Diabetes and COVID-19

I am as as mad as anything. I keep reading posts about how insurance companies are forcing medication changes on cost basis.
The same thing is happening with this virus we are more susceptible to.
Decisions need to be made on a persons welfare and safety and not economically.
By operating with the economy as the priority will, ultimately kill it anyway!

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Welcome to TuDiabetes, @Tongey! I agree with your sentiment about insurance company medical switching. The business decision makers see the various brands of insulin as medically equivalent and see no problem with forcing their subscribers to switch from one brand to another on an annual basis.

That does work for some people with diabetes but many of us experience much different results. For example, I’m allergic to Novolog and am doing well long-term with Apidra. My doctor is forced to jump through unnecessary hoops filling out bureaucratic “prior authorization” forms to get an exemption from medical switching edicts and my insulin supply can be delayed. Diabetes is hard enough to manage without the insurance company bean counters throwing us a curve ball.

You also raise a large issue of the tension found between the well-being of people and the economy. The movers and shakers of the economy can be short-sighted and fail to see how the long term sustainability of the economy depends of the health and well-being of everyone who makes up society, not just the economically well-off.

These topics, however, can easily stray into political discussion and those discussions these days will often degrade into a pie throwing contest! We try to keep comments that trigger those discussions to a minimum here as our primary focus is diabetes.

I am looking into today if I can do a phone appointment. Is it covered by insurance? The other night after watching nightly news I told my husband that I was afraid of this virus. I think the news did it more than anything. Made me anxious, normally I am not that way. No more major news watching. Lucky I have a nice yard to spend time in. Be safe everyone! Nancy50

I can’t answer the insurance question, but over the past two weeks I’ve had two doctor’s appointments over the phone, and I love it! I wish all appointments could be like that. So efficient, no travel time or need to miss work, and we covered everything needed. I needed a prescription refill and my doctor just sent it directly to the pharmacy. I do need to go in for a follow-up appointment for some allergy testing, which obviously couldn’t be done over the phone. But it would be great if this is something that continues to be offered for some types of appointments once this pandemic is over.

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If you are on Medicare it is covered 80% on your regular plan and the other 20% is covered if you have a supplement plan.

Yes, insurance is covering with no copay. She chatted with me on line I have an appointment in 2 weeks. See if it will be phone or in person. Nancy50

Could Insulin Resistance Mediate the Severity of Covid-19 Infection?

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I’m not entirely clear how this relates, as cytokine storms are - from what I’ve read - more often a problem in young, seemingly healthy, people, when their immune system overreacts, but…

It’s interesting to me to read this in the study @Jim_in_Calgary cites .

Finally, if an association between insulin resistance and COVID-19 severity was established, the next step would be to determine whether strategies to enhance insulin sensitivity acutely (such as carbohydrate restriction) could improve prognosis.

I know that science must move carefully and methodically due to its nature. I just wish that its skepticism was not enhanced by a lack of funding of this avenue of inquiry since restricting carbohydrates does not economically enrich anyone. Big Pharma and Big Food show no enthusiasm for scientifically establishing the link between modern processed carbohydrate-rich foods and ill health.

Perhaps the clarity and motivation provided by a pandemic could provide a breakthrough in reaching a clear understanding the role our modern diet plays in disease. Those of us who have lived with the metabolic reality of diabetes and the way our eating influences our glucose metabolism are perhaps a few steps ahead of science.

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I agree @Terry4.

For me and my diabetes, it’s just another reason to try to maintain blood glucose levels as close to non-diabetic as possible.

My personal journey allowed me to see the correlation between insulin resistance and foods ingested (as expressed via BMI).

As always, YDMV :slightly_smiling_face:

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Although focused on high-glucose levels and cytokines, it does point to the need for good control…

From Scientific American regarding another study:

In its latest study, the team revealed, at a detailed molecular level, how a glucose metabolism pathway activated by flu infection leads to an out-of-control immune response. During such an infection, high levels of glucose in the blood cause an enzyme called O-linked β-N-acetylglucosamine transferase (OGT) to bind to, and chemically modify, IRF5 in a process known as glycosylation. This step enables another chemical modification, called ubiquitination, that leads to a cytokine inflammatory response.

Paired with a recent study:

In conclusion, Yan et al have shown that patients with diabetes and severe Covid-19 have higher proinflammatory cytokines and a worse survival rate than non-diabetics.

Diabetes and covid-19: a global health challenge

I have been starved for information about inpatient care and insulin regimens for people with diabetes hospitalized with Covid-19. This blogpost shares links to webinars/podcasts with medical professionals discussing what is likely to be our care if those of us with diabetes are hospitalized with coronavirus. https://testguessandgo.com/2020/04/28/ada-webinars-and-podcasts-inpatient-care-for-covid-19-patients-with-diabetes/

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