Q: My doctor says that I have prediabetes. I know he wants me to get my act together, but all I hear is: “Lose weight! Exercise! Eat right!” How exactly do I do that?
Gwenda F., Des Plaines, Illinois
A: Your doctor has done you a favor by alerting you to your higher-than-normal blood sugar levels. More than one in three North Americans has prediabetes, but only one in 10 even knows it! That’s a shame, because prediabetes increases your risk for heart disease and stroke, as well as sexual dysfunction and cognitive problems. If you go on to develop diabetes, the health complications can be even more severe.
The Community Preventive Services Task Force (www.thecommunityguide.org) just released a new set of diabetes-prevention guidelines recommending programs that include trained providers who work directly with patients. Before these programs become mainstream, here’s how you can set up your own task force for diabetes prevention.
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Check out sharecare.com and myclevelandclinic.org for dietary advice (avoid the Five Food Felons), walking programs (10,000 steps a day, no excuses) and emotional support (check out sharecare.com/buddy, or get a coach and find a peer support group).
Set realistic goals. Losing just 5 to 7 percent of your body weight slashes your risk for Type 2 diabetes by 58 percent. Dr. Mike’s book “This is Your Do-Over” offers great ways to be successful.
Get support. Every study that shows success depends on building a good team around you. Find diabetes prevention programs in your area. Your American Diabetes Association chapter will be very helpful, and many Y’s offer programs. Check out www.defeatdiabetes.org for peer-support groups in all 50 states. Sign up for a walking program (www.walkertownusa.com lists walking groups in all states).
Besides saving up to $50,000 in health expenses over your lifetime, you’ll save a leg or two, your kidneys, heart and brain!
Q: I’m an ovarian cancer survivor. When my doctor said that I should have a CT scan to check out suspicious lymph nodes, my insurance company turned down the request. Luckily, my doctor didn’t take no for an answer. She asked for a peer-to-peer review with the insurance company doc, and the scan was approved. How can insurance companies challenge a doctor’s request for a cancer screening?
Maggie D., Poughkeepsie, New York
A: You make a tremendous point here, Maggie. Whenever you find yourself in this kind of situation, a physician’s peer-to-peer review (your doc talking to the insurance company doc) is in order. But you can bet your doc had to spend a lot of uncompensated time trying to get you the right treatment (one way insurance companies try to lower costs and hurt your care), and a lot of folks don’t even know it’s possible.
To be fair, though, one reason you ran into trouble is that today the cost of over testing and over screening is in the billions of dollars. A Canadian cancer study compared two diagnostic approaches: traditional cancer screening, such as bloodwork and X-ray, and CT (computer tomography) in patients with unexplained blood clots in the legs and/or lungs, often an indication of undiagnosed cancer. They found no difference in the number of cancers detected (4 percent in each group) or in the number of cancer-associated deaths.
And over testing/over screening can cost you: It leads to over diagnosis, which can lead to unnecessary treatments. Some researchers believe that one in three breast cancers detected by screening actually may be harmless. And after years of research we now know that about 70 to 80 percent of men with an elevated PSA do not have prostate cancer.
Clearly, the public, insurance companies and doctors have to find ways to hold down costs and eliminate unnecessary procedures. But in your situation, you were lucky your doctor spent the time asking for a peer-to-peer review. And we’re glad to spread the word: Peer-to-peer review of denial of services/payment is available for almost everyone with health insurance, including folks on Medicare and Medicaid.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com.