CMS-10407 Diabetes Scenario Narrative

Management of Type 2 Diabetes
A 52-year-old man has type 2 diabetes. His diabetes is well-controlled with metformin (500 mg)
twice daily and long-acting insulin (20 units), administered once daily. He is also on ramipril (10
mg once daily) to maintain appropriate blood pressure and kidney function, and aspirin as a
cardiovascular preventive service. He visits his primary care physician four times a year, his
podiatrist once a year, and his ophthalmologist once a year. Twice yearly, he receives tests for
blood glucose, hemoglobin A1C, urinalysis, and an estimated glomerular filtration rate. Once
yearly, he receives blood tests for microalbuminuria, a lipid panel, and a comprehensive
metabolic panel. He purchases medication and supplies as needed, including testing supplies so
he can test his insulin levels. In addition, he receives diabetes self-management education and
medical nutrition therapy education.
He receives an annual influenza vaccine, but has never received a pneumococcal vaccine, so will
receive one this year and another after he turns 65 years of age. His glucagon kit has expired so
he will purchase a new kit this year.

DISCLAIMER: This narrative and the accompanying benefit scenario illustrate care for a
hypothetical patient receiving treatment for type 2 diabetes. The care, and cost of care, will vary
for each patient. No portion of this narrative or the accompanying benefit scenario should be
construed as recommendations for care, or cost of care, by the United States Government.

OMB Control Numbers 1545-2229, 1210-0147, and 0938-1146