Blood Sugar Monitoring Dictated By Health Insurance Rules and Cost
Within 9 months of my diagnosis, I was living med-free. I attribute that to consistently checking my blood sugars, maintaining restrictive and scheduled meals, regular exercise, and whatever x factor (age, beta cells, luck) that allowed my body to do it. I lived a med-free life for almost three of the six years I have been living with type 2 diabetes. While I enjoyed being able to manage diabetes without medication, it wasn’t easy. One of the hardest parts was being encouraged to check my blood sugars less often and fighting a losing battle with insurance companies to get enough test strips.
Why not check blood glucose often?
Today, I’m on oral meds and maintain a A1C less than 6.5 but more than 5.5. According to my insurance company’s rules this means that I am allowed to have 50 test strips per month. When I was managing med-free (A1C consistently 5.5 or less), I wasn’t given any test strips. My efforts to explain that my numbers were low because I checked my blood sugars multiple times a day were in vain. I gave up on requesting more as none of my phone calls or letters reaped positive results. Even now, I am grateful for the 50 test strips I get monthly, but it’s not nearly enough to last a month.
I used to wonder why many of the type 2 people I came in contact with didn’t test their blood sugars often, but over time, I have come to understand. Each of the four endocrinologists I have had has said some version of “you don’t have to test so often.” However, it’s a catch 22 because these are the same people that are cheerleaders for lowered A1C results. When I explain that I am doing better because I test often and can make informed decisions about food choices when I know my blood sugar levels, they say they understand but must work within the parameters of insurance guidelines.
I think it’s unfortunate that I’ve had to pay more than $100 per month on test strips in order to get the data that I need to live and manage diabetes in a way that I feel most comfortable. I wish unlimited test strips could be a right that every person living with diabetes has rather than divide us by medication types and A1C numbers.
Part of me wants to get back to those med-free days of yesteryear, if it’s possible, but I am also hesitant about the lifestyle and financial changes that it would bring. I would need to be more restrictive than I am now. As a new mother, I have chosen to prioritize the spontaneity of parenthood over being extremely strict about my diabetes management. For example, this morning I ate three spoons of cereal with a big smile on my face followed by singing “Yummy, yummy, get in my tummy” after each bite. This was done in an effort to get my daughter to eat her breakfast. I didn’t think about how those three spoons would affect my blood sugar, but I know that there was an impact. When I was living med-free, I would never eat outside of my scheduled meal time nor would I eat or drink something without calculating the carbohydrates. The biggest reservation I hold is based on the financial impact it would have on my monthly budget. Adding a couple of hundred dollars for diabetes expenses on top of daycare expenses would be a squeeze that I’m not ready to embrace.
So, presently, I am managing as best I can in the face of advice, insurance rules, and financial costs that encourage me to test my blood sugar much less than I do. However, I know the benefit of testing often and so I am still doing it, even if I am not advised to.
What aspect of diabetes management do you struggle with most?