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Continuous Monitoring Is Here!


Feb 3, 2008

Dear Diabetes Health, after seeing your Web TV show where Scott King went on the Dexcom device for the first time, I have several questions.

Recently I went low in the middle of the night while sleeping. Luckily my husband realized it and helped me out. If I had had this device, would it have let me know I was starting to go low?

I showed my doctor the Dexcom device in your magazine and he said if I wanted it he would write the prescription. I would like to get the device very much, but I am not sure I can afford it and on-going sensors right now.

How much does the device cost? The Dexcom website lists it for $800. Does insurance cover this?

Leslie Stillman

Dexcom Responds:

At this point, some insurance plans are paying for the Dexcom CGM device.

Individuals will need to speak with their doctors and health plan to determine a process for securing reimbursement for the Dexcom system. In most cases, a claim can be submitted to your insurance after purchase of the device, which will include the original prescription, invoice for the purchase and letter of medical necessity from your doctor outlining the clinical indications for the use of continuous glucose monitoring to help improve glucose control and help better manage your disease. This claim will be reviewed by the individual's insurance company and a coverage decision will be made on a case-by-case basis.

The list price is $800, but the system is currently on promotion, priced at $450. The Dexcom sensors are sold in a four-pack and are priced at $240/box ($60 each sensor) The monthly on-going cost for continual use is $240/month (about $8.50/day). However, many people choose to wear the Dexcom sensor intermittently based on what their budget allows (for example, using two sensors per month would cost $120/month). Studies have shown even intermittent use can lend to improvement in glycemic control and reduction in A1c (Deiss et al, Diabetes Care, December, 2006).

The Dexcom sensors are FDA-approved for up to seven days of continual use. After seven days, you will need to insert a new sensor. The sensors are intended for home use, therefore individual patients insert the sensors themselves by using the sensor applicator that comes with each sensor.

Keri Weindel, MS, RD, CDE
Territory Manager, Northern California
Dexcom Inc.
San Diego, Calif.
www.dexcom.com


Categories: A1c Test, CGMs, Diabetes, Diabetes, Type 1 Issues



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Comments

Posted by Anonymous on 8 February 2008

Come ON!
Too COSTLY! Help us out--Give us a break!

Posted by Anonymous on 8 February 2008

A couple weeks ago I was a lab rat in a phase 1 trial of the Navigator CGM device. As part of the 5 day inpatient study, I also wore a Dexcom device and a Guardian device for comparison. The study was done by logging the meter BG values and a venous BG YSI value obtained thru an IV line every 15 minutes. 150 draws were performed during the study. The Dexcom meter ALWAYS read 30+ points LOW, compared to the YSI sample. One particularly aggravating event happened at 4am, on a day I had to awake at 5am. Because the meter read LOW, when my BG was actually around 85, which is my goal for tight control, the meter showed 55. At 55, the meter starts alarming a hypo event. I had to deal with awaking and shutting down a stupid meter that was INACCURATE. I lost over an hour of much needed sleep. After this study, and seeing the WIDE range of INACCURATE values these 3 meters show, I will NEVER use a CGM, not to mention the insane prices charged for sensors, etc.

Posted by YVONNELEET on 8 February 2008

THIS DOES COST A LOT. I HAVE HAD TYPE 1 FOR 42 YEARS NOW AND THIS ONE BE A GREAT HELP TO ME. I HAVE BCBST INS AND THEY DENIED THE CONTINOUS MONITERING DEVICE. SAID IT WASN'T MEDICALLY NECESSARY. I ALREADY HAVE TO CHECK MY BLOOD SUGAR 10 OR MORE TIMES A DAY.JUST THINK HOW THIS WOULD HELP. SOMETIMES IT MAKES ME WONDER IF ANYONE OUT THERE IS REALLY INTERESTED IN HELPING AT ALL. NO $$$$$ NO SERVICE. I KNOW IT TAKES MONEY YOU PAY FOR INSURANCE SO IT LOOKS LIKE THEY WOULD PAY FOR WHAT IS ACTUALLY NEEDED TO HELP OR EVEN SAVE YOUR LIFE..

Posted by Anonymous on 8 February 2008

i have been using cgms for almost two years and it is worth EVERY penny. i would much rather have this system than a movie and popcorn, lattes, eating out and cable. Plus many people wear the sensor for double their FDA recommendation for time, ie. 3 day sensors for 1 week and 7 days sensors for 14+ days. look at your budget, your health isn't that important to you? no i am not a rep or even in the industry. i am an athlete and this is v. important to me. those using $$ as an excuse are missing out. you can see where you are going with blood sugar trends and be PRO active with treatment.

Posted by Anonymous on 10 February 2008

I would love to have a continuous glucose monitor and my health is important enough to me that my last A1c was 4.9 with no meds whatsoever (I eat very low carb).

I cannot afford one of these monitors, even if my doctor would prescribe one for me, which I doubt.

I don't drink lattes, can't have popcorn, rarely see a movie in a theater, don't have cable TV, and rarely eat out. I also have 2 family members in college with a third starting soon.

I don't have a lot of luxuries to cut back on in order to afford this kind of hit to my budget. I wish I did!

