I have spent over 25 years caring for children and adults with diabetes. For the past 11 years, my patient population has been adolescents and adults with type 1 and type 2 diabetes. I also manage a large population of women with pregnancy and diabetes.
Type 2 diabetes has reached epidemic proportions in the United States and is the leading cause of blindness, kidney failure, cardiovascular disease and amputations. Improved control of blood glucose levels has been proven to delay or prevent these complications.
Medicare and private insurance companies impose multiple restrictions on the use of insulin pumps in Type 2 diabetics.
Despite the aggressive use of insulin with or without oral glucose lowering and/or sensitizing agents, many patients with type 2 diabetes have hemoglobin A1C levels well above 8%.
It appears that when these poorly controlled patients are placed on insulin pumps, there is a significant improvement in blood sugar control.
Yet, due to Medicare’s restrictions, these patients are denied the opportunity to utilize this tool.
My capstone project analyzes the health and economic outcomes of pump initiation in 15 adult patients with poorly controlled type 2 diabetes and the implications on future Medicare and private insurance policy.
I welcome any questions or discussion on this or other related topics.
Posted by Phyllis Wolff-McDonagh 
