Patient: Hello,I am not a patient, but an entrepreneur based in Japan who is trying to help people with diabetes and related complications avoid late diagnoses and complications.I would greatly value your advice on the following:1. When you pick up that one of your patients has diabetes, what stage are they normally at? If the diagnosis is late, what is the reason?2. How often do people typically get a general medical exam in the US?3. Is it true that general medical exams in the US do not include blood and urine checks by default? Are these ever done even if the patient has no diabetes symptoms, just in case?4. What is the typical cost of a general health exam?5. What is the typical cost of a diagnostic test for diabetes?6. Would it be at all helpful from the point of view of treating a diabetes patient, to have daily data since their last visit on their urine volume and pH, presence and levels of glucosuria, ketonuria, proteinuria and hematuria? If not, why not?Yours Sincerely,
Doctor: Thank you for your questions.Diabetes is known as a silent killer ….. meaning there are no early symptoms of the disease and as such many individuals do not know they have it and have no reason to seek medical care. That is why it is often diagnosed late in those individuals that do not attend their annual exam.Once diagnosed, monitoring is individual dependent. While more data is always helpful, daily data is often not required and would not alter the management plan significantly. Medications often take months to realize their full effect and this it is unlikely and changes would be made to treatment from daily fluctuations. The exception of course would be insulin managed diabetics.An annual exam will often include blood-work and urine testing but it is at the discretion of the physician and dependent on the patients age, medical history, medications and family history.Once diabetes is diagnosed, screening needs to be done to see if there is any evidence of end organ damage. Testing would be done related to the heart, kidneys and eyes. If no evidence of damage is found, the disease is likely caught in the early stage and prevention of end organ damage can be achieved.
Comments / Follow Ups
Patient: Thank you for this. Just to clarify:
1. What is the typical cost of a diagnostic test for diabetes?
2. You said that daily data would be helpful for insulin-managed diabetes. Could you clarify a little what this would mean in practice?
Doctor: This question thread has been closed by user