The latest data from groundbreaking human clinical trials of the effectiveness of continuous glucose monitors (CGM) show that the primary determinant of improvements in achieving better diabetes control is regular use of monitors – six days per week or more – rather than the age of patients, and that benefits continue well past the time when people with type 1 diabetes begin using the devices – including experiencing fewer low blood sugar emergencies.

This is the result of two studies funded by JDRF. It’s not only these two studies, it’s tons of anecdotal evidence from CGM users. Why then won’t most insurance companies subsidise them? A few will in the USA, but none will at this stage in Australia.

I guess insurance companies prefer to be paying for emergencies with hypoglycaemia and hyperglycaemia, and later on, to be subsidising the complications that are often a part of life for people with diabetes.

How does that make economic sense, let alone be serving the health of people who have to deal with this dreaded disease on an hourly basis? Sorry, but it makes no sense to me.

CGM is the future of diabetes, at least the forseeable future. I would do anything to get one. From all I’ve read about the CGMs available in the USA, and possibly coming to Austalia in the near future (Medtronic already markets one here), the  DexCom SEVEN^® PLUS is my current choice.

I work hard to keep my BGLs in range – in the lower range of my target if possible.  If I test before I go to bed, and I’ve tested 2 hours before, I often can’t tell if I’m headed up or down. Unfortunatlely I have to have that extra mmol/L of safety before I go to bed. Night hypos (nypos) while you’re sleeping are horrid and I’ll do anything to avoid one. A CGM would be ideal in this and many other situations.

If I could know if I’m headed upwards with my BGLs, I can take action. Without a CGM, you’re just going to test 2 or 3 hours later, and find out that you’re exactly where you don’t want to be! You’ve already got the spike and then you have to work to get it down.

CGMs don’t really replace testing blood sugar on a conventonal meter – you still have to test a couple of times a day to calibrate the CGM (I’m sure this will change in the furture). Their primary role is to alert you to trends. Going up? Going down? With a CGM you know and can take action.

Insurance companies need to understand that for those who want it, it’s mostly out of their financial reach. But… at around $1000 for a CGM, how many medical dollars will that save in the long run?

Figure just one incident – transport by ambulance to a hospital, doctors and nurses time, drugs, a hospital bed and a whole lot more. How much would that cost? I dare say a whole lot more than the cost of a CGM, and a subsidy on the $70 per week for consumables, or less if you don’t wear it all the time. If you’re getting to hospital for some reason around twice a year, figure the cost!

It not only makes more economic sense for insurance companies to subsidise CGMs, both short and long term, they need to be encouraging anyone on insulin to be wearing one!

Are insurance companies in the business of helping people to stay healthy or are they saying no for some other reason?

I’m still learning in preparation for my insulin pump start but also lamenting the fact that Continuous Glucose Monitoring Systems (CGMS) are so lacking in Australia. I had high hopes for the Freestyle Navigator and the Dexcom 7+, but they’re nowhere to be seen and don’t look like they’ll land here anytime soon. Pity.

CGMS, like insulin pumps, really do help in diabetes management. What you can’t see, even if you test 10 times a day, is accurate trends. Is your blood glucose going up or down? What’s it doing when you’re asleep? At what point after food do you spike? Answers make for even tighter control.

I’m insanely jealous of those forum posters who write about their experiences with CGMS. The only CGMS available in Australia at this time, is from Medtronic. They’re expensive, the sensor only lasts a 3 days (unlike those mentioned above) and the cost is beyond my current budget.