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Tuesday, February 18, 2014

Playing Guessing Games to Stay Alive: CGM & Medicare

I do not write often about Diabetes, because while I contend with it and live with it, I don't want to be primarily defined by that. I suppose most folks have at least one that, if not several of them.

This article at Texting My Pancreas, Continuous Glucose Monitoring and Medicare about a 65-year-old who lost an essential tool compels me to discuss my that.

So, for those of you who just arrived from another planet, diabetes is about a malfunctioning blood-sugar (glucose) function with your insulin, it comes in versions (Type 1 and Type 2), and for diabetics, staying alive involves monitoring your glucose levels. If a diabetic can monitor their glucose levels and then manage their inputs of food (and insulin, for Type 1s) then they're probably going to survive.

It all comes down to monitoring glucose. The 1990's way of monitoring glucose is: you prick a finger several times a day and use a sensor to calculate your glucose number. You get five or six datapoints a day. No trend info; you don't know if that 150 number is on an upswing or a downswing, you just know 150. It's not an exact science. It really is a high-stakes guessing game.

The blogger at Test, Guess and Go tells about her husband, who had a CGM (Continuous Glucose Monitor) from private insurance until he turned 65 and went to Medicare. Medicare will not pay for a CGM under any situation. Please click here to read more.

Action Item: Please contact your member of the House of Representatives and ask them to join Congresswoman Shea-Porter [D-NH1] and cosponsor, Congressman Matthew Cartwright [D-PA17] in asking Congress to pass H.R. 3710, the Medicare CGM Coverage Act of 2014.

And if I may go on a little bit further, since I'm writing about that.

The dirty secret is, industry makes an awful lot of money on test strips. They're about $1 each outside of WalMart. Do the math; $5/day for every diabetic in America; there's a huge incentive to not displace finger-pricking in routine American diabetic care.

What would displace finger-pricking in an age of Google glass, smart phones, FitBit and the Quantified Self Movement? Why, wireless continuous glucose monitoring. An internal sensor just under the skin, or an external sensor under a wristband, transmits a value every two minutes to your FitBit-wrist intermediate device. Sync it to your smart phone when you want, and upload your data to the cloud. See trend data, daily patterns, all the info you've never seen before. Take charge of your biochemistry in a way you never could.

In a world where you can insert an RFID chip into your dog (or aging parent) to keep track of them, coupled with the explosion of the diabetic population, the absence of consumer wireless CGM devices is shameful. A lot of people make a lot of money out of those prick sticks. Rat bastards.

1 comment:

  1. Thanks for spreading the word about Medicare not covering CGMS and encouraging your readers to contact their Representative's office. You're right that it is a crime how much test strips cost.