What is the Treatment for Diabetes?
This article was updated on: 10/21/2018
Diabetes is a disease where your body doesn’t adequately control blood sugar (glucose) levels, because it doesn’t produce enough of the insulin hormone or doesn’t use the hormone efficiently, according to the National Library of Medicine. The National Institutes of Health (NIH) reports that having diabetes increases your risk for stroke and heart disease. But you may be able to reduce these risks by keeping your blood sugar, cholesterol, and blood pressure levels in check.
How can you manage and treat diabetes?
I’ve put together some steps recommended by certain organizations (as noted) to manage your disease.
First and foremost, seek advice from your health-care provider. Your doctor can set up screening tests and use the results to develop a plan with you to treat or manage your diabetes. The American Diabetes Association (ADA) recommends that you find a doctor who has a lot of experience treating diabetic patients.
Keep a close eye on your glucose levels. This is a vital part of diabetes management, according to the ADA.
The test for measuring blood glucose levels is called A1C, says the National Institutes of Health (NIH). The NIH recommends talking with your doctor about whether you should do this test at home, how often, and how to do it.
A glucose monitor or meter is the tool you’d probably use for home testing, says the ADA. Ask your doctor for specific instructions about when to test (whether before or after a meal, or both), and about the acceptable range of results so that you’ll know whether your results are out of the ordinary.
Be prepared with a plan in case your glucose levels are too low. Ask your doctor what glucose level would be the point at which you should take emergency action to avoid insulin shock (hypoglycemia), the ADA advises. The ADA lists the following as symptoms of hypoglycemia, which can develop quickly. This is only a partial list:
- Lack of coordination
- Dizziness or feeling lightheaded
- Sweating or chills
- Numbness or tingling in the tongue or lips
- Rapid heartbeat
If you believe you’re experiencing insulin shock, the ADA suggests that you eat or drink 15-20 grams (about half an ounce) of glucose or simple carbohydrates – these are sugars found in foods such as fruit, vegetables, and milk, and are quickly absorbed by the body, according to the NIH. The ADA says two tablespoons of raisins or one tablespoon of sugar or honey would equal about 15 grams of simple carbohydrates. Then, check your glucose levels again in 15 minutes. If your levels haven’t returned to normal, consume another half-ounce of simple sugars and follow your doctor’s directions.
Watch your blood pressure and cholesterol levels. The Centers for Disease Control (CDC) suggests you work with your health-care provider to check these levels and keep them under control. High cholesterol levels and high blood pressure put you at risk for heart disease – which is especially dangerous for diabetics, the CDC reports.
Eat healthy foods. The CDC recommends:
- Controlling your portion size of your food. Be aware of what’s considered a “serving size” for different foods, and how many servings you need.
- Eating less fat, especially trans fats and saturated fats.
Make sure you consult your health-care provider for guidance about nutrition.
Exercise. The CDC reports that exercise can protect your health in several ways. Physical activity:
- Helps control weight, blood pressure, and blood sugar
- Lowers your “bad” (low-density lipoprotein, or LDL) cholesterol levels
- Raises your “good” (high-density lipoprotein, or HDL) cholesterol levels
- Improves your circulation, helping protect your heart and reduce the risk of nerve damage
Before starting an exercise program, be sure to check with your health-care provider.
Prescription medications. Your doctor might prescribe certain drugs (for example, insulin) to help treat or manage your diabetes, notes the American Diabetes Association (ADA).
How can you tell if your diabetes treatments are working?
If you take steps to manage your diabetes (such as the ones listed above), it may be useful to see how well your healthy habits are working. The National Institutes of Health recommends keeping an eye on the “ABCs of diabetes:”
- A1C for blood glucose levels – as noted above, A1C stands for a test that measures your blood-sugar level.
- Blood pressure
Ask your health-care team to help you compare your target levels against screening results and to explain what these results show you about your diabetes management progress.
Does Medicare cover diabetes management?
If you’re at risk for developing complications from diabetes, your Medicare-assigned doctor can order diabetes management training for you.
Medicare Part B covers up to 10 hours of diabetes self-management training (DSMT) during one 12-month period. It typically includes an hour of one-on-one counseling, and nine half-hour sessions in a group setting. You might also qualify for up to two hours of follow-up training each subsequent year. You pay 20% of Medicare-allowable charges plus any deductible amount. DSMT teaches you how to:
- Manage your diet
- Take your medications properly
- Monitor your blood-sugar levels
- Get the right kind and amount of exercise for you
- Recognize complications
- Reduce your health risks
You may also be entitled to medical nutrition therapy services with a registered nurse or dietician at no cost to you if your provider accepts Medicare assignment.
Does Medicare cover insulin and prescription drug treatment for diabetes?
Except in limited circumstances, Original Medicare (Part A and Part B) doesn’t cover insulin and other prescription drugs you generally take at home. If your doctor prescribes an external insulin pump, Medicare Part B may cover 80% of the allowable charges for the pump and the insulin used in this device, if they come from a Medicare-assigned supplier. Other anti-diabetes drugs are generally not covered under Medicare Part B.
If you’re concerned about coverage for prescription drugs and you’re enrolled in Medicare Part A and/or Part B, you may want to purchase a stand-alone Medicare Part D Prescription Drug Plan, which may cover prescription medications associated with treatment for diabetes, such as insulin. You can also enroll in a Medicare Advantage Prescription Drug Plan, which is an alternate way to receive your Original Medicare benefits. Medicare Advantage plans are required by law to provide all the same coverage as Original Medicare (except for hospice care, which is covered under Part A). They usually also offer coverage for prescription drugs and sometimes other benefits, such as wellness and fitness programs, that may be helpful for people with diabetes.
Stand-alone Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug plans use formularies, which list covered medications. You may want to make sure that any medication your doctor prescribes is covered under your plan’s formulary to avoid unexpected out-of-pocket costs. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
Does Medicare cover any other diabetes treatment?
In some cases, your doctor may recommend bariatric (weight loss) surgery as treatment for diabetes. If you meet certain medical requirements, Medicare may cover your surgery. If you receive your surgery as an inpatient in the hospital, allowable charges may be covered under Medicare Part A; medically necessary outpatient procedures are usually covered under your Part B benefits. You may be responsible for any Part A and Part B deductibles and coinsurance amounts.
Some people with diabetes develop serious kidney complications such as chronic kidney disease or kidney failure, which require treatment with dialysis. If you need dialysis as part of your diabetes treatment, Medicare may cover allowable charges; Part B deductibles and coinsurance may apply. If you receive dialysis as a hospital inpatient, Part A generally covers your treatment.
If you’re enrolled in a Medicare Advantage plan, the same basic Medicare Part A and Part B coverage would apply as described above, but check with your plan for details about out-of-pocket costs and coverage rules (such as using a plan network).
If you’d like to know more about Medicare coverage of treatment for diabetes, I’m available to help. You can request more information in a personalized email or schedule a phone call by clicking on one of the links below. To view a list of plans you may qualify for in your area, click on the “Compare Plans” button.