Juvenile Diabetes

[Mr_Ed]

Transamerica, Prudential, or American General are your best bets.

to correct my earlier post, Transamerica will not insure him if he was diagnosed with type 1 diabetes before age 45. So, if it was truly "juvenile diabetes" (meaning he was diagnosed as a child), then Pru or AmGen are best bet.

But, we really need to know his exact a1c readings over the past 12 to 24 months and his height/weight over the same time period.

 

[Arthur Rudnick]

Personally, I've never been comfortable with Pru's underwriting.
This is from their underwriting guide.

Type I (Juvenile Diabetes)
[FONT=Sabon,Sabon][FONT=Sabon,Sabon]Controlled (A1c < 8), < 60 units of insulin, weight within Preferred weight range, stable for 24 months, LDL < 140, BP < 140/90 and none of the diabetic concerns/complications* [/FONT][/FONT]Standard III (+150%)

[FONT=Sabon,Sabon][FONT=Sabon,Sabon]*Diabetic Concerns/Complications[/FONT][/FONT]
[FONT=Sabon,Sabon][FONT=Sabon,Sabon][/FONT][/FONT]•Frequent medication adjustments for lack of diabetes control or hospitalizedwithin 12 months for diabetes-related condition
• Average fasting blood sugar > 200
• History of CHF, Cardiomyopathy, or Heart Attack (MI)
• Significant Coronary Artery Disease including bypass surgery, angioplasty or stent placement
• Atrial Fibrillation within past 5 years or history of Left Ventricular Hypertrophy
• Carotid Artery Disease > 50% blockage
• Peripheral Vascular Disease, claudication, or Peripheral Neuropathy
• TIA within the past 5 years
• Smoking within the past 2 years
• End organ disease (eyes, kidneys, skin breakdown), dialysis, or history of amputation
• Retinopathy, or treatment for glaucoma, or progressive or significant vision lossassociated with diabetes
• Abnormal renal function with BUN > 30, and creatinine > 2.5 OR proteinurea/microalbuminurea
• History of Diabetic Ketoacidosis, Hemochromatosis or Bronze diabetes
• Chronic steroid usage
[FONT=AvantGarde,AvantGarde][FONT=AvantGarde,AvantGarde][/FONT][/FONT]

 

[CALTCAgent]

What confuses me with Prudential type 2 Diabetes they have listed the amount of insulin a person can take. With other definitions of type 2 Diabetes it is considered non insulin dependent.

I guess they call type 2 (Adult Onset) as their definition.

 

[VolAgent]

No, type 2 diabetics can eventually require insulin. Type 1 refers to the inability of the body to produce insulin. Type 2 refers to the body's resistance to properly using the insulin it produces.

 

[CALTCAgent]

No, type 2 diabetics can eventually require insulin. Type 1 refers to the inability of the body to produce insulin. Type 2 refers to the body's resistance to properly using the insulin it produces.

Thanks for that info!

When I wikipedia diabetes it says type 2 "formerly referred to as non insulin dependent".

I also notice at least 2 underwriting guides refer to type 1-as insulin dependent (IDDM) and type 2-as non insulin dependent. (NIDDM)

I guess there has been a change in the definition at some point.

 

[VolAgent]

Thanks for that info!

When I wikipedia diabetes it says type 2 "formerly referred to as non insulin dependent".

I also notice at least 2 underwriting guides refer to type 1-as insulin dependent (IDDM) and type 2-as non insulin dependent. (NIDDM)

I guess there has been a change in the definition at some point.

I'd say better understanding. It use to be juvenile and adult diabetes. The understanding has improved faster than the new knowledge has been disseminated.

 

[retread]

I'd say better understanding. It use to be juvenile and adult diabetes. The understanding has improved faster than the new knowledge has been disseminated.

Nicely said. I'm not an expert on the subject, but my sister has had "Juvenile" diabetes for over 50 years. I remember when they changed this term to "Type I", ostensibly because it was confusing to say someone at age 50 had "Juvenile" diabetes.

That said, Type I begins in Juveniles due to the fact that their pancreas does not produce insulin (or at least enough to sustain a blood glucose stability). In "Adult onset", now called Type II, the symptoms tend to come on gradually, sometimes over decades.

The current hypothesis revolves around a concept of "insulin resistance" in the uptake of glucose in body tissues because the body's own naturally produced insulin is not working properly. The thought is that insulin opens the cells to allow sugars in the circulatory system to enter cells to be converted to energy, etc. For the "insulin resistant" person, and because the body has some natural methods to compensate, more insulin is released by the pancreas. Unfortunately, giving insulin is not going to help in this situation since there is already an oversupply. Eventually, the pancreas drops the "hyper" release of insulin and now artificial insulin has to substitute. This event can come on suddenly.

As to gradual onset, my wife, for example, is considered "pre-diabetic" and prescribed Metformin, although she is not diagnosed with diabetes (yet). IF the disease progresses, she would be expected to follow a diabetic diet to control her blood sugar, and if that doesn't work, then oral insulin and eventually, injectibles. Because people vary in their "insulin resistance", it may take a couple of decades and some may die of other causes before the diabetes progresses to the point where injectible insulin is required. Ergo, not all "Type II's" will be taking injections. They could be on oral medication, or controlling it with diet alone.

The point an agent should remember, is to encourage your client to stick with the regimen prescribed by the doctor.

The major goal is to stabilize the patient's blood sugars. It is those high blood sugars that do extensive damage to the eyes, heart, and other organs. Those roller-coaster swings are more than just a concern for an emergency response, it is a disiplined routine that must be followed to avoid organ damage. That's why tracking the A1c is so important. It's a tell-tale that let's the doctor know if the patient is keeping to the discipline, as well as how well the insulin dose, if prescribed, is or is not helping.

Too many diabetics think that because drinking a sugared soda will stop a low-blood sugar light headed/dizzy feeling, they rely on this rather than watch their diet and excercise regimen. They view insulin as a miracle drug to be used to combat too much sugar, and sweets to halt a low. Let them know this yo-yo situation can result in blindness, etc.

 

[Small Town ND]

to correct my earlier post, Transamerica will not insure him if he was diagnosed with type 1 diabetes before age 45. So, if it was truly "juvenile diabetes" (meaning he was diagnosed as a child), then Pru or AmGen are best bet.

But, we really need to know his exact a1c readings over the past 12 to 24 months and his height/weight over the same time period.

Yes, he truly has "Juvenile Diabetes" so I know he has that factor in all of his previous life insurance.

He mentioned how his last A1C rating, taken a month ago was an 8 (he did mention how he was stressed with grandkids the day before) but it has been a 7 for the past 10 years.

His height is 5'11" and weight is 198, he looks really fit, so I would assume that it hasn't changed all that much. He mentioned on how it is monitered closely by a dr and how he goes in 3 times a week.