Summer 2010
Volume 19
No. 3

In This Issue

From the desk of Nurse Lorraine

Dear Friend,

If you test your blood sugar and have Medicare – you will want to read this letter!
As a person with diabetes, you know the importance of testing your blood glucose (sugar) as prescribed by your doctor. However, if your doctor has asked you to check your blood sugar more frequently than Medicare guidelines allow, you now must provide proof that you are testing as often as asked.

Know the Medicare guidelines for covering blood sugar test supplies.
I am sure you have heard the old saying “the proof is in the pudding.” You could say when it comes to Medicare covering the cost of your test supplies, “the proof is in your test log.” To receive the supplies necessary to test as your doctor has asked, you must provide proof. Without this proof, we will not be able to ship your prescribed number of test supplies.

If either of these applies to you, you are required to provide proof of testing:

  • You take insulin and your doctor asks you to test more than 3 times a day.
  • You do not take insulin and your doctor asks you to test more than 1 time a day.

Medicare requires all companies that provide diabetes test supplies to submit proof of how often customers are testing.If you have not already received one, we will mail you a 28-day test log in the near future. You will need to complete and return this test log once every 6 months. That being said, we can send test strips for the number of results written daily on your 28-day test log. Your test log entries must match the number of times your doctor has asked you to test.

For example, if you take insulin and your doctor prescribes you to test 4 times a day, your test log should have 4 test results written in each day.

If you have any questions, please call 1-866-286-7585 toll free and speak to a Customer Service Representative Monday through Friday, 8:00 a.m. to 5:00 p.m. Central Time.

Sincerely,
Lorraine Farrar, MSN, RN, APN, BC-ADM, CDE
Vice President, Education and Wellness

P.S. This Medicare requirement applies to everyone with Medicare Part B no matter where you get your test supplies. But, don’t worry, we are here to help make this easy for you.

Building Blocks of Diabetes

As with reading, there are ABC’s of diabetes to learn as well.

Knowledge is power. When you have diabetes, the more you know about it, the better equipped you are to manage your blood sugar and live a long, healthy life! Before you could learn to read, you first had to learn the alphabet. As with reading, there are ABC’s of diabetes to learn as well. This issue of Diabetes Directions reviews the ABC’s of “self-care” blood sugar monitoring.

“A” is for Accuracy.

Many things affect the accuracy of your blood sugar test results, from the storage of the test strips to the cleanliness of your hands. For accurate results, follow these steps:

  1. Wash your hands with soap and water before testing.
  2. Store test strips in the original packaging ONLY.
  3. Store your meter and supplies somewhere dry and do not expose them to extreme high or low temperatures. Also avoid storing them in a potentially humid location, such as a bathroom.
For specific instructions about your meter, consult the owner’s manual that came with your meter, or contact the manufacturer at the telephone number printed on the back of the meter.

“B” is for Benefits.

Diabetes can be sneaky – its symptoms are often vague until a condition becomes more severe. Many people with diabetes believe they can tell what their blood sugar is based on how they feel – but this is an incorrect and harmful belief. When blood sugar fluctuates it can cause feelings of fatigue, confusion or irritability – but the body will adapt to these feelings and may not alert you when there are problems. The ONLY way to know your number is to test. When you know your numbers, then you are in control of what to do about them. If you do not test, you lose this benefit – simple as that. To learn more about how your numbers can work for you, be sure to read “Let Your Numbers Do the Talking” on the back cover of this newsletter.

“C” is for Control.

“Paired testing” is gaining popularity for improving blood sugar control. This type of testing involves checking your blood sugar prior to an event, such as a meal and then following up with a blood sugar test afterwards, (2 hours after the start of eating in the case of a meal). This “pair” of tests gives you a benchmark from where you started and it gives you feedback on how that event (food, activity, medication, etc.) affected your blood sugar. Comparing your “paired testing” results helps you and your doctor evaluate how well you are managing your blood sugar.

