Criteria announced for Type 1 diabetes monitors prescriptions

NHS England has announced details of how people with Type 1 diabetes will benefit from flash glucose monitors from April 2019.

In November, it was announced that patients will be able to receive Freestyle Libre glucose monitoring on prescription.

The criteria as set out by NHS England for Flash Glucose Monitoring reimbursement is:

• People with Type 1 diabetes or with any form of diabetes on haemodialysis and on insulin treatment who, in either case, are clinically indicated as requiring intensive monitoring more than eight times daily, as demonstrated on a meter download or review over the past three months or with diabetes associated with cystic fibrosis on insulin treatment;
• Pregnant women with Type 1 Diabetes - 12 months in total inclusive of post-delivery period;
• People with Type 1 diabetes unable to routinely self-monitor blood glucose due to disability who require carers to support glucose monitoring and insulin management;
• People with Type 1 diabetes for whom the specialist diabetes MDT determines have occupational (e.g. working in insufficiently hygienic conditions to safely facilitate finger - prick testing) or psychosocial circumstances that warrant a six-month trial of Libre with appropriate adjunct support;
• Previous self-funders of Flash Glucose Monitors with Type 1 diabetes where those with clinical responsibility for their diabetes care are satisfied that their clinical history suggests that they would have satisfied one or more of these criteria prior to them commencing use of Flash Glucose Monitoring had these criteria been in place prior to April 2019 and has shown improvement in HbA1c since self-funding;
• For those with Type 1 diabetes and recurrent severe hypoglycaemia or impaired awareness of hypoglycaemia, NICE suggests that Continuous Glucose Monitoring with an alarm is the standard. Other evidence-based alternatives with NICE guidance or NICE TA support are pump therapy, psychological support, structured education, islet transplantation and whole pancreas transplantation. However, if the person with diabetes and their clinician consider that a Flash Glucose Monitoring system would be more appropriate for the individual’s specific situation, then this can be considered.

One in five Type 1 diabetes patients are expected to benefit from the devices and sensors.