continuous glucose monitoring

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In the News: Apple Patent Hints at Non-Invasive Glucose Monitoring Tech for Apple Watch

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News has been circulating that Apple has been developing a non-invasive sensor to continuously measure blood glucose levels since last year. In fact, this tracker has been said to become the “holy grail” in diabetes.

In August, a patent was published that potentially offers clues into Apple’s rumored non-invasive monitoring solution. Apple submitted a patent application in 2015 for “Reference switch architectures for noncontact sensing of substances,” a method by which an electronic device can be calibrated to measure the concentration of a particular substance in a given sample. This is an optical system that enables determination of the concentration of a target substance by applying light with known properties to a sample. Although the patent documentation does not specifically explain what substances this proposed system might be used for, it resonates with rumors that Apple is working on a non-invasive glucose monitoring solution for use in their Apple Watch. Learn more about the science behind Apple’s patent application at appleinsider.

Healthy Living provides leading continuous glucose monitoring (CGM) systems that monitor blood glucose levels in real time for Blue Cross Blue Shield, Health Alliance Plan of Michigan (HAP), Priority Health and Priority Health Advantage, and Medicare members. CGM helps people living with type 1 or type 2 diabetes make more informed treatment decisions that lead to better glycemic control. To learn more, call 866.779.8512 (option 2) to speak with a member of our Insulin Pump & CGM Therapy Team!

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Michigan Medicaid & CGM Coverage -- Let Your Voice Be Heard

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Comment on the new Michigan Medicaid proposal via email, phone, fax, or letter.

Comment on the new Michigan Medicaid proposal via email, phone, fax, or letter.

Share your experience and thoughts, and let your voice be heard! Michigan Medicaid has proposed a new policy that will allow coverage of continuous glucose monitors (CGM) for eligible members. Now is the time to review the proposed changes in Medicaid policies and procedures. Your comments are due soon — September 26, 2018.

How to Submit Your Comments

Email Address: trumbelll@michigan.gov 

Mailing Address:

Lisa Trumbell, DMEPOS Policy Specialist 

Bureau of Medicaid Policy and Health System Innovation 

Medical Services Administration 

P.O. Box 30479 

Lansing, Michigan 48909-7979 

Telephone Number: 517-284-1226

Fax Number: 517-241-8969 

The proposed effective date is December 1, 2018. Our Healthy Living team has already submitted a letter to Michigan Medicaid to express our support of continuous glucose monitoring therapy as a highly effective way to help people with diabetes manage their disease.

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Healthy Living Now Provides CGM to Medicare Patients

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Healthy Living has long provided insulin pumps and insulin pump supplies to Medicare members as a durable medical equipment (DME) benefit, and today we're pleased to announce that we're  accepting referrals for Continuous Glucose Monitor (CGM) therapy for Medicare members as well! Currently, the Dexcom G5 continuous glucose monitoring system has been approved for Medicare members.

A continuous glucose monitor is a small, wearable device system that tracks your glucose throughout the day and night, notifying you of highs and lows so you can take action when needed. The Dexcom G5 CGM system is made up of three key components: a sensor that measures your glucose levels, a transmitter to wirelessly send your glucose data to your smart device or receiver, and a display device where you can see when your glucose is trending high, low, or just right. The display device can be either a compatible smart device with the Dexcom G5 Mobile app or the Dexcom G5 Mobile Receiver.

What are the benefits of CGM?

  • With CGM, you’ll reduce your daily fingersticks dramatically, continuing them only for calibration of the CGM.
  • The CGM system monitors blood glucose levels in the interstitial tissue every five minutes, offering much more information than four to eight finger sticks per day.
  • CGM is very useful when you are struggling with nighttime lows, providing alarms and alerts.
  • Dexcom sensors and transmitters are water-resistant. They are relatively small and discreet to wear.
  • With Dexcom G5 Mobile, dynamic glucose data can be accessed and shared safely and conveniently to your smart phone device.

Call us today at 866.779.8512 (Option 2) or fill out our expedited enrollment form online to learn more about your Medicare insurance coverage, and start the process for receiving CGM supplies from Healthy Living. We’re here to help! 

