March 10, 2016

AACE Is Asking for More CGM Research

Apparently, the AACE did not see fit to add this to their consensus paper, but to make this statement after the conference and call for more research. This may be necessary because the experts disagreed and did not feel this was important enough. As I said in the blog about the consensus statement, the AACE missed a good opportunity to talk to Congress and point out what the CMS is doing by not allowing CGMs for people over the age of 65.

The participants in the conference must have felt something was important enough to issue this press release after the conference. Access to continuous glucose monitoring (CGM) should be available to all patients that could benefit from it, participants in a conference held by the American Association of Clinical Endocrinologists agreed.

I do appreciate that the attendees said the following - more studies are needed to show that CGM technology can benefit other populations, like patients with type 2 diabetes on intensive insulin therapy, according to a summary of the conclusions posted on the association's website. The conference, held late February, included representatives from scientific and medical societies, patient advocacy groups, the government, health insurers, and pharmaceutical companies.

Other conclusions from the consensus conference included:
  • Use of CGM has reduced hypoglycemia and has improved control of blood glucose
  • Recent technological advances have improved reliability and accuracy of CGM technology
  • Robust data support a benefit in patients with type 1 diabetes

Medicare does not cover the use of CGM, but an administrative law judge recently ruled that a Medicare provider in Wisconsin had to cover it for one of its patients. That case is still ongoing, however, and George Grunberger, MD, the president of AACE, told MedPage Today earlier that, "All of our meetings, petitions, and lobbying have met with rejections thus far in spite of uniform recommendations of all relevant professional societies."

In an email to MedPage Today, Vivian Fonseca, MD, the chair of the conference, said that it appears that insurers are approving CGM more often. But, there are two remaining government-related issues, he added: constraints on budget, and the statute covering durable medical equipment doesn't allow for a CGM. "It may require a change in the law," wrote Fonseca, adding that at the conference it was mentioned that there are related bills before Congress.

He added that he thinks CGM will be covered by Medicare "well before" 5 years from now. "The science has advanced considerably and shows a clear benefits of CGMs – particularly in preventing hypoglycemia, which costs Medicare a lot of money," he wrote.

The fact that type 2 diabetes was even mentioned is a big step for the AACE.

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