The Power to Control Diabetes is in Your Hands
Information About Diabetes and Related Medicare Benefits
What is diabetes?
Diabetes is a serious disease. It means your blood glucose (often
called blood sugar) is too high. Your blood always has some glucose
in it because your body needs it for energy. But too much glucose
in your blood is not good for your health.
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Why should I control my diabetes?
If you control your diabetes, it can help you feel better and stay
healthy. Keeping your blood glucose close to normal lowers your
chances of having heart, eye, kidney, and nerve problems. To control
your diabetes, you need to know your blood glucose numbers and your
target goals.
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Why should I check my blood glucose?
Checking your blood glucose levels will help you control your diabetes.
It will also help you and your doctor or health care team to make
changes to your treatment plan.
You can check your own blood glucose to see what your
levels are. Food, medicines, physical activity, sickness,
or stress can affect your levels.
Ask your doctor or health care team about checking your
blood glucose levels.
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How do I check my blood glucose levels?
Ask your doctor or health care team to teach you how to use your blood glucose meter.
You use a blood glucose meter and a lancet (a tool to
get a drop of blood) to check your own blood glucose
levels. You do not have to go to the doctor’s office
to do it.
To check your own blood glucose, use a lancet to get a drop of blood. The meter will use the blood to give you a number.
This is your blood glucose level.
There are many types of meters. Some meters are made for people
who have trouble with their eyes. Some take blood samples from the
finger or other parts of the body. Each meter works differently.
Be sure to read the papers that come with your meter. Ask your doctor,
pharmacist, diabetes educator, or other health care team member
to show you the right way to use your meter.
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What should my blood glucose levels be?
Set your blood glucose goals with your doctor or health care team.
Write down your results, and show them to your health care team.
Ask your doctor or other health care team member what type of
blood glucose meter you have. Some meters measure whole blood and
others measure plasma values. Your blood glucose goals will depend
on the type of meter you have. Most new meters give the results
as plasma values. For most people, their levels should be:
|
Plasma Values |
Whole Blood Values |
Before meals |
90-130 |
80-120 |
1-2 hours after meals |
below 180 |
below 170 |
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Talk to your health care team about how often to check your blood glucose.
How often should I check my blood glucose?
Your doctor will tell you when and how often you need
to check your glucose. It is usually checked before meals,
after meals, and sometimes at bedtime. People who take
insulin usually need to check their glucose more often.
What should I do with the results when I check
my blood glucose levels?
Ask your doctor or health care team to give you a journal or log
to keep track of your blood glucose levels. Write down your number
each time you check your blood glucose. Make a note of things that
seem to change your glucose levels, such as eating too much or being
sick. Use the results in your journal to make changes to your diet
and physical activity as needed.
Call you doctor if your blood glucose numbers are higher or lower than your goal levels for 2 to 3 days.
Share your glucose levels with your doctor or health care
team. They will help you make a plan for keeping your diabetes
under control. Ask your doctor or health care team what
to do if your numbers are higher or lower than your goal
level. They may suggest changes to your diet, physical
activity, or medicines.
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What can affect my blood glucose levels?
Things that make blood glucose too HIGH:
Eating more than usual
Eating foods high in glucose (sugar)
Exercising less than usual
Stress
Sickness
Taking certain medicines
Not taking your diabetes medication
Things that make blood glucose too LOW:
Eating less than usual or delaying or skipping
a meal
Exercising more than usual
Taking more insulin than needed
Taking too much diabetes medication
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What other numbers do I need to know to control
my diabetes?
People with diabetes are at high risk for a heart attack or stroke.
So you need to control your blood pressure and cholesterol numbers,
too. Be smart about your heart. Take control of the ABCs of diabetes.
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What are the ABCs of diabetes?
A is for the A1C
test.
The A1C test is a simple lab test that reflects your
average blood glucose levels over the past 3 months.
It is the best way to know how well your blood glucose
is controlled overall. This test used to be called hemoglobin
(pronounced he-mo-glo-bin) A–1–C or H–b–A–1–C.
You should have this test at least twice a year. The
goal for most people with diabetes is below 7.
B is for blood
pressure.
The blood pressure goal for most people
with diabetes is below 130/80.
High blood pressure makes your heart work too hard.
It can cause a heart attack, stroke, or kidney disease.
Ask you health care team what your blood glucose goals are before meals, after meals, and at bedtime. Write them down.
C is for cholesterol.
The LDL cholesterol goal for most
people with diabetes is below 100.
Bad cholesterol, or LDL, can build up and clog your
blood vessels. It can cause a heart attack or stroke.
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What diabetes benefits does Medicare cover?
Medicare helps pay for diabetes self-testing equipment and supplies,
including blood glucose meters, test strips, and lancets.
In the Original Medicare Plan, also known as "fee-for-service"
Medicare, you only have to pay 20 percent of the Medicare-approved
amount after the Part B deductible. If you are in a Medicare
health plan, see if there is a copayment. Either way,
remember that Medicare pays for part of the cost of your
diabetes equipment and supplies.
To get your diabetes equipment and
supplies paid for under Medicare, you need a prescription
from your doctor. The prescription should say:
You have diabetes
How many test strips and lancets you need in
a month
What kind of meter you need (for example, if
you need a special meter for vision problems, your doctor
should say that and the medical reason why you need it)
Whether or not you use insulin
How often you should test your blood glucose
Keep in mind:
You can pick up your supplies at your pharmacy,
hospital, or clinic.
You can also order supplies from a medical equipment
supplier. But YOU must be the one to order them.