Submit Co-Pays FAST with Online Bill Pay from HLMS

One of the feature requests we receive most often from our customers is the ability to submit co-payments for insulin pumps, insulin pump supplies, CGM supplies, and other diabetes supplies online. While not widely known amongst our customers, this is a service that we currently offer - and once paid, you'll have a copy of your receipts and payment history for future reference. 

Get started with secure and easy online bill pay from Healthy Living today! Simply request to pay your bill online the next time you are working with an agent to submit a co-payment for your order. 

Update on Medtronic's Guardian Connect CGM System

Healthy Living Medical Supply’s Continuous Glucose Monitoring (CGM) Team had the opportunity to participate in a live webinar yesterday from Medtronic – the focus of the session was their new stand-alone CGM product known as the Guardian Connect CGM System. Our team has been eagerly anticipating the launch of this product since the product received FDA approval back in March.

Here are a few highlights of what we learned about the product during the webinar:

1.     The Guardian Connect transmitter connects via Bluetooth technology to iPhones (and iPod Touch devices if you can purchase one on eBay)

2.     The sensor is the same as the one used for the 670G closed loop system, but the Guardian Connect transmitter DOES NOT communicate with the 670G pump. The transmitter is labeled “GC” which differentiates it from the transmitter used with the 670G pump.

3.     The system does not have a receiver—this will be a great benefit to those patients who don’t want to haul around another piece of hardware.

4.     Android support is coming-Medtronic is targeting the end of the calendar year for Android users.

5.     The sensor features a new barrier which helps mitigate against skin irritation – this is also the smallest sensor ever for a Medtronic CGM product.

6.     Sensor wear time is up to 7 days and the system includes a one-year warranty.

7.     The system features a range of alerts, including predictive alerts which can notify of highs and lows anywhere from 10-60 minutes in advance.

8.     Patients can invite up to five care partners to view data and receive alerts via SMS and data is easily shared with providers via the Care Link system.

9.     The Guaurdian Connect CGM System providers users access to the Sugar.IQ diabetes assistant, which is a separate application on the phone. The Sugar.IQ app takes real time data from the Guardian Connect app, sync with IBM’s Watson, and then presents various insulin, food and motivational insights to the user.

Medtronic’s Guardian Connect Smart CGM system is slated to be released in early summer. The system is not approved by Medicare, but should be reimbursed by most major commercial insurances including Blue Cross Blue Shield, Health Alliance Plan of Michigan, Priority Health, etc.

If you are a patient and wish to learn more about the Guradian Connect Smart CGM system, visit this link.

For providers interested in learning more, visit this link.

If you would like to be contacted by Healthy Living once this system becomes available, please fill out the brief form below:

FDA Approves Dexcom G6 CGM

Dexcom's new G6 Continuous Glucose Monitoring System

Dexcom's new G6 Continuous Glucose Monitoring System

Yet another great piece of news in the area of Continous Glucose Monitoring technology advancement: Dexcom received FDA approval for their next generation, G6 CGM product.

For a more detailed analysis of the Dexcom G6 CGM, visit the recent blog posts from Diatribe, Juvenile Diabetes Research Foundation, and Beyond Type 1

The G6 solution is an exciting development for the diabetes community as it promises a ten day wear on the sensor, acetaminophen blocking, no finger stick calibrations,  potential integrations with the Tandem insulin pump, OminPod's tubeless pump and more.

A launch date has yet to be determined but Healthy Living Medical Supply will be ready to provide this new platform to our patients once it does become available.

Interested in learning more about CGM and the possible therapeutic benefits? Read this article from the Healthy Living blog on the benefits of CGM. 

We're here to help!

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Curious About CGM? Let Our Team Run a No-Cost Insurance Benefits Check for You

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Interested in Continuous Glucose Monitoring (CGM) to better manage diabetes? Did you know that most people with type 1 diabetes on commercial health insurance have CGM coverage?

We can run a no-cost insurance benefits check to find out if you’re covered. Just complete the form below or call our Insulin Pump & CGM Therapy Team at 866.779.8512 (Option 2) to start the conversation. Our experienced team can help you navigate the enrollment process and answer your questions.

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Are You Ready for CGM?

