[Ronman]

Hammer, I just wanted to chime in about the value of zinc when you are catching a cold. I saw a program on 20/20 or one of those news shows about a product called Cold-Eze about ten years ago. I was used to getting about 4-5 colds a year each of which would last up to two weeks. I thought that taking this product couldn't hurt and it has succeeded beyond my wildest dreams. I have had about 4 colds in the past ten years. Whenever I start getting that feeling that I am coming down with something, I start sucking on Cold-Eze and inevitably, I don't get sick. On the rare accasion I do get the cold, it lasts about three days at the most. Sorry if this sounds like a commercial. I have no stock in the company and I know that the major retailers have similar products with identical ingredients, but I always use the original product. Not saying it will work for everyone (sometimes I think it is pychological because I am a believer!), but if you get losts of colds, it would be worth your time to try it.

[Hammer]

Originally Posted by Ronman

Hammer, I just wanted to chime in about the value of zinc when you are catching a cold. I saw a program on 20/20 or one of those news shows about a product called Cold-Eze about ten years ago. I was used to getting about 4-5 colds a year each of which would last up to two weeks. I thought that taking this product couldn't hurt and it has succeeded beyond my wildest dreams. I have had about 4 colds in the past ten years. Whenever I start getting that feeling that I am coming down with something, I start sucking on Cold-Eze and inevitably, I don't get sick. On the rare accasion I do get the cold, it lasts about three days at the most. Sorry if this sounds like a commercial. I have no stock in the company and I know that the major retailers have similar products with identical ingredients, but I always use the original product. Not saying it will work for everyone (sometimes I think it is pychological because I am a believer!), but if you get losts of colds, it would be worth your time to try it.

Thanks for the tip Ronman. I rarely get a cold....maybe one cold every five years, and then it only lasts for maybe a day....two at the most. I read about zinc and how it can stop a cold that is starting, but you need to suck on a zinc tablet as soon as you think you're getting a cold.

The article where I read about it, was written by a doctor who had a little girl.(I think she was 4 or 5 years old). She started getting a cold with all the early symptoms, and the doctor tried to give his daughter her daily vitamins. She took them, but when he gave her a zinc tablet, she refused to swallow it and instead, sucked on it. The next day, her early signs of a cold were gone. This intrigued the doctor, so he began experimenting with zinc tablets and found that zinc kills the cold germs as they are trying to multiply in your throat, which is the central spot where your cold develops. As you suck on the zinc, you're killing germs before they get a chance to multiply and spread throughout your body. By holding off their ability to multiply and spread, your body has time to produce antibodies to fend off the cold.

Under normal circumstances, the germs multiply and spread a lot faster than the body can defend against them. Sucking on a zinc tablet keeps the germ population down. The thing is, if you wait too long, the germs will spread and the zinc won't do anything, so you need to suck on one as soon as possible. Even if you're a bit late with the zinc, sucking on one will make the cold less severe and last a shorter time.

[pegasus]

[quote=Hammer;327238]
I wondered about this also, so I've compared my morning reading (which has a little Dawn Phenomenon in it) and my before bed reading (which is after 6-8 hours of fasting), and the before dinner reading which was after 5 hours of fasting, and they are all similar....maybe 2 or 3 numbers different. There are many times when I'll go 4 hours between meals, and my before readings are always within a few points of my bedtime or first morning numbers. I took that to mean that the Lantus was keeping things at a constant level.[/QUOTE/]

Lantus is *not* perfectly level. It's peaks are significantly less than others like NPH or Ultralente, but it does have peaks. I knew it from my own experience, but my doc said it to me on his own. It's a boast of the maker.


[quote=Hammer;327238]No, actually I haven't. When I call his office, I talk to his nurse. She said, " Dr. XXXX recommends that you only test 3 times a day, since you're on Lantus." From that, I got the impression that she was acting on the doctor's instructions. I'll bring it up on my next visit. [/QUOTE/]

I wouldn't wait until your next visit. I would call the doc's office back. I always make friends with my docs' receptionists/nurses, sympathize with the pressure they're always under w/all the insurance paperwork or whatever's bugging them at the moment. So I'd say to the nurse, look, I appreciate that there are some studies that may show these things--and we know how hard it is to keep up with *so many* conflicting studies all the time--but especially since you've been changing meds, and since diabetes has so many varied complications, you've heard so much about how important it is to keep tight control, you just want to be extra careful and learn absolutely everything you can so you won't have to bug the doc w/lots of questions about what to do when you don't feel well ... etc. etc. etc.