Thank goodness my insurance covers my strips so I can test myself 5x per day and keep my BGLs low that way.

Posted by Anonymous on 11 February 2008

I lost my job due to several hypoglycemic episodes while working. I'm now recieving disability insurance and they would like to know what could be done for me to return to work. I'm unaware of when my episodes will happen but this device would be a life saver for me. I would pay to have this device if I could return to work with confidence that the CGMS was working. They have been on the market for a while (since about 2000 with GLUCOWATCH) but they were not very reliable. I bought a seperate meter I can carry on my belt but my employer released me on disability instead not wanting the liability and me hurting myself or others. I have been unable to find employment since being released due to the reason that my employer released me for having unrecognized hypoglycemia. My doctor has since changed my insulin and insulin dosages to have me carry a higher A1c in hopes that I will better recognize hypoglycemia. This device would save my life and my families life as I can't provide for them as I once did. Insurance companies should cover this instead of paying me $3600 monthly for disability.

Posted by Rick on 12 February 2008

I've had diabetes for 42 years and taken some serious hits. I have tried to get my insurance company to cover a cgms only to be denied. The funny part is they now have some kind of "wellness" program going and claim they're trying to keep me healthy! I guess an artificial leg or dialysis treatments are cheaper than cgms supplies. Or maybe they hope we'll just "go away". So to speak.

Posted by Anonymous on 14 February 2008

This looks like the answer to our prayers.
I'd be more than happy to pay the cost if it can be shipped to the UK.

Posted by Anonymous on 21 February 2008

I love my paradigm Real time with CGM. I am a pump wearer and could not imagine life without CGM. I use my flex spending account to pay for sensors...

Posted by jerrysmith on 22 February 2008

I have been using the Medtronic Minimed CGM system since November, 2007. It is great when it works but I have had inconsistent results. I have returned one defective transmitter and 3 sensors. The technical support from Minimed is also inconsistent. It is very frustrating to insert a new sensor and then have it fail. At times I have been ready to stop using the sensor but it is such a great tool that it is well worth the cost when it works!

I am on Medicare and have been a Type I for over 40 years. Medicare Part B covers 20% of my cost. I am hoping that the product becomes much more reliable.

Jerry Smith
Rochester, NY

Posted by Anonymous on 22 February 2008

Can anyone tell me where I can see this video?
("Web TV show where Scott King went on the Dexcom device")

Posted by Anonymous on 22 February 2008

$$$$$ I have been a diestronic pump user for the last 8 years. At that time I received 2 pumps for $5000!!! Now it is time for me to purchase a new pump because the warranty has expired. I am in the process of researching the various pumps on the market and I am amazed that my new purchase of 1 insulin pump is on average >$6000 !!!!!!!!
With the cost of today's technology I can purchase a BLACKBERRY Curve with GPS and MP3 for $250, I can surf the net, send emails, listen to music and find a map. So, why am I having to pay $6000 for a fraction of the technology?
THIS IS GOUGING!!!!!!!!

Posted by Anonymous on 3 March 2008

JerrySmith:

How did you get Medicare B to pay for 20% of the cost of the CGM? My diabetologist here in So Calif insists that there is no way Medicare will pay for either a DexCom or Medtronics CGM.
I, too, have been Type 1 for decades and decades and have lost about 1/3 of my brain cells from the nocturnal hypoglycemics events.
My opinion: I'm covered by Medi-DONT-Care!!

I believe that every legislator in Washington,DC ought to have a sufficient dose of fast-acting insulin injected into them to really see and feel the effects of hypoglycemic unawareness that most opf Type 1 diabetics develop after all these years.

Yeah, I know it's a budget problem but as long as there is porkbarreling and earmarks and bridges-to-nowhere, I'm convinced that our Congress people just don't get it!!

Posted by James on 21 March 2008

Leslie,
I have lived with DM since 1952-53, have been insulin dependent ever since and as a result have experienced many problems with this condition; hypoglycemic-uunawareness, peripheral neuropathy, ED, beginning of Charcot foot, loss of employment in 2004 due to being late to work by 2-5 minutes on 3 occassions within a period of a year as a result of having low BG those times & unconscious (in my vehicle) in the parking lot at work. As my supervisor explained, that was my problem, not the company's or hers.

However it is possible to have reasonably good BG control without a CGM, with determination & a persons willingness to change their way of eating. I was quite skeptical of using a low carbohydrate diet until last year....I started trying it last year and have been using that way since last July. I have had absolutely no loss of consciousness since beginning, I do have a partial reversal of ED, I now have at least a little awareness of when my BG gets too low, & can respond accordingly.

I had obviously been overdosing on insulin since the beginning simply by following the doctors advice in adjusting the insulin vs meals as per the ADA guidelines.

You might check out the book by a Dr. Bernstein, Diabetes Solution, from your local library and see if that method might help you. For me, it's been a life-saver. I've had very good BG levels since, reduced my insulin from the 30-45 units Novolog & 30-35 units Lantus daily, down to a maximum of 10 U Novolog & 9 U Lantus daily.
No more roller-coaster BG readings. Last A1C not particularly great, but 5.7 & getting lower.
Good luck in getting your CGM regardless.

James


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