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Periodic Contributor

Diabetic care need discussed.

Diabetic policy of the California health department, post critical facilities, and mostly the Federal Department of Health and Medicare requirements for diabetic elder care at facilities are antiquated and life threatening. These policies and requirements may already be destroying your loved ones health, if not actually causing them to experience pain and death for lack of action and common sense.

 

The current method of diabetic control affects 25 percent of the total population that are in hospitals or care facilities as they have stage 1 diabetes.  Just recently current and better diabetic control methods were approved during Covid for use in these facilities due to staffing shortages. That approval was removed with the covid restrictions. Diabetic control is not being done in accordance with the policies of these institutions due to policies mandated by our Federal and State Health departments. Out of control diabetes in hospitals and elder care are causing pain, kidney disease, blindness, and maybe premature death.

New types of Continuous Glucose Monitoring sensors and the newest Insulin pumps are now paid for by the government for low-income AMERICANS and those that are on Medicare due to availability of better diabetic control advances in technology. The findings of numerous studies of the new technology state that the control improvement using the CGM and Insulin pumps is significant.

If these same patients go into a hospital or post critical facilities, they must step decades into past medical practices in diabetes care POLICIES due to the requirements of facilities and agencies of the US Government. This puts them all at a high risk of uncontrolled or poorly controlled glucose.   

The current policy in the inland empire, the state of California and most likely the Nation is to test a patient 3 to 5 times a day with a finger stick for blood and using a sliding scale, administrating insulin based on the blood glucose taken level.  The time between the finger stick and insulin injection can vary from minutes to hours based on the RN workload. This also does not take into consideration any food eaten or therapy given which has a significant effect on blood glucose. This policy is also discussed in the above-mentioned studies and is found to be a detriment to diabetic health.

 There are numerous articles by AMA, ADA, and government review boards about the lack of diabetic management using the above method and how poorly it controls diabetes especially in the very young and elderly. There have been several discussions about these policies in care facilities including hospitals and they all agree that change is necessary due to the increase in diabetes in the general population.

 

My wife's story over the recent past month.

Her medical history over 50 years was, a type 1 diabetic for 50 years, suffering a stroke 6 years ago which then caused Parkinson’s, 20 years of chronic back pain caused by car accident, and other minor female ailments. These were her ongoing condition in October 2023.

Prior to the new pump system, she was on CGM and pump for 4 years that did not automatically administer insulin but allowed me to get warning and monitor her glucose level using the internet and a smart phone. Using this system allowed us to monitor and control her diabetes much better than finger sticks and injections with needle.  Prior she spent 40 plus years giving herself multiple fingerstick per day to monitor her glucose and injection with a needle several times a day to administer insulin.

She was 73 years old when she passed away in early January 2024. I was providing her care at our home for the last 7 years. During the last year my wife had a Medtronic’s G780 pump and a Medtronic’s continuous Monitor (CGM). This system does not only monitor her blood glucose like the finger stick but also through the pump communicating with the CGM administers insulin every 5 minutes. We had been using this system for about a year with very few incidents of high blood glucose over 250 and no levels under 90 being noted. The requirement of the system is to replace the CGM sensor every 7 days and the pump delivery system every 3 days.

 

A month ago, we both caught covid. I had no real systems, she got hammered.  Headache, pneumonia, cough, and weakness. We called 911 and she was transported to a hospital. Her Medtronic’s system timed out and was removed the first day. The procedure that was then started by mandate of the hospital, was the finger stick and sliding scale stated above. After a week of covid care, she was admitted to a post-acute care facility. Upon arrival I was trying to get approved for me to restart Medtronic’s system and was informed that I could not due to the facility being responsible for administration of medications and it being against company policies and the Department of health. I can understand the insulin pump not being approved due to the delivery of insulin but why not just a CGM for monitoring.

