The Savvy Diabetic
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How did my BG know that I was having a colonoscopy???

Seriously, after a day of fasting, I’m all over the place.  As if doing the prep and colonoscopy weren’t enough!!!  Really?!?!?!?

Is This a Good Thing?: Global Diabetic Care Devices Market Expanding to $25 billion by 2018!

According to Aracely McKay, writing for the Diabetic Investor:

The global diabetic care devices market is mainly driven by increasing technological advancements, increasing prevalence of diabetes, increasing aging population, increase in awareness of better diabetes management, and product innovation. The market was valued at $18.0 billion in 2013 and is expected to reach $25.3 billion by 2018, growing at a CAGR of 10% during the forecast period.

I’m having very mixed reactions.

Yes, of course, I want the best technology I can get to manage my diabetes.

On the other hand, do I really want my diabetes research dollars (which I work hard to raise) to go towards developing new devices that fund and expand private industry?  Should they fund their own development $$ or at least give back a significant amount towards research from their profits, made possible by $$ raised for research.

Or do they give back?  I just don’t know … what do you think?

Detail PDF Brochure Link:

The global diabetic care devices market is mainly driven by increasing technological advancements, increasing prevalence of diabetes, increasing aging population, increase in awareness of better diabetes management, and product innovation. The market was valued at $18.0 billion in 2013 and is expected to reach $25.3 billion by 2018, growing at a CAGR of 10% during the forecast period.

Exciting News! New Legislation about Medicare Coverage of CGM FINALLY!

Looks like a new bill was introduced into the Senate regarding Medicare’s coverage for continuous glucose monitors.  As you may have read on my blog, I appealed Medicare’s decision to deny me coverage for my CGM … up to the 4th level.  I was denied at every level.  Even though two Administrative Law Judges agreed that I had proved medical necessity AND cost effectiveness, I was still denied because Medicare ruled in 2006 that CGM was “precautionary.”

This bill, introduced by Senate Diabetes Caucus co-chairs, Senator Susan Collins of Maine and Senator Shaheen of New Hampshire, needs your action!

Please get INVOLVED, even if it doesn’t affect you YET, by taking the following 2 actions:

Click here to email your U.S. Senators to urge them to co-sponsor legislation that would ensure Medicare covers CGM
Click here to sign a petition to urge Medicare to act now to cover CGM

This is IMPORTANT for ALL OF US!!!

With much appreciation and thanks … let’s bring Medicare up to date on technology!

GUEST BLOG: An “Outsider’s” Point of View

Hello, my name is Laura Castillo. I am an incoming college freshman at the University of California, Irvine, who has only ever researched medical information for specific school assignments. I can give you information on urinary tract infections because I researched it for an informative speech I had to give in my public speaking class. However, now I have recently become friends with a woman who was diagnosed with type 1 diabetes at age 11. I have been asked the question- what do I know about diabetes?

Growing up, I believed diabetes fell upon those who had a massive amount of sugar intake in their diet. I see memetics* of overweight people, or cats, hovering above large platters of unimaginable desserts, and these only serve as validation to those as ignorant as I am- or as I was. 

In an attempt to learn more about type 1 diabetes, I watched a short clip of young people explaining the basics of growing up with type 1 diabetes ( In all honesty, while watching this video I felt like crying. I mean, I know this illness is not the plague, but the precautions of having it seem outrageous. One miscalculation or a bit of forgetfulness can become so suddenly fatal. Many people older or younger than these kids live their life under a virtual microscope. The highs and lows of blood sugar can only result in negative effects, even possibly death, for a person dealing with this disease. 

I’m curious to learn what you think is the most challenging part of living with this disease.  And I thank you, in advance, for allowing me to share my thoughts with you and receiving your feedback.



Follow Laura’s progress as she […]

I’m FREE … NO CGM for 6 hours!

I feel naked!  No, not really … but I’ve been wearing CGMs 24/7 since 2006!  Yup, I was at the head of the line for the first Dexcom, the STS, a 3-day sensor with wild variability … and Dexcom was such a small company that I invited the VP of Government Affairs and one of the 10 sales reps to my home to sit around and chat about my experiences with the Dex 3.  It was a frustrating device but with great potential … I fondly named it PoS. 

I switched to the Abbott Navigator, as soon as it became available on the market … and loved it (except the 10 hour start-up and the painful sensor insertion). And then, BAM, it went off the market in the US.  I even contemplated traveling to Israel or the Netherlands to buy it there.

But I settled for slinking back to Dexcom, for the Seven, and then the Seven Plus. It was indeed getting better and better, as I thought it would.  And I was the first in line to get the new Platinum G4 … WAY more accurate, although clunkier (explained to me for the parents who wanted a greater range away from the transmitter … which did not at all affect me but the size did).

