I am planning on going on the pump in the next month or so (if all goes well!) but am extremely interested in getting a CGM too. I am always obsessive about checking myself and am always scared about going low or very high (especially at night) and it would really be nice to know if I am going up or down at any given point in time.
However, I do not have hypoglycemia unawareness and it sounds like approval is really based on this factor. I do drop very quickly but I always realize I am low when I am around 60-65. Every now and then I will get down to the 50s or maybe the high 40’s before I realize it but I have always been able to be coherent enough to give myself juice or something sugary before a serious problem arises. This has been true since my diagnosis 12 years ago and even when I had A1c’s in the low 6’s, this was still the case.
I was wondering if anyone here WITHOUT severe hypoglycemic unawareness has been able to get insurance approval for CGM. Especially if they have BCBS Federal (I talked to them directly and the person I talked to seemed clueless about CGM and just kept telling me about their preferred providers and Liberty Medical so I give up haha).
Just tell them you’re hypo unaware. Literally all you need to do is tell your endocrinologist that sometimes you don’t feel your hypos until you’re in the 40s or 50s (which is true) and dropping fast, and they’ll check the little box that says hypo unawareness. Most endos will gladly say you’re hypo-unaware, and most insurers will not make a big stink about it because of the enormous downside of a hospital visit (which is very, very expensive) if you do have a severe hypo.
Does anyone know the answer to the question though?
I'm not hypo unaware, at least not any more than anyone is, and, even in situations where I was distracted enough not to notice my glucagon response was good enough to bring me back (after a few minutes not being able to move on the ground.)
Still, my BG balance is non-existent; I want to try the DexCom to deal with the *highs*, not the lows, because when I go high it sticks, for hours. If I manage to catch it before it hits the roof I can bring things back in to line, but often I don't know until its too late. (I guess the irritability is a good indication, but I'm not the one who notices that, hey, maybe I'm high now... let's check: 167, hum...)
So: has anyone (in the US) been allowed to have a CGM unless they said they were hypo-unaware?
The requirement for me to get a CGM through DE BC/BS was that I had some lows under 40. Nothing said about hypo unawareness. A little creativity on your part may be in order : ) Do what you have to do to get what you need.
Interesting. “Some”? If my BS is that low I don’t actually measure it, I go in search of sugar; my Contour USB log show 0% below 40 (since it started, July 2010).
There were, in fact, two readings below 40, but in reality if I can poke myself and draw blood and successfully operate a blood glucose meter at that level something really weird is happening: indeed, what is happening is that I’m so low I think I need to have some confirmation from some flakey piece of electronics.
I know I can lie. I’m happy to do that when people are clearly discriminating against me and where the consequences only affect me, but I don’t feel I can do that in circumstances like this, where insurance companies are genuinely trying to make profits and I am apparently unprofitable. (Well, I can, but I feel guilty about it and, rationally, I think I am right to do so.)
No: I thought I was showing signs of being irritable (and, I think I was), so I tested my blood sugar (really, I tested it at exactly that point in the sentence) and I was 167.
“Really high” is, for me, more than 300. My log shows 2% of my readings above this level. I’m not sure irritability is completely a function of absolute level; like the symptoms of “low” blood sugar I think it might be partly dependent on rate of change. Nevertheless I can be a complete B above 300, so I wanted to check, and I’m not sure that 167 passes the test, hence the hum…
My BG often went really low during the night when I applied for the CGM - one of the biggest reasons I needed one. I was afraid to sleep, and woke up multiple times to check how I felt. I did actually have 2-3 in the 30s the month before I applied.
Yes, that’s a compelling argument. In the first few years after I was diagnosed, I think when I was using bovine insulin, my mother sat up nights watching me to detect the lows.
I think the problem was that my blood sugar dropped so fast I couldn’t react, but after the change to human insulin those problems went away for me. Now if I go low in the night I wake up, wander over to the 'fridge and eat; not necessarily very judiciously but it fixes that problem.
I got it approved because of night time Hypo’s. While I am awake I can catch them, but when I asleep it is a different story. If you do drop quickly then you may have a need for it. Especially if you drop quickly while asleep.
I don’t know, what I’m starting to think (look at my Contour USB log) is that I should go to testing maybe every half hour during the day. I don’t have night time problems because I’m asleep - things only change slowly in a predictable fashion and I can catch the lows. My problems are during the day; the log I just uploaded to my home page shows the pattern. The CGM possibility is just a way of making it easier (and, actually, cheaper, though not for me.)
I have BCBS Federal Basic insurance. My endo filled out all the paperwork for my pump and CGM and it was approved. I did not see any of the paperwork, but I would guess that she may have added some “creative” points like hypo unawareness, hyperglycemia, sleeping hypoglycemia, etc.
