Dexcom needed


(Julie) #1

My 22 year old nephew is newly diagnosed with type 1. He attends college at UWMadison. He was told he can’t get a dexcom for 90 days because insurance is making him chart his highs and lows for that period of time. He would really benefit from having this device. My 8 year old has it and it is a life-saver…
Does anyone know a way around the 90 wait period with dexcom and blue cross blue shield of Illinois ???
Or does anyone have a dexcom 5 that they no longer use and would be willing to give him until he can get one in three months? Thank you for taking the time to read this. He is a great kid majoring in enginering and taking his new diagnosis with such grace.


(Dennis J. Dacey, pwD) #2

Hi Julie @JulieMurray, I’m not one bit surprised that he must produce those records.

Seven months ago I had to produce a 90 day record and then again last month before I was approved for a new pump I had to once again had to produce 90 days of BGL records plus a c-Peptide blood test that indicated "less than 0.1%. A CGM is a good device but not a “necessity” and in my eyes he may be better off without a device like that while he trains his awareness of BG levels. Oh, did I mention that I’m in my 7th decade living with very “brittle” diabetes and this is my first CGM other than some unreliable ones I tried 15 years ago.


(Julie) #3

Hi Dennis-
Thank you for your response. I do agree with you that it is good for him to become aware of his own body and his highs and lows without relying on the monitor. That is a very good point. My concern is in the middle of the night… it would be nice to have an alarm wake him up when he is too high or low. It is tough having to get up every 3 hours to test throughout the night. Thoughts or suggestions on how to handle the night?


(Ami-one) #4

@Dennis why on earth would they make you do that when you’ve had T1D as long as you’ve had?
@JulieMurray - I’m sorry your friend has to wait that long … if he experiences any lows without being able to recognize them, have him speak to his healthcare provider. Unawareness of lows is extremely dangerous. Also, if he lives alone or works in a job that would make it important for him to know if he was trending up or down. Still SMH about the waiting period.


(Dennis J. Dacey, pwD) #5

@ami-one, you ask why? Because those who make decisions act like robots - every box must be filled in before proceeding.


(Dennis J. Dacey, pwD) #6

Yes Julie @JulieMurray, it would be good to have an alarm to wake him during the night. For years, after the invention of reliable BGM, I got up between 2 & 3 AM to do a blood-check if I felt I was “low” - for my first 30 or so years I just got up and ate something because in those days a “blood sugar test” took days to get results.
As @ami-one has pointed out, your nephew isn’t aware that he can not recognize if or when his glucose level is approaching a dangerous level. There have recently been published reports that persons with diabetes who rely on tools such as CGM, Pump and including “closed-loop” systems have less favorable diabetes management.


(Ami-one) #7

:joy: remind me to give them cars with gas pedals but no brakes, headlights, speedometer, or cruise control and ask them to test their speed daily using a patrol man’s radar gun (with said policeman ready to provide tickets when needed) for 90 days before we give them a better equipped vehicle to drive. :joy: :joy:
Routing for your nephew!


(Ami-one) #8

FYI. My occasional unawareness of lows came after years of T1D. I could be fully operational at 35. It was only after a severe low that I started using Dexcom. It is very helpful because I really needed a partner in crime to keep any eye on my sugars while is still lived a very full, active life. Especially with T1D where insulin needs change day to day. Ergh!


(Andrew) #9

If he is new to Type 1, In my opinion he should take this time to fully learn to manage his blood sugars effectively without a pump. I’m 27 and have been Type 1 for 4 years and I have never tried a pump. I take pride knowing I can control my blood sugar with the most basic equipment: Syringe and Vial. And when I do finally get a pump (They are just too expensive at the moment, and I don’t feel I NEED it), I will have a sense of comfort knowing if it every died on me I would know exactly how to care for myself. So that is my vote, let him use this 90 days as a learning period without a pump!


