Page 89 - Life Insurance underwriting Ebook IC 22

4.2 Treatment of diabetes

The principal aims of treatment are to remove symptoms, normalize blood
glucose levels and effectively treat cardiovascular risk factors such as
hypertension and Dyslipidemia.

a) Type 2 diabetes

Type 2 diabetics may be controlled by diet alone or by a combination of
diet and oral hypoglycemic which act by promoting the secretion of
insulin (sulphonylureas such as glipizide) or enhancing the effect of
circulating insulin (biguanides such as metformin).

b) Type I diabetes

All patients with Type I diabetes need treatment with subcutaneous
insulin injections as well as a diet. Insulin is usually administered by
subcutaneous injection as insulin cannot be given by mouth because it is
destroyed in the gut before it can be absorbed. Insulin is generally given
at least twice a day.

4.3 Considerations to be given while underwriting diabetics

Long-term mortality rates in insured lives hate improved in the modern times but
Diabetes Mellitus still remains a significant risk to life.

✓ Type of diabetes: Base rating for diabetes depends on the type of
diabetes. Base ratings for Type I DNI are higher than that for Type 2
DM.

✓ Duration of diabetes: Longer the duration of diabetes in general
higher is the rating due to risk of developing early complications which
may not be picked by screening.

✓ Treatment and control: Degree of complications has a linear
relationship with the degree of control of diabetes, worse the control and
higher the risk of developing complications, higher is the mortality.

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