NHS England: More people with diabetes set to benefit from blood sugar monitors as NHS roll-out succeeds

NHS England | November 2021 | More people with diabetes set to benefit from blood sugar monitors as NHS roll-out succeeds

Half of NHS Type 1 diabetes patients in England are now benefiting from the use of “life-changing” flash monitors that allow them to check their glucose levels more easily and regularly, paving the way for more people to benefit.

Health service chief executive Amanda Pritchard, patient groups and senior clinicians have welcomed the milestone, showing that the NHS is ahead of target to roll-out the monitors, as the independent health advisory NICE, confirmed it was beginning to consult on expanding access to the convenient and effective kit.

The most recent figures show that around 125,000, or half, of patients living with Type 1 diabetes are now using these monitors to help control their condition.

The insight from the successful roll-out by NHS England has helped to inform the case for potential wider use of these technologies to benefit patients living with Type 1 diabetes, and potentially those living with Type 2 diabetes, as the health service continues to improve care for people with both forms of the condition.

The NHS Long Term Plan included a target to ensure 20 per cent of people with Type 1 diabetes were benefiting from flash monitors by March 2021.

Data for March shows the NHS significantly exceeded that goal, with the actual percentage of those benefiting hitting more than 45 per cent – double the target, with uptake by July hitting half of eligible people.

Eligible patients are currently able to access the monitors on prescription from their local GP or diabetes team, helping them to better manage their blood sugar levels.

The wearable gadgets have a sensor that easily attaches to the back of the arm, allowing patients to check their glucose quickly and easily with a simple one-second scan.

The monitors link to an easy-to-use app on your phone, where patients can access the data gathered by the device.

Unlike conventional blood glucose monitors they allow you to view patterns over time, not only showing current and previous levels but also where they’re headed (Source: NHS England).

More people with diabetes set to benefit from blood sugar monitors as NHS roll-out succeeds

Digital glucose monitors ‘reduce disease burden’ for diabetes patients

Nursing Times | December 2019 | Digital glucose monitors ‘reduce disease burden’ for diabetes patients

A study from the Netherlands aimed to evaluate the benefits of the device in comparison with self-monitoring of blood glucose, it followed more than 1,300 people with type 1 or type 2 diabetes who were using Freestyle Libre  (FSL-FGM )wearable glucose monitors for one year.

A feature in the Nursing Times outlines the positive findings, the data suggest that use of FSL-FGM results in improved well-being and decreased disease burden, as well as improvement of glycemic control. This finding appears to support the ongoing roll out of the devices for type 1 patients in England, which was announced earlier this year (Source: Nursing Times). 

Fokkert Mvan Dijk PEdens M, et al | 2019| Improved well-being and decreased disease burden after 1-year use of flash glucose monitoring (FLARE-NL4) |

 

Abstract

Introduction The FreeStyle Libre is a flash glucose monitoring (FSL-FGM) system. Compared with finger-prick based self-monitoring of blood glucose, FSL-FGM may provide benefits in terms of improved glycemic control and decreased disease burden.

Methods Prospective nationwide registry. Participants with diabetes mellitus (DM) used the FSL-FGM system for a period of 12 months. End points included changes in HbA1c, hypoglycemia, health-related quality of life (12-Item Short Form Health Surveyv2 (SF-12v2) and 3-level version of EuroQol 5D (EQ-5D-3L)), a specifically developed patient-reported outcome measures (PROMs) questionnaire, diabetes-related hospital admission rate and work absenteeism. Measurements were performed at baseline, and after 6 months and 12 months.

Results 1365 persons (55% male) were included. Mean age was 46 (16) years, 77% of participants had type 1 DM, 16% type 2 DM and 7% other forms. HbA1c decreased from 64 mmol/mol to 60  mmol/mol with a difference of −4 mmol/mol. Persons with a baseline HbA1c >70 mmol/mol had the most profound HbA1c decrease: −9 mmol/mol. EQ-5D tariff, EQ-VAS and SF-12v2 mental component score improved. For most, PROMs improved. Work absenteeism rate (/6 months) and diabetes-related hospital admission rate (/year) decreased significantly, from 18.5% to 7.7% and 13.7% to 2.3%, respectively.

Conclusions Real world data demonstrate that use of FSL-FGM results in improved well-being and decreased disease burden, as well as improvement of glycemic control.

The study is available from BMJ Open Diabetes Research & Care 

 

Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetes

NIHR | October 2018 | Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetes

Patients with type 2 diabetes who monitor their blood glucose themselves may see small, short-term improvements in blood sugar control. This is not enough to be clinically important or outweigh the costs and personal inconvenience of long-term self-testing, reports an NIHR Signal. 

The signal highlights a systematic review (SR) that identified 24 recent randomised controlled trials involving more than  5000 people with type 2 diabetes to compare self- monitoring with control strategies where people were not taking insulin.

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Self-monitoring gave a 0.3 percentage point reduction in glycated haemoglobin (HbA1c) at six months. This is just below the 0.4% threshold for a meaningful clinical difference in this measure of average 3-month sugar control. People who had poorer blood glucose control at the start saw a greater benefit. However, there was no difference between the self-monitoring and control groups by 12 months.

The review supports current guideline recommendations that self-monitoring is not routinely used for people with type 2 diabetes controlled on diet or tablets (Source: NIHR).

Read the signal in full from NIHR 

Machry, R. V., Rados, D. V., de Gregório, G. R., & Rodrigues, T. C. |2018|  Self-Monitoring Blood Glucose improves glycemic control in Type 2 Diabetes without intensive treatment: a systematic review and meta-analysis|  Diabetes research and clinical practice| 

Abstract

AIMS: Systematic review and meta-analysis to evaluate the effect of Self-Monitoring of Blood Glucose (SMBG) on glycemic control in patients with type 2 Diabetes (T2D).

METHODS: We searched the Medline, Embase, Cochrane Central, and ClinicalTrials.gov databases up to 20 July 2017. We also performed a manual search of abstracts from recent meetings of the American Diabetes Association and the European Association for the Study of Diabetes.

STUDY SELECTION: randomized controlled trials (RCTs) conducted in patients with T2D comparing any kind of SMBG to a control group. Two independent reviewers assessed the eligibility of references. Influence of SMBG in glycated hemoglobin (HbA1c) was aggregated as weighted mean difference accessed by direct random effect meta-analyses at 12, 24 weeks and 1 year. Sub-analyses were made to assess the effects of previous glycemic control and number of tests performed.

RESULTS: SMBG was associated with a reduction of HbA1c at 12 weeks and 24 weeks, but no difference was found for 1 year. Subgroup analysis including studies with baseline HbA1c greater than 8% showed a higher reduction of HbA1c: -0.83% at 12 weeks, and -0.48%  at 24 weeks, with no difference for 1 year nor for the stratification for number the tests.

CONCLUSION: SMBG seems to lead to a slightly better glycemic control in the short term in patients with T2D. Patients decompensated at baseline appear to have the greatest benefit. PROSPERO register: CRD42016033558.