GREY after diabetic consultant/specialist initiation within a Derbyshire Diabetes service - see JAPC briefing
Recommendation for use
Consultant identifies those with Type 1 diabetes:
- Or with any form of diabetes on hemodialysis and on insulin treatment - who are clinically indicated as requiring intensive monitoring >8 times daily - OR with diabetes associated with cystic fibrosis on insulin treatment
- Pregnant women with Type 1 Diabetes, with 12 months in total inclusive of post-delivery period
- People with Type 1 diabetes unable to routinely self-monitor blood glucose due to disability who require carers to support glucose monitoring and insulin management.
- Those whom the specialist diabetes MDT determines have occupational or psychosocial circumstances that warrant a 6-month trial of Libre with appropriate adjunct support.
- Those who have recently developed recurrent severe hypoglycemia or impaired awareness of hypoglycaemia (defined for example using Gold score ≥4) NICE suggests that Continuous Glucose Monitoring with an alarm is the standard. Other evidence-based alternatives with NICE guidance or NICE TA support are pump therapy, psychological support, structured education, islet transplantation and whole pancreas transplantation. However, if the person with diabetes and their clinician consider that a Flash Glucose Monitoring system would be more appropriate for the individual's specific situation, then this can be considered.
- People with Type 1 diabetes or insulin treated Type 2 diabetes who are living with a learning disability and recorded on their GP Learning Disability register.
In addition, all patients (or carers) must be willing to undertake training in the use of FreeStyle Libre® and commit to on-going regular follow-up and monitoring (including remote follow-up where this is offered).
(FreeStyle Libre®starter kit consists of the reader and 1 sensor - 1 sensor last 14 days)
FreeStyle Libre 2 will be available through the specialist team after February 2021.
RED: FreeStyle Libre 3 (Decision date - February 2024)