NOW I am angry

Type 2
1

I know that we have talked about this before, but, now I am angry. I just got a call from my doc’s office that I need to bring in my log book of my daily numbers to be copied and sent to Medicaid to substantiate my needing to test 3 - 4 times a day. I do that, because that’s how I was taught to control my numbers, one FB in the am, one after exercising, and one after my largest meal and before bedtime. AND then again if I have a low or a high episode, for two hours after that to be sure I’m getting in the right directions. Yes, that’s a lot of testing, but I think that if you aren’t knowing what your numbers are during the day, how do you know how to treat yourself? I realize that’s a lot of strips and yes they cost money. But again, how can you be in control, and not test? SD passed a mandate about 10 years ago, that diabetes was going to be treated in SD. We had a governor who was diabetic; diagnosed when he was gov.; thus our emphasis on diabetes. But since he is out of office, our support has been dwindling down to nothing…both financially and educationally from the state healthy department.

Thanks for letting me blow off the steam, now to get working to change this little (NOT) problem.

2

For what it’s worth - I’m angry with you.

Terry

3

Good for you. Keep fighting. You are absolutely right, you must test to maintain control. I have talked with T2’s who say they have good control only to find out they test 1-2 times per WEEK! Several others, including my father, have been told by their Dr. to test once per day (FBS) only. this is amazing to me. In either case you have no idea how well you are doing.
Being T1 I test a minimum of 6 times per day. Often it is more like 10. Anything less and I would be guessing how to bolus and how to eat. Even as T2 you need to test enough to know how you are doing. How else can you avoid complications?

4

definitely not a smart way to save $. complete BS

5

People of all stripes from bean counters to medical professionals can’t seem to understand that good numbers and good control don’t happen by themselves, it’s hard work and meter readings provide the data necessary for gaining better control. Actually strips, expensive as they are will save money in the long run, provided the patient will act on their readings. Also diabetes is a constantly changing condition. I use my pre dinner reading to decide whether to have foods like tomatoes or a few beans in my meal, if I have a good reading I will go ahead and include them in my meal, high and I skip them. Meter readings also tend to keep me on the straight and narrow in regards to controlling my carb intake, it’s a simple matter of positive and negative reinforcement for me.

Unfortunately, I also know why they are so tight with the free strips. Just look at Ebay and you will find strips for sale at very good prices, way better than you can find anywhere else on the web. In many cases these are strips paid for by insurance that the people choose to sell instead of use.

I hope this works out in your favor Cathy, actually I would not say that 3-4 is a very high number. Even though I’m T2 I still test more like 6/day and If my numbers go haywire as they do from time to time I’ll test even more to try and troubleshoot the problem. Also If you are subject to lows the responsible thing to do is test before driving or operating machinery.

6

I hear you Cathy. The strips are such a big issue. I’ve never had a script for strips myself and believe me, I’ve tried!! This is such a huge issue on this site. If we are to be “outraged” about anything, I think we should be “outraged” about the price of these strips! Good luck ! I hope you are successful. Certainly 3-4 times a day is not excessive!! Joanne

7

These doctors and insurance company execs who think diabetics don’t need enough strips to monitor - they should be taken into a room, blindfolded, spun around, their paychecks tacked to the wall, and asked to pin the tail on the paycheck. If they don’t put a tack in their paycheck within a few minutes they don’t get paid.

Maybe then they’ll understand the stress of trying to hit a target one can’t see in order to maintain life, health, and wealth.

8

another call from the doc’s, and for what purpose…they are having to write the script for only testing once a day! What a pain in the ■■■! The medical people tell us to test often, ADA tells us to test often, control is an issue, but as one said, how can you hit a target that you can’t see. GRRRRR. This is about as smart as eating too much chocolate because it’s a bean!
I’ll keep you posted, I am a mad dog when t hings like this happen, so won’t let this bone go!

9

Welcome to the club. Medicare has been pestering me and I just got records together on this matter
and sent in. The funny joke is they approved my last most expensive bill and rejected the two smaller bills for test strips saying they were not substantiated.

Diabetes does not go away change and if the last month - most expensive is properly documented and approved, why reject the 2 prior months.

$ 38 dollars later, I finally got appeal and records off to both CMS/Medicare and the contractor.

I could scream at the nonsense.

10

Infuriating! Another horrible case of penny wise & pound foolish. They care about short-sighted cost cutting measures now at the real expense of our health. Absurd. Prevention has never been a priority in healthcare. Raise hell & fight the good fight.

11

Unfortunately, bureaucrats focus on studies like the one in Britain that “proved” that frequent testing did not improve control in Type 2’s. However, what they did not consider was, what does a Type 2 do with the information. I would venture that most Type 2’s are never taught how to use meter results to modify eating habits, or exercise habits or anything else. They keep logs, so their doctors can say, “Hmmm, we need to increase your medication, or add another one”, but no one ever gives them any way to deal with BGs on their own. So they become very passive. And then they are blamed for being “noncompliant” and “unmotivated” :frowning:

There is also the assumption that Type 2’s have very stable BGs, and therefore don’t need to test very often because their BGs won’t differ by much over the course of days. In fact, in Britain, at one point, Type 1 and Type 2 were called “unstable” (or “brittle”) and “stable” diabetes. So, with that biased mindset, it SEEMS to make sense that Type 2’s just don’t need to test very often. :frowning:

When I was first (mis?)diagnosed as a Type 2, and actually did have significant insulin production, the attitude was that if you go high after a meal, but come down by the time of the next meal, that was sufficient. No consideration of peaks after meals at all. And of course, I was expected to eat by the exchange plan, at regular times, and with measured, small amounts of food for what turned out to be 6 snacks a day. It was unbearable. The best thing that ever happened to me was discovering the embryonic DOC, going on insulin, and figuring out what worked for ME!

