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Flash and Real-Time Continuous Glucose Monitoring: NICE Diabetes Guidance Update
by NHS
Information for Patients
NICE Type 1 and Type 2 Diabetes Guidance Updates (March 2022)
The updated NICE guidelines recommend increased access to flash (e.g., Freestyle Libre) and real-time continuous glucose monitoring (CGM) devices. This leaflet explains these updates and how patients attending the Diabetes Clinic at King’s may access these devices. If you have any questions or concerns, please contact your diabetes healthcare provider.
What Has Been Published?
NICE (National Institute for Health and Care Excellence) is an independent organisation that provides recommendations for treating health conditions, including diabetes. Their updated clinical guidelines for managing type 1 and type 2 diabetes include changes to medications and blood glucose monitoring methods for adults with diabetes in England.
Adults with Type 1 Diabetes
NICE guidelines recommend that if you are 18 years or older with type 1 diabetes, you should be offered a choice of intermittently scanned glucose monitoring (e.g., Freestyle Libre) or real-time CGM on the NHS. CGM should be offered if you are pregnant and have type 1 diabetes.
Adults with Type 2 Diabetes
For adults 18 years or older with type 2 diabetes who use insulin two or more times daily, intermittently scanned glucose monitoring (e.g., Freestyle Libre) should be offered if:
- You experience recurrent or severe hypoglycaemia impacting quality of life.
- You have impaired hypoglycaemia awareness.
- You have a condition or disability that prevents self-monitoring by capillary blood glucose tests but allows use of a Flash device.
- You are advised to self-measure glucose levels at least 8 times a day.
If you require assistance from a care worker or healthcare professional for glucose monitoring, a flash device should be offered.
NICE recommendations are based on evidence of effectiveness and cost. Healthcare professionals will decide based on individual circumstances, in consultation with you and/or your carer. NICE uses the term ‘offer’ when confident that an intervention will benefit most patients.
When Does This Guidance Come into Force?
NICE’s clinical guidelines do not have a specific implementation date. However, hospitals in London are already discussing how to implement these guidelines. NICE’s regional consultants will assist with this process. This also applies to those self-funding.
Will All Eligible Patients Have Access to CGM or Flash on the NHS?
Yes, in time and at the discretion of your healthcare team. For type 1 diabetes, there are no longer specific criteria. For type 2 diabetes, criteria must be met. Your healthcare provider will use NICE recommendations and their professional judgement to determine the suitability of these devices.
Which Flash and CGM Devices Are Included?
All devices in these categories are included. Currently, Abbott’s Freestyle Libre is the only flash device available, but other brands will be included if they become available. The guidance covers all CGM brands available in the UK.
How Can I Access the Device I Want or Need?
Ask at your next clinic appointment. There may be training involved. We appreciate your patience as we work to provide these devices alongside our usual clinic duties.
Can I Change My Appointment to Get a Device Sooner?
Changing your appointment will not expedite the process. NICE estimates that the new guidance will affect 250,000 people with type 1 diabetes and 193,000 with type 2 diabetes. We are using remote training and technology to speed up the process.
What About Ongoing Funding? Can a Device Be Taken Away?
Devices may be discontinued if they are not beneficial. Ensure you use the device fully and follow up with your diabetes specialist regularly. Additional training may be provided if necessary.
Further Information
Learn more about glucose monitoring with flash and CGM at the DTN-UK virtual showroom, JDRF, and Diabetes UK websites.
PL1038.1 April 2022 Urgent and Planned Care
Review Date: April 2025
Article by NHS
