Dr Kevin Fernando looks forward to expert analysis of new NICE guidance on continuous glucose monitoring at Guidelines Live 2022 

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On 31 March 2022, NICE issued updated diabetes guidelines that recommend wider access to intermittently scanned (or ‘flash’) and real-time continuous glucose monitoring (CGM) for people living with type 1 and type 2 diabetes.1–3

The updated guidelines state that clinicians should offer adults with type 1 diabetes a choice of real-time or flash CGM based on their individual preferences and needs, as well as on the characteristics and functionalities of the devices available.1

Flash CGM should also be offered to adults with type 2 diabetes if they are on multiple daily insulin injections and they have recurrent or severe hypoglycaemia, impaired hypoglycaemia awareness, or a condition or disability that precludes self-monitoring of blood glucose by traditional capillary blood glucose monitoring.2 Clinicians can also consider real-time CGM for these individuals if it is available at a similar or lower cost.2

Importantly, the guidelines state that CGM should be provided by a team with expertise in its use to support people self-managing their diabetes.1–3 This will necessitate training for many clinicians working in primary care, where familiarity with the devices and software available, as well as concepts such as ‘time in range’, may be limited.

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The updated guidance represents a paradigm shift in the management of diabetes; however, NICE issues a reminder that stark inequalities persist in access to diabetes technologies,1–3 which commissioners, providers, and healthcare professionals must address in a meaningful way. 

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Join our primary care diabetes experts in the Diabetes Stream at Guidelines Live 2022 to understand how to implement these far-reaching guidelines and how to interpret CGM data in primary care. Book your tickets today for only £99.

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References

  1. NICE. Type 1 diabetes in adults: diagnosis and management. NICE Guideline 17. NICE, 2015 (last updated March 2022). Available at: www.nice.org.uk/ng17
  2. NICE. Type 2 diabetes in adults: management. NICE Guideline 28. NICE, 2015 (last updated March 2022). Available at: www.nice.org.uk/ng28  
  3. NICE. Diabetes (type 1 and type 2) in children and young people: diagnosis and management. NICE Guideline 18. NICE, 2015 (last updated March 2022). Available at: www.nice.org.uk/ng18