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Ask an Underwriter: Why should clients be screened for diabetes?


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November is American Diabetes Month and, ironically, the month for pumpkin pie! But … diabetes is about far more than skipping or modifying dessert. It’s a common condition affecting millions of Americans with potential life-threatening complications.

In fact, according to the American Diabetes Association, 29.1 million Americans, or 9.3 percent of our population, had diabetes in 2012, and 1.4 million Americans are diagnosed with diabetes every year.

So, even if your clients haven’t been diagnosed as diabetic or pre-diabetic, it’s important to understand the disease and its risk factors. One simple screening could save a life or a lifetime of complications! Unfortunately (or fortunately), their lab results can come back with surprising results.

 

Types of Diabetes

Type 1 diabetes

usually develops in childhood or adolescence (prior to age 30) and accounts for 10-15 percent of all cases. In Type 1, the cells in the pancreas responsible for producing insulin have either been destroyed or produce no insulin. Since no natural insulin is available, treatment involves injection of laboratory-manufactured insulin for effective control of glucose metabolism. Risk factors for Type 1 include autoimmune disease and a family history of diabetes.

Type 2 diabetes

is commonly associated with obesity and onset after age 30. A family history of diabetes is common, and sufferers probably inherit a predisposition to glucose intolerance, which is exacerbated by obesity. 

Gestational diabetes

starts or is first recognized in pregnancy, in a previously non-diabetic woman. It usually becomes apparent during the 24th to 28th week of pregnancy. Risk factors include family history of diabetes, obesity, birth weight over 9 pounds in a previous infant, unexplained death in a previous infant, congenital malformation in a previous child and recurrent infections. Thirty to 50 percent of women with a history of gestational diabetes develop non-insulin dependent diabetes within 10 years. 

 

Potential Complications

  • Diabetes Mellitus

    is a group of metabolic disorders characterized by chronic hyperglycemia from insulin deficiency or resistance, or both. It is usually irreversible and, although a reasonable lifestyle can be enjoyed, the late complications result in reduced life expectancy. Macrovascular disease leads to an increased prevalence of coronary artery disease, peripheral vascular disease and stroke. 

  • Neuropathy

    is damage to the small blood vessels that supply all nerves, causing numbness and tingling in the extremities, abnormal sensations and muscle weakness.

  • Nephropathy

    is a progressive kidney disease caused by damage to the capillaries due to longstanding uncontrolled diabetes.

  • Retinopathy

    is damage to the retina in the eye from microvascular changes which can cause blurry vision and, in extreme cases, blindness.

  • Proteinuria

    is the presence of excess levels of protein in the urine due to damage to the kidneys.

 

Testing – Hemoglobin A1C

The industry gold standard for identifying applicants with, and those at risk for, diabetes is an A1C screen. This test measures a person’s average levels of blood glucose, or blood sugar, for the past two to three months. It is measured as a percentage, and the ideal range is less than 5.7.

A hemoglobin A1C screen is stable, is not affected by glycolysis and does not require fasting, making it more reliable and accurate that a glucose test. These screenings can empower applicants to take control of their health, especially those who are pre-diabetic and have the chance to make life-saving changes.

So let’s all become aware – about diabetes or any disease. Ask questions. Educate yourself. Be an advocate for yourself and your clients. More importantly, know your number!

 

Learn More

Statistics About Diabetes, American Diabetes Association: http://www.diabetes.org/diabetes-basics/statistics/

 

About the Author

Debra Misko is passionate about her work and gratified to help clients find security for their family’s future. She has worked in underwriting for 21 years and has been with Ash Brokerage for more than eight years. A graduate of Schoolcraft College, she has a business degree and has also completed two of the Academy of Life Insurance Underwriting exams. 

 

UW Underwriting Diabetes