So, I was finally able to just be approved under my BCBS/MyBlue’s DME benefits for the Dexcom! I am too excited. No more fingersticks. My poor fingers are so bruised. Let me tell you, though, it was such a fight to get approved. They were trying to run it under pharmacy benefits - and my pharmacy benefits are awful.
I was also trying to get on the Omnipod (I know it and like it because my 20 year old son has used it since he was 14) but that’s not going to happen. They have to run that through pharmacy, and my copays would be $300 for the intro kit and $900 per month for the refill pods. INSANE! I applied for their financial assistance program, and I was approved for a 20% discount – but even so, the copays were only brought to $250 for the intro kit and then $600 for the refills. Still not gonna happen.
So, I’m trying to get a Tandem Tslim x2 I think it’s called - works directly with the Dexcom and it’s supposedly able to be covered under DME. If so, I won’t have any out of pocket copays as I have 0% responsibility on my plan with the DME. Praying it goes through. I have only felt comfortable giving myself injections in my stomach but as things currently stand I’m so green, blue, and purple on my stomach from all the bruises I can’t wait to get a pump. I did attempt an injection in the back of my arm the other day, my arm hurt for 2 days. Did one in the side of my thigh yesterday, I don’t have enough meat on my outer thigh for it not to hurt.
Do people inject their butts or right above them? I have plenty of chunk there
Hi @HisWifeTheirMama the dexcom still needs a finger stick once in a while especially the first day when (for me) it reads “a little off”.
Pumps like x2 need infusion sets and cartridges, which might not be DME you have to check those consumables against your coverage they are expensive if you can’t get them covered
You can put a pod or infusion set anywhere you inject. I like “top of butt” but there are a lot of locations to use and rotate to.
I found a way to inject my upper arm:
*Hold the syringe between your index and middle fingers.
*Squeeze the skin at the site between your thumb and ring finger.
*Press firmly with your index and middle fingers to insert the needle. The pads of all your fingers should be touching your skin.
Lift your index finger and move your thumb to the syringe - you should now be holding it with the thumb and middle finger.
*Press the plunger with your index finger
Ta-dum! I find it works like a charm, although you may want to practice with an empty syringe until you’re comfortable. I also used the side of my stomach (the famous love handles) and the top of my thighs but I have plenty of flesh to use.
I use a pump but next time I give myself an allergy shot I’ll try to remember to post a video.
Here’s a diagram of injection sites - most are pump friendly.
Thanks so much for the tip! And for the diagram! I’m navigating and learning through the process. It’s not easy, but every day I learn something new! Thanks again
Congrats on getting your dex approved! I have the tandem pump and overall it’s a great pump. Id recommend searching the forum for more info/experiences with the tandem as plenty of other people have started threads about it.
As a pretty skinny person I use all the injection sites that I can (whether on pump and MDI)- inner leg, thigh, inner/outer arm, lower back, upper butt, stomach, etc. I’ve learned that steering clear of muscles or areas with lots of nerves and blood vessels (like joints) is key to avoiding pain. Also pinching up skin like Dorie recommended is a great tip! Interestingly the more you inject in an area the less it hurts as the nerve endings are damaged. One of the reasons why it’s good to switch up your sites.
One thing to remember is that our bodies change over time. If you lost a lot of weight pre diagnosis then you’ll probably gain some back. Just because your arms hurt now when injecting doesn’t mean they will forever.
I believe most insurances are on board with most pumps now, but occasionally additional authorization is necessary - usually your physician needs to document some things for insurance. But I’ve found the device reps take care of things up front so hopefully if you experience anything it will be a slight delay and not a road block.
Sarah @HisWifeTheirMama it is good to hear the progress you’ve made for the CGM.
After I gave up on bending the “new” thin needles trying to get them into my thighs, I began using my arms. The method, I’d place my arm over the back top-rail of a chair, relax and push relaxed tricep making a soft fleshy bulge.
@HisWifeTheirMama hopefully you won’t bend any needles when inserting your sensor. But if you do - or if you have any other problems - Dexcom should give you a replacement free of charge.
Put Dexcom’s number on your contacts as you will need to call them directly.
I’m with you on the outer thigh being painful. Top of the upper thigh is my sweet spot. Dorrie’s pic doesn’t show it but JDRF’s does. Insulin Injection Techniques and Tips - JDRF (@joe and @Dennis: know anyone who does content for JDRF? That pic could use an update)
When new diabetics mention injection pain the three things to check are is the insulin room temperature, what needle did the doc prescribe and which make and model syringe or pen needle are you using? I went from a 29ga 1/2" needle to a 32ga 4mm and it made a world of difference. Then the brand I had been using became unavailable in that size and I tried others. BD Nano Gen2 was the second most pain free pen needle in my experience.
A T1D diagnoses is definitely a time to reevaluate your health insurance options. In addition to what your employer offers check your spouse’s (if you have one handy) plan options and the Healthcare Marketplace plans. If nothing is affordable or you want a pump soon, have you seen Joe’s post about the new Tandem Mobi pump?
wow that is not the best graphic - I don’t know who manages the pages on the main site but I can ask around. The general rule is “if you can pinch it you can put a infusion set there”.
I’d like to address the painful fingersticks , make sure to use a new lancet each time because they dull quickly and that is when they become painful and scar…
I transitioned to an insulin pump over 24 years ago because I got tired of the multiple daily injections and the unpredictability of absorption and the bruising. It’s a personal choice. Everyone has to figure it out for themselves . There is no choice that’s best, just the one that’s best for you. My Medtronic pump and supplies have always been billed under DME and thankfully it’s been zero co-pay as compared to others that bill through your prescription plan.
