Home Diabetes Care Medicare Massively Expands CGM Coverage for Individuals with Type 2 Diabetes

Medicare Massively Expands CGM Coverage for Individuals with Type 2 Diabetes

Medicare Massively Expands CGM Coverage for Individuals with Type 2 Diabetes

When you’re on Medicare and you employ basal insulin to administer your diabetes, you’re now eligible for a continuous glucose monitor (CGM).

The change took place on April 16, 2023, and the result’s significantly expanded access to CGMs for individuals with type 2 diabetes.

Previously, coverage was mostly limited to individuals with type 2 diabetes that employed rapid-acting insulin before meals in an intensive insulin management strategy. Now, nonetheless, those that use only basal insulin — one or two each day shots of a long-acting insulin similar to Lantus — can even get their hands on the game-changing technology.

Medicare can be expanding CGM access to some individuals that don’t use insulin but have a history of “problematic hypoglycemia.” Among the adults that find themselves on this category could also be users of sulfonylureas, a well-liked class of diabetes drugs that stimulate insulin production and may subsequently cause dangerously low blood sugar levels.

Dexcom and Abbott Laboratories, the manufacturers of the 2 hottest CGM systems, report that the change could bring CGM technology to as many as 1.5-2 million people. And there may eventually be knock-on effects that help bring access to more Americans — private insurers often look to Medicare to come to a decision which medicines and devices to cover.

The change was cheered across the diabetes community.

“We applaud Medicare’s decision allowing for all insulin-dependent people in addition to others who’ve a history of problematic hypoglycemia to have access to a continuous glucose monitor, a potentially life-saving tool for diabetes management,” said Chuck Henderson, CEO of the American Diabetes Association.

Many experts imagine that CGM technology ought to be available to everyone with diabetes, no matter their insulin use or risk of hypoglycemia. Initially, the CGM was mostly limited to individuals with type 1 diabetes, a condition that entails a really high risk of life-threatening hypoglycemia. CGMs can sense low blood sugar and sound an alarm, alerting the user to take motion. It’s a feature that may save lives, but individuals with 2 diabetes are likely to have less need for such alarms, especially in the event that they’re not using rapid insulin before meals.

Even individuals with no serious risk of hypoglycemia, nonetheless, can profit hugely from CGM technology. Thomas Grace, MD, the medical director of Ohio’s Blanchard Valley Diabetes Center, told Diabetes Day by day that CGM is amazingly priceless as a “lifestyle modification tool.” People using the device “find out about what they’re eating, they learn what happens once they take their medications, they learn the advantages of physical activity.”

Dexcom, whose G7 might be covered under the updated Centers for Medicare & Medicaid Service (CMS) policy, helped fund the MOBILE Study, which provided among the data that was instrumental in CMS’ decision. That trial showed that CGM use significantly improves A1C and increases time in range for adults with Type 2 diabetes on basal insulin. The improvements, in truth, are on par with those of adults that use intensive insulin management.

“It is a major win for the diabetes community, and one other validation of how CGM can profit all people living with diabetes,” said Thomas Martens, MD, in a Dexcom press release. Dr. Martens was the lead investigator of the MOBILE study and is the medical director of Minneapolis’ International Diabetes Center.

Martens stated: “The evidence is obvious: Real-time CGM use helps individuals with diabetes on every type of insulin, not only mealtime insulin, achieve higher glycemic outcomes.”

Abbott Laboratories, the manufacturer of the favored FreeStyle Libre CGM system, also celebrated the change. Jared Watkin, senior vice chairman for Abbott’s diabetes care business, called it a “monumental step.” The brand new coverage will apply to the FreeStyle Libre 2 system and the FreeStyle Libre 14 day system, however the business’ newest model, the Libre 3, will not be yet eligible for coverage.

Each businesses also identified that the move should help to deal with racial and socioeconomic inequities in diabetes complications. Several studies, including a special survey commissioned by Diabetes Day by day, have shown that minorities in the US are likely to have lesser access to the perfect diabetes technology. Coverage across the board for Medicare recipients might help bridge among the gaps.

Each major CGM makers have arrange web sites to assist patients on Medicare find out about and order their products:

Dexcom for Medicare Users

FreeStyle Libre for Medicare Users


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