Continuous Glucose Monitoring - FOI Response Register

The use of Continuous Glucose Monitoring (CGM) in people living with diabetes is now being more encouraged. Type 1 adults, children & young people and Type 2 adults across NHS England and Wales all had the opportunity afforded them in March 2022 to have greater choice with the publication of NICE Guidance. (NG17, NG18 & NG28)

With recommendation for more widespread use of CGM devices can you outline if NHS Shetland plans to offer choices?

The Dexcom 1 CGM system is available on prescription however the majority of our Type 1 patients are currently using the freestyle libre.  The most recent update from ABBOTT who manufacture the Freestyle Libre 2 sensors who use a Smart Phone are now on CGM

Please can you tell me?

1. What policy is in place within NHS Shetland for the use of CGM?

We are currently guided by the National Diabetes Group – Scotland and NHS Grampian.  However we are aware of the NICE guidelines which covers England and Wales. 

2. What criteria does NHS Shetland employ when selecting patients for the offer/use of CGM?

Children are offered CGM

Adults who have hypoglycaemia unawareness resulting in severe hypoglycaemia requiring 3rd party intervention.  Admissions with DKA or diagnosed with Diabetes Distress through the psychology services.

All pregnant or planning pregnancy Type 1 ladies are offered CGM.

Type 2 or gestational diabetes patient who move onto insulin are offered the Libre which is now a CGM or the possibility of the Dexcom 1 CGM.

3. If not already offered why would patient choice not be a major contributing factor in the allocation of CGM?

Data from SCI-Diabetes 25.07.23

Therefore it is clear that NHS Shetland patients are not experiencing any inequalities in accessing CGM.