Diabetes questions...

  1. 0 [font="comic sans ms"]i feel like an idiot, but diabetes is not one of my strong points (except for all the complications i see with the patients that my students care for ). so i for ask the help of my colleagues.

    my dad was just diagnosed with type 2 diabetes. he seems okay with it, emotionally. he's 56, hx of htn and gout. had prostate ca 10 yrs age, but is doing well otherwise. so he's not completeyl paralyzed and devastated by the diagnosis (oh, he's also a paramedic, so he has medical knowledge).

    anyway, my mother has a lot of questions. her main concern is his diet, and she's the one who will insure he is compliant with his diet. he's never cooked a meal a day in his life, and my mother loves to cook. she's rounded up all these diabetes cookbooks, starting to read labels, etc. she also bought a 'cooking with splenda' cookbook. what is the deal w/ splenda and diabetes? i'm assuming it's okay. my only knowledge of splenda is with atkins.

    anyway, my other question is this (my mother asked me). should he be monitoring his fingersticks at home? i'm thinking he should, to some extent. definitely not q ac and hs, but just to have an idea (as my mother puts it). and if so, do insurance companies cover the cost of it for type 2? he's not on medicare (yet) or medcaid. but is it a justifiable expense? if not does anyone know how much they cost, and do you need a perscription?

    any other advice or patient ed. links would be greatly appreciated.
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  3. Visit  ProfRN4 profile page

    About ProfRN4

    ProfRN4 has '19' year(s) of experience. Joined Apr '03; Posts: 2,222; Likes: 1,270.

    15 Comments so far...

  4. Visit  rayofsunshine profile page
    0
    I'm a second semester nursing student and we just covered diabetes. It is very important that your dad do fingersticks at home. That way he will know what his baseline is and when he's getting into trouble. I think he should check it at least twice a day. I don't think you need a Rx for the glucometer and strips. I do know that the strips are quite expensive but it's something that he needs. I think some insurances cover them but you would have to check. I'm not a nurse yet, but I thought I'd try and answer your questions anyway.
  5. Visit  clee1 profile page
    0
    Quote from nurse educate
    should he be monitoring his fingersticks at home? i'm thinking he should, to some extent. definitely not q ac and hs, but just to have an idea (as my mother puts it). and if so, do insurance companies cover the cost of it for type 2? he's not on medicare (yet) or medcaid. but is it a justifiable expense? if not does anyone know how much they cost, and do you need a perscription?

    any other advice or patient ed. links would be greatly appreciated.
    my grandfather had dm-2, and he died from complications due to failure to maintain his bs level.

    many patients at the ltc i have been on rotation at have dm-2 and on accuchecks 3x week. your dad should monitor his bs levels; diet and exercise may not always be enough.
  6. Visit  KrysyRN profile page
    0
    I think I would contact your dad's doctor and find out if the doctor wants your dad to routinely monitor his sugar or keep some sort of log. I know some doctors aren't specific about how often to check, but at least he could give you his opinion.

    As far as glucometers and test strips, some insurances cover the cost of both, and some only cover the cost of the glucometer. Some doctors offices get free glucometers from companies to give to patients. Have your dad call his insurance company's customer service number to see what diabetes supplies are covered. Also see if diabetes education is covered. If it is, maybe your dad's doctor could write an order for it, and all of you could sit in on the classes. I've sat in on them before, and they are really beneficial.
  7. Visit  luvmy2angels profile page
    0
    He should definately be monitoring his blood sugar levels at home (wether the Dr recommends it or not) it is important to do that. Has he been put on any oral meds or insulin or does the Dr say he may try and get in under control through diet alone?? That is important to know as well.
    As far as the meter and strips go each insurance company has their own policy as to what they will cover. Most of them will cover the meter if they have a letter from the Dr stating that it is necessary to monitor at home. It is the same with the strips, some insurances companies will cover them, some won't. If you pay out of pocket it can range anywhere from $50-$80 for a box of strips (it depends on the type of meter you have).
    Good Luck to your dad!!
  8. Visit  Marylou1102 profile page
    0
    I am about your dads age and was diagnosed with typ II about 9 months ago. I go in every 3 months for a check. I get an Hgb A1C, CBC and Chol checked prior to the appt. The Dr. told me I didn't need to check my blood sugar at all, but the Nurse Practioner about had a fit. She has me check a couple times a week at various times and keep track. That way I know how I am doing with my diet. She said four or five times a week is all I need to do for now. I am on an oral med, I am assuming your dad is too.

