The use of HCL may enable provision of different CGM options. We agree that, provided accuracy standards are met, cost-effectiveness needs to be considered, and therefore encourage choice based on clinical need, with selection of the lowest cost device that meets an individual’s specific requirements. It is sensible that the lowest cost option should be the default choice, but where this does not meet an individual’s requirements an alternative should be available. There are certain groups with a clinical need for functions which are only available on specific CGM options in certain HCL systems.
These groups include, but are not limited to, individuals with type 1 diabetes who require:
1. A share and follow function for family members or carers to track glucose levels and receive alerts. For example:
- Children whose parents need to track glucose levels and receive alerts while the children are at nursery or school.
- Vulnerable adults who rely on carers or family members to track their glucose levels and receive alerts remotely.
2. Predictive low glucose alerts
- These alerts may be essential for those experiencing problematic hypoglycaemia.
3. Individuals who have personal preference based on clinical need (for example a skin reaction to a certain sensor, preference to wear the sensor on a non-arm site or requirement for direct to watch features to ensure safety with specific activities).
In all the above circumstances, a clinical decision from a specialist team will be required to support the use of the desired CGM. A mechanism for funding from ICBs must, however, be established to support appropriate choice via national procurement frameworks.
Diabetes Technology Network (DTN) UK Committee
