Diabetes is a condition that causes a person's blood sugar level to become too high.
There are two main types of diabetes:
- Type 1 diabetes – a lifelong condition where the body's immune system attacks and destroys the cells that produce insulin.
- Type 2 diabetes – where the body does not produce enough insulin, or the body's cells do not react to insulin properly.
Continuous glucose monitoring (CGM) and flash glucose monitoring (trade name Freestyle Libre©) are alternatives to traditional blood glucose monitoring using finger prick tests. Both constantly monitor the levels of glucose in the body, although there are some practical differences about how they work, and who they are most suitable for.
NHS Birmingham and Solihull ICB commission both CGM and flash glucose monitoring for specified groups of people with diabetes via specialist diabetes centres. More details are available in the policies below.
The ICB continues to commission traditional self-monitoring of blood glucose using finger prick tests for all patients with diabetes who require it to manage their condition effectively.
- Policy for continuous glucose monitoring in diabetes
- Policy for commissioning of flash glucose monitoring for patients with diabetes meeting the NHS England funding criteria
November 2022: Diabetes glucose monitoring interim position statement
In March 2022 the National Institute for Health and Care Excellence (NICE) Diabetes guidelines were updated to include important new recommendations for both real-time continuous glucose monitoring (rtCGM) and intermittently scanned continuous glucose monitoring (isCGM, commonly referred to as 'flash').
The NICE recommendations can be found within the following guidelines:
- Type 1 diabetes in adults: diagnosis and management (NG17)
- Diabetes (type 1 and type 2) in children and young people: diagnosis and management (NG18)
- Type 2 diabetes in adults: management (NG28)
- Diabetes in pregnancy: management from preconception to the postnatal period (NG3)
Our Integrated Care System must develop local guidelines which both meets the needs of our patients and financial budget. The NICE recommendations are currently undergoing a review process by the local diabetes specialist services clinicians together with commissioners, pharmacists and clinical leads from Birmingham and Solihull Integrated Care Board before they are applied across the healthcare system. We politely ask that patients and clinicians bear with us whilst we complete this process. Further information will be released when available in due course. In the interim please refer to the existing policies (available via the links above).