Kind of fascinating … the history of Medicare’s decision to cover CGM.   

 

Could Medicare Cover Hearing Services? reported by Shohet Ear Associates, 8 July 2017.

Since the inception of the program 50 years ago, Medicare has excluded coverage for dental, vision and hearing services. The program has directly contributed to sharp declines in mortality and longer life expectancy for those aged 65 and older. Today, however, given the linkage between increased costs and poorer overall health and disorders related to these three conditions, policy experts are rethinking how Medicare, a single-payer, national social insurance program administered by the US federal government, could begin covering dental, vision and hearing services for adults aged 65 and older.

According to Amber Willink of the Bloomberg School of Public Health at Johns Hopkins University and her two co-authors, the low uptake of hearing services by older Americans on Medicare is supported by a 2012 Medicare Current Beneficiary Survey that indicated 75% of Medicare beneficiaries reported having a lot of trouble with their hearing, and 84% of that group reported that they did not have a hearing aid. Further, the authors cited a 2017 report that found Medicare beneficiaries spent 4% of their incomes on dental, vision and hearing services; with the average spend on hearing services being $1338. Since these services are mainly an out-of-pocket expense, many Medicare recipients are likely to forgo these services and cope with the negative consequences associated with them.

Why is this important for T1s?  Health experts medical researchers have debated the possible link between diabetes and hearing loss since the 1960s and early attempts to establish such as association were not very convincing. But in recent years there has been growing evidence to suggest diabetes contributes to hearing loss.

NIH research: In June 2008, a study by the U.S. National Institutes of Health (NIH) published in the Annals of Internal Medicine, found a strong and consistent link between impaired hearing and diabetes.

After analysing the results of hearing tests given to a nationally representative sample of working-age adults in America, the investigators found participants with diabetes or pre-diabetes were more likely to have at least mild hearing loss in their ability to hear low-to-mid and high-frequency tones compared to people without diabetes.

Japanese research: In July 2011, researchers from the Tsukuba University Hospital Mito Medical Center in Ibaraki, Japan, found that hearing loss is more than twice as common in people with diabetes than in non-diabetics.

How does diabetes cause hearing loss?

While it unknown exactly why hearing loss is more common among people with diabetes, autopsy studies of diabetes patients suggest this association is caused by neuropathy (nerve damage), which is a common complication of both type 1 and type 2 diabetes.

Researchers believe prolonged high blood glucose levels may lead to hearing loss by affecting the supply of blood or oxygen to the tiny nerves and blood vessels of the inner ear. Over time, the nerves and blood vessels become damaged, affecting the person’s ability to hear. 

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