 90-say supply is 900 strips--exactly 18 boxes. But 18 boxes need 18 control solution tests (yes, I actually use that stuff). That's 2% of my order, going toward the blue-green dye? Hello! But nope, they won't cover for that.
I could live with that. Overall, it isn't much to complain about. But they keep changing the types of strips they carry, or the lancing devices and lancets they carry. They keep trying to send me their SMS control solution, which I get yelled at for using by OneTouch. They keep trying to send me their SMS lancets, which hurt worse than the fingerpricks they do in doctor's offices. They keep saying that they carry a type of lancet, then they don't, then they do, then they don't. And then they don't tell me when my preferred lancet type is available.
Let's get something straight, CCS. My fingers are full of tiny holes and black dots. Some of them are so calloused at the moment that I can't get any blood from them. If I say that the Fastclix hurts less and is less annoying than the OneTouch lancets, than the SMS lancets, and even than the Multiclix, then I want the Fastclix. You can say whatever you want about getting supplied with them, but at the end of the day, I'd rather get my lancets late than not at all.
The second petition I have is for endocrinologists, the ADA, and anyone else who will listen.
Diabetes needs to be diagnosed properly in order to be treated properly. It's very easy to say that people over the age of 20 have type 2 and people under 20 have type 1, but it ins't true. Your body can decide that it hates your beta cells any time it wants to, including and up to the age of 90. The best way to decide whether someone has type 2 isn't through a BMI calculator, it's through a blood test. At the very least, do a c-peptide! Antibody tests are covered by most insurance companies; take advantage of that and test your patients!
Also, there are more than two types of diabetes. There's type 1, type 2, then there's LADA, and there's MODY. Type 1 has a typical presentation, but type 2, LADA, and MODY do not. Within those subtypes are multiple diagnosis stories. And between type 2 and MODY, there are many things that can be wrong.
If you have any sense at all, you'll change the guidelines for diagnosing diabetes.
Furthermore, a diagnosis of diabetes should not be made from A1c alone. My blood sugar will spike over 200 with ANY significant amount of carbs (read: 10 or more) if I weren't on Metformin. My last A1c, even without Metformin, was 5.1. My A1c doesn't reflect the highs or the amount of time I spend high. Get your facts straight: 200's do damage. They make me feel sick. I hate getting that Look from doctors when I tell them I'm insulin resistant instead of type 2. (I also hate saying that I'm type 2, but that's because I'm sooooo overweight because I should lose about five pounds.)
Finally, to the media.
STOP BLAMING TYPE 2 DIABETES ON THE PEOPLE WHO HAVE IT!!!! When you do that, you cause everyone else to judge them, like they aren't judging themselves enough. Actually, let me repeat that: they're judging themselves. The most recent evidence suggests that insulin resistance causes weight gain, which then leads to more insulin resistance, which causes more weight gain. It's a vicious cycle initiated by insulin resistance, which is caused by a problem with the way the body processed insulin, not by being fat.
Type 2 diabetes can be controlled by diet and exercise to a point. And then there's no choice but to take medications, sometimes eventually insulin. Even if a person loses weight (which is very, very hard to do), they still may need medication. There is no reason for them to feel badly about failing when they didn't fail. Don't make things harder for them; they have enough to deal with.
"I'm deafened by the silence/Is it something that I've done/I know that there are millions/I can't be the only one" ~Simple Plan
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