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31 January 2023
Dr Waqas Tahir explains expanded NICE eligibility criteria on the use of flash glucose monitoring for type 2 diabetes.
Currently, nearly 5m people in the UK live with diabetes, the vast majority (90%) have type 2.1 An additional 13.6m people are now at increased risk of type 2 diabetes1 and Diabetes UK predicts that 600,000 more people will be living with the condition by 2030.1
The figures suggest that diabetes is of growing concern, and primary care providers will play an increasingly important role in the management of diabetes in the years ahead. So how can we support our patients to make more informed decisions and choices long after diagnosis?
Flash glucose monitoring (flash), such as Abbott’s FreeStyle Libre 2 system, can help reduce potential complications, improve quality of life, and lessen the burden of daily management routines.2,3,4
In March, NICE updated its guidelines meaning all people with type 1 diabetes in the UK are now eligible for flash or continuous glucose monitoring (CGM) via the NHS.5 Access has also been expanded to those living with type 2 diabetes who rely on insulin and there has been a renewed focus on those with learning disabilities and other vulnerabilities.6
The updates to NICE’s guidelines mark a huge step forward for those living with type 2 diabetes, who have the technology included within the guidelines for the first time. GPs now have the power to transform those lives by becoming more accustomed with the evidence, identifying the right patients and implementing the right care.
To date, access to glucose sensing technology like flash or CGM has been prioritised for those with type 1 diabetes. But a meta-analysis of 75 real-world studies recently found that use of flash is associated with significant reductions in HbA1c at three months. The reductions in HbA1c followed a similar pattern in people with both type 1 and type 2 diabetes and were sustained for at least 12 months.7
This demonstrates the value of flash to support glycaemic control in people with advanced type 2 diabetes who use insulin in a real-world setting.
So at local level, where people with type 2 are seen the most, GPs can now direct those who rely on insulin to a proven solution that allows them to live with more control and fewer finger-pricks.8
With more people now eligible for this technology, as healthcare professionals we must be actively identifying those eligible patients with greatest need so they can be initiated on the device for better glucose management and a better quality of life.
As well as those who are easier to reach, it is important for primary care clinicians to seek out patients who may be considered vulnerable cohorts living with type 2 diabetes. This could include people living with a learning disability, a language barrier, or cultural groups such as the travelling community.
These groups tend to be at a higher risk of developing diabetes complications, avoid hospitals, and engage mostly with primary care. Ensuring such patients, who are traditionally harder to reach, are also considered within the system is a key element in ensuring the most effective and equitable implementation of the expanded access.
Key questions we must ask are:
Utilising patient data, search tools and data analyst teams can play a key part in routing a pathway to change. Filtering data can help to identify patients who are clearly eligible, but who might not necessarily advocate for themselves or be particularly knowledgeable about what is available to them.
Once eligible patients have been identified, the next critical step is to enable prompt prescriptions followed by continued support, which should include education on self-care and the self-management of diabetes. There is more information on Abbott’s FreeStyle Libre website to help guide GPs on how to get patients started with the FreeStyle Libre 2 system.
It is exciting the see such positive change in the field of diabetes management – as GPs we should feel empowered to make an impact and help people living with diabetes better manage their condition to live better lives.
Healthcare professionals can learn more about the FreeStyle Libre Flash glucose monitoring system here: https://freestylediabetes.co.uk/health-care-professionals
Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries.
Connect with us at www.abbott.co.uk on LinkedIn at www.linkedin.com/company/abbott-/, on Facebook at www.facebook.com/Abbott and on Twitter @AbbottNews.
ADC-67948 (v1.0) 12/2022
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