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    • 10 hours, 59 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 11 hours, 2 minutes ago
      atr likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I had ketones thrn I am sick. If mid to large I wd call my endo or if also vomiting or dehydrated from diarrhea. I wd go to the ER
    • 12 hours, 16 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 12 hours, 17 minutes ago
      Marty likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      When I test positive, I increase my insulin dosage to a “sick day” level, which can be anywhere from 125% dosage to 400%. I usually start with small increases in dosage, and work my way up until my blood glucose levels even out. Also, increase my water intake. I would not call my Endo unless I was unable to get my blood glucose down over a lengthy period of time. That has never been the case.
    • 12 hours, 24 minutes ago
      KSannie likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 12 hours, 26 minutes ago
      Patricia Dalrymple likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 12 hours, 40 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I increase my basal and insulin ratios if I eat until I show no longer test positive. I do only test if I have been high for a longer than usual time.
    • 12 hours, 40 minutes ago
      Lawrence S. likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 13 hours, 2 minutes ago
      Judith Halterman likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      I'd most likely call my endocrinologist and ask their advice.
    • 13 hours, 5 minutes ago
      Derek West likes your comment at
      Do you have a management plan if you test positive for ketones? Please share more in the comments.
      If I were not feeling too bad, I would change my site, increase my insulin, drink more water and monitor closely
    • 1 day, 4 hours ago
      KCR likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      None of the specialists I’ve seen have suggested, recommended or prescribed methods for doing this in the lovely 40 years I’ve been T1D. My 80th birthday is the summer. It will officially be half of my life.
    • 1 day, 10 hours ago
      Marty likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      I have a blood ketone monitor. It works just like a glucometer.
    • 1 day, 12 hours ago
      Kathy Hanavan likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 1 day, 13 hours ago
      Judith Halterman likes your comment at
      Do you know how to test for ketones? Please share more in the comments.
      Perhaps only the poets who love alliteration could love the phrase, “killer ketones.” The ungodly pain experienced is your body eating and devouring itself. 🥵 Ketones are relentless killers. Do not give the bad guys a chance.
    • 2 days, 7 hours ago
      Anthony Harder likes your comment at
      Do you have ketone testing strips?
      Hi, Marty. Does your specialist have a source for that claim? It makes little sense that ketones would rise faster than BG since the metabolic pathway is much slower. If there's a source, however, I'd look further into the claim. FWIW, I've been a Type 1 for over 50 years; I can't remember the last time I tested for ketones. I possess no ketone testing strips.
    • 3 days, 10 hours ago
      Marty likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      Covers it with co pay
    • 3 days, 11 hours ago
      atr likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      It covers both. I prefer to have the the nasal version as I think it would be easier for someone else to administer.
    • 3 days, 13 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I’ve been T1D for 60 years. As a child my mother didn’t like needles or injections so she just fed me when low. In college, explained use to dorm mates and classmates would’ve been a waste of time. Now married, my wife assumed the role of my mother and doesn’t like using needles on me either. I don’t have glucagon.
    • 3 days, 13 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      Yes, always have one or two nasal glucagon kits (Baqsimi) at home in easy to reach locations (ie at bedside and special container in living area) and always keep one with me when I go out ( along with glucose tabs or other simple carbs for treating LBS.). I apparently required injectable glucagon several times as a child and needed injectable glucagon only twice as an adult, both more than 15 years ago . More recently I needed my husband to give me Baqsimi after eating a difficult to dose for, high fat meal. The experience was terrifying so I don’t go anywhere without it now.
    • 3 days, 13 hours ago
      Lawrence S. likes your comment at
      Do you have a non-expired glucagon prescription?
      I actually have 2 non-expired prescriptions. One for Baqsimi and one for Gvoke. I have not filled either of them because they’re $500-600 each.
    • 3 days, 13 hours ago
      Lawrence S. likes your comment at
      Does your insurance cover injectable glucagon, nasal glucagon, or both?
      My Medicare Part D essentially doesn't cover glucagon when any form is nearly $500!
    • 4 days, 3 hours ago
      Amanda Barras likes your comment at
      Do you have a non-expired glucagon prescription?
      Same here. Been as low as 19 (struggling with a vacuum cleaner bag and refused to let it win) but was still able to swallow food. I did used the “red needle” as my husband refers to it once when I went low but was scheduled for surgery and couldn’t eat or drink anything. Only once in 26 years. Fortunate.
    • 4 days, 22 hours ago
      Karen Newe likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 11 hours ago
      Natalie Daley likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
    • 5 days, 12 hours ago
      atr likes your comment at
      Share some of your favorite T1D-related books in the comments:
      Marcus Aurelius Meditations for the benefits of stoicism. Dante’s Inferno for the nine levels of diabetic hell. Kristen Lavransdatter for the benefits of suffering. And best of all, Cervantes Don Quixote for the absurdity of tilting at so many worthless windmills of frenzied diabetic activity.
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    In the past year, has your health insurance required you to change medications or devices?

    Home > LC Polls > In the past year, has your health insurance required you to change medications or devices?
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    When treating a low (i.e, less than 70 mg/dl) how often do you over treat, resulting in high blood glucose levels?