It's no skin off his back to prescribe the strips you want, and if he doesn't, it's time to find someone who will.

[pegasus]

Here's an article cite that might help:

Clinical Diabetes 20:45-47, 2002

[Hammer]

I just got an e-mail from the doctor. I e-mail him my BG readings an I asked him about the test strips. He keeps saying that testing that often isn't necessary, and that I need to take a class for diabetics to teach me proper eating.(he's told me this several times.) I know what to eat, so this is rather frustrating.

He says that if I want to test more often, go ahead, only the insurance won't pay for the extra strips. Well, now I know that it's his recommendation to test 3 times a day, not his office's policy. Oh well....

[shake_sugaree]

Just a quick in-and-out "thanks!, everyone" post for the zinc tablet/Cold-Eze info.

[Hammer]

This is what I'm up against when wanting to test more often and the doctor refusing to give me a prescription for more strips.(under the "When To Test Your Blood Sugar").

[Hammer]

Since this concerns test strips, or more accurately, the elimination of them, I thought I'd use this thread to ask if anyone has heard anything recent about the infra-red BG monitors that you place near your eye to get a reading. They don't require a blood sample, so you don't use any strips, there's no lancing of the fingers, and it's accurate enough to be comparable to the existing methods.

I keep reading the same old articles mentioning that they should be out by 2009, so I wondered if anyone else had read any updates on them. It would be nice to have a meter that you could use to test your BG as often as you wanted without needing to buy a load of strips. Heck, you could test every hour if you wanted.

Anyone heard anything more about them?

[pegasus]

Originally Posted by Hammer

I just got an e-mail from the doctor. I e-mail him my BG readings an I asked him about the test strips. He keeps saying that testing that often isn't necessary, and that I need to take a class for diabetics to teach me proper eating.(he's told me this several times.) I know what to eat, so this is rather frustrating.

He says that if I want to test more often, go ahead, only the insurance won't pay for the extra strips. Well, now I know that it's his recommendation to test 3 times a day, not his office's policy. Oh well....

Try this on him, from the NIDDKD:

especially pp 8-9, 14, and 19.

SOBs. Maybe you should check directly with your insurance plan. I'm assuming (from our previous thread) that it's a UAW plan--there should be someone there who can help.

[pegasus]

Sorry--the link didn't come out. I'm tracking it back; will post when I get it.

[pegasus]

I can't seem to put in the link, but here's the relevant cite and text:

Department of Health and Human Services
National Institutes of Health
National Institute of Diabetes, Digestive and Kidney Diseases

Report on Closing the Disparity Between
Hemoglobin A1C Treatment Guidelines and Practice

p.8
Notable Barriers to Achieving HbA1c Less Than Seven Percent: Control of diabetes is highly burdensome both in terms of its economic costs and the human effort required to achieve recommended levels of glycemic control. Moreover, glycemic control, the subject of this report, is only one of the aspects of diabetes care proven to reduce complications. Patients and care providers must also strive to achieve recommended levels of blood pressure and cholesterol control.

Managing blood sugar, blood lipids and blood pressure may each require use of multiple medications. Because individuals with diabetes may therefore require 10 or more medications taken multiple times daily, adherence to prescribed medications can be costly and challenging. Some of the most important barriers to achieving recommended HbA1c levels are
essentially financial rather than medical. As noted above required medications are costly, as are supplies for testing blood glucose levels at home, a key component of glycemic management for many patients. The demographic data in
the preceding section indicate that lack of health insurance and/or lack of access to health care are critical barriers to good diabetes management. The problem is particularly serious because type 2 diabetes is increasingly a disease of the poor,
and because previously diagnosed diabetes may make it harder for a person to obtain health insurance. Even among people with health insurance, reimbursement practices do not always favor aggressive management of blood sugar levels. Patient education on diabetes self-management and nutrition has been a key component of the clinical trials which demonstrated that improved glycemic control reduced complications of diabetes.

