A1cnow

#1

Has anyone used this product? I’m interested because my doctor said because I’ve lowered my blood sugar enough, I’ll only be eligible once a year for an A1C test. Is it worth it or better to just use daily glucose monitor?

(Bob M) #2

It is a bit pricey ($200 as of the date this is put in):

Once a year seems crazy, if the goal is to reduce that. What most studies show is that HbA1c plummets on low carb/keto. You can get a tremendous decrease quickly. (Unlike body fat for most of us, sadly.)

The problem with the daily glucose monitor is you’re using a lot of strips and the daily fluctuations make it hard to determine sometimes what’s happening.

It’s a good question, one for which I’m not sure I have an answer, other than a year seems like a long time to wait.

#3

Actually, I received an add which says I can buy it for $60.00 with four test strips. So four times a year. I can’t find where you can buy only the test strips.

If you think it is bad, only to be tested once a year, my Medicare plus supplemental health insurance will only pay for one test strip a day. I test three times so it is all on me.

(Bob M) #4

One test a day? That is beyond useless.

That is weird – I also can’t see where you can buy extra strips for the A1c.

I would definitely test at least 3 times per day, as this is my blood sugar:

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You can’t get these curves without testing a lot.

We really need to have CGMs get cheaper.

#6

That’s another thorn. My doctor won’t prescribe unless I test in the 170’s. He said he isn’t allowed to. I keep wondering how all the Youtubers who aren’t diabetic have them.

I am really pleased with my progress. I don’t have charts but I test three times a day. Morning and then two hours after a meal. If I only eat once then I test at the time I would have eaten. I average these. I know not scientific but I can see a trend. When I began 9 months ago I was in the 170’s that quickly dropped to the 140s then a slow drop to the low 130s. This past month I dropped to 120.

Still have a long way to go but the medical guru’s don’t want to make it easy.

(Bob M) #7

Those are great numbers.

#8

For T1’s yes.

For T2’s…do you not think that’s a wee bit paranoid, especially with this WOE?

If you have reversed T2, 6 months bloods is what NHS (UK) advise…but you may have other consultations in between. Especially if you have quit meds.

#9

You can’t just buy the strips, the meters are coded to the amount of tests they’re allowed to do. That said, there’s one company making those for everybody, you can buy them at CVS/Walgreens/Walmart (usually a 2 pack) for $35-$40, I wouldn’t try to get them in that big of a bulk or spend that money given how often you’d test.

#10

Apologies folks. Again, it’s different in each region.

Obviously, I’m UK, and the majority on here will be US.

#11

Sorry, I don’t understand.

If you are referring to the allowed testing I think the reason that labs and tests are so restricted is because I’m on Medicare, even though I have a private supplement. Other insurances may have different standards and requirements.

#12

Thank you for the info. Makes sense.

#13

Apologies, I wasn’t clear there, sorry.

We don’t have medicare, but we can get private med insurance if you are so inclined,
That may be a part of your job’s T&Cs. If you are that lucky.

We have NHS, National Health Service, across all 4 parts of the UK.

Well loved, well respected.

A huge drain on tax…but in the round, across the board, supported.

#14

I don’t understand how his medical judgement can be questioned like that. Who does not permit it? His boss? Medicare? The state medical board? I understand that insurance may not cover it but that is not the same as being prohibited from prescribing it.

As for the Youtubers, there are a few companies, with Levels being one of them, where they arrange for you to get a prescription and then they send you a supply of CGM. I am not that familiar with them and am not a customer or endorsing them but I think they send you the freestyle libre and then they have an app that helps you analyze the data. It costs significantly more than buying it at Costco with the Costco discount and a prescription and paying out of pocket (a friend paid $150 for 4 sensors (8 weeks) over the summer at Costco in the US). Costco originally quoted him a higher price but then they added a discount card to his account since he was member without insurance and that was what he paid cash price, no insurance.