    As for a monitor, the office should have some they can give him. That's where I got mine. They cost next to nothing. Its the strips where the companies make their money. They are expensive. He will need a script for those and most insurance companies will cover them at least partially.

    If there is a Diabetic counselor at one of your local hospitals your parents should try to get some teaching. They will probably need to be referred by the Physicians office. The insurance companies usually cover at least part of this too. They are a good referral source and will be able to answer your mothers questions. The American Diabetes Assoc. and the American Dietary Assoc. both have good web sites.

    I hope this helps. Good luck to your parents.
    Last edit by Marylou1102 on Feb 4, '06
  9. Visit  grannynurse FNP student profile page
    0
    I've been a diabetic for more then ten years and an insulin dependent one for four years. I learn something interesting, while my blood sugar is better control on insulin, it adds to my weight control problems. Oral drugs help to control my levels and even the flow of my insulin. I test my sugars four times a day because of my medications. As a new diabetic, it is strongly advised that you monitor your blood sugars four times a day. Your dad needs to meet with a diabetic nutritionist and a diabetic nurse educator. Generally health insurance will pay for his visit and Medicare will pay for a session once a year. Your parents should check with their local hospital for the availability of classes and most important, SUPPORT GROUPS.

    Grannynurse
  10. Visit  CardioTrans profile page
    0
    I agree that he should be checking his sugars. Some MD offices have monitors that they will give your dad for next to nothing. You asked about Splenda.... it is along the same lines as Sweet N Low or Equal, just tastes more like real sugar...doesnt have that funny after taste.

    You can go the American Diabetes Assoc and there are free magazines that they will send him that teach about diabetes, the complications, diet, exercise and sick day care.

    A good support group or educator is essential to him and will help your mom with learning how to cook for him.
  11. Visit  TheCommuter profile page
    0
    My mom and dad are diabetics (ages 48 and 49), as were all 4 grandparents. I also have plenty of other relatives who are diabetics, so there's a very strong history of it in my family.

    Your father should test his blood glucose at home at least twice daily. The splenda will help because it is a sugar substitute, meaning that your father can sweeten his foods without adding real sugar. Equal is another good sugar substitute. Your father might want to do 30 minutes of cardiovascular exercise at least 3 times weekly, because exercise uses up the excess glucose in his blood and turns it into energy (thereby lowering serum glucose levels).
  12. Visit  ProfRN4 profile page
    0
    So I have 9 different responses with 9 different opinions...very interesting.

    For the students who answered, thanks, but no offense, I do know all about the complications of diabetes, thanks to the enormous amount of patients that my students are assigned to. I guess I should have rephrased the question. I wanted to know what the standard is (and if there is one) for newly diagnosed type 2 diabetics. Is this soemthing that they immediately start doing? I was looking for someone, perhaps an expert (aka a diabetes educator) that had some more practical experience with it.

    As for the nutritionist, he will be consulting with one. Thanks for the glucometer and strip info, but I still have no idea whether or not he'll be covered. I was just looking for a consensus. Oh well...
  13. Visit  pugmum profile page
    0
    Quote from nurse educate
    i feel like an idiot, but diabetes is not one of my strong points (except for all the complications i see with the patients that my students care for ). so i for ask the help of my colleagues.

    my dad was just diagnosed with type 2 diabetes. he seems okay with it, emotionally. he's 56, hx of htn and gout. had prostate ca 10 yrs age, but is doing well otherwise. so he's not completeyl paralyzed and devastated by the diagnosis (oh, he's also a paramedic, so he has medical knowledge).