Diabetes education requires substantial provider time that may exceed what can be accommodated or reimbursed in typical health care settings. It has been reported that reimbursement is more often provided, and more likely to cover actual provider
time spent in patient care, for expensive procedures like dialysis and limb amputations required after complications have developed than for relatively inexpensive preventative care, such as visits to nutritionists. A major barrier to the practice of intensive glucose control with medical therapies, such as insulin, is the potential for acute episodes of hypoglycemia (low
blood sugar). Fear of hypoglycemia may discourage patients from aggressively managing their diabetes with these methods, and may discourage some physicians from prescribing them. Using these medications properly requires careful regulation of nutrition and physical activity, along with frequent self-testing of blood sugar, typically by pricking a finger, which can be both burdensome and painful. Insulin and some other diabetes drugs are taken via injection, which may cause discomfort and serve as a barrier to control. Further medical barriers include accompanying medical conditions such as mental health problems or alcohol or drug dependency that may increase the risks of medication use and affect adherence to therapy. Other side effects of diabetes therapies such as weight gain associated with insulin and some oral medicines, also limit the
acceptability of these therapies.

An additional compounding problem is that of “clinical inertia,” defined as the inadequate intensification of treatment in response to worsening symptoms. While there is evidence that providers are improving at meeting guidelines for measurement of HbA1c in patients with diabetes, they may not appropriately
intensify care when this measure is above the threshold for taking action. For example, one study found that doctors delayed prescribing insulin for as long as possible (Diabetes Care 28:2673-2679). Another found that African American patients with diabetes were less likely to receive aggressive therapy to lower their HbA1c in a standard primary care practice than they were in a specialty diabetes clinic, even though the average HbA1c of the patients in the general practice clinic was significantly higher than that in the diabetes clinic (Diabetes Care 31:564-571). Another study showed that although by several criteria the disparity between care obtained by white Americans compared to African Americans is
narrowing, it continues to widen in the area of diabetes management (N Engl JMed 353:692-700).

(P. 14)
Overcoming Financial Barriers to Diabetes Care: As noted above, recent data from NHANES indicate a significant disease management disparity between insured and uninsured people with diabetes. Programs that either directly or indirectly increase the insurance rate among people with diabetes can thus be expected to improve blood sugar control within the population. Further, programs which help to fund or to lower the cost of diabetes medicines and supplies for people with diabetes would be expected to make it easier for those with and without insurance to lower their blood sugar, effectively reducing the human and financial burdens of later complications. Because Medicare benefits are often used as a model by other insurers, diabetes coverage by Centers for Medicare and Medicaid services (CMS) can have an effect which extends even beyond those eligible for CMS-funded programs. Of note in this regard is coverage for testing
for diabetes and for nutrition and diabetes self-management education.

(P. 19)
Conclusion
A substantial body of research exists to highlight the importance for people with type 2 diabetes of adhering closely to established guidelines for good glycemic control. Data on diabetes management clearly indicate, however, that the majority of Americans with diabetes do not meet those guidelines, a fact with grave implications for the future health and health-care costs of tens of millions of Americans. This report describes many of the reasons why achieving good
glycemic control can be challenging for people with diabetes, and suggests some approaches that government can take to help overcome these challenges.

[Hammer]

Thanks for posting the cite and text. I'll take a copy of it with me when I see my doctor again. I doubt he'll budge though. I was talking to the nurse there and she said that it's not recommended that you test all that often if you're on Lantus and Byetta. She said that the doctor was telling her (and she agreed with him) that testing more than 2 or 3 times a day created unnecessary worry for the patient.

She said that if I took a nutrition course that the local hospital offered for diabetics, I would know what foods to eat and that made testing often unnecessary. By taking Lantus, my basal BG numbers only needed to be checked once a day....before breakfast or before bed. By taking Byetta, I only needed to check once after my biggest meal (usually dinner). I might possibly want to test after breakfast, since I'd have taken Byetta before eating that also. So 2 or 3 times a day was sufficient to obtain the BG numbers I needed.

No matter what I suggested, they said the same thing....I needed to take the hospital course to learn how to eat, then I wouldn't need to test that often.

The way my insurance works, they submit a form to the doctor and he fills in what I need for my testing supplies. I never see the form. It's mailed directly to him. When he first received the form, it had 7 tests a day listed. When he saw that, he changed it to 3 tests a day.

