NHS England Libre Criteria
Criteria for FreeStyle Libre:
- People with Type 1 diabetes OR with any form of diabetes on haemodialysis and on insulin treatment who, in either of the above, are clinically indicated as requiring intensive monitoring >8 times daily, as demonstrated on a meter download/review over the past 3 months OR with diabetes associated with cystic fibrosis on insulin treatment.
- Pregnant women with Type 1 Diabetes - 12 months in total inclusive of the 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.
- People with Type 1 diabetes for whom the specialist diabetes MDT determines have occupational (e.g. working in insufficiently hygienic conditions to safely facilitate finger-prick monitoring) or psychosocial circumstances that warrant a 6-month trial of Libre with appropriate additional support.
- Previous self-funders of Flash Glucose Monitors with Type 1 diabetes where those with clinical responsibility for their diabetes care are satisfied that their clinical history suggests that they would have satisfied one or more of these criteria prior to them commencing use of Flash Glucose Monitoring had these criteria been in place prior to April 2019 AND has shown improvement in HbA1c since self-funding.
For those with Type 1 diabetes and recurrent severe hypoglycemia or impaired awareness of hypoglycemia, NICE suggests that Continuous Glucose Monitoring with an alarm is the standard. Other evidence-based alternatives with NICE guidance or NICE Technical Appraisal (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.
Other NHS England Requirements
- Education on Flash Glucose Monitoring has been provided (online or in-person).
- Agree to scan glucose levels no less than 8 times per day and use the sensor >70% of the time.
- Agree to regular reviews with the local clinical team.
- Previous attendance or due consideration is given to future attendance, at a Type 1 diabetes structured education programme (DAFNE or equivalent if available locally).
Continuing prescription for long-term use of Flash Glucose Monitoring-post initial 6 months- would depend upon evidence of agreeing with the above conditions and that on-going use of the Flash Glucose Monitoring is showing an improvement in an individual’s diabetes self-management - for example improvement of HbA1c or Time In Range; improvement in symptoms such as diabetic ketoacidosis (DKA) or hypoglycaemia; or improvement in psycho-social wellbeing.
If you have type 1 diabetes and meet the criteria then you will need to discuss this with your GP and obtain a prescription for the sensor.
Once you have the prescription then please contact the Diabetes Specialist Nurses at Yeovil District Hospital (01935 384517) so that it can be arranged for you to obtain the sensor reader. This will be done either on an individual basis or as part of a group education session depending on demand.
The hospital will need to provide the first sensor and the reader. This can be discussed with the Consultant at your next appointment. Once this has been commenced the ongoing prescription will be provided by your GP.
In line with the NHS England criteria the continuing prescription for long term use will be dependent upon evidence that on-going use is “demonstrably improving on individual’s diabetes self-management”, and this will be reviewed and discussed within the Consultant clinic.