[s and t]

Originally Posted by 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.

[nurse educate]

Originally Posted by 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.

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'

[Hoozdo]

Originally Posted by 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.

[nurse educate]

Originally Posted by Hoozdo

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.

Well, now they know, since this has happened. But prior to this, they were living in a world of ignorance. Thanks to my ex husband, who was constantly on and off Atkins, I have a very good baseline of what foods have high carbs. Yesterday, my mother said to me, "do you know how much sugar is in raisins", to which I replied, "uh yeah....". You know that "healthy snack"? By no means am I suggesting he go on Atkins, but as I told my mother, you need to look at carbs, not just sugar, and you can't assume something like a banana is okay to eat because it is a fruit. She does that w/ my daughter. She loves applesauce. My mother thinks there's nothing wrong with it, forget that it is loaded w/ sugar.

Anyway, they're not really stupid people, just a little ignorant-my mom, that is. My dad just eats whatever she gives him (very traditional roles in that house).

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.

So they may cover it for type 2? I guess he'll find out.

It's ironic, but, my insurance does not pay for insulin

But isn't insulin fairly cheap?? We had a diabetic cat, and we had to pay for insulin (and the syringes actually), and I recall the needles costing more than the insulin. But his insulin lasted longer, I guess. I was a kid then. but I know insurance didn't cover anything

[mojorn]

From an FNP standpoint, I always rec a new diabetic pt check their blood sugars ac and hs for as long as they have >130 blood sugars, once they have consistent blood sugars <130 can back off to once daily done in a random manner, then if blood sugars remain under control they can back off to 3-4 times a week as long as the sugars remain <130, if sugars go up they have to go back to ac and hs, I also have them keep a food diary and bring it to me at every visit, I also compare the blood sugars with their Hgb A1C and that will tell the true picture
also most insurance companies will pay for monitor and strips and I always wrote the RX to read blood sugars QID and prn, that way they have a full month suppy and then if sugars are controlled they don't have to pay the copay monthly, also any monitor can be replaced free from the company, they make there money on the strips.
I also highly recommend Splenda,
hope this answers your questions
mojorn

[Hoozdo]

Originally Posted by nurse educate

So they may cover it for type 2? I guess he'll find out.



But isn't insulin fairly cheap?? We had a diabetic cat, and we had to pay for insulin (and the syringes actually), and I recall the needles costing more than the insulin. But his insulin lasted longer, I guess. I was a kid then. but I know insurance didn't cover anything

Oh yeah, insurance will pay for strips for type 2. Insulin now is about 35 bucks a vial. The vial is only good for 28 days. If you take two different kinds of insulin, (as I do), then you have 70 bucks out of pocket every month. The needles are pretty cheap....and the alcohol wipes - I always have some in my pocket from work

BTW, I have the same diabetic issues with my Dad. He eats whatever is put in front of him. 1/2 the time he forgets to take his meds. My Mom (the cooker) has no clue what foods have carbs. ay ay ay ay ay