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Diabetes 101 - How to Win at Life and Life Insurance


By Ed Hinerman

A recent article from the Hilton Head Health Institute stated, "The evidence is growing that diabetes - especially "late onset" type 2 diabetes - is becoming an epidemic. American's well-known attachment to the "couch potato" lifestyle - fatty, high calorie foods and an aversion to exercise - may be the contributing factor to the spread of the disease. On the opposite side of the coin, the healthy lifestyle is believed to contribute to diabetes prevention and management." A January 9, 2006 New York Times article declared, "that the Centers for Disease Control estimate that 21 million Americans are currently diabetic while 41 million more are suffering from pre-diabetic symptoms, and many aren't even aware of it yet. Over the past decade, the rate of diabetes has increased 80% in the US. Yet most health officials still emphasize the threat of communicable diseases, which are far less deadly than chronic conditions such as diabetes."

Any life insurance agent that has been around for very long will attest to the statements made in that article. Diabetics now make up a large percentage of our client base and the number of people diagnosed as diabetic or pre or borderline diabetic on life insurance exams has sky rocketed. While most diabetics are insurable at fair rates, it is alarming to see how many diabetics have truly stayed somewhat uneducated about their condition and do not fully comprehend or care about the fact that diabetes can have a compounding effect on other health issues and ultimately be at least the root cause of a health decline that leads to an early death. Those diabetics who do take the situation seriously, educating themselves, monitoring their diabetes and taking control of other risk factors such as hypertension and obesity, can ultimately lead a long, healthy life. Not surprising that this group is also rewarded with life insurance rates that reflect their concern with their own longevity. It should be no secret that life insurance companies reward those who have an interest in their own mortality.

Those that do not take care of themselves are usually still insurable, but will pay a premium that reflects the end of the risk pool they have chosen to swim in. Not understanding the disease, not monitoring your glucose on a regular basis, not changing your lifestyle and not being compliant with your physician's suggestions will all contribute to higher rates that you really have to pay if your concern factor was a bit higher. Good quiz for a diabetic: Do you know what your hbA1C, or A1C level is? Do you even know what it is referring to? The A1C, a test done by your physician every time you have a checkup is a measure of how well you are controlling your diabetes. Blood glucose binds to the hemoglobin through a process called glycosylation. The higher the blood sugar the more the glucose binds to the hemoglobin. A blood test can measure the amount of glycosylation that has occurred revealing the average blood glucose levels for the previous three to four months before the test.

Do you understand why this is important to you? With a healthy A1C level of say, 6.5 or less, you know that your glucose is staying in check over long periods. Do not fool yourself into believing that the glucose reading you took before breakfast this morning is indicative of where your glucose is all the time. For instance, let us say you take your glucose at an optimal time, before breakfast, and the reading is 110. Then let us assume that your A1C is 7.5. That would indicate that your average glucose over the last 3 months is around 165. So, if the average is 165 and the low end is 110, that means that there are many times when your glucose is well over 200, not a healthy level. What are the complications of type 2 diabetes? What really worries life insurance underwriters? This list came from the American Diabetes Association website. www.diabetes.org:

Heart Disease and Stroke

People with diabetes have extra reason to be mindful of heart and blood vessel disease. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.

Kidney Disease

Diabetes can damage the kidneys, which not only can cause them to fail, but can also make them lose their ability to filter out waste products.

Eye Complications

Diabetes can cause eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. Early detection and treatment of eye problems can save your sight.
Diabetic Neuropathy and Nerve Damage

One of the most common complications of diabetes is diabetic neuropathy. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs.

Foot Complications

People with diabetes can develop many different foot problems. Foot problems most often happen when there is nerve damage in the feet or when blood flow is poor. Learn how to protect your feet by following some basic guidelines.

Skin Complications

As many as one-third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. In fact, such problems are sometimes the first sign that a person has diabetes. Luckily, most skin conditions can be prevented or easily treated if caught early.

