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A fasting blood glucose level of 126 mg/dL is indicative of diabetes. Avoiding proper treatment can result in lower life expectancy.
Medicare covers blood testing supplies, dietary counseling, and other tools to help older people manage diabetes and increase life expectancy.
If you’re asking yourself if you have diabetes, you’re not alone. Of the 37.3 million people with diabetes living in the United States, 8.5 million of them are undiagnosed, and nearly half of the older adult population has prediabetes: an asymptomatic condition in which your blood glucose level is elevated, but not yet high enough to count as diabetic.
If all of this is evoking visions of insulin pens, don’t panic: type 2 diabetes is a very manageable condition, especially in older people, and can often be treated with lifestyle changes and oral diabetes medication, increasing life expectancy. However, it’s important to understand how diabetes works in order to understand your risk factors.
Diabetes, also known as diabetes mellitus, is a condition in which the body is unable to properly process glucose. Glucose is one of our body’s primary fuel sources, especially for our brains. Glucose is a type of sugar: it’s a major component of sucrose (the sugar we commonly add to our foods to make them sweet), but it can also be found in all sorts of fruits, vegetables, and grains.
Our ability to process glucose is governed by insulin, a hormone produced by the pancreas. Insulin promotes the uptake of glucose into our cells, where it can be used to fuel our metabolic processes.
In a non-diabetic body, the pancreas uses insulin as one of a cocktail of hormones to regulate glucose levels in the blood. When glucose levels are high, such as after a meal, the pancreas produces more insulin in order to tell the body to use that glucose as fuel. When glucose levels are low, the body uses other hormones to raise our blood glucose level through a variety of processes. When this process is disrupted, diabetes begins to manifest.
The most severe form of diabetes is Type 1, also known as insulin-dependent diabetes. This type of diabetes occasionally referred to as juvenile diabetes, as it most frequently manifests in children. However, it is possible to develop type 1 diabetes at any age: conditions that aggravate the immune system, such as stress or infection, can cause an autoimmune response in the pancreas. This inhibits the body’s production of insulin, leading to a rapid onset of symptoms.
Extreme hunger, even if you are eating
Irritability and mood swings
Unexplained weight loss
Cuts or bruises that are slow to heal
Cognitive impairment or diabetic coma
In extreme cases, this may result in diabetic ketoacidosis (DKA), in which the body attempts to break down muscle and fat for energy due to its inability to process glucose. This causes ketones to accumulate in the blood and urine and leads to blood becoming more acidic. If left untreated, this condition will rapidly decrease life expectancy. Symptoms of DKA include:
A fruity odor on the breath
Type 1 diabetes has a very rapid onset. Symptoms of diabetes type 1 (including hyperglycemia and hypoglycemia) can manifest in a matter of days, and the first warning sign many people recognize is the onset of DKA. There have been cases of people being diagnosed during unrelated checkups, or even by off-duty doctors, because of the distinct, fruity odor on their breath.
Fortunately, type 1 diabetes is rare. It’s usually a congenital disease, meaning you’re born with the genetic trigger for it. Only 8 percent of diabetes cases are type 1, and symptoms are rapid and severe. Most diabetes cases in seniors are lifestyle-related and much slower to manifest.
Type 2 diabetes, also known as adult-onset diabetes (though it too can manifest at any age) makes up over 90 percent of diabetes cases. In type 2 diabetes, the body is still capable of producing insulin. However, this insulin is insufficient to properly manage glucose levels; either because the body cannot produce enough, or because the body has become resistant to insulin.
Insulin resistance occurs when blood glucose level is abnormally elevated for an extended period. Eventually, the cells stop responding to normal insulin levels, requiring increased insulin production for the metabolism to function. Eventually, the pancreas simply can’t keep up with demand, and symptoms similar to type 1 diabetes manifest.
Insulin resistance usually occurs when the body takes in a lot of glucose but does not process it in a timely manner. In other words, when we eat a lot of foods (especially sugary foods) and don’t burn off that glucose with activity. This is why obesity is commonly associated with type 2 diabetes, though this is a comorbidity rather than a direct cause. Lifestyle choices that lead to type 2 diabetes, like an unhealthy diet and a sedentary lifestyle, commonly lead to obesity as well.
