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Question:

From Colorado, USA:

I've been a Type 1 diabetic for 25 years now and have always had good control with little complications, specifically retinopathy. I'm 33 years old, have returned to college to finish my undergraduate degree. In the past six months, I have had perhaps a half dozen bad (<50 mg/dl, EMT response) hypoglycemic reactions, along with numerous typical reactions. My financial situation as a student is limited and my student health insurance doesn't cover any of my diabetic supplies (>$230/month) or my endocrinologist referrals. After months of altering my diet, types and amounts of insulins, and activity levels, I'm still having these bad reactions which reveal no rhyme or reason, and respond little to management actions. My doctor feels the only way we are going to get a handle on this, before my luck runs out, is by the use of an insulin pump. I'm desperate since pumps cost approximately $5000 and my insurance won't even consider it.

Do you know of any resources or medical studies which would help me to obtain a much needed insulin pump so that I might again be able to live my life as normally as possible?

Answer:

I must state that personally, I'm unimpressed with any studies that conclude that insulin pumps are any better than multiple dose insulin programs. That doesn't mean that there aren't individuals who definitely do better on pumps than shots, but please don't harbor a false hope that a pump will be a cure-all for your problem. It would seem to me from your letter that it'd be cheaper for the insurance company to spend the money on your endocrinologist's consulting fees than for you to end up in the hospital with another severe insulin reaction! Your doctor should be able to persuade the insurance company of this with little problem: it's simply a matter of finances (which is all the insurance companies seem to understand).

If your insurance company won't consider a pump, I wonder if you haven't written enough letters. I jokingly say the first two letters you send to an insurance company, they throw away without reading; the third, they read, then laugh and throw it away; the fourth they read then file; the fifth, they respond. And be sure to send copies to your state's Insurance Commissioner, and your Congressman, and the people who are funding your policy (usually an employer). And keep copies of all the correspondence you get back, and include the copies with your next round of letters. It's the squeaky wheel that gets the grease, you know.

If your doctor sincerely believes you'd benefit from a pump, he should writing letters of medical necessity to help get funding for it. Also, the pump companies representatives can be of big help in choosing what words to be sure to include in such a letter to impress the insurance companies of the need.

WWQ

Original posting 15 Feb 98

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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