ISSUE: A Veteran living with type 2 diabetes contacted us after Veterans Affairs Canada (VAC) denied their request for a Continuous Glucose Monitor (CGM), which was prescribed by their doctor for severe nighttime hypoglycemia, or low blood sugar. A CGM is a wearable device that tracks blood sugar every few minutes on a constant basis. The Veteran needed a CGM because it would alert them if their blood sugar level fell too low while they were sleeping at night. Their request was denied by VAC because a CGM is generally prescribed for people with Type 1 diabetes.
ACTION: We found that the Veteran’s request was missing some important information. We encouraged them to ask their doctor to provide an explanation as to the medical necessity for a CGM. When the doctor provided that additional information, we sent a reconsideration request to VAC.
RESULT: VAC reviewed the case with the additional medical information and approved the Veteran’s request to be reimbursed for the CGM. This decision recognized the Veteran’s need for continuous glucose monitoring to protect their health.