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Practice Guidelines

Continuous glucose monitoring for adults and children with diabetes: summary of updated NICE guidance

BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2418 (Published 26 October 2022) Cite this as: BMJ 2022;379:o2418
  1. Caroline Mulvihill, technical adviser1,
  2. Augustin Brooks, consultant physician diabetes2,
  3. Neel Basudev, general practitioner3,
  4. Paul Lincoln, committee chair, independent public health consultant
  1. 1National Institute for Health and Care Excellence (NICE), Manchester, M1 4BT, UK
  2. 2University Hospitals Dorset, Royal Bournemouth Hospital, Bournemouth BH7 7DW, UK
  3. 3Springfield Medical Centre, London SW8 2SH
  1. Correspondence to: C Mulvihill, National Institute for Health and Care Excellence, Centre for Guidelines, London E20 1JQ UK caroline.mulvihill{at}nice.org.uk

What you need to know

  • The guideline update recommends real-time continuous glucose monitoring (CGM) and intermittently scanned CGM to a broader group of people than in previous recommendations, offering all people with type 1 diabetes access to this technology

  • New recommendations for intermittently scanned CGM have been made aimed at a defined group of adults with type 2 diabetes who use insulin to manage their diabetes, particularly those who have recurrent or severe hypoglycaemia, impaired hypoglycaemia awareness, or a condition or disability that means they cannot self monitor their blood glucose levels and require input from carers

  • The new guidance from NICE is likely to challenge short term funding from providers for glucose sensors, but cost effectiveness analyses within the guidance suggest that there are long term benefits to be gained from sensor use for patients with diabetes

Until this year, the National Institute for Health and Care Excellence (NICE) had recommended technology for continuous glucose monitoring for adults and children with type 1 diabetes in only a limited and defined population to ensure cost effectiveness, with capillary blood glucose fingerprick testing being the standard of care for most people with type 1 diabetes. New guidelines now recommend continuous glucose monitoring (CGM) should be offered to all adults and children living with type 1 diabetes. NICE has also recommended extending the use of intermittently scanned CGM (commonly referred to as “flash”) to adults with type 2 diabetes who take insulin therapy in certain circumstances where they meet guidance criteria.

This article summarises these updated recommendations, published on 31 March 2022, referring to NICE guidance for type 1 diabetes in adults,1 diabetes (type 1 and type 2) in children and young people,2 and type 2 diabetes in adults.3

Recommendations

NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of …

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