-
YOU must request refills of diabetes supplies. Do not accept
shipments that you did not order.
You will need a new prescription from your doctor
for your lancets and strips every 6 months.
Medicare also covers diabetes
self-management training and medical
nutrition therapy services.
Diabetes self-management training helps you learn how to control your diabetes. Your doctor
must prescribe this training for you. A diabetes educator
will show you how to:
Manage your blood glucose
Make good choices about nutrition and physical
activity
Prevent and treat problems from diabetes
If you receive blood glucose meters, test strips, or lancets from a supplier without ordering them, Medicare will not pay the cost.
Your doctor will give you information about where to get
diabetes self-management training. You can check with the
American Diabetes Association at
1–800–342–2383
or visit the website at www.diabetes.org/education/eduprogram.asp
to find a Medicare-approved training program near you.
Medical nutrition therapy services help you learn which foods are best to eat and how much
food is right for you. Your doctor must prescribe these
services for you. A registered dietitian or nutrition
professional will provide these services, which include:
A review of your current eating habits
How much to eat of what foods
Tips on how to manage your life and how to make
healthy food choices
Follow-up visits to check how well you are doing
with your food choices
Ask your doctor to refer you to a nutrition professional,
or contact the American Dietetic Association at 1–800–366–1655
or visit the website at www.eatright.org
and click on "Find a Nutrition Professional."
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Other Medicare Benefits
Medicare also helps pay for other services for people with diabetes
who have Medicare Part B. You should ask your doctor or other clinician
about obtaining these services:
Foot care. Medicare also
covers foot care if you have nerve damage in either foot
due to diabetes. It allows a foot exam every 6 months
by a podiatrist or other foot care specialist. You do not need a doctor’s
prescription for this exam.
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Medicare Prescription Drug Plans Begin January
2006
January 1, 2006 marks the beginning of Medicare prescription drug
plans. These plans may cover certain diabetes medications. Enrollment
in these plans begins November 15, 2005. For answers to your questions
about Medicare, visit www.medicare.gov
or call 1–800–MEDICARE (1–800–633–4227)
or 1–877–486–2048 for TTY users.
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Medicare Now Offers Diabetes Tests for People
at Risk for Diabetes
Since January 1, 2005, Medicare Part B covers diabetes screening
tests for certain people who are at risk for diabetes. People at
risk for diabetes may have high blood pressure, high cholesterol,
obesity, or a history of high blood glucose. Medicare allows up
to two screenings a year. For more information, visit www.medicare.gov
or call 1–800–MEDICARE (1–800–633–4227)
or 1–877–486–2048 for TTY users.
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Points to Remember
Learn the right way to use your blood glucose
meter. Ask your pharmacist, doctor, or another health
care team member to help you.
Write down all of your blood glucose levels.
Share them with your doctor or health care team at every
visit.
Ask your doctor about the ABCs of diabetes: A1C,
blood pressure, and cholesterol.
Do not accept shipments of diabetes equipment
and supplies that you did not order.
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Here are some questions you can ask your doctor
or health care team:
How can I control my diabetes?
Should checking my blood glucose be part of my diabetes
care plan?
How often should I check my blood glucose?
What are my ideal blood glucose levels? What levels
are too high or too low for me?
What should my blood glucose level be before I eat?
What should it be about 2 hours after I eat? What should
it be before I go to bed?
What is the correct way to use my meter?
What should I do if my readings are too high or too
low?
What are my A1C, blood pressure, and cholesterol values?
What are my goals?
Do I qualify for any Medicare benefits such as diabetes self-management
training or medical nutrition therapy services?
Are there classes to help me learn more about how to
control my diabetes?
Doctor’s name and phone number
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For more information about diabetes, contact:
American Association of Diabetes Educators
1–800–TEAM–UP4 (1–800–832–6874)
www.diabeteseducator.org
American Diabetes Association
1–800–DIABETES (1–800–342–2383)
www.diabetes.org
American Dietetic Association
1–800–366–1655
www.eatright.org
American Heart Association
1–800–AHA–USA1 (1–800–242–8721)
www.americanheart.org
Centers for Disease Control
and Prevention
1–877–232–3422
www.cdc.gov/diabetes
National Diabetes Education
Program
1–800–438–5383
www.ndep.nih.gov
National Heart, Lung, and Blood Institute
301–592–8573
www.nhlbi.nih.gov
National Diabetes Information
Clearinghouse
1–800–860–8747
www.niddk.nih.gov
National Kidney Disease Education
Program
1–866–4–KIDNEY (1–866–454–3639)
www.nkdep.nih.gov
For free information about Medicare’s
coverage of diabetes screening, supplies, and self-management
training, contact: Centers for Medicare & Medicaid
Services
1–800–MEDICARE (1–800–633–4227)
TTY/TDD 1–877–486–2048 (TTY/TDD)
www.medicare.gov/health/diabetes.asp
This booklet was reviewed by Carolyn Leontos, MS, RD,
CDE., Nutrition Specialist, Cooperative Extension, University
of Nevada Reno.
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U.S. Department of Health and Human Services
|
The
U.S. Department of Health and Human Services’
National Diabetes Education Program (NDEP) is jointly
sponsored by the National Institutes of Health
and the Centers for Disease Control and Prevention
with the support of more than 200 partner organizations.
www.ndep.nih.gov |
NIH Publication Number 00-4849
revised September 2005
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For more information on diabetes control, see National Diabetes Information Clearinghouse (NDIC) Publications.
To order printed materials on how to control your diabetes, call the National Diabetes Education Program automated phone line at 1-800-438-5383 or use the order form.
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