From the Better Care BookschenTM - Cooking with Ken & Lori

Tomato-Chicken Crunch Bread

Ingredients:

  • 12 slices of Italian bread, 1/2 inch thick
  • 1/4 cup olive oil
  • 1 large tomato, chopped (about 1 cup)
  • 3 tbsp fresh basil, chopped
  • 1 tbsp capers
  • 1/2 tsp salt
  • 1/2 tsp black pepper
  • 12 pieces mozzarella cheese, deli-sliced
  • 2 boneless chicken breasts, diced

Directions:

  1. Heat oven to 375 degrees F.
  2. Place bread slices on ungreased cookie sheets. Drizzle 1 tsp olive oil over each bread slice.
  3. Mix tomato, basil, capers, salt and pepper. Spread half of the tomato mixture over bread slices; top with cheese slices and chicken. Spread remaining tomato mixture over cheese and chicken.
  4. Bake approximately 8 minutes or until bread is hot and cheese is melted. Serve Hot.

Healthy Meal Plan

  • 1 serving or slice of Tomato-Chicken Crunch Bread (1 carb)
  • 1/2 cup of green beans
  • 1 cup pasta salad in light Italian dressing (2 carbs)
  • 1 small apple or choice of fruit (1 carb)
  • Water or diet drink

Yield

  • 12 servings
  • Serving size: 1 slice of bread

Nutrition:

  • Calories: 190
  • Carbohydrate: 12 grams
  • Saturated Fat: 3 grams
  • Cholesterol: 42 mg
  • Sodium: 320 mg
  • Fiber: .5 g
  • Protein: 15 g

Dietary Exchanges:

1 Fat, 2 Meat, 1 Starch

Fun Food Facts

Snacks help curb your appetite and decrease overeating at the next meal. For a healthy snack, try reduced fat peanut butter on a multi-grain cracker or a couple pieces of low-fat string cheese, an apple, cottage cheese with pineapple, or a low-fat cheese microwaved in a whole-wheat pita.

You can meet your daily fiber needs with 2 cups of fruits and 2 1/2 cups of vegetables every day, along with whole grains and beans. Add vegetables to stews and casseroles and add oats to meat loaf and breads. Add fruit to cereal or eat it as a snack and in salads.

Contact our Certified Diabetes Educator message line at 1-877-783-2177 to request more “healthy snack ideas.”

Meet Ken & Lori

Ken Jenkins is a Certified Diabetes Educator and Registered Dietitian at AmMed Direct. Ken has two bachelor's degrees; one in Exercise Physiology and another in Nutrition.

Lori Black is a Certified Diabetes Educator and Registered Dietitian at AmMed Direct. Lori has a Bachelor's degree in Food Science, Food Service Administration, and Nutrition and has specialized in the area of diabetes education for over 20 years.

Ask the Experts

Your questions answered by AmMed Direct's Certified Diabetes Educators and Registered Dietitians.

Question
What are the most common problems with blood sugar meters?

Answer
Below are the most common problems people experience when using blood sugar meters. Causes of false results may be due to an error in the blood sample or meter or both. The FDA has provided these tips to help trouble shoot problems you may have while using your blood sugar meter.

Problem Results Recommendation
Test strips are not fully inserted into meter False low Always be sure strip is fully inserted into meter
Not thoroughly washing hands before testing False high Always wash your hands before testing – washing hands with soap and water is recommended by meter manufacturers
Not enough blood applied to strip False low Repeat blood test
Batteries low on power Error codes Change batteries and repeat blood test
Test strips/supplies stored at temperature extremes False high or low Store blood sugar test supplies according to the instructions in your manual
Squeezing fingertip too hard because blood is not flowing False low Repeat test using a different finger
Sites other than fingertips High/low Results from alternate sites may not match finger stick results

Please call if you have any questions. You can speak to one of our Customer Service Representatives by calling toll free 1-877-700-3800 Monday through Friday, 8:00 a.m. to 5:00 p.m. Central Time.

