Diabetes Care, Treatments, And How To Save

This guide is focused on helping you understand your risk, get better outcomes, and find ways to secure more affordable care.

What Is Diabetes?

Diabetes is a condition that occurs when your body can’t maintain stable blood sugar levels.

Diabetes exists as two types of conditions, type one and type two. Type two diabetes is a controllable disease, but requires lifestyle modifications in order to be successful.

Most Common Types of Diabetes

Type 1: Usually diagnosed in children and young adults, type 1 diabetics need to have insulin supplementation for their entire lives.

Type 2: Usually a result from lifestyle choice, especially diet, type 2 diabetes is where your body gradually looses it’s ability to produce insulin, becoming more and more inefficient over time.

Where To Start: Finding The Right Provider

Start With A Visit To Your General Practitioner

It’s always best to start with a visit to your general practitioner (GP). Your GP will be able to run assist in the process of the diagnosis as well as helping you choose an specialist that’s right for you. Trying to find a specialist on your own—in this case, an endocrinologist—is possible, but not easy. There are important things you need to take into account before actually choosing a specialist to provide you with ongoing care.

Use Doctor Review Sites and Cost Estimator Sites To Find An Endocrinologist

There are many things to consider when it comes to finding the right specialist. If you’re just starting the process the best way is to start with a recommendation from your GP.

Most of the time your GP can take care of your needs as a diabetic, but if this is your first time being diagnosed it's a good idea to see an endocrinologist.

If you’re comparing a few different endocrinologists, review sites, transparency sites and insurance cost estimator tools are a great way to understand where endocrinologists stack up in regards to overall price and how successful they are at helping patients achieve positive outcomes.

Top Doctor Review Sites For Endocrinologists

• Medicare.gov Doctor Compare
• Healthgrades
• Zocdoc
• US News & World Report
• The Leap Frog Group (for hospitals)

Cost Estimator Tools For Diabetes

Your insurance company might also provide cost information as well as patient satisfaction information. These are the resources you have access to if you’re insured by a major insurance company. Note, you will need to log in to your account to access the tool.

• United Health Care Cost Compare
• Cigna Cost Compare
• Anthem Cost Compare
• Humana Cost Compare
•  

If you aren't insured by a major carrier these tools also provide price transparency information:

• Healthcare Blue Book
• MD Save
• Guroo
• FairHealth Consumer
• Clearhealthcosts.com
• Medibid

When it comes to comparing costs, no one tool is always the best. The cost tools provided by your insurance provider will be the most accurate, but it's important to check all the tools to see how well your insurance is doing in terms of its discount and see the whole playing field.

Selecting The Specialist That's Right For You

Beyond cost and reviews, what are the other factors you should consider? It’s important to interview a few doctors first before you seal the deal. You want to find a doctor that’s not only a good match financially, but one that you can build a relationship with, as well.

Start With This Checklist Of Questions

• Are they easy to access?
• What is the quality of their care?
• What do they charge?
• Are they in your network or out of it?
• Are they board certified?
• Do they have experience managing your condition(s)?
• How long have they been in business?
• Are they taking new patients?
• What is their hospital affiliation?
• Are there any red flags such as malpractice suits or sanctions?
• Are they vested in technology?
• Do they participate in electronic medical records and coordinate electronically with pharmacists, other specialists, hospitals, and you?
  

Always Look For Practices With Support Programs

For diabetes, one of the most important factors in selecting a specialist is whether or not the practice has programs that provide support between visits. For those with Type 2 diabetes, where behavior change and diet change is critical, these support programs are especially important.

Many practices now have programs that help you better understand your treatment, help you track your progress and act as an advocate who coaches you on how to achieve the best possible outcome. They do this by getting you on board and keeping you on track with your treatment plan, which helps you get better, faster.

Patient support services are offered at no extra cost to the patient and are usually referred to as a number of different names, that all do the same thing. When you’re researching endocrinologists, look for:

• Health navigators
• Care navigators
• Patient navigators
• Care managers
• Chronic disease management programs

These individuals are responsible for guiding patients through the healthcare system, when it comes to their chronic condition. They can connect you to dietician services and behavior modification programs, ensure that you’re using medication properly and that you’re keeping to the schedule recommended by your doctor.

Having these educators and advocates in your corner can be huge difference makers when it comes to controlling your condition.

