As the
incidence of diabetes continues to grow we see ever more
seniors who must watch what they eat. Uncontrolled
diabetes is no laughing matter. It can directly
contribute to vision loss, kidney failure and
circulatory problems. As a professional I see far too
many seniors who have lost part or all of a leg, and
it's almost always as a result of diabetes.
And far
too many of our elders with diabetes really don't
understand their nutritional needs. Just recently I met
Betty, who was recently diagnosed. She had some
diabetes pamphlets, and she was trying her best. She threw away
all the cookies in the house and bought sugar-free
desserts. She was choosing fruit for snacks, eating up
to half a dozen fruit servings every day, and she
switched to whole wheat bread.
Betty
isn't an ignorant woman, but she's not a dietitian. She
knows that sugar isn't good for her diabetes, and she was trying
to avoid it. But she didn't understand how the other
"natural" sugars and starches she was eating affected
her diabetes. She was frustrated because her blood sugar
continued to run high.
Betty
was more than willing to visit with someone who could
explain the ins and out of eating with diabetes,
especially when she learned that it would be covered by
her (traditional) Medicare. She has a way to go, but she
already has a better handle on things after just one
meeting with her dietician.
Sadly,
a lot of internal medicine physicians, who are the
primary physicians for most of our elders, don't seem to
know that Medicare will cover nutritional counseling for
patients with diabetes or kidney disease, so they don't
make a referral. Endocrinologists, who specialize in
diabetes, seem to be a little better informed.
If your
parent or spouse has diabetes, has had a kidney
transplant, or has kidney disease but is not on
dialysis, Medicare will cover "medical nutrition therapy
services" when ordered by a doctor. The services must be
provided by a registered dietician or nutritional
professional who participates in Medicare. As with most
Medicare services, the patient must pay 20% of the
Medicare-approved amount unless he or she has a
supplemental policy which will pick up this co-pay.
If your
elder is covered by a Medicare HMO (an Advantage plan)
you will have to check with the individual plan to see
whether they cover nutritional counseling.
I
highly recommend that everyone with both diabetes and
Medicare get this counseling. A good instructor can make
it both fun and enlightening - and life-and-limb-saving,
too.
