NICE has expanded the recommendations in its diabetes guidelines to endorse real-time continuous glucose monitoring for everyone living with type 1 diabetes

Andrey Popov CGM continuous glucose monitoring diabetes type 1 flash

For the first time, NICE has added recommendations on real-time continuous glucose monitoring (CGM) to its guidance on type 1 diabetes, endorsing its use in all people living with type 1 diabetes.

The newly updated guidelines recommend intermittently scanned CGM in particular, known more commonly as flash monitoring, for all adults and children with type 1 diabetes in the UK.

Flash glucose monitors are small, around the size of a £2 coin, and contain a sensor that sits on the arm. They link to a smartphone app, with which users can access the data collected by their device and check their glucose levels with a 1-second scan. In addition, they can view trends in their glucose levels over time, and predict future glucose levels based on the data already collected. Some versions also offer optional alarms and alerts, warning their users of high or low blood sugar levels.

NHS England currently spends approximately 10% of its budget, equating to £10 billion per year, on diabetes support, and tools like CGM, which help patients to manage their condition and reduce associated illness and hospitalisations, have proven to be particularly cost-effective. Experts have estimated that the roll-out of further access to CGM is likely to reduce the need for finger-prick testing by as much as 50%, for example, as this technology does the monitoring for them.

Currently, around 50% of people living with type 1 diabetes in the UK have been given flash devices, a figure that far exceeds the NHS Long Term Plan’s goal of 20% by March 2021.

NICE has also recommended extending the use of CGM to adults with type 2 diabetes on insulin therapy, making the technology available to a further 193,000 people across the UK.

The news comes just after research was presented at the Diabetes UK Professional Conference 2022 stressing that CGM improves blood glucose levels and quality of life in people with type 1 diabetes.

National NHS Specialty Adviser for Diabetes, Professor Partha Kar, said: ‘This announcement is the biggest step forward for type 1 diabetes care in years, allowing everyone eligible to have one of these easy to use pieces of tech if they want to—building on the success of the NHS in its roll-out so far. I am delighted to see NICE endorse the use of this technology.

‘These monitors are a win–win: they support diabetes patients to live healthier lives, reduce their risk of hospitalisation, while also helping to reduce pressure on NHS services and provide better value for money for taxpayers.’

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.’

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