Are You a Diabetic With Myasthenia Gravis?

New US Medicare coverage rules may be helpful to some MG patients like me who are also non-insulin dependent diabetics.

I was recently put on prednisone for my MG and it has caused a lot of instability with my glucose levels. This in turn caused my Neurologist to change my MG meds resulting in more and different issues for my diabetes treatment. The only way I am able to manage all of the changes in my meds and the resulting volatility in my blood glucose (BG) levels is with a continuous glucose monitor (CGM) like the Libre 3. Unfortunately, most insurance (including Medicare) will not cover the devices for non-insulin dependent diabetics. There have been recent changes to Medicare coverage, though, that may allow many of us to get coverage, if you are like me and are experiencing wild swings in your BG levels.

There are several conditions that must be met to qualify. Again, if you are like me most of the conditions you likely have been meeting for years. I will not go into all of the conditions here for that reason. A simple google search will provide all the detail you may need relative to ALL the requirements. The main thing you need to be aware of is that having multiple events hyperglycemia of less than 54 mg/dl can possibly qualify you to be covered by medicare for use of a CGM device.

In my case I do not always no when I am that "low" on my sugar levels. If am inactive (watching TV for hours) I will not know if my sugar is low until I get up to do something. This happened to me recently. When I stood up, from my hours long couch potato status, I immediately knew something was wrong and had a reading of 54 on my finger stick glucose monitor. I sat back down and had my wife find me some sugary candy (gummy bears, yumm) to get my sugar up. I soon started to realize how bad I could have been if I had not realized my problem in time.

It is important to understand that prior to the recent changes to my MG and diabetes meds, I had only had one previous hypoglycemic event. Now, I am having many of them. I began to worry about having an extremely low hypoglycemic event while I am asleep. So, I got my doctor to prescribe a CGM to me, against his advice because of cost. ($150-$300/month) Since, getting the CGM I have documented multiple hypoglycemic events I would not have otherwise have been able to detect or document, unless like before I just happened to standup at the right time. I will soon be applying to Medicare for coverage. Hopefully, they will provide me the coverage I obviously need. Otherwise, my monthly expenses may preclude me from continuing to use the CGM technology to protect my health

I do not have diabetes. But, prednisone raises my blood sugar. After several years on it prednisone, I had a couple of yeast infections in a row which led me to believe my blood sugar wasn't controlled well. I got a real-time glucose monitor and a book about carbohydrate counting and learned how to balance my meals so I do not get sugar spikes. I also will eat, for example, a fruit salad, between meals instead of at a meal to spread out the carbohydrate load.