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Thursday, May 23, 2013
Diagnosis of Diabetes
DX with Diabetes-Code(250.00)induced by RX Decadron. I am not taking any medications as my glucose levels have return to normal and my A1c is in the middle 5% range. I have never been pre-diabetic or diabetic prior to this episode.My annual eye exam with dilation which was conducted 10 days prior to taking RX Decadron and then becoming symptomatic was unremarkable with no diabetes noted. Am I going to be labeled or branded a diabetic for the rest of my life due to a side effect of the drug?
The answer to your question is not straightforward. The approach you are taking is that you would never ever develop diabetes if you had not been exposed to the drug. However, there are some experts who say that you would not have manifested diabetes with the drug unless you had some predisposition towards it that gives you a higher risk of diabetes in the future. Please note that I said risk of diabetes but not a certainty.
So, as you can see, this is a gray area. There are two different considerations: 1) what is the best approach for maintaining your future health? 2) What will you be labelled as - rightly or wrongly? My suggestion would be to live your life as if you have the risk for developing diabetes and have the testing done to make sure that your blood sugar remains well controlled...but fight like "heck" against being labelled with the diagnosis. If you maintain (and document) a normal fasting glucose and a normal HbA1c annually for years to come, whoever wants to label you will have a harder time doing so - and you'll likely enjoy better health than if you hadn't made the effort.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati