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In 2017, as advocates and researchers discussed the potential for continuous glucose monitoring (CGM) to become a tool in clinical trials, most of the discussion involved testing in new therapies. The discussion culminated in an international consensus on CGM, published in December 2017, that included standards for assessing hypoglycemia in clinical trials.

Even when things go well, managing diabetes is not easy. Keeping tabs on this disease 24/7 takes planning, commitment, support, and the right tools. For years, a chief complaint among those living with diabetes has been that managed care nickel-and-dimes people over basic supplies, which are comparatively cheap—things like test strips and sensors for a continuous glucose monitor—but will shell out thousands for dialysis and amputations. In the years ahead, if Congress wants to understand rising costs for end-stage renal disease or an increase in emergency department visits for hypoglycemia, it should look directly to CMS’ foray into competitive bidding for blood glucose test strips.

Three years after results from a study in Diabetes Care revealed how flaws in CMS’ Competitive Bidding Program endangered Medicare patients who rely on supplies to test their blood glucose, the federal government has allowed contracts to expire for the dwindling number of suppliers, raising fears that the program for seniors with diabetes has reached the point of collapse.

This week, the top managed care news included new primary prevention guidelines that could increase the use of some diabetes drugs; the FDA expanded criteria for which patients can take part in clinical trials; a summit on value-based insurance design showed the need for tough conversations with stakeholders.

This week, the top managed care news included the 2020 budget plan proposing a mix of healthcare spending cuts and increases; the FDA approving the first immunotherapy regimen for breast cancer; and researchers uncovering how sodium glucose co-transporter-2 inhibitors work.

This week, the top managed care news included increased demand for long-acting contraception since President Trump took office; a payer decision on an insulin pump alarmed diabetes advocates; and despite being involved in cancer treatment decisions, many primary care providers don't feel prepared to do so.

This week, the top managed care news included House and Senate hearings on the cost of prescription drugs; a study finding patients with diabetes can be safely switched to cheaper insulin; and the first non-chemotherapy combination being approved for the treatment of chronic lymphocytic leukemia.

We present an International Classification of Diseases, Tenth Revision (ICD-10) translation of the adapted Diabetes Complications Severity Index and show its performance in predicting hospitalizations, mortality, and healthcare-associated costs.

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