Perhaps the ADA and the JDRF can lobby the powers that be, whoever they are to add a new sub code for for type 1s with insulin resistance. These people would have to use more insulin than other type 1s and may experience gaining extra weight.
Looking through this ICD 10 code list there is no sub code for type1 with insulin resistance. If this code existed then doctors would be able to prescribe drugs like Metformin and GLP-1 agonists inhibitors on label without taking flack from the insurance companies etc.
This is a real thing. Having type 1 autoimmune diabetes doesn’t prevent one from having the genetic variants that cause type 2 insulin resistant diabetes.
I think up to 10% of the general population has type 2. If my math is correct, then 10% of those with type 1 can have type 2 as well.
Many endos now add T2 as a diagnosis to T1, so they can add the insulin resistance code, and get T1 patients the treatments they need and covered by insurance. It’s unfortunate to have to do this, but they want to help treat their patients!
The FDA is the hurdle for T1 - the liability/risk of hypoglycemia.
Same reason “artificial pancreas” pump settings don’t allow the targets and limits appropriate to each person’s therapy - it’s all about hypoglycemia risk. Somehow, they just don’t care about the long term risks of hyperglycemia, which blows my mind.
If you have negative consequences/die from hypoglycemia you likely do it on their watch cause that can happen fast.
If you experience negative consequences/die from hyperglycemia- which is to say that you experience and/or succumb to the longterm effects of those consequences of high sugar - they’re betting that they get to kick that liability/responsibility can down the road between now and then and make it someone else’s problem, or lean on “plausible deniability” about confounding variables in the eventual outcome And that’s to say nothing of quality of life concerns meantime.
And “experts” wonder why Americans pay so much more for such inferior outcomes in healthcare capitalism and a litigious society at its finest…
Correct me if I’m wrong, but doesn’t hypoglycemia when you’re in the hospital directly affect Medicare reimbursement rates for following years for the medical facility? That would be a great reason to be phobic… Not justifying it, but acknowledging one reason. Their financial bottom line. Better to be hyperglycemic than hypoglycemic in their opinion.
And that’s to say nothing of quality of life concerns meantime.