Since being diagnosed with Type 1 diabetes in 1961, Chris Stiehl has witnessed every innovation in care over the past 50 years. Yet, with all the great medical and technological advances, he lives each day — like everyone with diabetes — with the threat of dangerous low blood sugar levels. And he fears that in two years, he will no longer be able afford the device that has helped him easily manage his glucose levels because it’s not covered by Medicare.
Back when Chris was first diagnosed, the only way to measure blood sugar was to have blood drawn at the hospital on Saturday morning. The results wouldn’t be available until Tuesday, rendering this process useless in managing his diabetes. Over the next three decades, many different, complicated ways to measure blood sugar were introduced, but none of them were very accurate. In the 1990s, electronic blood glucose meters made it a little easier, allowing people with diabetes to lance their fingertips to put drops of blood on a glucose test strip. This method provides current blood sugar, an improvement, but one which has limited value in helping to manage constant glucose fluctuations, especially while sleeping at night.
At the age of 53, Chris began using a continuous glucose monitor, which provides real-time information about his current blood sugar, where it is trending and how quickly. This has proved to be extremely beneficial in managing his diabetes and in short, keeping him alive. Now 63, Chris is worried because people with diabetes who are using CGMs through private coverage are being denied access to this life-saving technology when they turn 65 and transition to Medicare.
That’s simply unacceptable, and it’s time for Congress to ensure this doesn’t happen. The economic data alone are compelling — Medicare beneficiaries with T1D have disproportionately high hospitalizations and emergency room use, often due to low blood sugar, which can result in seizures, comas or death. The cost of an average hospitalization for such an event is $17,500 per patient. A recent study found 16 percent of elderly patients with T1D had at least one seizure or episode of unconsciousness due to low blood sugar in the past year.
By providing patients like Chris with alarms and real-time trend information, CGM technology enables them to take action to prevent these dangerous low blood sugars. In fact, in results from the JDRF CGM clinical trial published in 2009, the rate of low blood sugar events among adults with T1D fell by two-thirds over the first year of CGM use. That’s just one of the reasons why all diabetes clinical guidelines recommend use of CGM devices.
Nearly all private health plans cover CGM devices, and it’s time for Medicare to do the same. Sens. Susan Collins, R-Maine, and Jeanne Shaheen, D-N.H., agree. Together they have introduced the Medicare CGM Access Act of 2014 to require coverage for CGMs for seniors. Congress must act to ensure that the health of our loved ones doesn’t sunset at the age of 65. It’s time for Medicare to provide its beneficiaries with access to life-saving CGM technologies.
When Chris was 10 years old, his doctor told him to live fast and loose because he would die before turning 50 — and if he didn’t, he would certainly be blind. While Chris has had many complications from this disease, so far he’s proved the doctor wrong. But now he faces the prospect of being told he will no longer have access to the medical technology that has helped him avoid that dire prediction. Chris deserves better, and so do his fellow seniors with diabetes.
Derek Rapp is the CEO of the JDRF, the leading global organization funding Type 1 diabetes research, which is currently sponsoring $568 million in scientific research in 17 countries.