What?
In a landmark decision from NICE (the National Institute for Health and Care Excellence), all patients in the UK with Type 1 Diabetes who are using insulin are to be offered continuous real-time glucose monitoring devices to check their blood sugar (blood glucose) levels. Additionally, flash monitoring will be offered to all such patients, and around 193,000 people with type 2 diabetes who use insulin as part of their medication regime.
Glucose monitoring sensors partly replace traditional finger-prick glucose monitoring with a small sensor that is pinned onto the skin to take glucose readings. They are split into two forms:
- Continuous glucose monitoring: the sensor takes continuous readings and uploads blood glucose levels to a mobile device via Bluetooth. These are graphed and show blood glucose trends throughout the day
- Flash monitoring: an electronic reading device is taped onto a sensor worn on the body and takes a ‘flash’ reading. This might be before a meal to dose insulin, or to check if you are hypo- or hyperglycaemic.
Why?
These sensors allow patients to take glucose readings without the need to continuously prick the skin and take a small drop of blood to test blood glucose levels throughout the day. It can also allow real-time monitoring of glucose levels in the body to help fine-tune insulin doses.
There is evidence to show that the use of an implantable monitoring device, that allows patients to quickly and easily take readings, can improve long-term blood glucose control. This is vital to prevent long-term damage to organs caused by high blood glucose levels. Examples include diabetes-related diseases of eyesight, blood vessels, kidneys and the nervous system.
NICE, the body responsible for the recommendation of medication and medical devices in the UK, has taken heed of this evidence and approved their prescription in the NHS – now on a much wider basis.
How (does it affect me)?
If you have diabetes and you use insulin as part of your treatment regime, this news has a massive positive effect on your healthcare. Patients with Type 1 Diabetes will have access to both continuous and flash monitoring, and at present those with Type 2 Diabetes will have access to flash monitoring only.
These sensors remove the often uncomfortable and sometimes painful ritual of pricking your finger multiple times a day to test blood glucose. Such sensor devices have been prescribed in the NHS for a few years, but previously had been restricted only to patients who met special criteria.
Flash monitoring is a useful tool to quickly and painlessly check blood glucose throughout the day, and therefore allows patients to achieve ‘tighter’ diabetes control. The sensors of both flash and continuous glucose monitors can be enabled to deliver alerts if blood glucose is heading too high or too low.
This allows the patient to take immediate action either through delivery of insulin to bring sugar levels down, or a quick hit of sugar to bring their levels up. For many, this will help remove the pre-bedtime anxiety around experiencing a ‘hypo’ (low blood glucose) whilst asleep.
An even more exciting prospect is coupling a continuous glucose monitoring device with an insulin pump to make an ‘artificial pancreas’. In patients with Type 1 Diabetes, the pancreas does not produce insulin to lower blood glucose levels. Certain patients (not all, yet) can use an insulin pump to manually (bolus doses) and automatically (basal doses) deliver insulin through the skin at set times and doses throughout the day.
Theoretically, if these two devices are linked, the sensor will tell the pump the body needs insulin, and the pump will automatically deliver a dose via the artificial pancreas. This is a medical innovation in its early stages, but it has the potential to further revolutionise diabetes care.
There are a few drawbacks however. The sensors are still not quite as accurate as finger prick blood testing, and patients should double-check a sensor reading that seems too high or low. Some may not like wearing a sensor at all times, and may not wish to advertise that they have diabetes. You can find out more in-depth information about these sensors on the Diabetes UK website.
If you have diabetes in the UK, you may want to read the myHSN guide to getting better diabetes care. This will arm you with tactics to improve your glucose control and see the right people in order to get the best care. Additionally, with the above news, it’s a good idea to speak to your GP, diabetes consultant or specialist nurse as soon as possible to enquire about getting one of these devices. They should be offered to the groups mentioned above and they might just change your life.
Painless and accurate monitoring of glucose, and even automatic insulin delivery are tantalising prospects for those with diabetes. Perhaps one day we may even look back on diabetes as part of medical history!
As always, best wishes from myHSN