    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. 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    20 Comments

    1. LizB

      This year I had to switch to using One Touch meter/strips because that’s the only brand my insurance covers at the normal co-pay. Any other brand would cost me a lot more money.

      5 years ago Log in to Reply
    2. TomH

      They didn’t cover my Endoscopy preferred insulin on diagnosis, but suitable sub is working fine. I’m not sure how docs determine which insulin is appropriate anyway, think it’s what they’re used to.

      5 years ago Log in to Reply
    3. M Fedor

      In order to have my insulin covered under Medicare Part B with Advanced Diabetes Supply, I had to switch from Fiasp to Lispro .

      5 years ago Log in to Reply
    4. Joan McGinnis

      Not changed but costs more due to the fact the meds I need are not on their formulary or are tier 3 or 4. The so called donut hole does not look like it’s going to be dealt with by insurance companies

      1
      5 years ago Log in to Reply
    5. Moira Motyka

      Wanted me to change test strips (meter works with my closed loop system). Doctor wrote a pre authorization so that I could keep using the test strips he prescribed.

      5 years ago Log in to Reply
    6. Sridhar Rajamohan

      None of the diabetes medications are covered under insurance in India

      5 years ago Log in to Reply
    7. BARRY HUNSINGER

      I was using Medtronic’s 670g pump and guardian 3 sensors. When I switched to Medicare I had to re- prove that I was a T1D to get Deccom because they don’t cover guardian sensors. It took three months to get everything sorted out.

      5 years ago Log in to Reply
    8. James Goldman

      My health insurance supplier has required a change in medication but only to a generic brand. This has saved me a lot of money.

      1
      5 years ago Log in to Reply
    9. Thomas Brady

      Despite all of the negatives with Medicare “rules” relating to diabetes pump and CGM supplies, doctor visits, etc., I have not had any issues with changes to medications and devices.

      5 years ago Log in to Reply
    10. Kristine Warmecke

      They want me to change to Humalog, even though I’m allergic to it. So I’m forced to pay for Novolog (while I wait to see if I qualify for assistance from the company and ration what I can afford to buy). There are currently no Medicare plan’s in my area that cover it.

      5 years ago Log in to Reply
    11. Andrew Stewart

      I had to change from Humalog to Novolog because Aetna removed Humalog from their formulary list. I haven’t noticed a difference.

      1
      5 years ago Log in to Reply
    12. Sue Martin

      I had to change my glucometer since the insurance didn’t cover the strips for the Freestyle Lite. I really liked that one since it had a light in it, which allowed me not to turn on a light at night. The new is doesn’t consistently work or doesn’t always like the test strip. I’ve had to use multiple strips to get a good read.

      1
      5 years ago Log in to Reply
    13. Tod Herman

      “Other” was my response. My insurance didn’t require me to switch insulins, they only subtly switched their preferred formulary brand without telling me and my co-pay more than doubled. My Endo discovered this and switched me over to the other brand. Saved me $60 per refill (went from $100 to $40).

      5 years ago Log in to Reply
    14. Kim Murphy

      But they also don’t cover the devices and supplies I do use.

      5 years ago Log in to Reply
    15. Mark Schweim

      My insurance changed less than a year ago and every time my insurance changes, so does which Insulin the insurance will allow me to get. I’ve lost track of how many times I’ve been switched back and forth between Humalog and Novolog Insulin by my insurance over the past decade.

      1
      5 years ago Log in to Reply
    16. Angela Naccari

      Started medicare this past January. I was using Afrezza and Tresiba. I could find only one supplemental or advatage plan that would cover Afrezza at the highest tier. I decided to get the tslim pump instead to not have to deal with such high prices! I have had dufficulty with pump use before Afrezza due to absorption problems after 59 years of TD1. So I was not forced to change but did not want to change

      5 years ago Log in to Reply
    17. ConnieT1D62

      No. The only thing they do not cover is Baqsimi, (which is my preferred choice) but they do cover the Gvoke hypo pen – which works for me as second best choice. I am hoping that the powers that make tier coverage decisions will get onboard and approve Baqsimi in the 2022 formulary.

      5 years ago Log in to Reply
    18. Paul Hanson

      This is frustrating. Truly. Insulin is not insulin. One long acting basal vs another yields a totally different experience and outcomes/individual impact should be the measure, not agreed upon price points set to maximize profit.

      1
      5 years ago Log in to Reply
    19. Sue Herflicker

      Yes, had to switch from Novolog to Homolog and my test kit, from a One Touch Verio to a Contour … both work well so no issues.

      5 years ago Log in to Reply
    20. Cheryl Seibert

      Not in the past year….. but prior to that yes. Insurance companies should NEVER have the power to require a change in medication or devices. THIS GOES FOR THE FDA IN THEIR ‘guidance’ on number of test strips for Type 2 (1 strip / day) and T1D (3 strips/day). Insurance companies claim their quantity limits are “for your safety” …. “we are following the FDA requirenments…… FDA should not set a specific number… it should say “a minimum of 3 strips/day”. Insurance companies and especially 90-day pharmacies (PBMS) take these ‘recommendations’ and make them ‘hard and fast’ “all diabetics should only use 1 strip/day. Sorry about the rant.

      5 years ago Log in to Reply

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