Obtaining a pathology ticket exemption is the first step in receiving blood glucose measuring devices. Supplies may vary depending on the place of residence
Any patient with a diagnosis of diabetes (of any type: 1, 2 or gestational) has the option of receive from the National Health Service a series of medical devices for self-monitoring of blood glucose (i.e. the amount of glucose present in the blood, which in the fasting diabetic subject exceeds 126 milligrams / deciliter or 200 after taking 75 grams of glucose by mouth) and, if necessary, for the infusion of insulin (the hormone used to control blood sugar levels). Therefore, without charges, completely free of charge. I am entitled to it both resident citizens and non-resident citizens with medical domicile in the municipality of transfer (i.e. enrolled in a general practitioner in the city of a different region), subject to authorization by the local health authority of residence.
How to request them
The first step to be entitled to the devices (test strips, lancing needles, insulin pens, glucometer, sensors, insulin pumps) to obtain the code of exemption from the payment of the health ticket attributed to the diabetic disease (013), which it must be requested from the local health authority. To establish the quantity and type of the aids that can be periodically granted the diabetes specialist responsible for the personalized treatment plan (in some cases, if the values are stable, it can be the general practitioner or pediatric doctor of free choice) based on the patient’s pathological condition.
The differences
It almost always exists a level of variability between regions in supplies tools for self-measurement of blood glucose and insulin therapy. And this can generate some disparities in treatment. Here are some examples. The maximum monthly number of test strips to measure the blood glucose value intended for patients who need to take multiple insulin injections per day 250 in Abruzzo (for 5-7 injections daily), 150 in Liguria, Emilia Romagna or Veneto, 125 in Sardinia and 120 in Piedmont.Under 18s with diabetes are usually entitled to 250, but in Campania there are 200, in Lombardy 175 and in Sardinia 125. To women with gestational diabetes on insulin therapy: up to 300 in Veneto, 250 in Liguria and Molise and 150 in Tuscany and Piedmont. Diabetics who have simply been prescribed dietary treatment do not need glycemic control. For proven needs, the Regions can however guarantee from 50 to 25 strips every month, only a dozen (as in Campania) or a couple (in Veneto). While for those who use an insulin pump, a patch or worn externally (with a subcutaneous cannula to administer insulin at variable rates during the day), the quantity not to be exceeded varies between 100 and 150 with a combined sensor and between 175, 200 and 250 without .
Blood glucose monitoring
If you take oral hypoglycemic drugs that can cause hypoglycemia: from fifteen to 25, up to 60. Sicily has set the maximum limit of 25 monthly strips for all patients. But, according to the Region, pending the new decree, the specialist can prescribe it without limit if he deems it necessary. A adequate number of lancets and pen needles containing the insulin vial, and delivered a glucometer (the instrument that estimates the rate of glucose in the blood). On the judgment of the physician, patients with multi-injection treatment, unstable diabetes or insulin pump can be applied a sensor for continuous blood glucose monitoring. The insulin pump is reimbursed to those at risk of suffering severe hypoglycemia and has a high glycemic variability, in order to better manage insulin doses.
Method of prescription and withdrawal
The prescription of diabetic aids to public health requires the drafting of a personalized treatment plan issued by the specialist of the diabetes center. The plan can be paper or dematerialized and is renewed annually. In some regions (in Abruzzo, for example, where the document has not yet been computerized, or in Lazio where the plan is already online) the citizen needs also of the family doctor’s prescription to collect the material. Otherwise, just show the health card (or the paper plan, as in Sicily). The distribution it can happen directly in local pharmacies (public and private) or through the pharmaceutical services of hospitals and local health authorities (as in Emilia Romagna, Abruzzo or Liguria, where the supply on behalf of the local pharmacies is also being tested).
Long waiting lists
THE30% of patients with diabetes have never received a specialist visit underlines Andrea Giaccari, professor of Endocrinology at the Catholic University and head of the endocrine and metabolic diseases center of the Gemelli polyclinic in Rome. The reason? There are many patients and often there are long waiting lists for the first access he replies to the diabetes center. Sometimes the general practitioner who does not consider it appropriate to send the patient to the center but only the specialist can prescribe the innovative aids and drugs to prevent cardiovascular events and nephropathies associated with diabetes. As a result, at least 50% of those who need them do not hire them. The Italian Medicines Agency announces that by 2022 the drug treatment plan for diabetes will be computerized and will allow us to verify the prescriptive appropriateness and promote epidemiological investigations.
December 5, 2021 (change December 5, 2021 | 11:31)
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