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Arden's Day Blog

Arden's Day is a type I diabetes care giver blog written by author Scott Benner. Scott has been a stay-at-home dad since 2000, he is the author of the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal'. Arden's Day is an honest and transparent look at life with diabetes - since 2007.

type I diabetes, parent of type I child, diabetes Blog, OmniPod, DexCom, insulin pump, CGM, continuous glucose monitor, Arden, Arden's Day, Scott Benner, JDRF, diabetes, juvenile diabetes, daddy blog, blog, stay at home parent, DOC, twitter, Facebook, @ardensday, 504 plan, Life Is Short, Laundry Is Eternal, Dexcom SHARE, 生命是短暂的,洗衣是永恒的, Shēngmìng shì duǎnzàn de, xǐyī shì yǒnghéng de

Medicare Announces Criteria Covering Dexcom G5 Mobile CGM for All People with Diabetes

Scott Benner

press release

March 24, 2017

Medicare Announces Criteria Covering Dexcom G5 Mobile CGM for All People with Diabetes on Intensive Insulin Therapy

SAN DIEGO--(BUSINESS WIRE)-- DexCom, Inc. (NASDAQ:DXCM), the leader in continuous glucose monitoring (CGM) for people with diabetes, is pleased to announce that the U.S. Centers for Medicare & Medicaid Services (CMS) has published an article clarifying criteria for coverage and coding of the Dexcom G5 Mobile system, the only therapeutic CGM under this CMS classification. People covered by Medicarewho have either Type 1 or Type 2 diabetes and intensively manage their insulin will now be able to obtain reimbursement.

"This is a new era and a huge win for people with diabetes on Medicare who can benefit from therapeutic CGM," said Kevin Sayer, President and Chief Executive Officer, Dexcom. "This decision supports the emerging consensus that CGM is the standard of care for any patient on intensive insulin therapy, regardless of age."

According to CMS, therapeutic CGM may be covered by Medicare when all of the following criteria are met:

  • The beneficiary has diabetes mellitus; and,
  • The beneficiary has been using a home blood glucose monitor (BGM) and performing frequent (four or more times a day) BGM testing; and,
  • The beneficiary is insulin-treated with multiple daily injections (MDI) of insulin or a continuous subcutaneous insulin infusion (CSII) pump; and,
  • The patient's insulin treatment regimen requires frequent adjustment by the beneficiary on the basis of therapeutic CGM testing results.

In order to be included in this category, the system must be defined as therapeutic CGM, meaning you can make treatment decisions using the device. Dexcom G5 Mobile is the only system approved by the FDA to meet that criteria.

The entire release can be found here


Daylight Savings Time

Scott Benner

Don’t forget -- your microwave isn't the only clock that requires adjusting tonight.

The clocks in your meters, insulin pumps and CGMs need to ‘Spring Forward’ as well… #diabetes #daylightsavingstime

Important: Some insulin pumps may not offer bolus calculations for a period of time after you make clock adjustments.

PHOTO: National Geographic - news.nationalgeographic.com Photo of a man adjusting giant clocks. Peter Shugrue checks a clock at the Electric Time Company factory in Medfield, Massachusetts, on March 8, 2013.

PHOTO: National Geographic - news.nationalgeographic.com

Photo of a man adjusting giant clocks. Peter Shugrue checks a clock at the Electric Time Company factory in Medfield, Massachusetts, on March 8, 2013.


Juicebox Podcast

A diabetic boy’s parents ‘didn’t believe in doctors.’

Scott Benner

Now they’re guilty of his murder.

from the Washington Post

Alexandru Radita’s first medical crisis began when he was on the verge of turning 3. His parents brought him — thirsty, feverish, vomiting and suffering from abdominal pain — to a hospital in British Columbia in December 2000. Lab tests confirmed that young Alex had Type 1 diabetes.

A doctor spoke to Alex’s mother to explain her son’s diagnosis and how they would need to treat him at home. Type 1 diabetes is a lifelong condition in which a person’s pancreas does not produce enough insulin. People with it need regular blood tests and insulin injections to moderate blood-sugar levels.

According to court documents, “Mrs. Radita . . . made it clear that in her view the diagnosis was incorrect and she would prove that the doctors were wrong.”

The entire article can be found here.

Little Girls are like Snowflakes

Scott Benner

Little girls are like snowflakes, no two are exactly the same...

Snow day! It is snowing here as I write this post which is strange because it was sixty-five degrees yesterday afternoon when Arden came home from school and asked me this question.

"Can I have a sleepover tonight if school gets cancelled tomorrow because of snow?".

