I recently came back from my quarterly check up at my endocrinologists. I should be very happy. He checks my A1c and it is 5.7. He asks me how many significant hypos I recently had and I reply "zero". He looks at me slightly confused, then goes on to mumble "..that is quite unusual..!" I smile and say:" Thank you!" Then I try a joke: "Well maybe I m not really a diabetic.." My attempt backfires. For a moment I can see him thinking, then he looks at the computer. "I can see we measured your c-peptide and antibody count, so I must assume you really are diabetic and dont come here to get prescriptions to later sell test strips over the internet!"
Now we arrived at his favourite subject matter: me and my test strips. Every time I see him he somehow manages to make me feel guilty about how much I am testing. Even when he tells me "you should be happy, not many diabetics are as fortunate as you with their A1cs and hypos", to me it sounds like "why do you believe you are entitled to a prescription of 200 strips a month when others have a harder time controlling their diabetes?"
This time he also tells me he recently got an email from some state health insurer recommending to only prescribe 500, not 600 test strips a quarter year from now on to Type 1s.
The problem is: They RECOMMEND it – the final decision lies with the endo. And he knows he has a budget for every one of his patients. (How it works in detail between insurer and doctor, I dont know. What I do know is the state health insurers in Germany continue to have more and more money available each annum, but keep making it harder for patients to get prescriptions they need. What I also know is, the more I test my BS, the better my control. The better my control is, less chances my health insurance will have to pay for my heart surgery when I m in my 60s – am I not being logical here???)
I refuse to feel guilty for the way I control my illness. I can live with "your insurance will only pay for 600 strips per quarter" – alright, I will buy some additional strips over the internet. But I cannot live with being afraid at any given moment my insurance could react to some new study which says "it is now actually enough for a T1 to test 3x a day" and my endo reacting by making it harder for me to get the prescription I have to be able to rely on.
I refuse to beg for what I need to manage my illness – in a country like Germany which is supposed to have a functioning social system with health care for everyone.
I refuse to feel guilty about being a responsible patient. And I refuse to apologise for my steady A1c in the 5 something region.
This is BSBS- (blood sugar bull shit)!