I recently had a pump problem and was MDI for 4-1/2 days. My numbers were so horrible. Although I have used injected basal occasionally as a companion to my pump, I hadn’t used injections for meals/corrections in almost 20 years. It was so hard and I was starved for data like insulin on board, etc. Plus I take such small doses of insulin for meals that it was hard to not take too much or too little. I was very happy to get back to my pump.
And although I periodically fight with Control IQ, I greatly missed the help it gives me in staying in range.
I am sure that if I permanently switched to MDI I would get better at it. I would probably have to go super low carb or else increase the size of my meals because boluses of 1.5-2 units are difficult to get reliably precise. I felt more comfortable with syringes because with small doses I felt I couldn’t trust a pen to give me the right amount and have it all absorbed.
But the 4 days did a good job of making me grateful for my normal diabetes regimen.
I just received my first Medicare (part B) pump about a month ago and wasn’t required to provide a c-peptide. My only c-peptide was at diagnosis 17 years ago and that one showed some insulin production.
I have had to wait a long time for approval also. Usually I find that Medicare needs some information or an Authorization form or something from the doctor. Once you are set up future order refills should go smoothly. If something changes though like your pharmacy or your insurance company etc. it becomes a problem again.
Your best bet is to tell the doctors office that you are having a problem getting it and see if they can help get it straightened out.
When you go onto Medicare you don’t have to get a new c-peptide if your doctor has an older qualifying one. No idea whether your test 17 years ago met Medicare criteria or whether you just got your pump without one. The Medicare regulations also show that if you test positive for autoantibodies, that is sufficient. Many of us with longtime T1 have never been tested for autoantibodies but probably many of the newer onset folks have had that test.
Regardless, glad you got your pump.
According to Medicare, criteria A or B must be met.
"A. 1. C-peptide testing requirement – must meet criterion 1 or 2 and criterion 3:
C-peptide level is less than or equal to 110 percent of the lower limit of normal of the laboratory’s measurement method.
For beneficiaries with renal insufficiency and a creatinine clearance (actual or calculated from age, weight, and serum creatinine) less than or equal to 50 ml/minute, a fasting C-peptide level is less than or equal to 200 per cent of the lower limit of normal of the laboratory’s measurement method.
A fasting blood sugar obtained at the same time as the C-peptide level is less than or equal to 225 mg/dl.
Phew! I’ve reviewed that Medicare section of rules regarding eligibility for pump and supply coverage in years past but I’ve forgotten about its dense bureaucratic format.
When I started on Medicare, I had to get a C-peptide test along with a concurrent glucose test in order to establish eligibility for supplies (infusion sets, reservoirs, and insulin) used in my current (and before Medicare) durable medical equipment pump.
Medicare has since, for years, covered my pump supplies including insulin. I have not, however, started a new pump since I became Medicare eligible. I trust that my endocrinology clinic has the expertise to navigate that bureaucracy when the time comes!
@Laddie, thank-you for commenting on this Medicare topic. I needed the review!
I got my current pump under a marketplace plan in 2020. They also required the c-peptide test then. But will likely do again this year for MC in June when my Tandem pump is out of warranty.
Probably. But Medicare is a giant government program so no one is going to be surprised if medicare insists they pay for another test so your medicare EHR has the test order and result.
Are you sure that’s a test result and not a diagnosis?
I hope everything goes smoothly for you and your new endo is a keeper.
Actually, I was surprised the result wasn’t 0. DX in 1965.
I only had 2020 C-peptide tested for insurance to use for approval/denial of last insulin pump.
Will find out if MC will accept this in June when current pump is oow.
For regular labs, I think that <0.1 is lowest result that you can get for a c-peptide test. I have had two c-peptide tests and that was my result on both. I think it’s considered to be 0. Certainly good enough to get a pump under Medicare.
