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Question:

From Woonsocket, Rhode Island, USA:

I've had type 1 diabetes for about 23 years, I've been on a pump for about five months, and I have never had a C-peptide test. Previously, I ordered pump supplies with no problem, but when I ordered more a few days ago, my doctor's office called me and told me that the pump company says I need to have a C-peptide test done.

How long has the C-peptide test been around? Should my doctor, an endocrinologist, have ordered this test before now?

Answer:

Your insurance company is really driving this. Many are now saying that they will limit reimbursement for insulin pumps and supplies to only those with type 1 diabetes. So, the pump supply company is acting on instruction/guidance from your insurance company. Using the C-peptide is one way of demonstrating you have no insulin secretion.

The C-peptide test has been around since 1980. Usually, when a person has type 1 diabetes, the C-peptide should be unmeasurable to very low. If the C-peptide is not low, this might be consistent with type 2 diabetes, and it gets the insurance company out of having to provide supplies for a condition they won't cover. This is an oversimplification of the situation. However, if this has not been done, you might as well get the C-peptide, and then it will be on the record.

It is not improper medicine to not have had had a C-peptide in the past. Previously, this was more of an academic test.

JTL

DTQ-20030307124120
Original posting 12 Mar 2003
Posted to Insulin Pumps and Blood Tests and Insulin Injections

  
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Last Updated: Tuesday April 06, 2010 15:09:42
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