Flash blood glucose monitoring must be available to eligible patients, rules NHS England

CCGs will be expected to make wearable sensors that allow continuous monitoring of blood glucose levels available to all eligible patients with type 1 diabetes from April 2019, NHS England has said.

Flash glucose monitoring is designed to help improve self-management of diabetes in people who use insulin. | DR P. MARAZZI/SCIENCE PHOTO LIBRARY

All eligible patients will be able to receive the FreeStyle Libre device ‘on prescription from their local GP or diabetes team’ from April, NHS England said.

Currently around 3–5% of patients with type I diabetes in England have access to the monitoring system; however, if current guidance was followed, this could rise to at least 20–25% of patients, NHS England said.

It highlighted guidance from the Regional Medicines Optimisation Committee, which recommends FreeStyle Libre for patients aged 4 years and above who fulfil one or more of the following criteria:

  • Patients who undertake intensive monitoring at least eight times daily.
  • Those who meet the current NICE criteria for insulin pump therapy (HbA1c >8.5% [69.4mmol/mol] or disabling hypoglycemia as described in NICE TA151) where a successful trial of FreeStyle Libre may avoid the need for pump therapy.
  • Those who have recently developed impaired awareness of hypoglycaemia.
  • Frequent admissions (>2 per year) with diabetic ketoacidosis or hypoglycaemia.
  • Those who require third parties to carry out monitoring and where conventional blood testing is not possible.

Continuous glucose monitoring

The FreeStyle Libre system monitors glucose levels in interstitial fluid using a sensor worn on the upper arm, relaying readings to a smart phone or e-reader. It eliminates the need for regular fingerprick testing of blood glucose levels.

NHS England said that the technology would give patients greater confidence to manage their condition because they would be able to more easily notice when their sugar levels were starting to rise or fall and take action earlier.

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