I thought for a moment and decided that if Arden had friends overnight then they would stay up late and if they stayed up late... then they would sleep in. I immediately imagined a morning to myself, smiled and said "sure!". 

The sleepover brought one surprise that I hadn't pre-planned for, I needed more food at dinner time then I had in the house and so we ordered out. When the pizza, fries and some other stuff arrived at the door we bolused, set an increased temp basal and Arden ate. About an hour later her BG began to slowly drift up. I had been noticing all day that her BG wasn't responding to boluses the way I expected and began considering if we needed a new pump site. An hour later after I wasn't getting the movement that I wanted (her BG was 160) Arden changed her pump. 

I was aggressive with the insulin after the site change because of the new infusion, pizza in her belly and the excitement of a sleepover. Still around midnight her BG was still stuck at 150. When I went into Arden's room the three girls were passed out on an inflatable mattress that they set up next to Arden's bed. So it was air mattress on the far side of the room, then Arden's bed, then me. I was farthest from the air mattress because of where Arden's Omnipod PDM was located. I clicked a few buttons sent a bolus to her pod (it has great range) and went back to bed.

Not ten minutes later I decided that I should have also used an increased temp basal rate and so I snuck back in to the room. It was dark but I could see that Arden had made her way from the air mattress and was now sleeping in her bed. I crouched down next to her and held the wireless PDM close to her abdomen where she had recently put her new pod. The PDM couldn't connect. I tried again, wouldn't connect. I jammed the PDM between Arden and the mattress... nothing. As I began to worry that the new pod might not be working correctly Arden jumped up in the darkness, I had scared her. This felt wrong as she has never responded in the middle of the night like that. As I was about to ask if she was okay a voice said, "Sorry you scared me... Mr. B... I'm not Arden".

So it turns out that Nadia, Arden's friend was the one who moved from the air mattress to Arden's bed and the reason I couldn't connect to Arden's pod? It was across the room and Nadia's body was absorbing the signal.

We don't get too many middle of the night insulin related laughs around here and I imagine that you don't either so I wanted to share. I have to remember to tell this story on the podcast sometime. I felt like an idiot. 


Individuals with Disabilities Education Act (IDEA)

Scott Benner

Today, I am begrudgingly breaking a long standing rule on this blog of not talking about politics...

Betsy DeVos

Betsy DeVos

Yesterday a new Education Secretary, Betsy DeVos, was confirmed by the Senate. DeVos a wealthy Republican donor who never attended a public school, is not an educator and has spent most of her life promoting charter schools and vouchers is now in charge of almost 100,000 public schools. 

Today the government website for the Individuals with Disabilities Education Act is not responding...

I'm going to go out on a limb and say if it looks like a duck and quacks like a duck, you better start calling your Senators and Congresspeople. 

About IDEA from the ADA website

What is IDEA?

The Individuals with Disabilities Education Act (IDEA) is a federal law that requires states to provide a "free, appropriate public education" to children with disabilities so they can be educated to the greatest extent possible along with all other children. Qualifying children are entitled to special education and related services at no cost to their parents/guardians.

Who is covered?

To receive services under IDEA, a child with with a disability must show that he or she needs special education and related services in order to benefit from education. An evaluation of the child must show that, because of the child's disability, the child's educational performance is harmed. There are three situations in which a child with diabetes might be covered under IDEA:

1. The child has another disability which impacts his or her ability to learn, but diabetes itself does not cause an impact in learning. For example, a child with Down syndrome might have an impact in learning.

2. Both diabetes and another disability combined impact the child's ability to learn. For example, it might be determined that a child's ability to learn is impacted by both autism and diabetes.

3. The child's diabetes, by itself, causes an impact on learning. This is categorized as an "other health impairment" under the IDEA.

While it is most common for a child with diabetes to qualify for IDEA because of having another disability in addition to diabetes, it is also possible that diabetes itself can cause an impact in learning. For example, it is often difficult to learn when blood sugar levels are either too high or too low. If a child with diabetes is having difficulty managing his or her blood sugar level, this may hurt how well the child does in school. Academic progress might also suffer if a child with diabetes misses a significant amount of classroom instruction each day in order to attend to diabetes care tasks.

The Center for Parent Information and Resources describes "Other Health Impairments" like this.

“Other Health Impairment” is one of the 14 categories of disability listed in our nation’s special education law, the Individuals with Disabilities Education Act (IDEA). Under IDEA, a child who has an “other health impairment” is very likely to be eligible for special services to help the child address his or her educational, developmental, and functional needs resulting from the disability.

(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

You can read the rest on their website here.

update 9:54am - Dept of Ed says this is not purposeful.