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August 22, 2003

Blood Tests and Insulin Injections

Question from Bradford, Massachusetts, USA:

My father is 81 years old, is blind in one eye, and has to wear magnifying glasses to read. I am looking for a glucose meter that is easy for him to use. Right now he is using a meter which is okay, except that when I watch him use the machine, he can't see that well and doesn't put his glasses on. He's gets frustrated when he forgets that he has to turn the machine on first and wait until it tells him to insert the strip. So, he has to take the strip out and start over. (This is an age thing I know.) The next problem is that he has a hard time finding the little circle on the test strip to put the drop of blood, and because of his age, he has a hard time controlling his hand from shaking. Blood gets everywhere causing the machine not to work or he doesn't get enough blood on so he wastes a lot of strips at $44.00 per hundred. Is there a machine out there that's not complicated or expensive for the legally blind?

Answer:

You might want to take your father to a diabetes educator or a Guild for the Blind that trains people with diabetes in glucose testing. I just met with a 93 year old woman a few days ago with poor vision and shaking hands, and we systematically tried a bunch of meters and fingerstick devices. She did best with the LifeScan pen device which your father already had and an Accu-Chek Compact meter (the one with the drum). This meter made it easier for her because the strip was already in it, and she only had to press a button to get the strip out and ready to use. Another thought is the newest Accu-Chek Advantage which has a rubberized grip surface so it is easier to hold on to it. It would be worth your while to go to an expert for some help with the selection and training.

JS
Additional comments from David S. Holtzman, Esq.:

There are meters on the market which might be easier for your loved one to use, including some that test blood from other parts of the body, not just the finger. [ED: see Alternate Site Testing.] Medicare provides coverage for blood glucose meters for the visually impaired. But, here is the catch: there is a process your father must follow in order that his meter be reimbursed by Medicare:

His physician must prescribe a meter with magnified numbers or that has audio, or both.
You must purchase the meter from a medical supply dealer enrolled as a Medicare DME provider. Medicare no longer accepts reimbursement requests for diabetes meters or supplies directly from beneficiaries; they must be submitted by enrolled providers. Also, a medical supply dealer is more likely to be able to procure the special meters for the visually impaired. In my humble opinion, the mail order houses will not be able to provide your father the level of service he requires.

Have your father’s physician write an order for your father to receive training from a diabetes educator on the use of the new meter and to assist him in drawing blood. Even if he has had diabetes training covered by Medicare in the past, he is entitled to refresher sessions of up to two hours per calendar year.

DSH