    anyway, my mother has a lot of questions. her main concern is his diet, and she's the one who will insure he is compliant with his diet. he's never cooked a meal a day in his life, and my mother loves to cook. she's rounded up all these diabetes cookbooks, starting to read labels, etc. she also bought a 'cooking with splenda' cookbook. what is the deal w/ splenda and diabetes? i'm assuming it's okay. my only knowledge of splenda is with atkins.

    anyway, my other question is this (my mother asked me). should he be monitoring his fingersticks at home? i'm thinking he should, to some extent. definitely not q ac and hs, but just to have an idea (as my mother puts it). and if so, do insurance companies cover the cost of it for type 2? he's not on medicare (yet) or medcaid. but is it a justifiable expense? if not does anyone know how much they cost, and do you need a perscription?

    any other advice or patient ed. links would be greatly appreciated.
    two of our friends (male) were diagnosed with type 2 diabetes in the last year. one is 53 and the other 54. both also have histories of htn, and one is overweight by about 100 lbs, the other by 30. at the beginning, both monitored sugars every 2 days. the one who is 100lbs overweight is a desert junkie, and uses splenda for his sugar sub!
    they see different doctors and each is followed regularly. one continues to check q2days, the other no longer checks since he lost the 30 lbs. when newly diagnosed each were told to monitor sugars regularly for several months to learn what types of foods caused the most fluctuation in their blood sugars. sorry, but i can't help about the strip/glucometer question and if its covered by insurance.
  14. Visit  ProfRN4 profile page
    0
    Quote from sickandtired
    two of our friends (male) were diagnosed with type 2 diabetes in the last year. one is 53 and the other 54. both also have histories of htn, and one is overweight by about 100 lbs, the other by 30. at the beginning, both monitored sugars every 2 days. the one who is 100lbs overweight is a desert junkie, and uses splenda for his sugar sub!
    they see different doctors and each is followed regularly. one continues to check q2days, the other no longer checks since he lost the 30 lbs. when newly diagnosed each were told to monitor sugars regularly for several months to learn what types of foods caused the most fluctuation in their blood sugars. sorry, but i can't help about the strip/glucometer question and if its covered by insurance.
    [font="lucida sans unicode"]i'm curious to see how much weight my dad will be advised to lose. he defititely should lose some (well, more than some). honestly, i have no idea how much he weighs, there are some things my parents never seem to discuss w/ me (like how much $$ they have and their weight)!! naturally, they started their new years diet last month, but their idea of dieting is so warped. my mom thinks anything that doesn't have sugar in it is healthy. i had to intriduce her to the concept of carbs, and how even fruit, may not always be 'good for you'
  15. Visit  Hoozdo profile page
    0
    Quote from nurse educate
    So I have 9 different responses with 9 different opinions...very interesting.

    For the students who answered, thanks, but no offense, I do know all about the complications of diabetes, thanks to the enormous amount of patients that my students are assigned to. I guess I should have rephrased the question. I wanted to know what the standard is (and if there is one) for newly diagnosed type 2 diabetics. Is this soemthing that they immediately start doing? I was looking for someone, perhaps an expert (aka a diabetes educator) that had some more practical experience with it.

    As for the nutritionist, he will be consulting with one. Thanks for the glucometer and strip info, but I still have no idea whether or not he'll be covered. I was just looking for a consensus. Oh well...
    Well, I think you have a consensus from the diabetic RNs - I am a member of that group.

    Yes, he should be checking his glucose every day. I would recommend 4x a day to begin with to see how he trends. After he is comfortable with how he trends and his med(s) are working I would recommend at least a fasting blood glucose test in the AM.

    Yes, he and your mom should attend a diabetic class. If he doesn't know what foods are loaded with carbs then there is no way he can make this work! He also needs to know how illness or stress can pop his glucose up.

    The more information he can get the better. A HgA1C would also be helpufl Q3 or Q6 months.

    I have never seen an insurance company yet that does not pay for test strips. They may be picky about what brand of strips they pay for though. I believe all insurance will pay for Accucheck strips since they are the most common. Personally, I use Free Style because you just need the tiniest bit of blood and you can poke your arms for it.

    It's ironic, but, my insurance does not pay for insulin
    Hope this helps you out.


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