Diabetes: Keep the diagnosis or drop it?

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Diabetes: Keep the diagnosis or drop it?


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Old 09-27-2016, 23:04   #1
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Default Diabetes: Keep the diagnosis or drop it?

OK:

Brief history: I was diagnosed end of 2014 with A1c of 7.0 and FBG of something like 150. This diagnosis came after a round of prednisone for a bizarre case of hives that lasted 9 - 10 months. (Never any explanation for those!) I was annoyed to find that prednisone can kick off diabetes - never had heard that!

Anyway, I went LCHF thanks to the folks on this forum, and my A1c was 5.5 at my first checkup, then 5.3, then 6.0, and latest was 5.5 again. My doctor is newish to me: I switched to her maybe 9 months after my diagnosis, and after my A1c had dropped into the 5s.

After my last appointment, I got an e-message from her telling me that she didn't think I was diabetic but prediabetic. I messaged her back concerned that if she drops the diagnosis, I won't be able to get test strips under my insurance. She said that she could go either way on dropping the diagnosis or keeping it, but that one advantage to dropping it is that insurance companies stop recommending lisinopril and metformin. (I currently manage my numbers with no meds, and have good BP and cholesterol numbers.)

So: If you were me, would you have the doctor DROP the diagnosis, knowing that if the numbers creep up, you could always renew the diagnosis of active diabetes? Or would you want to KEEP the diagnosis for the insurance coverage on the strips?

(To tell the truth, with my copay it's probably cheaper for me to just buy my own supplies on Amazon. I'm spending about $.50 per strip after paying my copay.)

I'd really love to hear what y'all think. I personally think it's a little irresponsible to tell people who have diabetes that they don't have it - folks NOT like me might go back to eating the way they used to. But if I plan on managing myself without a lot of help from my doctor (as I've been doing for two years), does the official diagnosis make a difference? Would NOT having a diagnosis on my records help me in any way, for future health or financial reasons?

Thanks in advance for any advice!

Mary

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Old 09-28-2016, 02:06   #2
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Once diabetic always diabetic (with great control). Dont know how the MD would un-diabetisise you.

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Old 09-28-2016, 03:05   #3
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What does it mean that the insurance recommends a med? Mine can recommend all day long, and so can my doctor. If I don't want it, I don't take it. It doesn't mean I'm non-compliant, it means I'm not a lab rat.

I'd personally love not to have been diagnosed, but I have been and I know I can't change that fact, irregardless of my current numbers.

Does being pre vs diabetic change the rates? Now that would sway me.

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Old 09-28-2016, 14:14   #4
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Who cares what the records say? Just look from every angle which is more beneficial to you. Don't forget things like life insurance, driving licenses, etc.

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Old 09-28-2016, 15:32   #5
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From what I remember using an A1c or blood sugar test using a meter is not a definitive proof of diabetes or not diabetes. From me they ran a Glucose tolerance test over a 3 hour period to confirm my diagnosis, even though my A1c was like 11.1 at the time.

Some on here frequently recommend an added test to see what form of diabetes you have, type 2, type 1.5, or type 1! Unfortunately I do not recall the technical name of this test, but you doctor would know by your description.

I think it would be very dangerous to assume you do not have diabetes, to later find out you do and your A1c is through the roof. As others have said, no such thing as prediabetic, you either have it or you do not! Many of us, me included, do not like this prediabetic term because it implies you can be cured, which in fact you cannot! Once you are diagnosed with it you will have it for the remainder of your life....

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Old 09-28-2016, 15:43   #6
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Quote:
But if I plan on managing myself without a lot of help from my doctor (as I've been doing for two years), does the official diagnosis make a difference? Would NOT having a diagnosis on my records help me in any way, for future health or financial reasons?
I am managing my diabetes pretty much on my own also. I've stopped the prescription strips and just buy OTC. I prefer to have a little need for a doctor as possible.

If your insurance will penalize you for a diabetes diagnosis, and you don't need the doc for strips Rx, then, for me, I would be motivated to drop the diagnosis.

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Old 09-29-2016, 11:27   #7
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Thanks for your responses! I definitely will weigh every angle.

I'm definitely not dropping my INTERNAL diagnosis... but I do (like VeeJay) like being the captain of my ship. My doctor has done nothing thus far to coach me in managing my BG (save the twice-yearly A1cs), and the only help I've really gotten has come from these forums.

Oh, except... my new insurance company sent me a booklet about diabetes, advising me to eat the same type and amount of carbs at the same time every day. Super helpful.

And yes, Div2Liv... it did occur to me to say to my doctor, "You know you've never run a glucose tolerance test on me. I'm pretty sure I can't pass it as a nondiabetic." I'm not sure they are even really aware of that tool: no one has ever suggested it for me.

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Old 09-29-2016, 11:48   #8
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Quote:
Originally Posted by mbc1963 View Post
Thanks for your responses! I definitely will weigh every angle.

I'm definitely not dropping my INTERNAL diagnosis... but I do (like VeeJay) like being the captain of my ship. My doctor has done nothing thus far to coach me in managing my BG (save the twice-yearly A1cs), and the only help I've really gotten has come from these forums.

Oh, except... my new insurance company sent me a booklet about diabetes, advising me to eat the same type and amount of carbs at the same time every day. Super helpful.

And yes, Div2Liv... it did occur to me to say to my doctor, "You know you've never run a glucose tolerance test on me. I'm pretty sure I can't pass it as a nondiabetic." I'm not sure they are even really aware of that tool: no one has ever suggested it for me.
A1C is easily done at home for about $20. OGTT is easily done at home for the price of 75g of glucose (or dextrose) plus the strips required, depending on how often you want to check and on how many meters. I do it at least once a year. The only thing they could give which isn't easy to do at home would be an OGTT with insulin assay but I don't think they usually agree to that anyway. That would be way to expensive to do at home because home insulin tests are single test and you'd have to do a bunch of them.

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A1C 11/2010: 5.1 (DX + 14 months)
A1C 9/2011: 5.6 (DX + 2 years)
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Old 10-09-2016, 03:11   #9
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I'm GLAD they "promoted" me from pre-diabetic to diabetic. It motivated me to take the whole thing more seriously and more assiduously to DO something about it, which I have done. What matters is the physiology, not some bureaucratically-determined statistical standard. I've had two uncles lose legs to this d-----d disease, and my mother can't feel her feet. I want to avoid that. The labels are helpful to the extent that they help in my efforts: that's all.

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