The Doctor’s Communication Skills

Make sure your endocrinologist is a good communicator who seeks your input, asks probing questions, and answers your call (or calls you back) when you need help or information. Ask yourself this: Does the specialist answer my questions and explain complex medical issues clearly, so I can understand them?

The Practice’s EHR (Electronic Health Record) System

What’s an EHR? EHR stands for electronic health records. Back in 2009, the federal government passed a law called HITECH (the Health Information Technology for Economic and Clinical Health), which basically mandated that doctors start to use electronic health record systems.

About 80% of physicians now use a “certified EHR”. EHR’s allow doctors on the same system to easily and instantly share charts, notes and your medical history. Finding a specialist that’s on your hospital and GP’s EHR will make communication between doctors a whole lot easier.

Ask the specialist’s practice which EHR they use and then cross compare that to the doctors you’ve already established a relationship with. Here’s a list of the most popular EHRs:

• Allscripts
• Cerner corporation
• Epic systems
• eClinicalWorks
• CareCloud
• GE Centricity
• NextGen

Is it essential that your doctors are on the same EHR? No. But it will make your quality of life, and the doctor’s ability to communicate easier.

Alliances within the Medical Community

Endocrinologists often need to communicate with your other healthcare providers, such as your primary care provider. Ask about their ties to other medical professionals and what hospitals they’re affiliated with. This is important because if your specialist uses the same electronic medical records (EMR) system as your primary care provider, that higher degree of coordination will save time and increase communication—both of which can lead to a better outcome for you!

Whether They’re A Solo Practice or Multi-Physician Practice

A multi-physician practice will have better coverage or physician availability for patients if there is an urgent need. Though, if your disease is well maintained, this may not be as important of a consideration when choosing a doctor.

In addition, many specialists are outpatient providers, which means there are a few things you need to consider before choosing a practice to visit:

• Is it in network?
• Do they offer discounts? 

What To Expect From A Visit With A Endocrinologist

How to Prepare For An Effective Visit

Visiting your endocrinologist with concerns about pre-Diabetes or Diabetes can be overwhelming. Here are some tips to help you prepare and get more out of the experience:

• Keep a log of your symptoms and any medications you’ve tried in the past, including over-the-counter ones. 
• Be honest about what you've been eating and bring a record of your blood sugar levels
• Tell your doctor about any other symptoms you’ve had symptoms—such as elevated or decreased energy levels. 

How To Talk To Your Doctor

While most of us are used to relying on our doctor’s to guide the conversation, the only way to make sure you’re getting the best care is to speak up. Most doctors and practices are trained in the SBAR method. Use it to organize your thoughts.

• Situation: take ten seconds to explain your ailment
• Background: provide context with your medical health record
• Assessment: describe the specific problem/situation
• Recommendation: explain what you want to do about it and when

How Diabetes is Diagnosed and What to Expect

Both Type 1 and Type 2 diabetes are diagnosed by measuring how well your body processes sugar. Initially, this was done by measuring your blood sugar levels in a fasted state. Officially called the fasting plasma glucose test, this was the most commonly used test to discover prediabetes and diabetes.

Blood sugar levels for FPG test:

The A1C Test

If you’re in the process of being diagnosed with, or you’re currently managing your diabetes, make sure your doctor is using the A1C test.

What’s the A1C test? It’s a better measure of a patient’s blood sugar levels. Instead of measuring blood sugar directly, it detects the presence of sugar in the hemoglobin of your red blood cells. Basically, it gives you a much clearer picture of your blood sugar levels over the past three months, that’s less likely to be affected by what you had for dinner.

Blood sugar levels for A1C test:

Questions to Ask Your Doctor Ask You Discuss The Diagnosis And Treatment Options

• What is the test for?
• How many times have you done this procedure? 
  
• When will I get the results? 
  
• Why do I need this treatment?
• Are there any alternatives?
• What are the possible complications?
• Which hospital is best for my needs?
• How do you spell the name of that drug?
• Are there any side effects?
• Will this medicine interact with medicines that I’m already taking?
• What is my diagnosis?
• What are my treatment options?
• What are the benefits of each option? What are the side effects?
• Will I need a test? What is the test for? What will the results tell me?
• What will the medicine you are prescribing do?
• How do I take it? Are there any side effects?
• Why do I need surgery? Are there other ways to treat my condition? How often do you perform this surgery?
• Do I need to change my daily routine?

