NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Freestyle Libre for Patients with Diabetes

Following the decision to introduce the interstitial glucose monitoring system Freestyle Libre, the Diabetes managed Clinical Network have agreed an implementation plan.

 

This clinically prioritised approach means that patients who can benefit most will be targeted first including those with impaired hypoglycaemic awareness or who are either pregnant or pre pregnancy. All other patients will be considered at their next routine appointment. This includes patients who are currently self-funding.

 

GPs should not prescribe this product for any patient who has not been assessed as being suitable by the specialist teams.

The process for implementation is:

  • Patients will be identified from SCI Diabetes by the diabetes centres and written to directly by the MCN. The first group have already been contacted.
  • The MCN will co-ordinate the education sessions which will be run at various sites across the health board and started on the 26th June.
  • Patients are asked to complete the on-line Freestyle Libre Academy module prior to attending an education session. At the end of the session patients will be asked to sign a patient agreement prior to receiving the device.
  • GPs will be contacted by formal letter following the patients attendance at the education session advising to prescribed Freestyle sensors.
  • Patients who are pregnant or pre pregnant will be identified, prescribed and provided education at clinic. Patients identified during routine clinic will be channelled into the MCN co-ordinated education process.
  • A similar process has been established for Children. The paediatric team identified their clinically prioritised group of patients. The process for invitation and education will follow a similar format coordinated by the Diabetes Paediatric team.

 

The criteria are that Libre should be considered for those with type 1 diabetes who are attending secondary care diabetes centres, who are using multiple daily insulin injections (basal bolus) or insulin pump therapy, who have been assessed by the specialist clincian and are deemed to meet one or more of the following:

  1. Patients who undertake intensive monitoring with a miniumum of six tests per day.
  2. Impaired awareness of hypoglycaemia but not those with persistent hypoglycaemia unawreness where continuous glucose monitoring is the required intervention.
  3. Frequent admissions (>2 per year) with DKA or hypoglycaemia.
  4. Those who require a third party to perform monitoring or where dexterity or disablity denote that conventional testing is difficult or impossible.
  5. Those that meet the current NICE criteria for insulin pump therapy where a successful trial of Freestyle Libre may avoid the need for pump therapy.
  6. Women who are planning a pregnancy or are pregnant.

 

Published 2nd July 2018