Letters to the Editor
Thank You Once Again
Susan R. Wilk
Sound Beach, New York
We enjoy making sample copies of our newspaper available for educational events, diabetes fairs and at other related times. If anyone would like to obtain issues, please send us a letter. Be sure to describe the event and tell us how many people you expect to come.
I first got DIABETES HEALTH at our Diabetes Health Fair at Greenville Regional Diabetes Center. The January and February issues were excellent. I am an RN and we are parents of an 11-year-old with juvenile diabetes. Matt was diagnosed six years ago. Since then, I have been reading and attending classes to learn how to better care for my son. DIABETES HEALTH is one of the best "chuck-full-of-info" sources I've come across.
Judy Hoye, RN
I have type 2 diabetes and found Glucotrol to be ineffective. I found that my numbers did not change whether I took Glucotrol or not. However, I find that glucophage has significantly changed my numbers and helps me maintain a "closer-to-normal" range.
Joanna V. Martell
Looking for Recipes on an Electronic Cookbook
I was wondering if anyone has access to electronic cookbooks with diabetic receipes. I am a totally blind computer user and would like to get access to these if any are available.
Any information would be appreciated.
DIABETES HEALTH for the Blind?
Any suggestions for making information in your publication available to diabetics who are blind or have low vision?
Not yet. We invite readers to suggest the best way to go about this.
Seeking a Voice Module for a Meter
Regarding Veronica Elsea's column in the March 1996 edition of DIABETES HEALTH, is it in any way still possible to get a voice module for a One Touch II meter? My diabetic grandmother now suffers from a severe vision impairment and is totally dependent on my grandfather to tell her what the meter says. If any are still available, how would one get it?
In response to the same column in March 1996's issue, we offer these two answers. The first was received when we called LifeScan, while the second came from a reader at a diabetes supply company called MK Diabetic Support Services.
I've just read the letter from Veronica Elsea in the March issue of DIABETES HEALTH about blood glucose monitoring for the visually impaired and the blind.
Our company can provide a one-piece unit monitor that can speak in Spanish or English. It also has an earphone for testing privacy. Also, if the patient is insulin dependent, we can bill Medicare or the patient's private insurance.
For more information, please contact me at (800) 352-1783, ex. 106.
The One Touch II Meter company does not sell voice modules directly; instead they use a company named TFI out of Boston. They can be reached by calling (617) 242-7051. The cost is $189.00 for the voice module that works with this meter.
Be Well Informed About Your Insurance
As a diabetologist in a large multi-specialty group performing a significant amount of managed care, I found Kriss Halpern's story all too close to home [Feb. 1996]. He discussed concerns that people with diabetes have when it comes to getting the care you need.
It is my theory that the managed care insurers know well the needs of proper diabetes care, but are motivated by the fact that the turnover rate in the plan is so high that it is not in their financial best interests to invest in the long-term health of their enrollees with diabetes. Chances are that the cost of the complications will fall on another plan in the distant future. This completely ignores the responsibility of the health plans to provide ethical care to their clients.
Thus I feel that the risk of diabetes should be shared by the entire managed care system in a given state. We should organize and push politically for the "Standards of Care" outlined by the American Diabetes Association (ADA) to be mandated for managed care and then the actuarially calculated expense for this will be spread across the entire population of managed care members. This would put a stop to the jockeying and game-playing that is now going on and would make an easier case against providers and insurers who fail to adhere to these standards.
The individual can have a positive impact on his/her own care by obtaining a copy of the "Standards of Care" guidelines and insisting that the primary care provider either adhere to these guidelines or refer to a specialty manager who will take responsibility for proper care.
It disturbs me that the refusal of the health insurance industry to take responsibility for the benefit of their customers has to be replaced by a political solution, but if that is the only way the individual with diabetes mellitus can be insured reasonable care, then so be it! In managed care it pays to be an informed and assertive consumer. Hats off to Mr. Halpern.
William P. Croom, MD
A copy of the ADA's "Standards of Care" can be obtained, free of charge, by calling 1-800-DIABETES.
Praise for Using Overnight UL Insulin
After months of battling with overnight NPH and unpredictable results (no matter how precise we were) our ednocrinologist finally convinced me to try overnight UL with Ben, my son.
I was afraid of the long-term nature of it, so I went into it with a very reluctant attitude. But we have found it to be an incredible addition to our schedule.
We cut back both of Ben's regular doses by one half unit and his a.m. NPH by one half unit. We switched him from 1.5 NPH at bedtime to 1 UL at bedtime. I stayed up the first few nights, and found he would hit mid-70s around 4 a.m., so I'd wake him and give him a tad of milk. His fasting blood sugar was low 200s, though, so I finally stayed up the whole night and waited out the 70s. He did fine, coming up to 113 at 6:30 a.m.
We really love the UL addition now. It transfers a portion of his daytime insulin to a much slower insulin, so we are seeing longer periods of time at numbers like 83 and fewer fast drops from those numbers.
I thought I would report experiences in case there were other parents considering UL, but nervous about it like I was. But now, I am hoping to encourage other parents to use UL overnight. Sleeping now is wonderful. Peaceful. No worries about him dropping out. Beautiful fasting numbers. I love it.