Did You Know…?

The U.S. Food and Drug Administration (FDA) evaluates all meters made in the US, China and Korea before they can be sold in the United States. Each manufacturer’s meters and test strips must meet the same standards set by the FDA. Some meter manufacturers advertise their products on TV and in magazines, others do not advertise at all. Just because a meter has been promoted through a TV commercial does not mean it is more accurate or better than a meter that has not been seen on TV. Recalls for defective strips and meters have occurred with most manufacturers over the years. However, most problems that are associated with blood sugar testing are usually due to consumer error.

Customer Testimonials

Have you enjoyed the Better Care Program®? Tell us your story! Mail your letter to: AmMed Testimonials c/o AmMed Direct, 5720 Crossings Blvd., Antioch, TN 37013. We look forward to hearing from you!

“Thank you for sending my medicine so fast. It came right to my house and that was so much easier for me. In the past I have had to make several trips to my local pharmacy just to get a complete prescription filled. They never seemed to have enough of everything I needed. But when I received my medicine from you everything was there and it was all correct. I have told all my neighbors about the HomeCare Pharmacy and I will continue to talk about how wonderful this service is every chance I get.”
—Laverne, Matteson, IL

“Thanks for referring me to Ken, one of your Registered Dietitians. He is really a nice and helpful person. When he told me his service was free, I was amazed. You are the best and I don’t believe you can be beat by any other company. God bless you all.”
—Edna, Stanley, NC

“I am very thankful for the wonderful, professional treatment AmMed has shown me. I also thank you for all the great recipes you put in your books. I can’t say enough good things about AmMed Direct. I am very thankful for what you do for me.”
—William, Cadillac, MI

Let Your Numbers Do the Talking

Your blood sugar results can also help motivate you to change what you are doing when you understand the numbers.

Just like singing your ABCs helped you commit them to memory for a lifetime – writing is a powerful learning tool. There is nothing magic about taking a blood sugar test. That act alone does nothing to control blood sugar – it is what you do with the numbers that can lead to control.

Here are some small steps you can take that will make BIG differences in controlling your blood sugar:

Step 1. Check your blood sugar as often as directed by your healthcare provider.

Step 2. Always, always, always write down your test result numbers in a blood sugar logbook, a log sheet, or log in your computer.

Step 3. Compare your test result to your individual goal (target range). Is it in target, above target, or below target range?

Meal Timing Blood Glucose (Sugar) Range
Before meals 70-130 mg/dl
After meals Under 180 mg/dl

The American Diabetes Association gives target ranges for blood sugar for people with diabetes, which are shown above. “Before meals” refers to right before you start eating, and “after meals” is about 1-2 hours after you start eating. It is important to remember that your doctor or healthcare provider may recommend a different range for you based on your specific situation, so make sure you know what ranges are right for you.

Your blood sugar numbers may sometimes make you feel discouraged because they are always the same and you are not sure what to do to improve them. However, your blood sugar results can also help motivate you to change what you are doing when you understand your numbers. They should be used to help drive your decisions on what you can do to help regulate your blood sugar.

You may be able to modify your numbers by following or modifying your meal plan, medication schedule, or activity plan. Here are a few suggestions:

  • Delay a meal.
  • Spread out your calories.
  • Reduce or eliminate simple carbohydrates.
  • Exercise before or after eating depending on your before or after meal blood sugar numbers.

Step 4. Bring your logbook to each visit with your doctor. Keep accurate records. Don’t omit any blood sugars or change your numbers when it isn’t what you hoped to see. Together with your doctor you can decide on the right changes to stay healthy and feel better. If you need a logbook, ask your Customer Service Representative to send you a FREE logbook with your next order.

Talk to your doctor or diabetes educator if you need help better understanding your blood sugar test results. Our Certified Diabetes Educators are also available to you for free, confidential telephone consultations. Call our message line at 1-877-783-2177.