Diabetes Forecast

Don't Settle—Speak Up

By Christy L. Parkin, MSN, RN, CDE, Associate Editor ,

Most Americans agree that we need to find ways to reduce health care costs. However, as health care is increasingly ensnared in politics, cost-cutting authority is often left in the hands of people who do not fully understand diabetes or how to manage it. As a result, many people with diabetes are at a greater risk for losing coverage of or reimbursement for the tools they need to maintain good control over their diabetes. (As if things weren't tough enough already.)

Self-monitoring of blood glucose (SMBG) is one area where people with diabetes potentially face cutbacks in coverage. What can you do about it? Plenty.

First, make sure that you're testing with a purpose. For years, health care providers have handed out blood glucose monitors to people without ever discussing their targets, when to test, how to interpret the results, and what to do when blood glucose is too high or too low. This not only is a disservice that often leads people to stop testing, but it's also clearly a waste of time, money, and resources.

Second, fight to be reimbursed for testing supplies. Remember, the squeaky wheel gets the grease. Don't settle for "No, we won't cover that" from your insurance provider. Are your testing supplies billed under your pharmacy benefit or durable medical equipment benefit? This can make a difference in coverage. Keep calling, and ask your doctor to contact the medical director and other appropriate personnel at your insurance company.

Third, be your own advocate in all areas of your diabetes care, including SMBG. Talk with your doctor and other health care professionals to make sure that you understand your goals and how to achieve them. And be sure your health care team is willing and able to work with you in using test results to make appropriate changes in your treatment plan.

The International Diabetes Federation (IDF) recently published guidelines for effective, responsible SMBG in people with diabetes who do not take insulin. You can download these guidelines and take them to your next doctor's visit to help open up a discussion of how SMBG should fit into your treatment plan.

The American Diabetes Association also has helpful information about blood glucose control online. And Diabetes Forecast offers how-to articles and charts you can print out for tracking your blood glucose tests, medications, and meals.

Don't let the health care policy makers take away the tools you need to manage your diabetes. Talk to your health care team, test responsibly, and speak up—as often as it takes.



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