Type 2 diabetes and CGM access

Type 2 diabetes CGM access is a hot topic. If you have Type 2 diabetes, it can be tricky getting your medical aid to approve CGM use. We asked diabetes advocate Riaan Naude to share his experience.

“My advice regarding getting access to a continuous glucose monitor (CGM) would be to apply to your medical scheme through an Ex-Gratia application, a a formal request for your medical scheme to voluntarily cover medical expenses that fall outside your standard benefits or have depleted your available funds.

Have a look on your medical scheme’s website for the application forms, or contact them and request the necessary documents.

Ask your specialist(s) to provide a strong clinical motivation explaining your diabetes, any other medical condition(s), and how those conditions affect your glucose levels. They should also include details of your hospital admissions, diabetes-related complications (this is very important), and the impact these conditions have on your quality of life.

The more relevant medical information they can provide, the stronger your application will be.

Also make sure to include:

• At least 90 days of glucose data.
• Details of all hospital admissions.
• A quotation from the CGM company for the device your specialist recommends.

It is also very important to ensure that your medical scheme acknowledges receipt of your application and to follow up with them regularly on the progress of your Ex-Gratia application.

The process can take time. In my case, I waited 9 months for approval, which was ultimately granted because of my heart-related complications.

It is important that your specialist clearly explains your current complications, the risk of further complications, and how access to a CGM could help reduce those risks and improve your overall health and quality of life. Where clinically appropriate, they should also outline the potential serious health consequences if your diabetes cannot be managed as effectively without continuous glucose monitoring.”

Have you accessed a CGM as a Type 2 through a medical aid? Let us know below!