Dexcom Share Interruption
If you found yourself wondering why your Dexcom Share wouldn't work today, I have your answer.
“There was a power outage which overwhelmed the hosting companies power systems and backup power systems, it is back online now. ”
In the future (instead of making yourself crazy trying to fix the issue) you can always check out Dexcom's webpage; the current status of the Share system is always available at the link.
Judge: Medicare Must Cover CGM for T1D Patient
This article will be referenced in episode 39 of the Juicebox Podcast (to post at midnight 11/23/15). A conversation with Insulet's CCO Shacey Petrovich.
reposted from Medpage Today
by Parker Brown
Staff Writer, MedPage Today
A Medicare provider must cover a continuous blood glucose monitor (CGM) for one of its patients with type 1 diabetes, an administrative law judge has ruled.
The patient, Jill Whitcomb, had recently become eligible for Medicare, which does not cover continuous glucose monitoring devices, provided through United Healthcare of Wisconsin/Secure Horizons. Whitcomb has had type 1 diabetes for more than 35 years, with diabetic neuropathy and a history of hypoglycemia unawareness. A video of Whitcomb having a severe episode of hypoglycemia when she was not using a CGM because she lacked a Certificate of Medical Necessity from the doctor was used as evidence in a trial earlier this year.
United has not yet offered to cover the device and has until Dec. 14 to appeal the decision, said Dan Kraft, Whitcomb's caretaker.
Courts may be forcing CMS' hand for coverage of continuous glucose monitors
George Grunberger, MD, president of the American Academy of Clinical Endocrinologists (AACE), said in an interview with MedPage Today that he has been following this case with interest for several years. The AACE has tried to convince the Centers for Medicare & Medicaid Services to cover CGM for patients with type 1 diabetes who age into Medicare coverage, he added.
"All of our meetings, petitions, and lobbying have met with rejections thus far in spite of uniform recommendations of all relevant professional societies," Grunberger said. "This ruling will hopefully re-energize the efforts to bring 21st century thinking into Medicare decisions. It's all about safety, not just better care for our insulin-requiring patients."
Since the ruling last month, other administrative law judges have cited Whitcomb's case and have ordered that CGMs be covered for the plaintiffs, Kraft said. He provided a document of a recent ruling in which the judge found that the Whitcomb decision was "well reasoned and on point" and that "coverage of a continuous glucose monitor should turn on whether or not the item is medically reasonable and necessary for the beneficiary."
The costs of the monitors and supplies can be substantial: the device alone can cost $400 to $2,000, and the associated consumables can add up to $300 a month. But Medicare considers the device to be "precautionary" and therefore not eligible for coverage.
The court disagreed, ruling that the CGM falls under what Medicare calls a Durable Medical Equipment statutory benefit and is eligible for coverage. The judge also concluded that the device is "medically reasonable and necessary" for Whitcomb, citing evidence by the American Diabetes Association that CGM, "in conjunction with intensive insulin regimen, is a useful tool to lower A1C in adults with type 1 diabetes mellitus, and for those with hypoglycemia unawareness and/or frequent hypoglycemic episodes."
The judge wrote in the final decision that it was clear that Whitcomb was a "brittle diabetic" and that the device is medically reasonable and necessary in her case.
Appealing Medicare decisions is a five-step process. In 2013, an administrative law judge concluded that United must cover the device for Whitcomb, but United filed a request for a review by the Medicare Appeals Council -- the fourth step. That council reversed the decision, according to court documents, and Whitcomb and her attorney filed a complaint in U.S. District Court in November of that year.
But in May 2015, the district court remanded the case to the Secretary of Health and Human Services, saying that the secretary had erred in one of her conclusions. The Medicare Appeals Council vacated its earlier decision and the case was sent to the Office of Medicare Hearings and Appeals, where the latest decision was issued and United was ordered to process Whitcomb's claim.
"As far as moving forward, it will take patients themselves, individually and through patient advocacy groups, to pressure their legislators to change the Medicare coverage language to recognize the tangible benefits this technology represents to their constituents' lives," Grunberger said. "The professional societies have done their part in incorporating the technology into their position statements and guidelines."
Have Questions for Dexcom? Ask them here!
Your questions for Dexcom on the Juicebox Podcast...
Soon I'll be interviewing Mike Mensinger from Dexcom for my podcast. Mike is the Director of Mobile and Cloud Services Software Development at Dexcom - in short, Mike knows all about the apps and software at Dexcom and we are going to get to pick his brain, ask questions and offer suggestions.
At the moment we are in the middle of working out a time that works for us and will be recording this podcast episode either in the next few days or sometime next week. If you have something you'd like to add to the conversation don't hesitate. Leaving your thoughts as a comment on this post will help me to keep everything in one place but if you have something that you feel is private to add, feel free to email me.
Thanks in advance for participating! I'll do my best to get everyone's questions in during the time that Mike and I have together. In the meantime you may want to listen to my podcast episodes with Dexcom's CEO Kevin Sayer and their EVP Steve Pacelli.
The Juicebox Podcast is available online, at iTunes, with Stitcher and everywhere fine podcasts are heard.
Comedian Tracy Morgan Shows His Belly Exposing a Dexcom Transmitter
Tracy Morgan uses Dexcom!
