Freestyle Libre: available on the NHS?
DOI:
https://doi.org/10.15277/bjd.2018.168Keywords:
flash glucose monitoring, FreeStyle Libre, type 1 diabetes, interstitial glucose monitoring, funding, reimbursementAbstract
In 2017 the FreeStyle Libre flash glucose monitor became available on the NHS Drug Tariff. Clinicians and funders across the UK have had to debate where this device sits in the care of people with diabetes. While some would argue that this device is a replacement for self-monitoring of blood glucose and should therefore be widely available for those who may benefit, the financial climate in the NHS has demanded a more conservative approach. This article considers the current evidence to support the use of the FreeStyle Libre, its position in current and future care pathways and gaps in available evidence.
References
Leelarathna L, Wilmot EG. Flash forward: a review of flash glucose monitoring. Diabet Med 2018 Jan 22. http://dx.doi.org/10.1111/dme.13584
Olafsdottir AF, Attvall S, Sandgren U, et al. A clinical trial of the accuracy and treatment experience of the flash glucose monitor FreeStyle Libre in adults with type 1 diabetes. Diabetes Technol Ther 2017;19:164–72. http://dx.doi.org/10.1089/dia.2016.0392.
Edge J, Acerini C, Campbell F, et al. An alternative sensor-based method for glucose monitoring in children and young people with diabetes. Arch Dis Child 2017;102:543–9. http://dx.doi.org/10.1136/archdischild-2016-311530
McPhater A, Gardiner M, Modgil G. The impact of the Libre device for families and children with type 1 diabetes (abstract). Diabet Med 2017;34(Suppl S1):104.
Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kroger J, Weitgasser R. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet 2016;388:2254–63. http://dx.doi.org/10.1016/S0140-6736(16)31535-5.
Haak T, Hanaire H, Ajjan R, Hermanns N, Riveline JP, Rayman G. Use of flash glucose-sensing technology for 12 months as a replacement for blood glucose monitoring in insulin-treated type 2 diabetes. Diabetes Ther 2017;8:573–86. http://dx.doi.org/10.1007/s13300-017-0255-6.
Dover AR, Stimson RH, Zammitt NN, Gibb FW. Flash glucose monitoring improves outcomes in a type 1 diabetes clinic. J Diabetes Sci Technol 2017;11:442–3. http://dx.doi.org/10.1177/1932296816661560
McKnight JA, Gibb FW. Flash glucose monitoring is associated with improved glycaemic control but use is largely limited to more affluent people in a UK diabetes centre. Diabet Med 2017;34:732. http://dx.doi.org/10.1111/dme.13315
Ish-Shalom M, Wainstein J, Raz I, Mosenzon O. Improvement in glucose control in difficult-to-control patients with diabetes using a novel flash glucose monitoring device. J Diabetes Sci Technol 2016;10:1412–13. http://dx.doi.org/0.1177/1932296816653412
Campbell F, Kordonouri O, Murphy N, Stewart C. FreeStyle Libre use for self-management of diabetes in children and adolescents. Diabetes 2017; 66(Suppl 1A):LB28.
National Institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management. https://www.nice.org.uk/guidance/ng17 2015 .
Reddy M, Jugnee N, Spanudakis E, Oliver N. Impact on hypoglycaemia awareness of real time continuous glucose monitoring and intermittent continuous glucose data (I HART CGM). Diabetic Med 2017;34:29.
Hoss U, Budiman ES. Factory-calibrated continuous glucose sensors: the science behind the technology. Diabetes Technol Ther 2017;19:S44–S50. http://dx.doi.org/10.1089/dia.2017.0025
Aberer F, Hajnsek M, Rumpler M, et al. Evaluation of subcutaneous glucose monitoring systems under routine environmental conditions in patients with type 1 diabetes. 2017;19:1051–5. http://dx.doi.org/10.1111/dom.12907
Diabetes UK. Consensus guideline for flash glucose monitoring systems. https://www.diabetes.org.uk/resources-s3/2017-09/1190_Flash%20glucose%20monitoring%20guideline_SB_V9%5B4%5D.pdf 2017
National Institute for Health and Care Excellence. FreeStyle Libre for glucose monitoring. https://wwwniceorguk/advice/mib110 2017
Regional Medicines Optimisation Committee NHS England. Flash glucose monitoring systems – position statement. https://www.sps.nhs.uk/wp-content/uploads/2017/11/Flash-Glucose-monitoring-System-RMOC-Statement-final-2.pdf 2017
Abbott Laboratories. FreeStyle Libre. www.freestylelibre.co.uk/libre (accessed 22 Feb 2018).
Published
Issue
Section
License
Publish & Transfer of Copyright Agreement
For the mutual benefit and protection of the Author and the Journal Owner/Publisher it is necessary that the Author provides formal written Consent to Publish and Transfer of Copyright before publication of the Work.