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A continuous glucose monitor is a small wearable device system that tracks your glucose throughout the day and night, notifying you of highs and lows so you can take action when needed. Continuous glucose monitoring (CGM) helps many people with diabetes obtain greater insight into what is happening with their blood sugar levels and trends.

Benefits of CGM  

  • The CGM system monitors blood glucose levels in the interstitial tissue every five minutes, offering much more information than four to eight finger sticks per day.
  • CGM is very useful when you are struggling with nighttime lows, providing alarms and alerts.
  • Continuous glucose monitoring is great for pediatrics because their parents and caregivers can remotely monitor the CGM data from their smartphones.
  • Both Medtronic and Dexcom sensors and transmitters are water-resistant, if not waterproof. They are both relatively small and discreet to wear.

CGM & Insurance Coverage

  • Most commercial insurances cover CGM, and the end of the year is a good time to consider CGM since at this time deductibles are often satisfied.
  • Most insurances require a prior authorization on file, so it is essential that patients meet with their endocrinologist to discuss CGM. This is a good first step for obtaining a CGM system. 
  • Currently, no Michigan Medicaid plans consistently approve CGM, and plans will require a pre-authorization if the CGM is covered.

Starting with CGM

  • It is easy to begin using CGM, and you don’t have to commit to an insulin pump. Many patients using multiple daily injections (MDI) report that they get tighter blood glucose through the combination of MDI and CGM.
  • From start to finish, a CGM enrollment will take commercial members roughly 1-14 days and Medicaid members 2-4 weeks.

Get in Touch

Healthy Living’s Insulin Pump & CGM Therapy Team can help guide you through the process of starting with CGM and will work with your insurance company. You can reach us at 866.779.8512 (Option 2). Learn more about CGM on our website.

We love to help!

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Highlighting the Revolutionary Medtronic 670G – Features & Reviews

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Medtronic MiniMed 670G (Photo by Steve Wood)

Medtronic MiniMed 670G (Photo by Steve Wood)

The Medtronic MiniMed® 670G System is the world’s first hybrid closed loop insulin pump system, sometimes referred to as an artificial pancreas. The system constantly self-adjusts to automatically keep your sugar levels in range, based on how you live your everyday life. This FDA-approved system is specialized for type 1 diabetes patients, ages 14 and over, and requires a prescription.  The Medtronic MiniMed® 670G System is now shipping.

3 New Features that Set the 670G Apart from Earlier Insulin Pumps:

1.     Manual Mode – Suspend-before-low option helps you avoid lows and rebound highs proactively by automatically stopping insulin 30 minutes before you reach pre-selected low limits, then automatically restarting insulin when your levels recover (without alerts).

2.     Auto Mode – Automatically adjusts basal insulin delivery up and down every 4 minutes, based on your sugar levels, to keep you in target range, all day and night. The system can temporarily change your glucose target during athletic activity to help maintain a safe range.

3.     Guardian sensor 3 continuous glucose monitoring sensor – Offers seven-day wear and easy insertion, and is the first and only CGM sensor that is FDA-approved and trusted to control insulin dosing.

Other Medtronic MiniMed® 670G System Highlights:

  • Glucose levels are automatically kept within range all night long for a restful, uninterrupted night’s sleep.
  • The system is waterproof, with a bright color screen.
  • At meals and snacks, only check your glucose and enter the number of carbs when you administer a bolus. The 670G system will do the math to regulate your insulin and keep glucose levels in range without any necessary insulin injections.

Speaking from Experience

Jason Gensler is a person with type 1 diabetes and the founder of the Foundation for Type One Diabetes. Jason has been wearing the Medtronic 670G for the last 2 years or so and can share these insights (in his words):

  • "I am experiencing very impressive results, yet I’m only testing 4-5 times per day and calibrating three times."
  • "I’d say the best aspect is that the system itself is so intuitive and user-friendly. It’s always one step ahead, and the sensor is incredibly accurate."
  • "It’s a relief! The day that it sinks in, when you realize that you’ve relinquished a majority of the control to the pump, is the day you begin to experience the freedom that so many of us haven’t had since the day we were diagnosed."
  • "Living with T1D is hard, and staying positive can be even harder, but I’d like to remind everyone to appreciate just how far our industry has come. The technology that has been developed in the last few years is unbelievable! Let’s all be grateful that we live in a time where technology can help us lead normal lives, and that we can’t have unrealistic expectations and find a cure yesterday."

