Since being diagnosed with type 1 diabetes (T1D) in 1961 at the age of 10, I’ve witnessed every advance in care over the past 50 years. Yet, with all the significant medical and technological advances, I live each day—like everyone with diabetes—with the threat of dangerous low blood sugars levels. And I fear that in two years, I will no longer be able to afford the device that has helped me easily manage my glucose levels—because it’s not covered by Medicare.
It’s been a long journey. Back when I was first diagnosed, the only way to measure blood sugar was to have blood drawn at the hospital on Saturday morning. The results wouldn’t be available until Tuesday, rendering this process useless in managing my diabetes. Over the next three decades, many different, complicated ways to measure blood sugar were introduced, but none of them were very accurate. In the 1990s, electronic blood glucose meters made it a little easier, allowing me to lance my fingertip to put drops of blood on a glucose test strip. This method provided my current blood sugar, an improvement, but one which had limited value in helping to manage constant glucose fluctuations, especially while sleeping at night.
{mosads}Almost a decade ago, I began using a Continuous Glucose Monitor (CGM), which, for the first time, provided continuous information about my glucose levels, where they are heading and how quickly. This helps me see when my blood sugar is getting too low so I can eat something to prevent it. The CGM also has alarms to wake me up before it reaches dangerously low levels, providing protection when sleeping. I can’t imagine returning to what my life was like when I managed my diabetes without it.
Now that I’m 63, I’m worried because most people like me, who are using a CGM through private insurance plans, will lose coverage for this potentially life-saving technology when we turn 65 and transition to Medicare. I fear being without a CGM might be fatal, but without health care coverage to pay for the device, I won’t be able to afford it.
I am one of thousands of people with T1D who are being put at risk because Medicare doesn’t cover the cost of CGM devices, which have proven to improve glucose control. Medicare beneficiaries with T1D have disproportionately high hospitalization and emergency room use, often due to low blood sugar that can result in seizures, comas or death. A recent study found that 16 percent of elderly patients with T1D experienced at least one seizure or episode of unconsciousness due to low blood sugar in the past year; hospital admissions for low blood sugar cost more than $17,500 per patient.
By providing us with alarms and real-time trend information, CGM technology enables us to take action to prevent these dangerous low blood sugars. In fact, in results from the JDRF CGM clinical trial published in 2009, the rate of low blood sugar events among adults with T1D fell by two-thirds over the first year of CGM use. That’s just one of the reasons why all diabetes clinical guidelines recommend use of CGM devices.
Nearly all private health plans cover these devices, and Medicare should too. U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH) agree. They’ve introduced S. 2689, the Medicare CGM Access Act of 2014, to require coverage for CGMs for seniors. Congress must act to ensure that the health of our loved ones doesn’t sunset at the age of 65.
When I was 10 years old, my doctor told me to live fast and loose because I would die before I was 50, and if I didn’t, I would certainly be blind. While I’ve had many complications from this disease, I’ve so far proved him wrong. But now I face the prospect of being told I will no longer have access to the medical technology that has saved my life. It’s time for Medicare to provide its beneficiaries with access to these life-saving technologies, because my fellow seniors with diabetes and I deserve better.
Stiehl is a non-profit and management consultant. He has served on the board of directors of JDRF, as well as on the Leadership Council of the Pediatric Diabetes Research Center at UCSD in San Diego.