#15

When Doc’s don’t run their own practice, it’s typically the practice’s rules on many things, plus the Insurance you have can come into play. Which you really can’t argue, if somebody doesn’t have diabetic numbers, that’s eating a lot of cost on a recurring basis when somebody doesn’t “need” it. It’d be like asking your auto insurance to paint your car because the original paint doesn’t look as good as it used to. Getting into an accident and it getting messed up is another story.

On the people that just get them because, your doc will prescribe one for you if you ask, but without medical need, you’re eating the full cost for it. Most of the CGM companies allow you to buy them direct (at least in the US) but same deal, without a prescription or labs to back a “need” you eat the cost, which is fair.

#16

Was not arguing that, I acknowledged in my original post that insurance may not cover it if you do not have diabetes. Insurance not covering is not the same as a doctor refusing to prescribe it. My pediatrician is always hesitant to order extra lab tests until I explain that I pay a fixed co pay for lab tests for my kids, whether it is one test or 20 tests. When I say that I get them the full panels on everything they need. On the other hand, my friend on medicare cannot even get the strips covered because low carb eliminated his need for diabetic medications so even finger sticks are not covered. Sad really since he needs to check to make sure low carb is still working since he has been diabetic for many years, which is why he has a CGM instead. Paying cash (not insurance but with their member discount) at Costco with a prescription it costs him about $38 per two week sensor. He still uses strips to calibrate it but far fewer and it is worth it to him to have the CGM

Do you mean Abbott (the maker of the CGM) or do you mean companies like Levels?

Companies such as Levels still provide a prescription but it is included in the subscription and you pay a lot more than you would at Costco or Walmart with a prescription even paying out of pocket without insurance. Abbott requires a prescription in the US to get a CGM directly from them as far as I know through one of their programs

#17

I guess the thing that annoys me is if I do nothing to lower my glucose levels, my insurance will willingly, or perhaps unwillingly, pay for the meds to keep it at a lower yet very high level. If as a result of these high numbers, I need dialysis, amputations or other surgery it is covered.

Yet, if you started with high numbers, yet bring them down, to some level deemed not life threatening, the insurance will not pay for test strips or a CGM to help you keep those numbers low or reduce them further. It is as if they make a choice, no to prevention, yes to drugs and surgery.

Seems so backwards.

#18

Completely agree, could not have said it better. In addition, if you have pre diabetes or are borderline, insurance will also not pay. A CGM can be a wonderful tool to show someone who is borderline what they personally should and should not eat to spike their sugar. Test strips will help with that too.

Insurance status aside, I still do not understand how a physician can be prohibited from prescribing something that is not even a medication

#19

Right, because they’ll have to, if you can’t control it with diet they’ll stick you on meds, as they should. Typically, you’re not at a very high level at that point, but again, that’s individual.

Nor should they, if you’ve fixed the problem, why would they spend money on that stuff? Possibly test strips if somebody has freshly recovered sure, and the doc could keep that going for a while, but a couple good A1C’s would end that eventually, and it should. As far as a CGM, sorry, can’t agree there. Those are a luxury, not a requirement, even if you are diabetic. Insurance companies aren’t babysitters to make sure you don’t all of a sudden forget how you fixed your problem.

#20

They definitely are, but health insurance isn’t eating school, or personal trainers. Yet they’ll still pay for nutritional counseling most of the time. As a whole, it’s pretty much Biohackers, and Keto’s that are the only ones trying to get CGMs that don’t need them, this isn’t a normal thing.

A medical practice is a business, and the Doc’s are their employees. Just like all of them, there are rules, many times stupid ones. That said, I doubt many are actively telling them not to prescribe something insurance won’t pay for when the patient is willing to eat it out of pocket.

Last thing I knew of that was pretty much blacklisted from being prescribed at many practices was Accutane, and for GOOD reason!

There’s a ton of companies offering them now, “prescription” is a loose term at this point. All the online places usually have an NP or a PA on staff writing a bazillion of them for everybody vs the one Doc who never talks to anybody. None of it’s real anymore.

(Bacon is a many-splendoured thing) #21

Given that the health insurance companies in the U.S. all either own pharmaceutical companies or are owned by pharmaceutical companies, they have a vested interest in making sure there is a need for their products.