Success, after 24 months.

Insurance Update

As you've all been reading for over 2 years, my struggle with getting insurance to cover the CGMS sensors has been a long journey.

For the past 2 years Every time I order sensors, I have to pay for them with a credit card, and then submit to Humana manually.

Well, that has now changed. Much to my surprise, my last order was processed directly from Minimed to Humana, and is now covered at 80%. Every time in the past, my order would be declined. This is a huge step forward! No credit card, no manual claim submission.

Matt, good to hear from you again, please leave your email address so we can talk.

Sensors, Insurance, and Apidra Update

Well, I apologize for not posting in a while, and have been getting many requests to keep going!

Here is an update on a couple of things.

1. I have stopped using the Apidra insulin. This insulin is WAY to fast acting for my body right now. I had a very tough time controlling high and low values over the 3 months I was using it. I was experiencing low values right after meals, and then fairly high values after 2 hours. I went back to Novolog, which seems to be a better fit for me. I’d be happy to share more if anyone is interested.
2. Sensors Update – I have some good news and some bad news regarding how my insurance company covers the expense of the glucose sensors. Humana considers Medtronic as an OUT OF NETWORK provider of the sensors, so I have to reach a separate OUT OF NETWORK $1000 deductible, before they will cover 60%. I find this funny, as my insulin pump supplies, which come from Medtronic are considered IN NETWORK. And since Medtronic is the only supplier, I have no choice. I could talk on this topic for hours if anyone is interested.
3. Be careful with thinking the CGMS will solve all your glucose problems. I have now been on this for over 2 years and have some words of wisdom. I have found you can micro manage your blood sugar that will actually cause some problems. For example, the sensors are NOT always accurate and they are delayed from your actual readings. The method the sensors use to measure your glucose is NOT real-time with your actual finger prick. I will be blogging much more on this topic shortly.

I hope this helps people and I encourage feedback on my posts.

Apidra Update

I've now been using Apidra for over a month. I have to admit, it's a very fast acting insulin compared to Novolog. It has taken a couple of weeks to understand how it reacts to my food and activities.

For my breakfast and lunch times, I have been able to tune my dosage quite effectively. However, my dinners have been giving me some trouble. For the most part, my breakfast and lunches are very standardized. My dinner are a bit more variable. Listed below is a situation that I've been encountering:

6:00pm - Apidra bolus and begin eating dinner (normal bolus)
6:30pm - Blood sugar begins to drop
7:00pm - blood sugar begins to rise dramatically (so I bolus again)
8:00pm - blood sugar begins to stabilize nicely

In doing some research on the insulin curve for Apidra, it reacts very fast, and can be on it's downward peak after one hour. This matches exactly to my situation above.

To fix this, I've now been doing a dual-wave bolus, where I'm lowering my initial bolus and spreading out the remainder for about an hour. This has been working better. Anyone else using Apidra?

Test Driving Apidra insulin

At my last visit, my endo gave me a bottle of Apidra insulin to try out. I've been using novolog for many years, and have had my ups and downs with it. I've noticed the following things with using Novolog:

• When changing infusion sets, I always get a 2-4 hour period that the insulin doesn't seem to absorb well.
• Novolog doesn't act fast enough during my bolus
• After a couple of days, I've noticed that sites become less aborbant to the insulin

My endo recommended apidra to help with some of these reasons. After Apidra for the last 5 days, I am very pleased. It appears to act much quicker than Novolog and my infusion sites have been more stable.

Anyone else have opinions on Apidra?

Insurance Success

I realize it's been a while since my last post, so I'd like to provide an update on a couple of items.

1. After a long haul, I finally got my insurance company to cover the cost of the glucose sensors. I still have to manually submit all my claims from Minimed to Humana. I'm just happy they now cover the 80% of the cost. If anyone wants to know the specific steps I had to take, leave a post and I can elaborate

2. I love the CGMS. However, I have been having some problems with the tape products that I apply over the sensor (to keep it water-tight, and stable). I currently use the IV3000 product that is recommended by minimed. However, as you can imagine, trying to apply this IV tape over the battery / transmitter causes problems. I frequently have problems with folds occurring, which then does not make a solid adhesive with my skin. Then, after water gets into these folds, the entire tape begins to lift up.

I've requested a "tape kit" from minimed and am looking into other tapes to apply. If anyone has some other good experiences, please let us know.

Singing the Sensor Blues....

First of all, I love my CGMS and would trade it in for no other product. However, I must share the reality of the experiences.

If you've read my blog in the past, you will see my concern with the ability of Minimed to keep up with sensor demand. My last order was on backorder for over a month. Like a broken record, they are again on backorder. However, I will admit, that they have added some additional customer service steps. Now, they promise to call me back every 5 days to provide me an update. Kudos to them, this really saves my time for waiting on hold to ask the same question.

Moving on, I went to use a new sensor the other day. When trying to take off the protective plastic sleeve on the needle, I accidentally pulled the needle out of the unit...it was like in slow motion....as I watched another $35 being thrown into the garbage. I tried to reassemble, but quickly determined it was impossible...arg.

Continuous Glucose Monitoring (CGMS) Insurance Coverage

I am currently going through the process of obtaining insurance coverage for my Minimed Real Time Blood Glucose Monitor and sensors.

I am asking for people to to reply to this post with any suggestions. I am looking for people to share how they got the insurance companies to pay for the sensors as well as those that have been denied insurance coverage.

Feel free to include the name of the insurance company. I use Humana and will keep everyone posted. I'm currently awaiting for my doctor to send a letter of medical necessity to my insurance company.

Thanks!

A1C dropped to lowest ever....6.8

Just visited the doctor today, my A1C results showed a 6.8. Since April, I've been able to drop my A1c from a 7.3 to a 6.8 by using my CGMS (continuous glucose monitor).

Now, my doctor and I are beginning to fine tune my regimen. My doctor is a older gentlemen that is very intelligent. Together, he is getting used to reading my weekly charts that outline my 288 readings per day. This is very exciting.

Case in point, I'm finding my 3 hour after meals is elevated. We are now working on adjusting my eating habits and my basal rates. The image below shows the reports from my minimed unit. Each colored line is one day, and this graph is from one full week.

Insulin and Hamburgers

This week, I've learned a very interesting thing about my glucose levels, and the foods that I eat. I was noticing that after eating a cheeseburger at McDonalds (no fries), I was constantly having low blood sugar levels. Not that I eat them often, but it's close to work, and it's a cheap lunch.

Normally I would bolus 3 units to cover the carbs in the burger. What I've come to understand, by watching the trends on my real time glucose monitor, that I do NOT have to take any insulin for that lunch. My normal basal rates, along with how my body reacts to this type of food was very interesting. This may not be the case for everyone, but it works for me.

I would never have been able to pattern this, without the use of the continuous glucose monitor. Boy, it feels good to master the challenge of certain foods VS insulin requirements.

Anyone else experience this?

Sensors have arrived!

After 2 weeks, I finally received my minimed glucose sensors. Of course, it was a rough ride. My sensor package was mis-sorted by UPS, so my overnight delivery took over the weekend. Instead of ordering my normal 4 pack, I ordered the 10 pack (just in case this backorder thing is a trend).

Normally, I have never wasted a sensor. But, this time after inserting the sensor, it bled quite a bit. This prohibited me from putting the IV tape over the unit right away. One hour later, the blood ruined the tape on the sensor, and it pulled out (just was I was going to put on the IV tape)....arg....there went $35 on a wasted sensor. Oh well, I'm just glad to have it back.