Only seven weeks to go!! Now that we are in November there are less than two months to go until our Medicare part D patients get their new program and they can get back out of the "donut hole." We really need to make an effort to help them stay on their medications. We need to give them samples, vouchers or coupons or help them find an alternative for the next few weeks. 

Speaking of vouchers, yesterday one of my colleagues called me with an interesting question. They wanted to know if a Medicare part D patient could use a coupon to get some insulin. They had read on the back of the coupon that it could not be used with any Medicaid or Medicare program. This disclaimer appears on the back of almost all vouchers or coupons for medications. This is a common question pharmacists often get. To clear up the confusion we have to determine which kind of voucher or coupon we are talking about. If the voucher or coupon is for a reduction of copay, i.e. $35 off the patient's copay then it cannot be used with Medicaid or Medicare, as this would be reducing the copay. If the coupon or voucher is for a free supply and the pharmacist accepts it as cash and uses the coupon for the entire purchase price then this is okay, as there is no association between the coupon or voucher and Medicare or Medicaid. So when you are looking through your voucher box, make sure to select the one for free product or let your patients know they cannot use the dollars off one with their Medicare benefit.

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Last week it was the DPPOS, this week it is the results from the LookAHEAD study (See Item #1), which continues to prove the value of physical activity for our diabetes patients. Now with all this great information what is missing? I believe it is the order for exercise which works not the advice that we often give our patients. When we write an order for "Metformin 500 mg bid" our patients do not hesitate to get it filled because it is an order. But when we say you should get more exercise, that is advice and they often don't follow it. I recently found an article by Dr. Ranit Mishori that writing an order for physical activity may work.

According to Dr. Mishori, articles in the Archives of Internal Medicine, the British Medical Journal and the Scandinavian Journal of Medicine and Science in Sports, all prove that writing a physical activity prescription works. So this week see if it will work in your practice. Grab your RX pad and write for something simple like walking 10 minutes a day or bicep curls with water bottles for 5 minutes a day and see if your patients take it more seriously.

A special report on the global pandemic of diabetes; a pharmacist explains how your medicines can interact with your diabetes treatment; and dLife's doctor on call answers your questions about insulin and weight gain. Plus, Chef Michel Nischan with a crispy veggie taste treat. Watch more great programming from dLifeTV: Sundays on CNBC at 7 PM ET, 6 PM CT, and 4 PM PT.

TCOYD: Conference in Albuquerque, NM, Nov. 21

CGM, weight management, carb counting, insulin use in Type 2's, advanced pumping techniques, motivation, foot screening, health insurance, tai chi, Type 3 issues, grocery store pitfalls and gems, empowerment, keeping your kidneys kicking, cooking demos, zumba dancing, laughter, integrative medicine, Type 1 research update, cutting edge treatments for neuropathy, sexual health and diabetes, the list goes on and on and on.  Register today!  www.tcoyd.org

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We can make a difference!

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Check out this week's "Test Your Diabetes Knowledge" question.

Dave Joffe, Editor-in-chief