Sources for Jason Gensler quotes:

https://asweetlife.org/what-its-like-to-use-the-medtronic-670g/

http://jasongensler670gexperience.com/

Learn more about the 670G directly from the Medtronic website. 

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CGM Basics: Clarifying the System & Benefits in 5 Questions

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Checking CGM data on an iPhone, image from pexels.com.

Checking CGM data on an iPhone, image from pexels.com.

Over a big group dinner the other night, I found out that there is a considerable amount of confusion about both what CGM is and the differences between CGM and insulin pumps. Hopefully this blog will help shed some light on these questions!

1. What information will I get from Continuous Glucose Monitoring (CGM)?

CGM measures glucose in the tissue fluid throughout the day and night, about every five minutes, and sends the collected data to a receiver, phone, or insulin pump. This information can tell you how your glucose levels are trending, so you can make better decisions about your insulin dosing.

2. How can CGM help me manage diabetes better?

A continuous glucose monitor is a small wearable device system that tracks your glucose throughout the day and night, notifying you of highs and lows so you can take action. A CGM system consists of 3 parts:

  • Small, under-the-skin sensor that measures glucose levels
  • Transmitter that attaches to the sensor and transmits data
  • Receiver that displays real-time glucose information

3. Are there additional benefits of CGM?

Continuous glucose monitoring can help you make the best possible decisions since you'll be able to see your trend data provided by the CGM instead of basing choices only on a number from a blood glucose meter reading. You can also set thresholds for high and low numbers, and the CGM will alert you when it senses your glucose levels have moved out of the safe range you set.

4. Is CGM covered by insurance?

Yes, CGM is covered by many insurance plans. Our Insulin Pump & CGM Therapy Team can help you obtain a prescription from your doctor, navigate the insurance verification process, and place your CGM system order. They also help customers with CGM supply refills.

5. What is the difference between CGM & insulin pumps?

Continuous glucose monitoring collects information on your blood glucose levels. This information can be used for proper insulin dosing through your insulin pump. CGM and insulin pumps can be used separately (a person can use just one or the other) or together.

 

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Apple Watch’s Non-Invasive Glucose Tracker: Said to Become the “Holy Grail” in Diabetes

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Apple Watch, image from pexels.com.

Apple Watch, image from pexels.com.

From Hints to a Peek at an Apple Watch CGM

Tim Cook, CEO of Apple, told students at the University of Glasgow in February that he had been wearing a glucose tracker, and that it helped him understand the impact of different foods on his blood sugar levels. Fast-forward to April. News surfaced that Apple was developing a solution, integrated with its Apple Watch, to diagnose and manage diabetes, with a non-invasive sensor that continuously measures blood glucose levels. One month later – May. Tim Cook was spotted wearing a prototype glucose tracker that pairs with the Apple Watch around Apple’s campus.

For over five years, Apple has had a team of biomechanical engineers working on developing a continuous blood glucose sensor to pair with their Apple Watch that does not break the skin. Their Palo Alto-based research team has already begun feasibility tests with the tracker they have engineered to date. Apple calls their challenging intention of creating this technology the “holy grail” in diabetes.

"It's mentally anguishing to stick yourself many times a day to check your blood sugar," Tim Cook said, according to CNBC. "There is lots of hope out there that if someone has constant knowledge of what they're eating, they can instantly know what causes the response... and that they can adjust well before they become diabetic."

Speculation about the Tracker’s Functionality & Watch Integration

Based on the description from CNBC, it sounds like the tracker Cook is wearing is a separate, independent unit that communicates to the Apple Watch over Bluetooth, as opposed to a feature integrated inside the Watch itself. Some are hypothesizing that Apple will sell the glucose tracker as an additional accessory. This could be especially helpful since the blood monitoring feature requires approval and regulation of the FDA. If Apple sells the tracker as a separate accessory, they will be able to avoid adding regulatory procedures to the production of the entire Apple Watch.

One report indicated that Apple would manufacture smart bands that expand the Watch with additional functions, meaning the glucose monitor could become a part of one of those separate smart bands, which would communicate with the core Apple hardware.  

