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[IP] AACE 2011 Guidelines



I stumbled on the following web site after reading a news article in Yahoo!
yesterday:
 
http://www.aace.com/pub/pdf/guidelines/DMGuidelinesCCP.pdf
 
The 2011 guidelines cover about fifty pages.  I was very upset when I read the
following statement on page 11 about continuous glucose monitoring:
 
"Although still early in its development, continuous glucose monitoring (CGM)
can be useful for many patients to improve A1C levels and reduce
hypoglycemia."
 
CGM has been available for about ten years!  It is hardly 'early in its
development.'  I am 71 years old and have been using CGM for more than three
years.  It has helped me prevent seizures, coma, and untimely death.
 
As many of you know I have been battling my Medicare Advantage HMO (MVP
Preferred Gold NY) over their denial of coverage.  Medicare regulations in
many regions, such as New York, deny coverage because CGM is 'precautionary.'
 It must be used in conjunction with a BG meter reading before treatment can
be initiated.  My question to the AACE & Medicare bureaucrats:  How does one
know enough to take a BG reading when you have nocturnal hypoglycemia
unawareness?  The use of a CGM with a low BG alarm will act as a trigger to
check your BG with a meter!
 
I am very disappointed with the wishy-washy  statement from the AACE.  Ask
your endocrinologist on your next visit if s/he agrees with the AACE guideline
for CGM use.  If the AACE cannot come out with a strong statement supporting
CGM for medical necessity, e.g. nocturnal hypoglycemia unawarenes, then how
can we expect Medicare to support a National Determination of Coverage
guideline for CGM?
 
I will now get off my soap box.  Am I the only one outraged by the lack of
support for CGM by AACE, the American Association of Clinical
Endocrinologists?
 
Her is the address and email if you wish to respond:
 
Lori Clawges
American Association of Clinical Endocrinologists Publications &
Communications Director
245 Riverside Ave., Suite 200
Jacksonville, FL 32202
Tel: 904-353-7878, ext. 129
email @ redacted
 
Jerry Smith
Rochester, NY
 
 
     
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