The reason that it originally had 7 tests a day was because I told the receptionist at the doctor's office that I was testing 7 times a day. Apparently, after I called the durable medical goods provider (which is who I have to go through to get my supplies mailed to me, since there isn't any place nearby that my insurance deals with), they called the doctor's office and talked to this receptionist. She called me while the medical goods provider was on another line, and asked me how often I test. That's when I told her seven. She told the medical goods provider seven, and they sent me a box with supplies for seven tests a day for one month.

The medical goods provider then mailed a form to the doctor, and that's when he saw the 7 tests a day and changed it to 3. The medical provider said that since I needed more than 6 strips a day, I needed to keep a log of each test I did and to mail it to them at the end of 30 days to have the insurance pay for them. Since the receptionist told them I was using 7 strips a day, they would cover them for one month, but since the doctor changed them to 3 a day, they would then send me 3 a day after that.

The medical goods provider was at first going to charge me for those extra 4 strips a day. If they tried to do that, they'd have had a war on their hands. I'd have sent them back. They charge a ridiculously high price for the strips. I was buying my own strips for $60 per 100. They charge $200 per 100. What a ripoff.

[Petruchio]

Hammer,

Can you shop around for another Dr?

[Hammer]

Originally Posted by Petruchio

Hammer,

Can you shop around for another Dr?

I've thought about that, but I've got this one broken in. Aside from this test strip thing, we get along like old buddies. He's easy to talk to, and he doesn't bug me about things. By that I mean that, once he's discovered yet another ailment I've developed, we'll discuss it, and if I don't care about what it is or what it will do to me, then he gets the idea and doesn't mention it again.

When he found that I had diabetes, he gave me all this literature, a prescription for metformin, and he scheduled several more tests. I filled the prescription for the metformin, and when I found it bothered my stomach, I threw it away. I never read the literature, so I threw that away also. I also cancelled all the tests he scheduled. I wasn't interested in my condition, and I told him that the next time I saw him.

Whenever I'd go to his office to see him about an unrelated matter, he'd try to set me up to do some more diabetes related tests. I told him not to bother because I wouldn't go. He'd fill out the forms for me to take to the hospital anyway, so I'd throw them in his trash can on the way out.

When he saw that I really didn't care about my condition, he stopped bugging me. Most doctors think they're god and to not listen to them is a sin. My doctor isn't like that...that's another reason I like him. I guess that he found it hard to believe that I wasn't the least bit interested in my diabetes. I have it, so what? That's why it's hard for me to understand why a lot of people get so depressed when they are diagnosed with it. To me, diabetes is no big deal, so what's there to get depressed about?

Keep in mind that before I found him, I never had a family doctor. I'd just go to the hospital when I needed medical attention. My philosophy was always, "If I'm paying for it, he'll see me on my time. I'm not going to make an appointment and have to wait two weeks before seeing a family doctor....I might be dead by then."

Many years ago, I needed to get the nicotine patch. Back then you needed a prescription for it, and unless the doctor was your family doctor, they didn't want to prescribe it. I needed to get a family doctor, so I called the physician's referral service and was told there were no physicians in my area that were accepting new patients. They told me to call back in a year or so, and maybe by then there would be some new doctors.(I guess if I had diabetes back then, I'd have died before I had been diagnosed.)

Two years later, I called and they gave me several new doctors names, so I asked them which one was the youngest, and they told me him, so I went to him. I'm sure there are many more new doctors in this area, but I don't like change so I'll just stay with him. I figured that with my three strips a day allowance, I might test every other day, that way I'd still get to do 6 tests in one day.

[pegasus]

Originally Posted by Hammer

I've thought about that, but I've got this one broken in. Aside from this test strip thing, we get along like old buddies.

I don't like change so I'll just stay with him. I figured that with my three strips a day allowance, I might test every other day, that way I'd still get to do 6 tests in one day.

Well, one easier option might be to ask him to recommend an endocrinologist in the area, who'd actually know about testing properly. From your post above, I'm guessing the idea of seeing any more docs wouldn't appeal to you (not an approach I'd recommend, but if you're content ... ), but if you can get one who'll prescribe 10 strips a day (mine did) you could see him even less often (mine also will fax them in without a visit, if I need it).

I find it bizarre that he'd recommend all those other tests that you reject, and the one test (or series) that you're willing to do, he won't help with. That's really pretty friggin' weird.

Have you tried *that* argument? That here you're finally showing some interest in taking care of your health and he won't help ? Guilt: the world's equal opportunity motivator