How to Save On Diabetic Testing

The A1C test serves as a baseline for managing your diabetes but managing the condition day to day means a lot of testing. When it comes to tips on testing and step by step instructions, the American Diabetes Association provides great resources and the Mayo Clinic offers guides on how to choose different blood glucose meters.

As far as saving on the materials you need to test, here are a few things to keep in mind.

• Use supplies covered by your insurance company
• Check online for coupon codes at sites like RetailMeNot
• Buy generic testing strips over branded testing strips and buy in bulk

Treating Diabetes

Common Treatment Options for Type 1 Diabetes

Insulin is the only drug class that is effective for individuals with Type 1 diabetes. The most common treatment option is to use a mix of long acting and short acting insulin before meals. This gives you better control of your blood sugar, but long acting insulin is more expensive.

Another common course of treatment is to use a 70/30 mix of long acting and fast acting insulin, but this is more difficult to manage.

Common Treatment Options and Drug Classes for Type 2 Diabetes

For Type 2 diabetes, there are a number of classes of drugs that help you manage blood sugar levels.

• Alpha-glucosidase inhibitors
• Biguanides
• Bile Acid Sequestrants
• Dopamine-2 Agonists
• DPP-4 inhibitors
• Meglitinides
• SGLT2 Inhibitors
• Sulfonylureas
• TZDs 

Metformin is the first course of treatment for anyone with type two diabetes.  Most Type 2 diabetics are responsive to Metformin, but if the dosage isn’t effective on its own, a second course of treatment will be recommended.

Questions To Ask Your Doctor About Your Medication

• How else can I control my diabetes?
• What side effects can I expect?
• When is the best time of day to take the medication? And how often?
• What alarm symptoms should I watch out for as I start this treatment?

Common Prescription Treatments For Diabetes And How Much They Cost

Saving On Prescription Drugs

Whether your health insurance covers prescription medication or you have to pay out of pocket, drug cards are one of the most effective way to save on Rx. See our how drug cards on our How to Save page.

Drug cards aren't the only way you can save on prescriptions, though. There are tons of insider tricks you can follow, starting with asking your doctor the right questions. See our guide to the questions you should be asking to save money on your prescriptions.

Medication and Lifestyle Change: Why It’s Critical To Do Both

If you ask a doctor what the most important thing is a patient can do when it comes to managing their diabetes, or going from Type 2 back to pre-diabetic, they’ll tell you compliance. There’s no way around it.

But why is compliance so important, especially for diabetics? Diabetes is constantly wearing your body down, which means that if it’s not controlled, you become much more at risk for illness and infection—not to mention the additional cost of new specialists like podiatrists and cardiologists.

Yearly Tests That Help Avoid Complications

To lower your risk of complications related to Diabetes, you should schedule the following yearly tests:

• Annual eye exam is important
• Annual urine test for kidney issues
• Annual foot exam

Lifestyle Changes That Will Improve Your Health

Changing Your Lifestyle to Help Cope with Symptoms and Increase Your Health

While Type 1 diabetes is a genetic condition, Type 2 is usually a condition caused by lifestyle. Diet and exercise should be your first priority. The best way to achieve a better outcome for your health is to master the things you have control over.

Diet is the biggest way to reduce your need for prescription drugs for diabetes is to reduce your weight and consume food that doesn’t cause your blood sugar levels to spike.

1. Avoid foods with a “high glycemic index” – processed, sugary foods, simple carbohydrates like white bread and russet potatoes
2. Increase the amount of vegetables and lean meat

For more information on what you should be eating to control your diabetes, The American Diabetes Association’s guide What Can I Eat? is a great resource.

Living With A Chronic Condition

Living with a chronic condition can be incredibly difficult. Being diagnosed with Diabetes can be stressful and scary, but the good news is that having the diagnosis means you can begin to make changes that will positively affect your life.

Start keeping an accurate health record, focus on modifying your lifestyle and make sure you are scheduling regular testing to avoid the side effects and other chronic diseases that diabetes can put you at risk of.

We continually update this guide with the latest tools, resources and savings tips. If you have a story to share about your treatment or how you’ve Uncovered better healthcare, join our community and share it!