That all said, I’ve been CGM-ing (is there a better term … maybe BG-sensing or BG-ing?) for about 8 years.  Yup, wearing a sensor, learning about Hypofix and Skin Tac, Yahoo’s Diabetes CGM forum, figuring out where to stash the receiver when wearing formal attire, etc.  Twenty Four Hours a Day, Seven Days a Week. 

I am NOT complaining at all. I am so grateful for the technology and […]

COLTON, the Diabetes Alert Dog

Our support group GNO had the opportunity to visit with Colton, the wonder diabetes alert dog recently. And he was truly amazing! Trained by one of our members, Jessica Ching, Colton wears a special collar. He is able to sense/sniff high, low or changing blood sugars … and then alert his owner by pulling on the tags on his collar or otherwise getting her attention. He is so obedient and sweet. And I understand that when he is flying on an airplane, he frequently alerts his owner because he senses a blood sugar event from another passenger.

What a wonderful dog and thank you, Jessica, for bringing him over for a visit!

By the way, I will give a free book to anyone (not associated with GNO) who can guess what GNO stands for.


The Changing Face of the Endocrinology Office

When I was first diagnosed, in the dark ages, there were NO insulin pumps, NO CGM, NO blood glucose meters, NO HbA1c, NO disposable syringes, NO human recombinant DNA insulin.  Yup, certainly seem hard to believe … almost 50 years ago.

Then came advances:  human insulin, portable (and even tiny) meters, disposable syringes and Lantus, insulin pumps with and without tubing, CGM, A1c … AMAZING and WONDERFUL new techniques and technologies, helping me to live better and longer and with fewer complications.

In all that time, the “doctor’s office” changed too.  Improved?  Jury’s still out on that and much of it depends on where you live, your doctor’s office and staff, and how proactive you are about managing your own health and your medical team.

Here’s what I see … and the caveat is that I live in a large metropolitan county within an hour’s drive of both Los Angeles and San Diego.  Indeed, we are offered top notch and accessible medical services.  But is it better?

I see endocrinologists, mostly in group practices, who manage T1 PWD’s mostly by the lab results and the numbers.  They are busy … very busy.  (there is talk that there will soon be a shortage of internal medicine doctors, not to mention the trickle down to a more severe shortage of internists specializing in endocrine disorders (endocrinologists).  The endos in practice do NOT have a shortage of patients, as there is a horrific boom in the diagnosis of both Type 1 and Type 2 diabetes.  What feels lacking is compassion and a sense of truly caring. 

To handle their large caseload of patients, from my vantage point, they are less personal, give less time and have less direct follow up.  They […]

And TODAY is a better day!

Why is it better today?  Don’t know!

But … it sure feels better, like this …

Reallllllly? It’s a ROLLERCOASTER day!

This was my 24-hour CGM readings yesterday!


I DON’T KNOW.  But I sure know it didn’t feel grand!

In fact, it felt like the picture below!  Know what I mean?

No Medicare CGMS Coverage??? Are you kidding me?????

by Joanne Milo
16 July 2014

Medicare (except in Advantage HMO plans) does not cover any CGMS. There are codes for sensors, receivers and transmitters! But their ruling, in 2008 (when they just came on the market), deemed them “precautionary.”
How is “precautionary” defined? Who knows … it’s certainly not a term one can find in all the Medicare formulary data. So this becomes circular logic. No one knows what “precautionary” means but because Medicare cries, “PRECAUTIONARY,” CGM is NOT COVERED.

I just couldn’t believe that I couldn’t somehow convince Medicare that CGM was not only critical to my life and my long term well-being, it was also cost-effective over multiple daily test strips. I threw my heart and soul as well as hours of research and letters from my doctors.

First Level Appeal: DENIED because CGM is PRECAUTIONARY.
Second Level Appeal: DENIED because CGM is PRECAUTIONARY.
Third Level Appeal and phone hearing with Administrative Law Judge, whose 50 year-old son has
diabetes (probably Type 2) and does just fine testing 2-3 times/day. DENIED because CGM is PRECAUTIONARY. The ALJ even wrote that I proved medical necessity and I proved cost efficiency! But still denied!
Fourth Level Appeal: DENIED because CGM is PRECAUTIONARY.

My next step, if I had the time and money, was to sue Medicare. Don’t have the money or time. Asked for support from a CGM company … again DENIED.

CGM has been available to the diabetes market since 2008 … and been improved and revised. According to Dr. Steve Edelman, UCSD and a T1, the best strategy for avoiding sudden death in bed is to use a CGM. This is an essential medical device […]