Medicare policies potentially harm patients with T1D who use insulin pumps

  • Argento NB & al.
  • J Diabetes Sci Technol
  • 31 Mar 2019

  • International Clinical Digest
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Takeaway

  • Current Medicare insulin pump policies present challenges to people with type 1 diabetes (T1D) that could lead to delays in receiving supplies and subsequent adverse outcomes.  

Why this matters

  • People with T1D are living longer, and more are becoming eligible for Medicare.

Study design

  • Survey of 241 adults with T1D who had been on insulin pumps with Medicare coverage for ≥6 months.
  • Funding: None.

Key results

  • Reported problems included difficulties in obtaining supplies (56%), getting paperwork completed (24%), and getting the required face-to-face provider visits every 90 days (18%).  
  • Changed behaviors resulting from delayed access to supplies, reported by 39% overall, included leaving sites in place beyond the recommended 3 days (66%), reusing pump supplies (34%), using injections to compensate for inadequate supplies (23%), or temporarily stopping pump therapy (18%).  
  • Of 88 who had changed behaviors because of Medicare-related challenges, reported adverse effects included more erratic or higher blood glucose (48% and 42%, respectively), increased anxiety/frustration (44%), site pain/irritation (34%), and more site scarring (28%).  

 Limitations

  • Respondents recruited from online community T1D Exchange Glu, predominantly well-educated, white, and well-managed patients.
  • Those responding to the survey may have been more likely to have had negative experiences.

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