My friend has badly controlled T2 diabetes and won't test as often as she is told to. She is a nurse, 59 and really has bad habits. Her HbA1c most recently was 11.2

Anyway her insurance company has told her unless she tests like they tell her to, and she gets her HbA1c down, they will be charging her $50 a month more to cover the cost of complications that are likely to arise.

This seems entirely reasonable to me, but I was wondering-how common is it?

I have to admit I am not sure how common this is, but I do agree that is reasonable considering the fact that she is putting herself at a very high of health issues in the near future.

Perhaps this will be the wake up call she needs to get back on track. I am always surprised how healthcare workers (who see the horrors of uncontrolled diabetes) can ignore their own diabetes control. Perhaps they are so overwhelmed and scared that they ignore it, even though they should know better.

I really hope your friend makes the changes needed. Her A1c is very (dangerously) high, and she possibly needs insulin. A good idea would be to offer to cook healthy meals and exercise (i.e. go for walks) with her. She knows what she needs to do, now she just needs the support to do it. However, while I agree 100% that people need support, they also need to take responsibility for what they do. I hope your friend realizes that her life is important and makes the changes she needs to make. No one will help you if you don't want to help yourself.

Best wishes!

__________________
Pre-Med Student

Thank you! Unfortunately she cannot walk more than a short distance without becoming out of breath and quickly exhausted. More over, she says that my cooking is bland and boring and she has to eat soon after she gets home because I don't serve enough.......

Can we see the problem here I think that the $50 is entirely deserved, if a little sad.

Aside from her own person choices about not wanting to change, I do want to say that I am worried about your friend. You are a very nice person to try and help her!

There is a good chance that she is fatigued due to her dangerously high blood sugar levels. I assume she is also overweight. While she may simply be breathless due to her excess weight, she needs to have an evaluation to make sure she does not have heart damage due to her uncontrolled diabetes. Very high levels of ketones, found when there is insulin deficiency, can also cause breathlessness. This can be life threatening. She really needs proper medical attention.

Unfortunately, you can remind her of what diabetes can do, but in this case, it seems like she knows and has given up. Perhaps she is depressed and feels hopeless or ashamed? Perhaps there is someone she can talk to?

It may come to the point that a wake up call will be the only thing that will get her to take this seriously. One day next week she may wake up having a heart attack. Tell her you care about her, and don't want this to happen.

If a personal story to tell her will help, I have one. Just this past week, a friend of my parents died due to obesity and uncontrolled Type 2 diabetes. She was only in her 40's. The sad part was, she did not have to die so young.

She was obese, and did not change her diet. She did quit smoking, but still ate chips, cookies, etc. and did not exericse.

A friend came to check on her one morning and witnessed what happened. She stood up to get out of bed, and collapsed. She never woke up, and remained in the ICU for 3 days before being taken off of life support. She had a massive stroke.

The bad news is, yes this disease *can* kill you. The good news is, Type 2 diabetes can be controlled, and it doesn't *have* to cut your life short. I wish your friend would see this.

All you can do is try, and you have been a great friend. Perhaps when she sees how well you are doing, she will be inspired.

__________________
Pre-Med Student

Your friend is already suffering with all the ill effects that this disease is doing to her. She is already paying the price in pain and suffering because she is -- for whatever psychological reason -- not doing what she knows is right. I do not see how making her pay the insurance company money is the right thing.

If the company is so concerned with her health and what she might cost them in the future, why doesn't the company insist that she go for counseling to find out why she's refusing to save her own life? I think that would a be better way to help her than a fine.

But the insurance company wants a profit and is punishing her in a way they will make money for them in the short run, but it won't save them money in the long run, like real mental help would.

And I warn us all, if the insurance company can fine her for not complying to what they tell her to do, then rather quickly we will all find ourselves being fined for not complying.

Soon, woe to us who aren't completely healthy and doing exactly what others tell us to do -- and are getting the results others think we should. We will all be punished for not toeing the line.

What happens when your control becomes bad, for emotional reasons or illnesses of loved ones or because your body is fighting you for some reason. Will you then feel that it's right for the insurance company to charge you money instead of paying to find out why you are not well?

Go to your friend and sit with her and ask her how you can help and KEEP on asking until she sees that you won't be put off and that you will be there for the long haul. Tell her that your heart hurts to think that she won't be there in your future if she doesn't help herself now. Talk to her and talk some more.

She's obviously not taking her medication to be stubborn or just because she just wants to eat junk food. Find out why she's doing her best to kill herself, because, bottom line, that's what she's doing.

Maybe find a mental health center near you and you can take her there. Maybe someone she knows in the healthcare field can help you put together an intervention with other friends to help save her life.

A money fine will not help anyone other than the insurance company's coffers!