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Diabetes Screening

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Close to 26 million Americans have diabetes—a serious disease that can have life-threatening complications if left untreated. The majority of people with diabetes have Type 2 (formerly called "adult-onset" diabetes). In the past, diabetes occurred mainly in people over age 45, but is now seen in younger people, even children, due to increasing overweight and obesity levels.

Pre-Diabetes

Many people are "pre-diabetic," which means that their blood glucose (sugar) levels are higher than normal, but not high enough to be diagnosed as diabetic. People who are pre-diabetic are much more likely to develop diabetes within 10 years and are also prone to having heart attacks or strokes.

But diabetes is often a preventable disease, and many of the steps you can take to prevent diabetes are simple. In some cases, if you are overweight, losing just 5-7% of that weight can prevent or delay the disease.

Risk Factors

Many factors increase your risk to become diabetic, including:

  • You are 45 years or older
  • You are overweight
  • You have a parent, brother, or sister with diabetes
  • Your family background is African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
  • You had diabetes when you were pregnant (gestational diabetes)
  • You have higher blood glucose levels than normal (pre-diabetic)
  • You blood pressure is 140/90 or higher or if you've been diagnosed with high blood pressure (hypertension)
  • Your cholesterol levels are not within normal ranges—the HDL ("good") cholesterol is less than 35 and your triglyceride level is higher than 250
  • You are physically active less than three times a week
  • You have polycystic ovary syndrome (PCOS)
  • You have been told you have blood vessel issues affecting your heart, brain, or legs

Though you can't change some of the conditions listed above, you can become more active, change your diet, work harder to keep your blood pressure under control, and do what you can to improve your cholesterol levels.

Get Tested - Fasting Plasma Glucose Test

If you are at high risk for diabetes or are pre-diabetic, you should be tested by your doctor. There are simple, easy tests that will give you and your doctor the information you'll need to know if you are diabetic. The most common test for diabetes is a Fasting Blood Glucose Test or Fasting Plasma Glucose Test. This test can usually be done in your doctor's office.

  • Before your test you should not eat for 12 to 14 hours.
  • It is a simple blood test—a sample of your blood is drawn and sent to a lab.
  • The test reveals the levels of glucose you have in your blood.
  • The results are measured in milligrams per deciliter (mg/dl)
  • A normal reading is 70 to 90 mg/dl, pre-diabetes is 100 to 126 mg/dl. A reading over 126mg/dl is where diabetes is usually diagnosed.

If you tested in the "lower" high range, your doctor will discuss a plan of action with you. Most likely, he will suggest you lose weight if you are overweight, watch your diet, and other tasks that are recommended to prevent diabetes.

After the test, if your doctor diagnoses you with diabetes, you will discuss treatment for your diabetes, including the lifestyle changes mentioned above.

Medicare Coverage for Diabetes Screening

Medicare Part B covers up to two Fasting Blood Glucose tests each year. You are eligible if you have any of the following risk factors:

  • High blood pressure
  • History of abnormal cholesterol and triglyceride levels
  • Obesity
  • History of high glucose levels

Medicare will also cover these tests if you answer yes to two or more of the following questions:

  • Are you 65 or older?
  • Are you overweight?
  • Do you have a family history of diabetes (parents, brothers, sisters)?
  • Do you have a history of gestational diabetes (diabetes during pregnancy) or delivered a baby weighing more than 9 pounds?

If the doctor who performs your Fasting Blood Glucose Test is a Medicare-approved provider, there is no cost. You DO NOT have to pay your Medicare Part B deductible to have this covered.

Risk Factors and "Disease Management"

You'll notice that the high risk factors for diabetes listed at the beginning of this article differ from the ones listed under your Medicare coverage. If you are in the highest risk category, it means that you have more factors that can tilt the scales towards you becoming diabetic. You will have to work harder on your health to prevent, delay, or treat your diabetes.


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