Prediabetes refers to this period of elevated blood glucose level, in which insulin resistance has yet to develop. At this stage, lifestyle changes can prevent the onset of diabetes. Unfortunately, once you hit the tipping point, that’s it: you’re diabetic, and there’s no going back.
The symptoms of type 2 diabetes are similar to those of type 1, though unexplained weight loss does not occur. In addition, you may notice tingling or numbness in your hands and feet. This can be a sign of neuropathy or damage to the nerves in the extremities. This, combined with the slow healing time, can lead to an elevated risk for infection, and potentially lead to a need for amputation.
If you’re concerned about diabetes, an easy way to identify your risk level is with an over-the-counter glucose monitor. These are easy-to-use, inexpensive systems that allow you to test your blood glucose level with a simple finger prick. They’ve fallen out of favor among diabetics due to the advent of continuous glucose monitors, but are still useful as a self-monitoring tool.
Blood sugar is measured in milligrams per deciliter (mg/dL). Your current blood glucose level varies depending on a variety of factors: it peaks when you first wake up and after every meal, and valleys when you fast or are about to go to sleep. It’s recommended that you test your blood glucose level while fasting (i.e, having gone more than two hours without eating or consuming anything but water), as well as after eating. Here are some glucose levels to look out for. Note that these are prolonged glucose levels, indicating repeated results in this range over several periods of fasting and eating.
Hypoglycemia: >70 mg/dL. This is considered low blood sugar. Hypoglycemia can lead to dizziness, confusion, fainting, and seizures. If your blood sugar is at this level, eat some carbohydrates ASAP. Sugary soda is a common source of emergency glucose, but you can also consume several pieces of hard candy, bread, or fruit to fend off hypoglycemia. If your blood sugar does not rise after eating or is below 54 mg/dL, seek medical attention for hypoglycemia immediately.
Healthy Levels: 70-100 mg/dL (Fasting), >140 mg/dL (After Eating). These are healthy blood sugar levels, and indicative of a functioning metabolism. Ideally, your blood sugar should be somewhere in this range.
Prediabetes: 100-125 mg/dL (Fasting), 140-199 mg/dL (After Eating). These are elevated levels of blood sugar. Not enough to be considered diabetic or hyperglycemia, but enough to cause concern.
Diabetes: 126+ mg/dL (Fasting), 200+ mg/dL (After Eating). If your blood sugar is consistently at these levels, you’re likely diabetic, and are probably experiencing some symptoms of type 2 diabetes.
DKA: 300mg+. This is a hyperglycemia: a dangerous blood sugar level and should be met with medical attention if maintained for an extended period, or if you have other DKA symptoms.
It should be noted that these over-the-counter tests should be used primarily for monitoring over a brief period, particularly if you have other symptoms. They’re not meant to be a self-diagnostic tool, as blood sugar levels can change for a variety of reasons. If you’re experiencing dangerous high blood sugar readings regularly, it’s time to see a doctor. Keep a record of your blood sugar readings over the course of a few days, and bring them with you when speaking with your doctor. There is no harm in self-monitoring, but do not use any over-the-counter devices as a substitute for medical advice.
There are a variety of diabetes benefits for older people available under both Original Medicare and Medicare Advantage. The most significant of these benefits is an A1C test. This test identifies your average blood sugar levels over the past three months. This is a routine blood test included in your annual wellness screenings. If your A1C is above average, your doctor may recommend self-monitoring.
Should you be diagnosed with diabetes, Medicare Part B will cover the following
Tests for common comorbidities, like neuropathy, peripheral artery disease, and glaucoma.
Diabetic socks and shoe inserts
However, it will not cover injectable insulin or diabetes medication: those fall under the purview of Medicare Part D.
One way to maximize your diabetes coverage is through a Chronic Condition Special Needs Plan (C-SNP). A diabetes C-SNP will allow your primary care, endocrinologist, and other medical providers to coordinate your care, in addition to providing you with insulin and other diabetes supplies. Diabetes C-SNPs are among the most commonly offered special needs plans, so it is worth speaking with your doctor about a potential referral.
If you’re interested in C-SNPs or other ways Medicare can help manage your diabetes, we can help. Our licensed insurance agents are Medicare experts and can help you better understand your options. Call us today at (800) 950-0608, or enter your zip code into our free comparison tool to begin your search!