Gastroparesis and Diabetes

Gastroparesis is a disorder that affects people with both type 1 and type 2 diabetes.

Depression

Feeling down once in a while is normal. But some people feel a sadness that just won't go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression.

Ultimately there is good news for type 2 diabetics working to acquire life insurance. With improvements in treatment and all of the available diabetic education, you can control your condition and to a great extent control your ability to get affordable life insurance. Type 1 diabetes Type 1 diabetes, often called juvenile diabetes, is different from type 2 diabetes but often has many of the same complications. While type 2 diabetes is occurs when a person has too little natural insulin or his or her body is not able to use the insulin `effectively, type 1 diabetes is the absence of insulin altogether. From www.ehealthmd.com we get this take on the cause of type 1 diabetes. "Diabetes is an autoimmune disease. That means the body's defense system attacks some of the body's own cells. In type 1 diabetes, the cells in the pancreas that make insulin are destroyed, and therefore they are no longer capable of making insulin.

We don't know exactly why this happens, but we do know that some people are born with a tendency to develop diabetes. Then something "triggers" the onset of the disease. It may be a virus that triggers the onset, or it may be something in the environment. There is nothing a person can do to prevent this from happening."

That having been said, a person with type 1 diabetes is left with two options. They can control their diabetes by persistently monitoring their glucose levels and being very committed and dogmatic about administering insulin as prescribed. There is an often-misunderstood relationship between diet and diabetes. The Mayo Clinic's website at www.mayoclinic.com suggests the following: "Contrary to popular perception, there is no diabetes diet. Furthermore, having diabetes doesn't mean you have to eat only bland, boring foods. Instead, it means you'll eat more fruits, vegetables and whole grains - foods that are high in nutrition and low in fat and calories - and fewer animal products and sweets. Actually, it's the same eating plan everyone should follow." So, a healthy diet and persistent monitoring and treatment are the key.

The other option I suggested would be the option of not taking your diabetes seriously. A type 1 diabetic who only occasionally checks their glucose, is not horribly committed to a healthy lifestyle, and may not take insulin as prescribed, but more when they think they need it, is a person who is looking for a long-term health problem. The long-term affects of mismanaged type 1 diabetes are at best damaging and at worst deadly. It should be no wonder that life insurance underwriters pay special attention to the type of compliance you keep with your doctor and dietician and the type of control you have achieved and maintained with your glucose levels.Again, you will not impress a life insurance underwriter, or for that matter, a life insurance agent who is knowledgeable about diabetes by telling them your most recent glucose reading was 98. That may be control, but it might also be a well-timed glucose check. The real story comes from your regular lab work and the test that reveals all secrets, the hbA1C. This test will take both your 98 and 230 into account; the reading you did not want to discuss or possibly did not even take because you knew it was bad timing for a good reading.

Your doctor and the life insurance underwriter are preaching from the same book, and the sermon is CONTROL! CONTROL! CONTROL!The Mayo Clinic sums up the repercussions of not following that advice. "Long term complications include - Heart and blood vessel (cardiovascular) disease - Nerve damage (neuropathy) - Kidney damage (nephropathy) - Eye damage (diabetic retinopathy) - Osteoporosis and several skin conditions." "Short term complications such as low blood sugar (hypoglycemia), high blood sugar (hyperglycemia) and a high level of ketones in your urine (diabetic ketoacidosis), require immediate care. If left untreated, these conditions can cause seizures and loss of consciousness (coma)." In summation it seems clear that whether type 1 or type 2 diabetes, the conditions are something that simply has to be taken seriously or the results can be disastrous and deadly. This fact is not lost on the people who decide what rate you are going to pay for life insurance. Diabetes does not preclude getting life insurance at competitive and good rates. Poorly controlled diabetes, for abundantly obvious reasons, may very well make life insurance expensive and even unattainable.

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