November 28, 2019 Paying for glucose monitoring devices

Monitoring your blood sugar (glucose) levels can help you manage your diabetes better and, for many people, it can even prevent life-threatening emergencies and complications.

However, monitoring can be expensive—devices and supplies may cost up to several thousands of dollars yearly, depending on the system and testing frequency. The full cost of monitoring is often not covered by insurance plans, and some people have no coverage at all—this is something Diabetes Canada is working hard to change. Diabetes Dialogue spoke with Ann Besner, research and policy analysis manager at Diabetes Canada, to learn more about this issue.

What kinds of glucose monitoring devices are available?

Many people use a glucometer: This involves drawing a small drop of blood from the fingertip and applying it to a test strip fed into a glucometer, which provides a reading within seconds. The meters of today are more sophisticated. Many of them can log hundreds of readings and include features such as information uploads to smartphone apps.

Within the past 20 years, some people, particularly those with type 1 diabetes, have started using a continuous glucose monitoring system [CGM], which automatically monitors glucose levels every five minutes using a sensor inserted under the skin, and wirelessly sends these readings to a receiver, smartphone, or insulin pump. The device can alert you to highs and lows, tell you which way your glucose is heading and how quickly it is rising or falling. A flash glucose monitoring system, another fairly recent innovation, also uses a sensor worn on the skin to continuously measure glucose levels, detect trends, and track patterns; users can access their glucose readings at any time by scanning the device with a special reader or compatible smartphone app.

What difference do these devices make for people with diabetes?

They can save lives! One of the newest technologies, the hybrid closed-loop system, intended for people over seven years old with type 1 diabetes, combines CGM with an insulin pump. When the monitor detects that your glucose level is approaching a preset low limit, the pump can stop the insulin infusion to help the person avoid hypoglycemia [low blood sugar], which can be life-threatening. The pump automatically restarts insulin when glucose levels have recovered.

The great thing is that there are so many different glucose monitoring systems now on the market! You should work with your health-care team to find the device that best meets your needs.

How does a person’s insurance coverage affect whether they can afford various devices?

Insurance plans differ in what and how much they cover, how often coverage is provided, and what the eligibility criteria are for coverage. Most public plans cover a portion of the cost of test strips, but in certain provinces, the number of strips that are reimbursed is lower than what Diabetes Canada would recommend. Also, most provinces have not yet approved coverage of continuous or flash glucose monitoring devices, with the exception of Ontario and Quebec, so there is still a lot of work to do..

Private insurance plans are often more generous than public plans in what they will cover, but they are still expensive: There may be co-pays, deductibles, or yearly maximums on plans, and whatever isn’t reimbursed must be paid by you. We know many Canadians have to adjust their personal budgets or borrow money so they can afford the expense of monitoring. And, unfortunately, lots of people simply aren’t able to monitor as often as they’d like or use the technology that’s most appropriate for them, because of the cost.

Diabetes Canada believes everyone with diabetes has a right to the tools and treatments that will help them best manage their disease. That’s why we are advocating for enhanced access, through governments and private insurers, to various monitoring systems and supplies. Visit Advocacy & Policies to learn how you can help.

Did you know?

Since 2013, Canada has been without a diabetes strategy to help address the epidemic. Learn more about Diabetes 360° and email your candidate today.

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(This article appeared in Diabetes Dialogue, Autumn 2019)