Borderline diabetic
My dr. says that my blood sugars are 5.6 (AC?) and that's borderline diabetic.I am 330lbs. and am trying to get approved for gastric bypass and need to be diabetic for the approval.My mother passed away from complications from her diabetes and she was only one year older than I am now.So frustrated.Any advice or ideas?
Congrats on your decision to take control of your health. It's so important.
I'm a little confused as to why your BMI does not already qualify you for surgery? Did a bariatric surgeon tell you that you needed to be "diabetic" or was that your family doctor? If not a surgeon, I'd try to get to one to find out what else might qualify you for surgery. There are other co-morbidities, like hypertension, heart disease, sometimes sleep apnea, that also qualify you (along with BMI).
I think you have to just start working the process, and it can sometimes be a long and frustrating one. But, working the process is good preparation for what you need to do post-surgically and beyond. So, it's good practice.
The other thing I would advocate is be honest with the surgeon and team, but also be persistent. Sometimes, the "squeaky wheel gets the grease" and you need to demonstrate how committed you are to this. That will often help to get you the documentation you need to meet the insurance requirements. Sometimes they also consider previous diet history and how well/poorly you did with that. My insurance had me go through 3 months of weight loss counseling/effort pre-surgery. Some require longer than that. Just stay positive and persistent.
Best of luck to you and keep posting about your efforts and their results. People will respond to you and provid you with suggestions....they definitely will. You are not alone with this.
I'm a little confused as to why your BMI does not already qualify you for surgery? Did a bariatric surgeon tell you that you needed to be "diabetic" or was that your family doctor? If not a surgeon, I'd try to get to one to find out what else might qualify you for surgery. There are other co-morbidities, like hypertension, heart disease, sometimes sleep apnea, that also qualify you (along with BMI).
I think you have to just start working the process, and it can sometimes be a long and frustrating one. But, working the process is good preparation for what you need to do post-surgically and beyond. So, it's good practice.
The other thing I would advocate is be honest with the surgeon and team, but also be persistent. Sometimes, the "squeaky wheel gets the grease" and you need to demonstrate how committed you are to this. That will often help to get you the documentation you need to meet the insurance requirements. Sometimes they also consider previous diet history and how well/poorly you did with that. My insurance had me go through 3 months of weight loss counseling/effort pre-surgery. Some require longer than that. Just stay positive and persistent.
Best of luck to you and keep posting about your efforts and their results. People will respond to you and provid you with suggestions....they definitely will. You are not alone with this.
First of all,thank you so much for responding. The only reason I "need" to be diabetic is for my insurance. It's the main and only one that matters to them. My bmi is 50, I have sleep apnea,high blood pressure etc.It sounds awful, but now I'm hoping my next A1c will be high enough.I can't believe I am saying that, but I want to live for my kids and I've yo-yo dieted up to 330.
Well, this is where I would start being proactive by questioning....and working with the insurance approval folks at the surgeon's office for any ideas or things they can do to help you be your own advocate.
Those other medical issues are equally valid - why would they wait until you ALSO have full blown diabetes, which will add additional expense to your ongoing medical care? I am sure the surgeon's office has worked with this insurance before - maybe they have some tips for you about how this can be positioned to your advantage? Maybe a letter from you or them would be persuasive? I was assigned a nurse case manager at my insurance company, who used to call and bother me all the time. I really didn't need the service, and politely thanked them....but perhaps one can be assigned to you that can help you navigate the system.
Basically, I would start appealing this decision through any venue available to me and making enough noise, while politely but firmly pointing out the illogical standards here, that they would just want me to go away (and thus approve the surgery).
This may be a new or unfamiliar way of doing things for you, so I understand if these suggestions make you cringe a bit. But advocating for yourself can be very powerful and persuasive and is maybe worth a try?
Those other medical issues are equally valid - why would they wait until you ALSO have full blown diabetes, which will add additional expense to your ongoing medical care? I am sure the surgeon's office has worked with this insurance before - maybe they have some tips for you about how this can be positioned to your advantage? Maybe a letter from you or them would be persuasive? I was assigned a nurse case manager at my insurance company, who used to call and bother me all the time. I really didn't need the service, and politely thanked them....but perhaps one can be assigned to you that can help you navigate the system.
Basically, I would start appealing this decision through any venue available to me and making enough noise, while politely but firmly pointing out the illogical standards here, that they would just want me to go away (and thus approve the surgery).
This may be a new or unfamiliar way of doing things for you, so I understand if these suggestions make you cringe a bit. But advocating for yourself can be very powerful and persuasive and is maybe worth a try?
(deactivated member)
on 5/20/12 7:23 am
on 5/20/12 7:23 am
I am so excited about this mineral bag that I have been using in my drinking water and I have lost 22 pounds in the past 3 months & kept it off!!! Some of my friends have had their diabete insulin reduced as a result of doing this also. If you would like some samples sent to you email me at [email protected] with your mailing information. It's time to LIVE LIFE TO THE FULLEST...not in pain! :))
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