Residents of British Columbia, 2 years of age and older with diabetes mellitus (DM) and meet the following criteria:

1. Requires multiple daily injections of insulini or insulin pump therapy as part of intensive insulin therapy, and
2. The patient/family/caregiver agrees to comprehensive and age-appropriate diabetes education by an interdisciplinary diabetes healthcare team and commits to regular follow-up, and
3. The patient has one of the following:
   • Hypoglycemia unawarenessⁱⁱ, or
   • Frequent and unpredictable hypoglycemic episodesⁱⁱⁱ, or
   • Unpredictable swings in blood glucose^iv, or
   • At least one functional restriction that inhibits the use of blood glucose test strips (BGTS) (e.g., dexterity, mobility, dermatological problems), or
   • An occupation where hypoglycemia presents a significant safety risk (e.g., pilots, air traffic controllers, commercial drivers).

i. Multiple daily injections of insulin is defined as 1 (or more) injection(s) of basal insulin and three (or more) injections of bolus insulin, with a minimum of at least of 4 total insulin injections per day.
ii. Hypoglycemia unawareness is defined as the inability of a patient to recognize or communicate early symptoms of hypoglycemia resulting in the inability to take corrective action to prevent severe hypoglycemic episodes.
iii. Frequent hypoglycemic episodes are defined as greater than 3 episodes per week. Unpredictable hypoglycemic episodes are defined as those that are not associated with predictable causes (e.g., physical activity, reduced food intake, acute illness, medication dosing errors).
iv. Unpredictable swings in blood glucose is defined as variability in blood glucose levels of less than 4 mmol/L and/or greater than 10 mmol/L throughout the day that are not associated with a predictable cause (e.g., physical activity, food intake, acute illness, medication dosing errors.

For a complete description of coverage criteria, please visit: https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/pharmacare/prescribers/special-authority/special-authority-request-forms-drugs-medical-devices-and-supplies