The Apple Watch & Health Monitoring

If Apple can successfully create this next-generation glucose monitor, it will transform the Apple Watch from a wearable accessory to a revolutionary health device, beyond heart rate and activity tracking. Tim Cook recently told a group: "This is an area where I'm very excited about Apple's contribution. Very excited."

Upcoming Dexcom Integration

Dexcom is an existing, trusted leader in continuous glucose monitoring technology. Apple announced at their recent WWDC (World Wide Developer Conference) that they were releasing a Bluetooth API for their Apple Watch that would allow it to pair directly with health sensors such at Dexom CGM.

Article References

https://www.theverge.com/2017/5/19/15662316/apple-watch-glucose-tracker-tim-cook

https://9to5mac.com/2017/05/18/report-tim-cook-testing-wearable-blood-sugar-tracker-on-apples-campus-connected-to-apple-watch/

http://mashable.com/2017/05/19/tim-cook-glucose-apple-watch/#HpD71gq60OqA

http://www.macworld.com/article/3197691/wearables/tim-cook-is-testing-a-new-apple-watch-device-that-monitors-his-blood-sugar-monitor.html

http://www.cnbc.com/2017/06/05/dexcom-stock-spikes-on-apple-watch-deal.html

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JDRF TypeOneNation Summit: Healthy Living Team Highlights

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The Healthy Living team at the JDRF TypeOneNation Summit, 2017.

The Healthy Living team at the JDRF TypeOneNation Summit, 2017.

This last Saturday, seven members from the Healthy Living team participated in the 2017 TypeOneNation Summit in Belleville, Michigan, hosted by JDRF. As usual, it provided us with a great opportunity to learn and continue building relationships with customers, potential customers, vendors, and members of the provider community (we were positioned right across from U of M's Mott Pediatric Diabetes Team). There was so much good energy and activity, and a lot of great programming for kids and adults.

HLMS Team Member Highlights

Here are some reflections from our team about the summit:

I also attended Dr. Schmeltz's Advanced Insulin Pumping session. It was truly an eye-opener to see and hear how diabetes can complicate simple tasks I take for granted. Even when using an insulin pump, patients and caregivers must plan carefully and tweak pump settings to do simple things like eat a piece of pizza or go on vacation. Pump technology definitely makes things easier but still demands serious dedication and self-control. I particularly enjoyed the end of Dr. Schmeltz's presentation where he discussed the latest in pump/CGM technology and products coming soon. It seems like the long-awaited artificial pancreas will be ready in the not-so-distant future. –- George K.

The day ended with an inspirational talk by Will Cross, who lives with Type 1 Diabetes and made it to the summit of Mt. Everest ten years ago - it was the kind of message that reminded me that we're here as a company to add value to our customers by making their lives better through exceptional customer care. –- Matt

I attended the "Taking T1D to School" workshop and learned a lot about state-funded schools and how they have to take classes on helping the students with T1D. They need to be able to help the student out if they cannot help themselves, and the student also has the right to test and inject in class without causing an interruption. A lot of parents, especially parents that have kids that are newly diagnosed, do not know much about how much assistance they can get and think it's all up to them, which makes it so much harder for them as well for the child. –- Rickelle

Along with interacting with everyone, I enjoyed attending the Advanced Insulin Pumping session with Dr. Lowell Schmeltz. I learned a lot more about insulin pumping and ways it can be used better for a patient to gain better control of their diabetes.  It was also neat to be able to go to each table and interact with educators, pump/CGM company reps and other organizations/companies that were there. -- Crystal

Personally, I was very excited to meet a couple of gentle therapy dogs at the table next to us. The husband/wife team actually trains each dog specifically for an individual and his or her needs. Related to diabetes, the dogs can learn to smell low blood sugar to alert their owners about the situation. -- Emily

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The Top 11 Questions about CGM & What You Need to Know

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If you are living with Type 1 or Type 2 diabetes, Continuous Glucose Monitoring (CGM) can help you make more informed treatment decisions that can lead to better glycemic control. 

Top 11 Questions about CGM

1. What information will I get from Continuous Glucose Monitoring (CGM)?

CGM measures glucose in the tissue fluid throughout the day and night, about every five minutes, and sends the collected data to a receiver, phone, or insulin pump. This information can tell you how your glucose levels are trending, so you can make better decisions about your insulin dosing.