Fans of comedian Tracy Morgan won't be surprised to hear that Tracy exposed his belly last week on the Emmy red carpet. But what none of us may have expected... Tracy - a type 2 diabetic - was wearing a Dexcom continuous glucose monitor.
So far I haven't found one news account that mentions his Dexcom transmitter, it seems to me that the websites are just excited to mistakenly refer to Tracy's stretch marks as, "scars from his accident". Too funny!
Added March 30, 2016: Tracey is at it again
Six Nights of Sleep
The insanity of youth sports may have just saved my life...
I've lost track of how long it's been since I've had a revelation about type 1 diabetes parenting that I felt should be shared. It has bothered me that I haven't written as much over the past year on this blog, professionally and for fun as I expected that I would, but I've rationalized the drop off by telling myself that I didn't have much to say.
Today I have something to say
Last week very early on Thursday morning I drug myself out of bed after only sleeping for a few hours because of a stubborn blood sugar and turned on the shower. It was just before five in the morning and I was about to drive to the airport with my son Cole. Cole is fifteen and his baseball team was about to compete in a week long tournament in Georgia. Cole and Arden have both played in tournaments in the past that have required a night or two in a hotel but this was my first experience spending a full week away from home where my wife and I had to split up to care for our kids.
I went to Georgia, Kelly stayed in New Jersey
Initially the trip caused us some angst. The cost of spending a week in Georgia is oppressive and felt ridiculous when considering that Cole is only 15. There was the specter of Arden's Omnipods and Dexcom CGMs needing to be switched during my absence, not to mention that Kelly had to use precious vacation time so she could stay with Arden. But I digress, let's get back to me in the shower.
Cole making a crazy catch in centerfield - Georgia
I was standing in that shower last Thursday morning completely sapped of physical and mental resilience. Next month Arden will have type 1 diabetes for nine years and I am so far past the day where I ignorantly believed that I was the one human being on the planet that didn't need a good night's sleep, that I now exist day-to-day in a zombie like manner dragging myself to the next handful of hours of sleep. Never-the-less I dutifully washed myself and woke my son, we drove to the airport and made our way to Atlanta where I met up with my son's team, each parent that accompanied had their own ideas about how to pass the time in Georgia - I was no different.
We all attended the games but there was so much downtime. One group of lone dads took the opportunity to relive their youth; some families traveled together and took day trips in between games... I slept because I had just enough focus left to recognize that if I didn't I wasn't going to make it much longer. The first two nights I slept for close to twelve hours respectively, on the third night I crammed in ten hours. On Sunday afternoon, my brain restarted. Some fathers were sitting around talking about the election and I was following what they were saying. The conversation moved back and forth, the topics were deep and flowing and I was keeping up and having thoughts of my own. I had not felt like this in a very long time. I then remembered a few months prior having a (semi) conscience thought that I was unfocused most of the day and that I was having trouble thinking. One night, not too long ago, I recall sitting up with a low blood sugar and feeling like my heart was going to burst. Yet after only three days of sleep here I was able to keep up in a fast-paced and thoughtful conversation.
I took some ribbing over the week for my early to bed late to rise game plan but I was undeterred and I tried to explain my exhaustion to a few of the other dads, they did not come close to being able understand, though I could tell that they thought they did. Yesterday Cole and I flew home after seven days of baseball in the unrelenting Georgia heat. I spent six glorious nights sleeping on a sketchy Marriott mattress that in any other situation, I'd have thrown out a window. Today I am a new person but that's not the end of my story.
While I was sleeping Kelly and Arden were at home living
Arden swapped two Omnipods by herself while I was gone and Kelly applied her first Dexcom sensor! I was super proud of both of them but not surprised in the least at the deftness at which they handled the tasks. It turns out that by removing me from day-to-day life, we removed a few misconceptions that have been solidified by time. You see up until five seconds after Kelly inserted Arden's Dexcom sensor, Arden was sure that only I could do such a thing. Now she knows that Kelly can as well and I'm betting that Arden is now on her way to believing that she can too. The girls also had fantastic control of Arden's BGs during a week were Arden played or practiced softball almost everyday and we all know that in itself, is no small feat.
The only thing left for me to do is to find a balance that keeps me from sliding back into the brain fog that allowed me to fall so far from feeling human without allowing Arden's care to suffer. It's too nice feeling like this again and I can't and won't ever go back. You have no idea how relieving it is to write this today... I thought I had lost my ability to write. I would have been heartbroken by that feeling, you know, if my brain wasn't numb. Instead my life was drifting away like a slow iceberg trudging along without me noticing the direction that it was taking.
If you are a long time diabetes parent please talk to your loved ones and find a way to get yourself significant quantities of rest and please don't stop sleeping until you feel like yourself again. You aren't the only person on the planet that doesn't need sleep and the fog that you are in right now is very likely clouding your reactions, thoughts and ability to live well.
If you are a new diabetes parent, heed this warning. You will not be the exception to the human need for sleep. I thought I was for years and had it not been for this baseball tournament, I may have died prematurely still believing that I was. No matter how badly I want Arden's blood glucose to stay in range, not sleeping to accomplish those numbers can't be the answer. A balance must exist and I'm going to find it.