NICE update recommendations for continuous glucose monitoring (CGM) and flash monitoring (Freestyle Libre) – now available for all people with Type 1 diabetes and people with Type 2 diabetes using insulin

Press release, March 31st 2022

More than 250,000 people living with type 1 diabetes are set to be offered new technology to help them manage their condition and at the same time reduce the need for finger prick testing by up to 50%, following new advice from NICE. New guidance from NICE has recommended the use of real-time continuous glucose monitoring (rtCGM) for adults and children living with type 1 diabetes for the first time. It will give them a continuous stream of real-time information on a smartphone about their current blood glucose level.

Alongside new rtCGM technology, the use of intermittently scanned glucose monitoring (isCGM) devices – also known as flash monitoring (the Freestyle Libre) – has been expanded to the whole of the type 1 patient population. Patients will now have a choice in picking the technology which is right for them in discussion with their diabetes team.

A rtCGM sensor is attached discreetly to the person’s body and collects the data which is transmitted to their smartphone. The data provides current and previous glucose levels but also a prediction of where the levels are headed meaning they can take action to stabilise their levels if necessary.

The real-time systems also feature active alerts or alarms that warn users of immediate and/or impending high or low blood sugar. Research has found both real-time and flash devices help a person in maintaining optimal blood sugar control.

Until now NICE had only recommended technology for continuous glucose monitoring for adults with type 1 diabetes in certain circumstances and capillary blood glucose monitoring (finger-prick testing) for people who weren’t eligible for the technology. With the introduction of new technology for everyone with type 1 diabetes, people will no longer have to monitor their condition with finger-prick testing as regularly as before. Instead the technology, calibrated using the person’s blood, will do that work for them. Experts predict this will reduce by half the need for finger-prick testing.

NHS England has rolled out NICE recommended flash devices to around 50% of those with type 1 diabetes. The flash devices require users to consciously scan a sensor on their arm to obtain blood sugar data and not all flash monitors provide optional alarms or alerts.

In other new recommendations:

  • NICE has recommended extending the use of flash monitoring to adults with type 2 diabetes on insulin therapy. This recommendation makes the technology available to around 193,000 people.

Dr Paul Chrisp, director of the centre for guidelines at NICE, said: “By recommending the use of either real-time or flash monitoring, our independent committee has made recommendations that will be a step forward in helping all people with type 1 diabetes manage their condition. Many people find finger-prick testing to be painful and time consuming and the introduction of technology for all people living with type 1 diabetes will reduce this considerably. This group of people also live with the constant worry of suffering from an attack brought on by dangerously low blood sugar while they sleep. Having an alarm which will alert them if this happens will give them the peace of mind knowing they will wake up in the morning.”

Eligible patients should speak to their diabetes team to access real-time or flash monitors on prescription.

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