2. Can I set a ‘safe range’ for my blood glucose readings?

You can set thresholds for high and low numbers, and the CGM will alert you when it senses your glucose levels have moved out of the range you set.

3. Do I still have to test my blood sugar when I am using CGM?

With CGM, to calibrate the sensor, you will still have to test your blood sugar 2-4 times per day, depending on the CGM system you have.

4. What parts make up a CGM system?

A CGM system consists of three parts:

  • A small under-the-skin sensor that measures glucose levels
  • A transmitter that attaches to the sensor and transmits data
  • A receiver that displays real-time glucose information

5. Do I need an insulin pump to use CGM?

No – although some CGM systems can tie in with a pump, CGM can be used independently.

6. What types of CGM systems are available right now?

Medtronic and Dexcom both offer CGM systems with different features.

7. How long can I wear CGM sensors before I need to change them?

You can wear sensors for 5-7 days, depending on which CGM system you are using.

8. Can I use the same insertion site for my insulin pump and CGM sensors?

No, CGM and an insulin pump require two different sites.

9. Can parents and other care team members access a patient’s CGM data?

Yes, certain models of CGM systems are compatible with the iPhone to allow care team members to remotely monitor CGM data via text alerts and/or an iPhone app. This can be especially helpful to parents who have children with diabetes, as they can monitor their blood sugar levels from afar (for example, the daughter is at school and her dad is at work).

10. Can I view CGM data on a smartwatch?

Yes, Dexcom G5 will display CGM on an Apple Watch. Visit Dexcom's Apple Watch page to learn more.

11. Is CGM covered by insurance?

Yes, CGM is covered by many insurance plans. Our Insulin Pump & CGM Therapy Team can help you obtain a prescription from your doctor, navigate the insurance verification process, and place your CGM system order. They also help customers with CGM supply refills.

You can reach George and Crystal on the Healthy Living Insulin Pump & CGM Therapy Team at (866)779-8512 (Option 2) and learn more about CGM and the systems we offer at myhlms.com/cgm.

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Medicare to Cover Therapeutic CGM

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Dexcom G5 CGM Mobile

Dexcom G5 CGM Mobile

Awesome news! Medicare has recently announced a new benefit category for continuous glucose monitoring (CGM) and is moving to cover CGM at some point in the future. To be included in this category, the continuous glucose monitoring system must be defined as a “therapeutic” CGM, meaning that patients can make treatment decisions using the device. The only CGM that currently qualifies is Dexcom’s G5 CGM System which received FDA approval for insulin dosing last month.

What is CGM?

Continuous glucose monitoring is a small wearable device system that tracks a patient’s glucose throughout the day and night. A CGM delivers fast and reliable blood glucose readings every five minutes or so to a receiver, a phone, or an insulin pump - logging hundreds of readings a day. Continuous glucose monitoring can help diabetes patients make the best possible decisions since they are able to see their trend data provided by the CGM instead of basing choices only on a number from a blood glucose meter reading. A CGM system consists of three parts: a small under-the-skin sensor that measures glucose levels, a transmitter that attaches to the sensor and transmits data, and a receiver that displays real-time glucose information.

Contact us with questions.

This announcement about upcoming coverage for CGM is great for all Medicare members and Healthy Living customers, many of whom will benefit from this important technology for helping control diabetes. Healthy Living’s Pump Therapy and Continuous Glucose Monitoring team is working with our partners to learn more and will be prepared to answer your questions as more details emerge.

We make managing your diabetes supplies easy.

  • We work with many insurance plan partners.
  • You can approve your refills via text or phone.
  • Our company’s focus is excellence in customer service.
  • In addition to providing supplies, we also have a mail-order pharmacy.
  • Diabetes is our specialty, and we’re prepared to help!

WE LOVE TO HELP.

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  • Call us @ (866)779-8512 or text us @ (248)577-9903.
  • Reach us through online chat at myhlms.com.
  • Check out our online store at myhlms.com/shop for accessories and over-the-counter medications.
  • Visit myhlms.com/providers to electronically complete and sign prescriptions for patients.