I lost the genetic lottery. Let me explain.
- My father was a type 2 diabetic. He died 18 years ago at 63 years old.
- My grandmother was a type 2 diabetic. She died 50 years ago at 63 years old.
- My grandfather died at 56 years old in 1948. It could have been diabetes, but there was no real testing for that back then.
- You can trace it back. My great-grandfather died at 47 years old, his mother died at 57 years old.
- My sister has diabetes. My brother does not.
So genetics are working against me here. I was diagnosed with diabetes about 12 years ago, while I was in my mid 40s. I went on a diet and lost 90 pounds. That was good enough to manage my diabetes for the next 6 years.
As you may or may not know, diabetes is a progressive disease. Those with it know that it will progress eventually, and I am medically knowledgeable enough to know that it will likely be what kills me at some point. I am just committed to making that date as far in the future as I can. So I watched what I ate, stayed active, and kept up doctor visits.
At any rate, it was about six years ago that my blood sugar began climbing. My A1C was right around 8. So the doctor put me on Metformin. The doses slowly increased, another drug was added. Still, my A1C stayed pretty good, wavering between 6.5 and 7.5.
My levels slowly have been increasing. Last September, my A1C was up to 7.8. Then in April, my A1C was as high as it ever has been: 10.0. The doctor tested my blood to see if I was still making my own insulin, and I am. So we talked about a few options.
One option is to stay the course. That is the worst of the choices and, considering my family history, will lead to a death within a few years. Not a good choice.
The second option is insulin, meaning that I would have to inject myself at least once per day. There are a lot of drawbacks to that plan, and isn’t much better than option one. I’ve seen for myself that type 2 diabetics don’t do well or last very long once they go on insulin.
The third option was to try one of the new drugs: Trulicity, Ozempic, Rybelsus. The one we decided on is Trulicity. The catch? The drug costs $800 to $1,000 a month. None of the others are any cheaper. My insurance company says that they won’t cover it unless I can prove that I am a diabetic who has tried other, cheaper options, and those options don’t work. The Dr wrote the prescription.
Of course the insurance company kicked it back and demanded more documentation. We provided it. According to their own website, I fit the criteria.
The doctor just called me. The insurance company denied it anyway.
I have some calls to make to try and take care of this. I don’t think that I have any legal recourse, so I have to review my options. It is stuff like this that makes me believe that insurance companies should be liable for malpractice.