Any patient living with type 1 diabetes should be able to access glucose monitoring technology, according to draft guidelines.
In the proposals, NICE has recommended making intermittently scanned glucose monitoring (commonly known as flash) and continuous glucose monitoring (CGM) available to all adults with type 1 diabetes.
The guidelines committee predicted that the proposed changes would result in broader access to flash and real-time CGM devices, ‘as opposed to a binary decision on access based on stringent criteria’.
’This should reduce inequalities and enable more people to use CGM. Currently, people with more time and knowledge to self-advocate are often more likely to gain access to these devices,’ the committee wrote.
New draft guidelines also proposed that children and young people with type 1 diabetes should have access to CGM alongside patient education on using the technology.
Flash, which is only licensed for children aged 4 years and over, could be offered to children and young people with type 1 diabetes if they were unable to use CGM or had a clear preference for flash, the guidelines stated.
Clinicians should consider a range of factors when assessing CGM for children including whether the device provided predictive alerts or alarms and whether these needed to be shared with a carer and how easy the device was to use.
‘One of the known factors determining the use of CGM devices among children and young people with type 1 diabetes is sensitivities to the device, for example local skin reactions to the adhesive used in the sensor,’ the committee wrote, adding it was recommending more research on CGM sensory adhesive to prevent sensitivities.
Separate draft proposals also recommended flash glucose monitors for people with type 2 diabetes who use insulin intensive therapy (four or more injections a day) and experience regular or severe hypoglycaemia together with other criteria.
The charity Diabetes UK, which has campaigned for increased access to the technologies, called the proposals a big step forward.
’At the moment, NICE only recommends access to CGM in very limited circumstances and the guidelines don’t mention flash at all,’ the charity said in a statement.
‘We’ve been involved every step of the way in this guideline update process, pushing for better access to this important technology. We’re thrilled to see NICE listen to us, and others, who have been calling for them to recommend wider flash and CGM use.’
The final guidance is expected to be published in March 2022.
Both flash monitors and CGM rely on sensors worn under the skin to measure glucose in interstitial fluid. CGM tracks glucose levels continuously and sends data to a handheld monitor or pump. While with flash monitors, patients must scan the sensor to take a reading.
It comes after a study found poor long-term blood glucose management increases the risk people with diabetes will need intensive care if they contract Covid-19.