Nothing like pushing the deadline for the October Blog Carnival by waiting until today to write my post. I could muddle on forever talking about the differences between the types of diabetes, so I have selected one area in which Type 1’s often have an easier time than people with Type 2.
And that area is Insurance. In general Type 1’s have an easier time than Type 2’s getting test strips and devices like pumps. Medicare’s standard allowance for test strips is crappy for everyone, but non-insulin users are only allotted one test strip a day. Insulin users (and that includes some Type 2’s) get 3 times as many with 3 per day. Still inadequate, but with documentation and proof of medical necessity from a doctor, overrides are available.
Pumps are easier for people with Type 2 to get than in the past, but there are definitely a lot of hoops to jump through to get coverage. A diagnosis of Type 1 diabetes is often sufficient for automatic pump coverage under many insurance plans. My first pump was approved by insurance in less than 24 hours. When I get to Medicare in 2.5 years, I will be required to have a c-peptide test to prove that I don’t produce insulin. I have been worried about that test but when I asked my endo if I should be concerned, she just laughed.
Continuous glucose monitors are almost impossible for Type 2’s to get insurance coverage for. Under my current insurance, the first mandate for CGM coverage is “Type 1 Diabetes.”
Often I read forum posts by adults who have been diagnosed as having Type 2 diabetes because of their age when they clearly have characteristics of Type 1 or the newer diagnosis of LADA. Occasionally someone will reply to them that it doesn’t matter what type they have as long as they are being treated properly. I disagree with my statement. I know that I have always had good insurance and I am not a Medicare or insurance expert, but if you are Type 1, you want to be diagnosed as Type 1 not Type 2. Although many doctors are starting to use the LADA diagnosis, there are currently no Medicare or insurance codes for that. So for insurance reasons, if you are LADA, you are Type 1. Get the diagnosis so you can get the care and devices that you need.
Do people with Type 1 diabetes have better insurance coverage because our type of diabetes is worse? Well, maybe yes. All types of diabetes are the “bad” kind, but Type 1 is flashier bad. We wear the costume of “cute little kid” even though we can be anything from an infant to an 80- year-old crotchety old guy. We pass out at inopportune times and occasionally scare the crap out of everyone with seizures. Our BG numbers can range from 30-450 in a single day and we don’t consider a jump from 100 to 110 in fasting BG to be significant. Without insulin we could die in a couple of days or weeks. In general Type 1 is more dangerous in the short run and yes, we need pumps and CGM’s more than most people with Type 2.
But Type 2 is a subversive and sneaky kind of diabetes. You may not get access to the fancy devices, but if you ignore your diabetes, you can get the nasty complications. Insurance will pay to treat your complications even if it won’t help you prevent them. So don’t ignore your diabetes. You have the bad kind too!
This post is my October entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at: http://diabetescaf.org/2014/10/october-dsma-blog-carnival-4/