50 Things You Need to Know about Diabetes. Kathleen Stanley

You are unable to eat (nausea, vomiting, diarrhea, other) for more than 6 hours

      

You have missed more than one dose of diabetes medication

      

You are spilling moderate (or greater) ketones, or cannot clear trace/small ketones

      

You have symptoms of diabetic ketoacidosis (DKA) if you have type 1 diabetes

      

You are having “runaway” high blood glucose levels for a few hours (starting at 200, then moving up to 300, then going to 400. Do I hear 450?)

       EMERGENCY SITUATIONS—TAKE ACTION

      If you are experiencing symptoms of a serious health problem, such as a serious injury, possible heart attack or stroke, or possible DKA, do not call your doctor’s office. Have someone take you to the nearest hospital or call your local emergency response center immediately.

       HOW TO CALL

      Find out what phone number to use for office hours and after hours. Some offices have a “triage” system where phone emergencies are called in and someone is appointed to call you back. Some offices have an automatic voice messaging/prompt system, which allows you to access someone by selecting a certain choice, even in emergencies.

       DON’T WAIT

      If you have been experiencing problems with your blood glucose for a couple of days, don’t wait until Friday night to call the after-hours support person. You may end up being connected to someone who is not familiar with your history and not associated with your regular crew. Don’t get mad if they require additional information (asking question upon question) from you in these situations. They are trying to do their best to make the right assessment of the situation, and they need your cooperation to get the right information.

       THE EMERGENCY ROOM IS NOT A SUBSTITUTE FOR YOUR REGULAR OFFICE VISITS

      It is important to stay on course with regular visits to prevent problems. If you run out of medication because of your lack of planning or knowledge of self-care, the emergency care center may cost you a fair amount of money, and you may still be referred back to your usual health care professional when they open the next day. Therefore, plan ahead for prescription renewals, attend classes to learn how to deal with problems, and keep regular appointments to avoid a Saturday-night trip to the local emergency room.

       BE PREPARED TO ANSWER QUESTIONS

      If you do need to call your doctor, be ready to answer the following common questions:

      

What type of diabetes do you have?

      

What is your current blood glucose?

      

When was the last reading (blood glucose) taken, and what was it?

      

What medications did you take today?

      

What medications are you taking for your diabetes management (actual name, dose, and timing)?

      

What have you eaten today? Can you hold down food?

      

Do you currently have a fever? For how long?

      

What is your pharmacy’s name and phone number?

      

What is your insurance company and policy number? (If you have secondary insurance, you will need the information on both.)

      

What are your symptoms and complaints?

      

Do you feel you need an appointment, or just need to ask a question?

      

What available phone number can you be reached at? (You may want to give a backup number of a family member or a friend if the information is urgent. Keep the phone on and available to receive the return call.)

      

If you feel you need to go in for a sudden visit, have you arranged transportation so that the appointment time can be made accordingly?

       MORE RESOURCES TO EXPLORE

       BOOKS

      Diabetes A to Z: What You Need to Know About Diabetes—Simply Put, 5th edition. American Diabetes Association; Alexandria, VA. 2003.

      YOU—The Smart Patient: An Insider’s Handbook for Getting the Best Treatment, by Michael F. Rozen and Mehmet C. Oz, with The Joint Commission. Free Press; New York, NY. 2006.

5 How to work with your insurance company

      Even though most people have had some complaint about their health insurance company at some point, they should consider themselves lucky. Millions of individuals do not have the luxury of having medical insurance in the U.S., even today. If you have diabetes, you will be utilizing your insurance benefits throughout your lifetime. You will need coverage for simple needs such as blood glucose meter strips, diagnostic exams, and, possibly, hospitalizations. Policies and plans vary from person to person, but all insurance companies share certain common characteristics. The best way to have a positive experience with your insurance company is to be well informed. This section is filled with tips that should help.

      

Do your research. Before choosing a a health insurance plan, research your options well. Make decisions based not just on your health as of today but what you anticipate your needs may be in the future. There may not be a perfect plan, but look at your needs, and the costs and access to services associated with each plan.

      

Curl up with a good policy. Familiarize yourself with your policy. Even though the brochures and paperwork they give you when you enroll are overwhelming, pour yourself a cup of tea, stretch out, and read every word. It is important to know the rules and guidelines to avoid frustrations later.

      

Stay in the loop. Read the policy updates you receive at work in the mail and stay current—most policies undergo several changes during the year. It is tempting to toss these updates,