Continuous Glucose Monitoring - Type 2 Diabetes (Adults)

In line with NICE NG28 (Type 2 diabetes in adults: management – Continuous Glucose Monitoring – last updated June 2022), the following CGM devices have been recommended by APC for use in adult patients with type 2 diabetes:

GREEN (PREFERRED) traffic light status

• Freestyle Libre 2 PLUS and Dexcom ONE PLUS

GREEN traffic light status

• Freestyle Libre 2 and Dexcom ONE

The above CGM for this indication will be considered, in the following circumstances when people living with type 2 diabetes:

1. are on multiple daily insulin injections (> 1x a day insulin dose) if any of the following apply:
   • they have recurrent hypoglycaemia or severe hypoglycaemia.
   • they have impaired hypoglycaemia awareness (Gold/Clarke score ≥4)
   • they have a condition or disability (including a learning disability or cognitive impairment) that means they cannot self-monitor their blood glucose by capillary blood glucose monitoring but could use an isCGM device (or have it scanned for them)
   •  they would otherwise be advised to self-measure at least 8 times a day
2. are treated with insulin and who would otherwise need help from a care worker or healthcare professional to monitor their blood glucose.
3. have learning disabilities and are on the learning disability register and using insulin. (as per previous Surrey Guidance)
4. are pregnant and having difficulty managing their glucose levels.

A NON-FORMULARY traffic light status has been agreed for the following CGM

• Dexcom G6
• Dexcom G7
• GlucoRx Aidex
• Medtronic Guardian
• Freestyle Libre 3