Abbott FreeStyle Libre ® Flash Glucose Monitoring System: April 2019 update

On 7th March 2019 NHS England announced the national arrangements for funding and criteria for the use of Freestyle Libre® Flash Glucose Monitoring. This can be found on the NHS England website following the link below:

https://www.england.nhs.uk/publication/flash-glucose-monitoring-national-arrangements-for-funding-of-relevant-diabetes-patients/

NHS BaNES, Swindon and Wiltshire CCGs continue to work with local hospital diabetes teams to support the introduction of FreeStyle Libre® from 1 April 2019 in line with the new NHSE arrangements.

 

Please see the following information about how to access FreeStyle Libre® locally on the NHS:

1. People with type 1 diabetes who are currently receiving FreeStyle Libre® from their hospital specialist/ Diabetes Specialist Nurse:

Your specialist will be writing to you and your GP to let the GP know that they can now take over the prescribing of your FreeStyle Libre® sensors. The specialist will advise what you should do with any current hospital-issued prescriptions for FreeStyle Libre® that you may have.

Patients will receive multiples of 1 month prescriptions each for 2 sensors from their GP.

The specialist team will continue to review the treatment aims* every 6-12 months and continued NHS supply of the Freestyle Libre® Glucose Monitoring System is dependent on achievement of the treatment aims agreed.

Community pharmacists have also been alerted to the change in provision of Freestyle Libre® sensors locally in order to reduce any problems with getting hold of them.

2. People with diabetes that are interested in starting to use the FreeStyle Libre® system:

Freestyle Libre® cannot be initiated by your GP. You should discuss your eligibility for FreeStyle Libre® at your next routine appointment with your specialist. Your specialist will assess your eligibility and circumstances and will advise whether you are eligible and if so, will ensure that you receive the NHS approved training about the use of FreeStyle Libre.® The training will maximise the benefits out of using the system. The specialist team will jointly agree aims* for you in terms of using FreeStyle Libre® to manage your diabetes. These aims will be reviewed every 6-12 months and continued NHS supply of the Freestyle Libre® Glucose Monitoring System is dependent on achievement of the treatment aims agreed.

3. People with diabetes that are currently self-funding FreeStyle Libre®:

As per the advice above for people who are interested in starting to use FreeStyle Libre®, eligibility can be discussed at your next routine appointment with your specialist who will assess your eligibility and circumstances and if eligible, will ensure that you receive the NHS approved training about the use of FreeStyle Libre.® The training will maximise the benefits out of using the system. The specialist team will jointly agree aims and review them every 6-12 months, as above.

*NOTE: Theses aims do not apply to people who are using Freestyle Libre® due to not having mental (e.g. learning disabilities) or physical capacity (e.g. manual dexterity problems which require a carer to do finger prick testing on their behalf) to undertake blood glucose monitoring.

Information about FreeStyle Libre®

The FreeStyle Libre ® Flash Glucose Monitor has two parts:

1. A sensor that is attached to the surface of your skin that includes a small needle-like attachment that sits just underneath the skin and measures glucose levels.

2. A wireless monitoring device that you pass over the sensor to display your glucose level. Each time you pass the monitoring device over the sensor, glucose level readings for the last eight hours will be transferred to the device. The Flash Glucose Monitoring device also comes with software so you can analyse your results and see patterns in your glucose levels.[1]

Note that the sensors need to be replaced every 14 days.

The sensor does not measure your blood glucose level. Instead, it measures the amount of glucose in the fluid that surrounds your body cells (called “interstitial fluid”).

Glucose levels in the interstitial fluid can lag-behind glucose levels in your blood by up to 5 minutes. This lag time is longest if your blood glucose level is changing rapidly, e.g. after eating or if you are exercising. For this reason, you need to do a blood glucose check (finger prick) if you’re thinking of changing your treatment (e.g. taking more insulin or treating an episode of low blood sugar).[1]

FreeStyle Libre® does not completely remove the need to do finger prick testing. Blood glucose finger prick testing is required in some circumstances e.g. during times of rapidly changing glucose levels when interstitial fluid glucose levels (measured by Freestyle Libre® Glucose Monitoring System) may not accurately reflect blood glucose levels, or if hypoglycemia or impending hypoglycemia is reported by Freestyle Libre® but your symptoms do not match the system readings.

Freestyle Libre® and test strip use for driving

On 14 February 2019 the DVLA (Driver and Vehicle Licensing Agency) updated their guidelines to make testing requirements simpler for drivers with insulin treated diabetes. This means that drivers may now choose to use finger prick glucose testing and continuous glucose monitoring systems such as FreeStyle Libre® and real-time continuous glucose monitoring for the purposes of driving.

The DVLA guidance states that users of FreeStyle Libre® must also have finger prick glucose monitors and test strips available when driving.

For full self-monitoring requirements, please contact the DVLA directly or visit their website.

For access to further information, resources, support and trouble-shooting https://www.freestylelibre.co.uk/libre/help.html#

Telephone: 0800 1701177 Abbott Customer Services

 

References

[1] Diabetes UK, “Flash Glucose Monitoring,” [Online]. Available: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing/flash-glucose-monitoring. [Accessed 22nd March 2019].