(Dennis J. Dacey, pwD) #10

Like you, I managed well for years and was able to function even when low - I can even remember getting a meter reading, without assistance, of 22. True, there were nights when my wife made me get out of bed because my perspiration was dripping off me and I’d go downstairs to eat.

I got my first pump after 47 years of injections because I felt that I was running out of usable territory for injections was running out and an insertion set every three days was advisable. It wasn’t until almost 60 years on insulin that medics had to be called because I passed out taking a walk without realizing how low I had gone.


(Julie) #11

Perfect analogy!!! :rofl:


(Julie) #12

The waiting period isn’t for a pump. He uses syringes and insulin. The waiting period is for a CGM to monitor his bg 24/7. I worry about him going low at night when he is sleeping and not knowing he is low.


(wadawabbit) #13

Hi @JulieMurray. I was diagnosed in 1963 and home glucose monitors were not available until about the time I graduated from college. Back then we were pretty much “flying blind” but we managed. Although I didn’t know what my numbers were at the time I always ate a snack to tide me over as I slept - I typically wake up in the middle of the night anyway and depending on how I felt I would eat a snack, or not. Since your son has diabetes you know the system, but if your nephew hasn’t done so yet it might help for him to meet with a nutritionist: they can help him find bedtime snack options that will help maintain his overnight numbers, even if he does have to get up to test.
BTW, I found an app called MyNetDiary that I like to share with people on this site from time to time. You can use it free for a few days then must pay for a yearly subscription, but it tracks your BGs, has a huge food database that you can select from, including menu items from national/fast food restaurants as well as selecting “a la carte.” It provides pretty complete nutrition information on most anything you can think of, and you can add your own item in if you don’t find it. It also has trackers for BP, HR, weight, etc. SO much better than the paper and pencil logs I had to keep back in the day!


(Dennis J. Dacey, pwD) #14

Julie, is he and his attending physician really believe that he needs a continuous monitor, the doctor can write the necessary prescription - yes, it will be expensive for him but if he needs that, he will find a way to pay.
Getting a third party to pat, an insurance company, is something else.


(Julie) #15

Yes , his physician does think he needs it and wrote the prescription already for him. It is just the insurance that is making him wait the 90 days and chart his highs and lows so they have evidence that he actually has high and lows. It is the insurance company that is making him wait.


#16

A letter of need from his endo, not just the RX for it (which should in my opinion be considered a letter of need from the endo but isn’t) might do the trick.
It might also make a difference whether his family is doing the “legwork” with insurance or whether you have a Dexcom/Byram Health Rep doing the legwork for you. We had a Dexcom rep working the system for us and doing all the work back & forth b/t Dr. & BC/BS and we never had to have any charting of blood sugars. I think they just get faster results as they know the system so well. And they also have the incentive–they want you on that CGM! The Dexcom rep got pre-authorization from BC/BS for us. Process took about 1 month from first call to them to delivery and happened in 4th month after dx.

If you really want him on it sooner you could always pool family funds and buy the Dexcom out-of-pocket ($600-800ish startup??). Or you could buy the Freestyle Libre out of pocket (way less expensive–roughly $200 for reader & first 2 sensors). It doesn’t link to iPhone but you can set reminder alarms to wake him up for quick checks overnight.

Hope some of that info is helpful.


(Jo) #17

I know someone that refurbishes G4’s for those in this situation if you are interested. Jo


(Julie) #18

Yes I am
Interested… could you give me more info about it? Thanks for reaching out.


(Jo) #19

I can connect you directly with him (my brother). I’m T1D and he is as well, recently… Also being a curious engineer is in our favor. :wink:
I have given him my “end of life” G4 supplies and he has given them life. Can give me your email or # and he can contact you. Not sure if u can message me thru this or not. What are you comfortable with. FYI he works in law enforcement so your safe in connecting on our end. Jo


(Julie) #20

Thank you so much! My email is
Juliemiller0620@hotmail.com

I really appreciate you getting me connected with your brother!