You, my dear Cathy, don’t fit into the legislative box. You ARE intelligent, motivated and pro-active, but the law doesn’t allow for that kind of mindset and behavior. I think you need to enlist your doc to help you appeal it, because it’s REALLY hard to appeal bureaucracy as a “dumb patient”. Especially if you are on Medicaid, you are presumed to be dumb! :frowning: If you and your doc can demonstrate a need for more strips, maybe you can win an exception. I sure hope so, because in the long run, you can save your state a lot of money! Good luck!

12

I am a type 2 and I test at least 7 times a day. I just started seeing a new nurse practitioner and even she told me it was excessive and she tried to knock me back down to 3 in my script. I really got mad because I had to show the person who originally wrote the script for 7 times that if I did not check during exercise I would go low and would not be able to come home. Now I have to rent a cgm from them because they want to see the changes in action. I guess my log is not enough to confirm. I bases my meals on what number I have before eating. I check an hour after to see how a meal impacts me. I change the meal if numbers are bad. So I am mad with you for not allowing you the amount of strips you need to manage. I can’t wait til the technology that will make strips obsolete gets here. Then the companies that make over priced strips will not make a profit from us. Keep fighting for what you need.

13

Natalie has provided excellent practical advice and it may be desireable to use a 3rd party contractor like Liberty to assist one as they will work with Doctor to provide help with appeals. Also make sure you always appeal and realize they are trying anyway possible to dump claims no matter how rational - legit. Appeal always. I would also write my congressman as well, he still needs your vote.



On the emotional get nowhere - front: Oh great, stupid three degree bastard time again.



Yes, if you study people who have their endoctrine system mostly working and have predictable stable BG, yes one can prove why yes one strip a day should be good enough.



If you have liver problems, huge dawn effects and liver dumps jumping BG up to 311 and 511 reliably and its important to stop these horrific events and/or unstable BG for any number of other issues and lastly control carbs and peaks , it is critically important to multiply test. With CGMS, I got down to 10 strips a day to keep the interstitial test turkey in line.



I am quite prepared to file a class action suit and my body as evidence against the insensitive fools and morans who promote this crap.



After 30 yeard on wrong drugs solving wrong problems - ie it must be your pancreas, and years later using 32 strips a day initially and the CGMS later with 10 strips a day, I have gotten my mess under control, stopped the body rot, contained the liver and now rarely get a massive unwarranted liver dump that some fools think its all in your mind ( notwithstanding the fact it takes unconcious brain power, liver sensors, liver switches and organ horsepower to regulate body).



Metformin is the KEY drug here now for me with a little insulin to compensate body aging on organs ( I am 64) along with tight 1200 calorie diet with carefull carbs control and hearty exercise to ensure food in ( energy in) and energy burn - out are in close balance to stop rot and keep body healthy.



Such fools and idiots who promote such crap about testing should keep it to themselves along with that other pack of morons promoting “its your fault” science.



Trying to reduce testing when type 2 diabetes rates are doubling and tripling is simply moronic, stupid and unhelpful. Such crap is a disgrace.
3801-Insulin_why_meds_fail.doc (246 KB)

14

On the appeal side:

Get a software program that can download your fingerstick machine and print out log of readings. Generally what is asked is for a 20 day period and show all readings - failed, good, bad. That will simplify task.

Freestyle lite and Nova each have software making his task less oderous.

Nova seems in my mind to have best package for fingerstick machines and allows one to enter readings for other machines by hand.

Its reports are excellent.

There is always a reason to run more extensive testing especially for those who have never seen the picture
of their BG through out day and night to get accustomed to.

The number of strips needed really is a personnal situation where one feels comfortable with body action and BG readings.

How the nurse pratitioner arrived at her conclusion, I simply cannot comment as i do not have full picture.

Except that 1 to 4 strips a day do not necessarily give the most important party to the Ball - the patient a good, descriptive picture and concerns about carbs and meal actions as well.

Being willing to test more frequently and history doing so should be the overridding guide.

Wetting ones finger and sticking into air once a day doesn’t tell one anything.

Who is paying for strips - insurance and who pays nurse - same insurance.

Best wishes, good luck and for commenting.

15

Medicare will only give up to 3 test strips a day to people using insulin. If you want more than that, you have to provide logs. Your state’s Medicaid program is really just following Medicare guidelines. I have been on Medicare since December, 2007 and I have never had a problem getting test strips. I am not angry at the people making the rules and wanting the logs to prove that I test. I am angry at the people that get strips thru their insurance and turn around and sell them on eBay – those are the people that are causing the problems for people that actually use the test strips.

A doctor or nurse telling someone they don’t need to test is a totally different story. Those people should be taken out, have some choice body parts chopped off and never be allowed to treat another diabetic again.

16

Will try again - as original post got lost in space. I’m angry at what you are being told. I have a feeling you are perhaps a T2 from some of the respones - but that shouldn’t make a difference - you want to take charge of your health so that is a good thing. I mentor diabetics - and trying to get some of them to test once a week (this was a T1) made me angry - and our provincial plan here in Quebec covered them for blood testing (they found it painful to test - despite my showing them proper technique). Another person I’ve been mentoring - who is trying to complete her A levels in UK - has been now been told they will only be able to get 50 test strips a month (compared to 150). That is appauling. Sadly, both parents don’t have work that has private insurance coverage - so they have to rely on the NHS. Hope you win your battle Cathy - alot of us are fully behind you!!