Today, thanks to Gina at Tu Diabetes, is CGMS Denial Day. While I am still awaiting word from my insurance company as to whether or not my Mini-Link CGM sensors will be covered, I wanted to join others in making sure insurance companies understand that CGM coverage is medically necessary.
I’ve had several bad hypoglycemic episodes, and I’ve noticed that they’ve become more frequent since I tightened up my control after I got married and starting thinking about pregnancy. While my A1c’s dropped to the low 6’s, the cushion I had between being low and not low diminished. Being in the 60’s pre-meal was a good thing, especially when pregnant, it gave me more room to bounce from 2 hours post-meal. This way I ensured my 2 hour readings never went over 125 while I was pregnant.
With these lower numbers, I’ve become unaware of my lows until they hit in the 40’s. The first bad low happened when I was 9 weeks pregnant. I had apparently just hit a point where my insulin needs were dropping, and my changes did not keep up. My husband and I woke up on Sunday morning. I was apparently telling him about a necklace I had gotten the day before. When he changed the topic, I kept talking about the necklace, and was not able to answer his questions. He got concerned, asked if I was low, and when I didn’t answer, he pulled out my meter and tested me. 37 flashed back at him. He fed me some orange juice, tested 5 minutes later and I was stil in the 30’s. He called 911. I came to as the paramedics were pumping dextrose into my forearm. I was embarrassed, and very scared of what harm I may have caused our baby.
AFter Naomi was born, I had another incident where I woke up unresponsive. Josh tested me, I was low, and he could not feed me juice, so called 911 again. I came to on my own before the paramedics arrived. Every night, Josh asks me if I have tested. I know he is scared that I will wake up unconscious, as my lows don’t seem to wake me anymore.
If these incidents are not reason alone for coverage of a CGMS, my continued hypoglycemia unawareness struck again this past spring as I was driving home from work. One Friday, I ate lunch at 11:30, gave what I thought was an appropriate amount of insulin to cover the carbs I ate, and got into my car at 2:00. My pre-meal blood sugar was 124. I did not test before I got into my car, and regret this still today. The last thing I remember was driving past the White House. When I came to about 10 miles away from where I remember last, I was being pulled out of my car by the Fire Department. They kept yelling at me – is your bloodsugar low? I could only look down at my clothes, trying to remember who I was and what I was doing here. I hope that I had just been having a bad nightmare, that this was just a really bad dream that I needed to wake up from immediately.
I hit 5 cars and caused thousands of dollars worth of damage. I am thankful that my daughter was not in the car with me at the time of the accident, and that I did not hurt anyone else’s children. I have to live with the regret of not checking my blood sugard before driving, but I would not be able to live with myself had I caused anyone harm.
The day after my accident, after I got home from the hospital, I called my Minimed Rep and told him I needed the CGM asap. I opted to pay out of pocket, because billing my insurance would add a few days to me receiving it. I have been working to keep my blood sugars higher over the past 3 months, in order to hopefully regain some awareness of lows when I am higher. But my CGM makes me feel better about not feeling a suddent dip when I am driving. My husband knows that I will wake up conscious the next day.
Anyone who says this device is not medically necessary does not understand the world of fear that I live in on a daily basis. If there is technology out there that can alert you to lows before they become life-threatening, why would you deny this to somebody? And why would you wait to allow someone to have this technology until AFTER an incident has already happened? Aren’t our lives worthy enough of having the most protection possible? I know the technology is new, and I do know for a fact that my CGM spits out bad numbers from time to time but, good lord, it is better than NOTHING.
Please do not deny my claim for coverage for a device that can help me be the best mother I want to be. Please do not deny my claim for coverage so my husband does not have to worry about me every night when we go to sleep. Please do not deny my claim so I can stop living in fear every time I get in my car.