Why the unfairness? Type 2’s dependents on insulin every day should be approved pumps. If they get multiple shots daily than the pump would serve the same purpose. It also would give better glucose control and carb control. And research also shows that type 2 diabetics on pumps A1C goes down and eventually also shed some weight. I’ve done the research and I’ve read a lot about it, also if a type 2 diabetic has a c-peptide level lower that 110 the insurances approve them for pumps. But why so much red tape, if the proof is in your medical chart and lab results why the discrimination. I’ve educated myself all these years so that when issues come up I have an answer. Obesety does not give diabetes!! people stop following the media.All they do is confuse. I know skinny people who are type 2’s and they are not over weight. I’m aware of the differences between the two, but when your an insulin dependent type 2 what does it matter.
It’s a moral issue. Eventually, when research indicates how little control T2s have over developing diabetes, the insurance companies may be forced to adjust. Right now, I’m sure they see providing pumps as encouraging T2s not to diet, exercise, etc.
Well that is not very fair!
an insurance company that has moral issues? I find that hard to believe somehow
it’s probably cheaper to treat T2 other ways besides pumps
I’m type 2 and have been on a pump for 8 1/2 years now. I’ve been on insulin for 15+ years. I know quite a few type 2’s on pumps.
Why would that be? T1s and T2s who are uncontrolled have all the same issues. Pumps are expensive. They are not going to expend that kind of money on people who are believed to have contributed to their own ill-health. Note, I said “believed to have.” If you don’t think insurance companies calculate moral hazard, you don’t know insurance companies.
If your endo will work with you, prescribe the pump “as a matter of medical necessity,” and document reasons why you need the pump, you may be able to get a preauthorization and get the pump, hopefully. This is very unfair, but there are a lot of Type 2s on pumps, and who could afford to pay for pump and supplies out of pocket? So insurance must be covering. I would call up the pump companies and ask for assistance (Minimed salespeople are very helpful). You may have to get a case manager and fight for an appeal but I hope you will be able to get one.
if it’s cheaper and effective what do they care? do people w/ lung cancer gotta put up with this?
I don’t think that a 6 year old who was not fat at all would be the cause of her diabetes. Wether pumps are expensive or not she should have a choice and it should be respected. Type 1’s have more priority than type 2’s and that should not be, diabetes it the same either way specially if insulin is involved in treatment.
My daughter is 13 now and eats as healthy as possible,does exercise and takes her insulin when she is supposed to. An insulin pump should be a personal choice and not controlled by doctors, if the patient want’s a pump it shouldn’t be an issue, just do the paper work and that’s it, but doctors refuse to work and rather let others do their jobs.
Yes… we also often forget that Type 2 is a progressive illness. Many Type 2’s will not be able to follow the “cheaper and effective” alternatives for all of their Diabetic lifespans, and will need more therapies, including insulin. Most Type 2’s WILL require insulin in 10-20 years after diagnosis, and sometimes earlier. They take much more insulin than Type 1’s do, due to insulin resistance, so what’s the big hold up with giving them a pump? It’s just a way to punish them for assuming they were “bad” people who should have “prevented” their disease… That’s all it is. Though to be fair, LOTS of Diabetics have had to fight hard for a pump… including Type 1s… and some have gotten them relatively easy. It mostly depends on the insurance company and the % of coverage.
why would an insurance company want to pass on a moral judgement at the expense of their bottom line. That doesn’t make sense
Well I was told that if type 2’s c-peptide is 110 percent low, than type 2’s can qualify for a pump and have insurance cover it. But the procrastination from the medical aspect is emotionally draining me and my daughter. Every shot and every prick takes it’s toll daily.
They pass moral judgment TO protect their bottom line and not have to pay for the things people want or need... It happens all the time, particularly with operations... Watch the news sometime.
I have heard of many Type 2s on insulin pumps, although I've heard they have to have c-peptide measured to prove that they are not producing insulin of their own and are truly insulin dependent (as opposed to just supplementing what their body makes with injected insulin).
I notice that your A1c is excellent, and this can be a barrier for people getting pumps (why would an insurance company want to pay for a much more expensive treatment if what you're using now is working?). Is there a particular reason you feel a pump would help you when, if your A1c is any indication, your control seems excellent already? I agree with what someone else said to contact the pump companies and get them to help you with insurance coverage, that is part of their job.
Good point made by Jennifer that your great A1c may be the reason. Your page lists you as Type 1.
Maybe , maybe Stephany is advocating for type 2's ??
I also know of type 2's wearing a pump here in Canada and my province
I don't know, but perhaps if the AACE would endorse or recommend them for T2, that would go a long way in getting pumps for T2's.
I was fortunate enough to be able to afford a CGM out of pocket, but shortly after the recent recommendation came out from the AACE to give a CGMS to type 1's with complications, they started paying for it. I was shocked and grateful. Previously they told me that they would only pay for it if I had hypoglycemia unawareness.
I am actually offended that the strategy taken by both medical professionals and insurance companies is to grant insulin pumps and CGMS to only patients that have poor control. As a type 2, my insurance company will only grant you a pump as medically necessary after you burn out your pancreas and demonstrate a loss of control. I am not exactly sure how that assures the best outcome for patients or for everyone who has to pay for this.
A pump and a CGMS is not some one button technology that fixes your control. In fact, the best candidates for pumps and CGMSs are probably patients who have demonstrated an good ability to implement an insulin regime with injections. Instead, we rewards the diabetic who can only remember to take half their shots, eats ding dongs and twinkies and won't bother to test, calibrate, set and press the buttons on these devices dozens of times a day.
And Baby Tee does have a point, but in the scope of things, the AACE is overpowered by the ADA. The AACE does have a Statement on Insulin Pump Management, and they have a position that supports type 2 use, but Medicare still has established criteria that trumps this. The AACE suggests that suitable candidates be from three classes, one of which is:
Selected patients with insulin-requiring type 2 DM who satisfy any or all of the following:
• C-peptide positive but with suboptimal control on a maximal program of basal/bolus injections
• Substantial “dawn phenomenon”
• Erratic lifestyle (eg, frequent long distance travel, shift-work, unpredictable schedules leading to difficulty maintaining timing of meals)
• Severe insulin resistance, candidate for U500 insulin by CSII
This is a reasonable set of criteria but given the current Medicare criteria, is unlikely to change things.
Everybody quit dancing around and just admit this Type 2 discrimination.
I am now a using insulin dependent and do 7 shots a day. I plan to talk to my Endo today about a pump and taking the C-peptide test. This scares me. I am wondering if my pancreas is dying on me or do I need to do more exercise. It is awful to think that you body is falling apart while you are living in it.
To make life easier I may have to seriously fight to get something that a Type 1 can get without being so aggressive. I am not saying Type 1's don' have to fight. Per what i just read on this blog a Type 2 having to get a pump is going to be a severe uphill battle.
I know I need support with this. I will admit I am not doing everything I can be doing but I am trying.