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Thousands more patients with type 1 diabetes are getting flash glucose devices, data show

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5895 (Published 07 October 2019) Cite this as: BMJ 2019;367:l5895
  1. Gareth Iacobucci
  1. The BMJ

The number of patients with type 1 diabetes who are receiving “flash” glucose monitoring devices on the NHS has increased markedly since NHS England told clinical commissioning groups to end the postcode lottery, show figures released to The BMJ.

Last year a BMJ investigation found that tens of thousands of patients were being denied the potential benefits of the devices because they were not being recommended in some areas.1

The national specialty adviser for diabetes, Partha Kar, said that The BMJ’s investigation had influenced NHS England’s decision to issue new advice to CCGs in its NHS long term plan, launched in January 2019,2 telling them to end the variation in prescribing practice.

The BMJ’s investigation, published in November 2018, estimated that only 3% to 5% of patients with type 1 diabetes in England had access to the devices, which work by a sensor attached to the skin. Abbott’s Freestyle Libre is currently the only sensor available in the UK.

But the latest prescribing data for August 2019, shared with The BMJ, indicate that an estimated 17% of patients with type 1 diabetes in England are now receiving the devices on the NHS.

Kar told The BMJ, “It has been a huge success and a very pleasant surprise to see every single part of the country now providing flash within just four months of launching the NHS long term plan. It’s a real achievement for the NHS, but we have also seen the life changing benefits it is already bringing to patients with type 1 diabetes.”

The figures show that substantial local and regional variation remains: the proportion of patients with type 1 diabetes receiving the devices is over 40% in some CCGs but below 5% in others. The East of England has been slowest—eight of the 20 CCGs with lowest coverage are in this region—whereas the Midlands has half (10) of the 20 CCGs with the highest coverage.

Kar said that this was to be expected, given that some areas were further ahead than others when NHS England issued its guidance. “Bearing in mind that some areas started in April while others started much earlier, the current levels are not unexpected,” he said. “All of the data are pointing the right way: the number of CCGs below the minimum commitment of 20% continues to shrink, which is good news.

“Areas that are leading the way with the rollout should be an example to others. They can help make the process for uptake smoother so that patients can benefit quicker.”

Kar said he hoped that patients would have access to a wider range of new diabetes technologies in the coming years. The long term plan pledged to roll out more in the future, including continuous glucose monitoring for all pregnant women with type 1 diabetes by 2020-21.

“The diabetes team has been harnessing the power of technology across its areas of work for a number of years, and this is something we will continue to do,” he said.

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