Best of luck to you…
I have the exact same insurance MyBlue and my daughter uses both devices. Carecentrix will be your go to with the approval and Adapt Health/ Solara will ship out your Dexcom supplies. They can be frustrating, I have to call every 3 months and make sure my supply order has shipped but they get the job done and I persistent.
I chose to have Tandem send out the pump supplies which is simpler with them but carecentrix you still get the approval from. All items are covered as DME, with our plan no out of pocket cost, however we pay a hefty amount for insurance every month. If I can be of any help feel free to reply. She has been using both for over 2 yrs.
Give yourself a pat on the back everytime you get over these hurdels
I have tried the Dexcom in the past, and may try again, but am hesitant because my insurance company (Excellus BCBS) will only cover a limited number of test strips, and you do need to double check at times to make sure the CGM is accurate. The one I am trying out now has been amazingly accurate so far, but in the past, I have found both the Libre and Dexcom to be way off, so needing a lot of test strips. I am curious to hear from those of you using a CGM, how accurate you find them, how often you need to test with a finger stick, and how many test strips does your insurance allow?
I use the G6 and very rarely do fingersticks. I lost my calibration code when I started a sensor a few days ago and get a Calibration reminder each day but otherwise I just do one of them if my numbers don’t reflect how I feel. I don’t even use one container of strips in a year.
Don’t forget, your CGM is considered accurate if the number is within +~ 15% of your fingerstick. It’s a questuon of percentages, not numerical difference.
Hi Jess. I had to do 5 finger sticks in the past year to check my G6. Twice the G6 was spot on, once I did a calibration but it was in the first 24 hours, and the other two times was a check and double check when there was a lot of bleeding after insertion that indicated the sensor was in a vein and not interstitial fluid and I was asking for a replacement sensor from Dexcom. I’ve had a CGM for 6 years now, and I think it took me 3 years to figure out the best locations for me and how to keep the adhesive stuck to me.
The year before last I had a bad day. I thought I was just tired at first and my G6 said I was fine. Then I got very low very fast while I was trying to eat lunch. I managed to ask my wife for help. She looked at the G6 saying 76 and got me a juice but it wasn’t enough so I got hauled off to the ER. That was the one time I’ve had a G6 exceed being more than 40% off for more than 20 readings spec when I finally got above 70. The next day I sat down with my wife and we reviewed the G6 specs in the back of the user guide The takeaway is a CGM isn’t always right but most of the time its close enough.
Have you reviewed the information in the back of the user guide to see what accuracy you can reasonably expect from a Dexcom or Libre CGM? Are you using Dexcom’s 20% chart to figure out when to calibrate? Is my Dexcom sensor accurate? | Dexcom
When it comes to insurance my plan looks like they copied and pasted the medicare standards so I get Dexcom covered as DME and am allowed 100 test strips a month with provisions to get more if I jump through their hoops of fire. How often are you testing with a finger stick and what standard are you using to determine “way off”?
What do you call “way off”, and way off from what? Oh, and in answer to your question, during the 4+ years I used the G6 I used possibly a container of check-strips, 25.
Statistically, as Chris @spdif pointed out the G6 is far more accurate than any finger-stick BGM, so you should use something else - like a well equipped laboratory - to really know if your G6 or G7 and the newer Libre are giving inaccurate readings. And as Dorie @wadawabbit points out, one of the important measurements is “how you feel”.
I typically use one strip a month for either G6 or G7.
For me when I find a place on my arm where I get consistently good readings then I use that same spot on that arm every time. I have a few places on each arm where I put my sensors. Finding these spots increases accuracy of the sensor results.
Thanks for all these responses! As I mentioned, the G7 I a currently wearing is reading very close to my finger sticks, and I haven’t used a CGM in years prior to that, so having trouble remembering just how far “off” my readings were. I want to say 30-40 points on a pretty regular basis. That would be compared to my finger stick. Dennis, you mentioned that the "G6 is far more accurate than any finger-stick BGM, so you should use something else - like a well equipped laboratory - to really know if your G6 or G7 and the newer Libre are giving inaccurate readings. " Really? So the CGMs are closer to lab results than finger sticks? I had not heard that, but if that’s accurate, that is good news!
And Chris, I did not know about the calibration - I will look at that for sure.
Thanks again, everyone. What a great resource this forum is!
Jess @Jsich, there are many, many BGM (Blood Glucose Meters) that have what is referred to as FDA 510(k) Clearance meaning that proper use of that device should not cause serious harm; and that is good and I, for one of many, rejoiced when the first digital glucose monitor appeared after I’d been living with dibetes for three decades. The "not so good, is that to achieve that FDA designation is that the manufacturer has to show its evidence that a particular meter will deliver a reading at least 85% of the time that is within 15mg/dl/15% of a reading obtained in a laboratory. This standard was adopted about 10? years ago being more strict than the former 90% within 20% / 20 mg/dl - even that broader range I found good for me.
In April 2017 the FDA created and adopted a new standard and new designation - FDA Approved for calculating and delivering insulin; and this designation was issued for the Dexcom G6. Details of the standard are spelled out in the 42-page letter FDA issued to Dexcom - I’m looking for my copy. As I recall, the G6 underwent testing by FDA and an independent third party proving accuracy at more than 93% of the time at a reading less than 7.0 MARD. Since the initial G6, FDA Approved designation has bee given to Dexcom for its G7 and to Abbott for two of its Libre systems.
Thanks again