On with the story. After one week my wife's blood sugar went to over 400. This required the facility to send her to a hospital. When she arrived, the hospital checked her blood. It was 853mg/dl and she had diabetic ketoacidosis and sever infection. This hospital also used the finger **bleep** method due to regulations. Another week in the hospital and she was returned to the post care unit with infection under control and lower glucose that still did not meet the required minimums.  I requested her glucose readings that led up to the hospital trip from the acute facility. These reports show that her blood sugar was being checked 4 to 5 times a day with insulin being delivered 4 times. Here blood glucose was bouncing every day between 130 to 350 mg/dl with some being below 70 mg/dl.  I cannot comment on food intake/carbs due to the facility not taking food consumption into account and didn't record this information. This is not diabetic control or within the polices of the DPH or the Facility and resulted in the 853 reading at the hospital. Since her return there have been 2 times that they sent her back to the hospital due to her blood glucose going over 400 which mandated hospital input. There were also several times that she went over 400 but by the time the doctor checked in, up to 3 hours later, her glucose was below 400 by just a bit, so hospital input was not required.

A feeding tube was inserted in late December 2023 during another Hospital visit due to out-of-control diabetes. They were again able to get her infections and glucose to THEIR accepted levels and she was returned to the acute care facility. One week later, she went back to the hospital again due to not being responsive to care and high glucose levels. After 3 days the staff at the hospital recommended proceeding to hospice care as her condition was now unrecoverable.

 

I wanted to bring this to your attention, not for my wife as she died January 8 2024 from these policies, but to bring to the attention of Doctors, nurses, care facilities, hospitals, the State Health Departments, the Federal Department of Health, Medicare, and our politicians of all brand, the way these policies of diabetic treatment is causing the families to watch their loved ones health decline, the pain that it causes the diabetic with eventual death.

The economic cost caused to all Americans was above my ability to compute. The new technologies that are now available would save the cost of multiple finger stick with strip and monitor that must be performed by trained staff, the administration of insulin that MUST be given by a qualified nurse and that related injection support equipment, and the setting aside, due to NOT APPROVED, of multiple millions of dollars of CGM and pumps paid for by the Government under Medicare, Medicaid, and health insurance programs. I still have the pumps and CGM for my wife sitting in a box.

This letter is for the millions of other diabetics of today and in the future that are or will be denied the care provided by medical advancement due to old and outdated policies. No one wants their child, spouse, or parent to suffer this kind of abuse.

 

Hopefully you and your investigators will investigate this and consider the lives, health, and cost worth looking into. I have sent a similar email to other news organizations, health officials, government agencies and politicians in an attempt to get some help in having common sense care for diabetics in today health care system. I have received NO RESPONSE to any of my emails.

Hopefully others that are experiencing, have experienced, or may experience this health care problem will also send me their comments and stories, as the KILLING OF OUR DIABETIC LOVED ONES MUST BE STOPPED.

Social Butterfly

This is the Introduce yourself sub-forum. Have you looked at and posted this in this 

sub-forum, Health Forum (aarp.org) or maybe this Conditions & Treatments - AARP Online Community.

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Esteemed Social Butterfly

@SteveW876191 , I am so sorry for your loss [a member of the AARP Grief & Loss Forum]  💙💙💙

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Periodic Contributor

Thanks for the comment. I would so much rather have you actually look into the care failure with all the power of AARP to rectify this situation. When my wife was in acute care and the hospital. I walked by numerous rooms with people waiting to have proper diabetic care, and to have policy and procedures in place by our government causing all of this pain and suffering need to be changed. I have to wonder how many other technical advances have been made in healthcare that I do not know about that are not being implemented just due to lack of concern or even the lack of caring by our health professionals and politicians. I would love to know how much economic savings there would be in just changing the diabetic care, let alone improving the care itself, by allowing CGM and pumps. The CYA environment is now causing great pain, suffering and death in our health care system, let alone the abuse of the cost. 

Esteemed Social Butterfly

@SteveW876191 , I DO NOT work for AARP, sorry. I am a regular person like you and active in the AARP Grief & Loss Forum. Maybe @AARPConsumerCare will respond on MONDAY. Take care!  👵

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