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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