Medicare expands Dexcom/CGM coverage for Type 2 not on insulin

Dexcom stock popped Thursday after the Centers for Medicare and Medicaid Services said it would cover continuous glucose monitors for a broader group of type 2 diabetics.

The decision goes into effect in April, earlier than companies predicted. Under the new rule, CMS will reimburse the cost of continuous glucose monitors for patients whose diabetes doesn’t require insulin treatment. The agency also will cover CGMs for patients with low blood sugar.

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If I wasn’t on insulin ,would I feel overwhelmed with all that data? I thing a Libre would work fine,in my opinion. Nancy50

Dexcom for medicare would likely be used by those using insulin and or frequent dosing with pens.

Libre is good for those not on insulin.

Dexcom newer G7 is more similar to Libre, and might be good for anyone with diabetes even used periodically and share with doctor at appts to identify potential changes to meds, etc by seeing trends.

But choice may be most limited by insurance coverage.

‘Long time survivor of type 2 with my 2 cents - I think those of my tribe who are not using insulin yet would be more likely to be compliant in managing their blood glucose levels with the use of a CGM.

Very few want to do the kind of extensive finger sticking needed to learn which foods and what amounts affect their BG the most. With a CGM they can see how exercise affects BG levels.

I doubt this will bring the most hard case non-compliant T2DMs, but those probably won’t bother to use the device(s). There’s a lot of my tribe that don’t think it is important, even as they have an amputation or kidney failure. For these people a CGM of any type would not be helpful

As to @Nancy50 ’s comment about too much information for non-insulin using type 2 DMs, I respectfully disagree.

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Luis,I am a type 2 of 32 years. I did not say they don’t need information. I am saying do they need a Dexcom for $7,000 or a Libre for a lot less money ? I love my Libre, but I do not feel I need a Dexcom . I am on medication and injectables. Thank you. Nancy50

@Nancy50 I think your thinking is correct, but the cost for me on Medicare would be the same out of pocket-wise for either CGM. I did have to meet the insulin injections (3 or more) plus 4 daily finger sticks daily. This was 2 years ago.

Anyway, it looks like this change in Medicare requirements covers both Dexcom and Abbot, perhaps the Eversense as well. I guess it will be up to the doctor and patient’s choice.

Mine is fully covered under durable medical equipment. Thank you for the discussion.

Nancy Matulis

“Be the reason someone smiles today”

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Does anyone remember the first CGMs where you had this large box taped to you. With a heavy wire going from the sensor to the box. And it would alarm if your position was not right. And it would alarm in the shower. And it had no screen so after 15 days you went to the doctor and he printed the data and showed how bad your control was, but it was so long ago you can’t really remember what you ate or what you were doing at the time. So you left deflated and with no hope for a better out come ? Remember those days? Good times.

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Like the first insulin pump??

https://www.reddit.com/r/OldSchoolCool/comments/eo5oz9/dr_arnold_kadish_in_1963_with_the_first_insulin/

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Just so you know that first insulin pump was a closed loop system.

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