I’ve been a Type 1 diabetic since 2006 and been through so much and the complications keep coming. My health is deteriating quickly and keeping up with the frequent checks has been increasingly tedious. Can someone help/point me in the direction to get one of these bad boys slapped on me please.
Get a Dexcom. Even if you have to pay yourself it is worth it.
most common route if you live in the states and have insurance is to have a endo declare you need one then it’s a matter of calling dexcom or medtronic and then they send you one.
outside the US or instances where there is no medical coverage - might be different.
for those without any kind of insurance, social healthcare, or money, a CGM is an expensive bit of technology.
getting one aside, if you use a CGM you will have to test your blood sugar more. you will need to calibrate the CGM which is the same tedious as testing your blood sugar but with a few more steps, you will need to know that the CGM lags reality (can be 10-40 minutes behind your actual blood sugar), and is inherently more inaccurate than your meter, your meter is only +/-20% accurate above 75 mg/dl to start with, the CGM will be worse.
sometimes your doctor can get you a temporary CGM to wear around for a week, then they download it and discuss your blood sugar - these may be billed like lab work.
sorry to hear you have complications. diabetes is a pain in the neck and fingers. maybe if you tell us more?
My insurance just denied my request to get a CGM. Apparently I don’t meet their criteria for having severe enough hypoglycemia. I’m hoping to appeal the decision. At any rate, just be aware that not all insurance will 1) cover a CGM or 2) approve a CGM unless you have had severe lows.
Also, Joe, I’m not sure what you mean when you say you have to check your blood sugar more. I am expecting to check it less. Currently I check it at least 7 times a day on MDI. I could see testing more than that if I was on an insulin pump to bolus for snacks and such. One of my hopes for a CGM would be to cut down on post meal checks. Pre-meal would still be necessary for insulin dosage.
If I may ask, how low do you go and do you have hypo anawareness? Are your lows very rapid?
It seems stupid that insurance would not cover a CGM which would in the long run help to prevent serious complications. Keep pushing for one and wear them down with persistance.
I just recently got a dexcom and it is amazing! It has helped keep my numbers in check and i would deffinatly recommend it.
Yes, thankfully I can sense my lows, only diagnosed in April.
I finally got the denial letter from my insurance and the reason given was that none of lows that were submitted were less than 50 mg/dL.
The lowest I submitted was a 55 at the time, since then I’ve had a 51. I’m going to appeal with my new low reading and try to explain that 2 mg/dL shouldn’t deny me a CGM, in addition to other factors. It is obviously ridiculous that they have such criteria.
The funny thing is that this denial might actually be a blessing. I was all set to get the Tandem t:slim G4 pump assuming I could get the Dexcom G4 CGM because I really wanted the integration without the need for a separate receiver but with the denial I put the order of the pump on-hold.
In the few days since I found out that Tandem is going to launch a new pump by the end of the year called the X2. This pump will eventually have integration with the Dexcom G5 later next year. Tandem has an upgrade program for their customers. For the late comers (pump purchased after July 1st, 2016) they have two upgrade choices for the t:slim G4 customers 1) Swap out for new X2, cost $799 2) Send to Tandem for retrofit, cost $399. However if you have the regular t:slim (purchased after 7/1/2016) and swap it for the new X2 by the end of the year, the upgrade is free. So now I think I will go for the regular t:slim for the free upgrade and save myself some money.
Hopefully I can get the Dexcom G5 CGM approved and then I’d only have to use a separate receiver for 6-9 months.
So ultimately the denial of the CGM might end up saving me $400-$800.
hi @A_LADA_LIFE, hey that’s a good story. I think sometimes things have a way of working themselves out - this one sounds like you get better equipment and save money!
Test more. I get it, it seems as if once you get a continuous glucose monitoring system, you can pitch your bs meter and strips…but it just aint so.
the accuracy of your bs meter is +/- 20% (twenty!) starting there and the fact that the CGM doesn’t measure blood glucose, but rather measures a kind of conductivity of interstitial fluid, you have to know that the CGM is less accurate then your bs meter. it has to be. the best way to “calibrate” your CGM is to wait for at least 30 minutes when your BS is not changing, and then you do a bs meter test and then feed that info into your CGM - this sets the reading of your CGM to whatever your meter thinks your BS is. This calibration needs to happen 2x per day so you will test at least that many more times just for calibrations.
The CGM makes no claim that you can use the monitor to bolus or otherwise correct your blood sugar, rather, ALL cgm manufacturers say you should test before you make any adjustments. many people do use insulin based only on the CGM, however, many people also find the CGM too inaccurate to trust at face value. I like my CGM for trending and for pump tuning, other than that I find it too inaccurate and too slow (interstitial; fluid is not real-time, it can lead or lag reality by 10-60 minutes) to use for exercise or to replace my BS meter.
since you end up doing as many and often more testing with a pump and then still more testing with a CGM… I am not sure if its the CGM or the more testing that will bring your a1c down. I design machine controls and know that if you want to control something, you take more readings.
sorry for the long story - as with everything, this is just an opinion and your mileage may vary. good luck!
final thought. I feel my lows pretty good even though I’ve been t1 for 35+ years. Still, I suggested to my doctor that I “don’t always feel my lows” and that way the diagnosis of loss of hypoglycemic awareness thing made it to my insurance company… then, when they resisted, i suggested to them that if they deny a cgm on paper, and I faint and hurt myself in any way… that they will surely need to “lawyer up” - because I was coming. and that was all it took.
Hi there! There’s already been some great advice, I just wanted to add what helped me.
I just got a Dexcom G5 in May, and the best advice I was given was to contact Dexcom right off. Dexcom has great customer service! My endo gave me contact info for the Dexcom rep in my area, and that representative guided me through the whole process and took care of a lot of it for me. The Dexcom rep guided me through what the insurance company looks for when they’re reviewing the request. Since they have a lot of experience with these things, I think it increases your chance that you’ll be able to provide the necessary info to get approved. They also took care of all the communication with my doctor and insurance, so it was really surprisingly, delightfully easy.
Also, as to whether you have to test more with a CGM…I think this is a very individual thing. I almost did not get a CGM because I heard warnings like this. Then, I got the chance to try one out for a week and totally changed my mind. Thankfully, the CGM is very accurate with me-it is frequently within 10 points of my fingerstick reading, and there have even been times when it is dead on. If I’m rapidly rising or falling, I do have to pay more careful attention. But in those cases, just the fact that the CGM tells you that you’re rising/falling is sufficient to alert you to a potentially dangerous situation. I do find myself testing less. The 2X calibrations required every day usually fit nicely with my pre-breakfast and pre-dinner or pre-bed tests. I used to test a lot more frequently just because I had no clue where I was at…the CGM helps me avoid those wasted tests, allowing me to focus my testing on times when my blood sugar actually NEEDS closer monitoring.
Best of luck!