Navigation Links
Determining Insulin Pump Need for Diabetics
Date:7/28/2009

WESTERVILLE, Ohio, July 28 /PRNewswire/ -- All doctors recommend diabetic patients control their glucose level, but how can they do this while preserving a normal lifestyle? By using an insulin pump and carbohydrate counting, a diabetic can maintain precise glycemic control and lessen the long-term effects of their disease. Still, because of the cost of insulin pumps and their supplies, health insurers often turn to independent review organizations (IROs) to decide their medical necessity.

"Using evidence-based criteria, IROs review the medical necessity of insulin pumps for health plans," said Seana Ferris, President of NAIRO, a trade organization of IROs. "They must weigh improved glycemic control, patient pump management, patient knowledge and lifestyle against the long-term cost of a diabetic's health care before approving a $6,000 pump that also requires hundreds of dollars a year for supplies."

When Insulin Pumps are Medically Necessary

Replacing injections, a pump delivers insulin 24-hours a day through a catheter under the skin. With a pump with carbohydrate counting, a patient can adjust insulin levels accurately for food intake and elevated or low blood sugar. "Health plans often cover pumps when they improve a patient's diabetic care and provide better control than multiple daily injections," said David Sand, M.D., Chief Medical Officer of an Ohio IRO, HMS-Permedion, and a pump-wearer. "They routinely cover pumps for patients with type-1 diabetes. The hope is that better glucose control lessens end-organ damage, which can benefit type-2 patients also."

Health plans may ask an IRO review the medical necessity for an insulin pump when daily doses of insulin don't achieve tight glycemic control and the hemoglobin A1c rises above the recommended seven percent set by the American Diabetes Association, or when hypoglycemia continues despite adjusting insulin doses. "Programming the pump to adjust basal insulin delivery rates and boluses throughout the day allows for more precise glycemic control, achievement of target HbA1c levels, and prevention of long-term complications," Sand said.

Demands Patient Skills

Sand explained that a concern of health plans about insulin pumps is the patient's ability to manage one. A healthcare provider team, including an endocrinologist and diabetes nurse educator, teaches the patient how to insert and change the catheter, set and adjust the basal rate and calculate boluses.

"While glucose monitoring is important for any diabetic, it's even more so for pump users who must adjust their boluses regularly for food intake and activity," Sand said. "Besides, pumps aren't an excuse for dietary indiscretion. Patients must learn carbohydrate counting to deliver correct insulin boluses at mealtimes."

About NAIRO

NAIRO works to promote the value and integrity of the independent medical review process, as an integral part of improving U.S. health care. Its members embrace an evidence-based approach to medical review for resolving coverage disputes between enrollees and their health plans. For more information, visit www.nairo.org.


'/>"/>
SOURCE NAIRO
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Determining Who Will Respond to Brain Tumor Therapy
2. Patients Say Costs Determining Factor in Their Treatment Decisions
3. Mothers Play a Powerful Role in Determining Strength of Daughters Bones
4. MRI: Effective tool for determining pathologic stage of prostate cancer
5. Experts Weigh in on Controversial Issue of Determining Value of Cancer Care at NCCN Conference
6. Determining risk for pancreatic cancer
7. Gender is key factor in determining overall survival of lung cancer patients
8. Determining Valuations in Challenging Times
9. Past Earnings Play Role in Determining SSDI Benefits
10. PET/CT scan could be valuable noninvasive tool for determining stages of ovarian cancer
11. Fitness a Key Element in Determining Male Diabetics Longevity
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... March 24, 2017 , ... “Finding Christ Through Social Media: ... journal chronicling the writer’s path toward true communion with God. “Finding Christ Through ... is the creation of published author Lea Michelle Johnson, a follower of Christ, ...
(Date:3/24/2017)... (PRWEB) , ... March 24, 2017 , ... ... collection of inspiring stories about real people of God in congregations across the ... John Miller, a Presbyterian minister ordained in 1964 who has served congregations in ...
(Date:3/23/2017)... ... 2017 , ... A recent report from the National Council on Teacher Quality ... report suggests, based on a review of GPA and SAT/ACT requirements at 221 institutions ... U.S. It argues that this higher bar should be set by states, by the ...
(Date:3/23/2017)... New Braunfels, TX (PRWEB) , ... March 23, 2017 , ... ... a new clinic, located at 960 Gruene Road in Building 2. The clinic is ... co-owner Dr. Andrew Bennett, PT, says opening the company’s second New Braunfels location brings ...
(Date:3/23/2017)... ... 23, 2017 , ... The MBI “Hall of Fame” recognizes the contributions of those whose careers ... impact on the careers of all others involved. , On Monday, March 21st, ... MBI’s Hall of Fame. The induction took place during the World of Modular – ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... , Mar. 24, 2017 Research and Markets has ... Analysis, 2016" report to their offering. ... The IPF pipeline is very strong with a total ... & Co., Inc., Biogen and Sanofi are involved in the development of ... which one is in Phase III stage, 15 are in Phase II ...
(Date:3/24/2017)... YORK , March 24, 2017 ... and Equipment stocks, which are: Neovasc Inc. (NASDAQ: NVCN), Hologic ... Heart Inc. (NASDAQ: SSH ). These companies are ... its prior gains on Thursday, March 23 rd , 2017, ... afternoon, while shares of health care companies in the S&P ...
(Date:3/24/2017)... surveys with 9,250 insured consumers fielded from February 2015 ... help from their plans in five key areas: 1) ... help closing gaps in care, 3) better digital connections, ... real-time guidance. Meeting these needs is essential to promoting ... A Reason to Stay Engaged in Health ...
Breaking Medicine Technology: