I have a patient who says she is diabetic.  But the problem is that she has a normal a1c and is not on any medications.  Do I take her on her word?  

Weight loss is a know cure for diabetes, i.e. gastric bypass etc.  Likewise, steroid induced diabetes or gestational diabetes often resolves, so diabetes can in fact be a temporary state.

 Can we take her at her word and treat her wound as a diabetic wound?

Should we do an oral glucoe tolerance test and determine if she is diabetic based on current guidelines?  (my preference) as we have no testing supporting her claim.

I believe HBO is likely to help her wound, however, I can see a denial of payment due to "not being diabetic" if I simply take it on her word, in light of her not being on any meds and having a normal a1c.