Reply to Emily

Emily

Thanks for getting the information directly from the State. I see I miss-spoke about the claim period for those with insulin, which is good. I might be wrong, but in talking to

I was informed about the situation by Alameda County Medical Center, who is writting letters against it. Their primary concern was for pregnant and diabetic women of that age group, pointing out that they often have to monitor their "blood glucose levels 4 to 8 times daily, whether or not they are on insulin or oral hypoglycemic medications. Therefore this number of test strips (150 strips-90 day period for women on insulin and 100 strips -90 day period for those not on insulin) is an insufficient amount of strips to insure good control and optimal pregnancy outcomes." This is just one of the conditions that may be problematic for these standards.

Diabetics are a diverse group. Providing one standard for all will not work and means greatly increasing the need for documentation by the medical providers to cover all the needed variances. You are increasing demands on the medical professionals and your agency in time and costs. Even splitting between those on insulin and those not, is not sufficient.

I have achieved good control without medication via diet and exercise. But it is often a delicate balancing act and usually have to monitor my BG 2 to 4 times a day to keep things in line.

There are other situations that will come up unexpectantly for most people. Periods of illiness, stress(finacial, job, relatives, family problems etc), travel, unexpected need to exert oneself intensively and a host of others. These are usually not predictable and it’s not realistic, nor a wise use of medical dollars to require diabetics to run to the doctors to make-up for shortfalls that these incidents may cause.

I understand that a doctor (backed up by a pharmacist) can provide documentation, which also does not seem like a wise use of medical resources. The need to renew the requirment periodically is a problem. I get to see my Doctor every 6 months for 20 minutes and he is very hard pressed to take care of the problems I have, let alone provide additional documentation. And I understood that the claim period for non-insulin-users is 90 days, not 6 months. Increasing paper-pushing time, just to offset an ill considered policy doesn't seem efficient use of valuable resources.

Diabetes is largely self-managed. Doctor’s time and resources are not available on a day to day basis, or even month to month basis to provide the level of detailed management that this would require. Restricting the ability of diabetic’s to self-monitor and make necessary adjustments is extremely ill-advised.

I guess I am sensitive to this issue, because in a small support group I belong to, the issue has come several times with several people on private insurance who are having a devil of a time of controlling their DM. I had to give up on helping one person make a transition to diet and exercise control because they couldn't get and could afford additonal tests strips (also limited to 1 a day by their insurance).

Diabetes is a challenging chronic disease & possible complications are far more costly, than cost of properly monitoring & controling it. Diabetes related diseases account for 30% of medical costs and are going up. That is aside from the human suffering from the complications. Doing anything that might lead to increased problems seems very shortsighted.

I know from talking to Pansy that they are doing this because people have abused the system and are selling back excess testing strips. Shame on them. But I assume a very small minority of diabetics abuse the system. It’s neither fair, nor wise to greatly punish those who are trying to manage this chronic disease, as best as they can because of a few bad apples. (Throwing out the baby with the bathwater etc.). And the wasted costs of the excess strips has to be offset by the increased bureauracy and potential suffering.

There has to be a better way. Its really too bad that the State decided to not open the issue up to public input - or even try to put the word out.

Brent