New Patient Information about supplies for people with diabetes in Jersey & Criteria for support with Flash Glucose Monitoring

Since 20 November 2019, obtaining diabetes supplies from the Diabetes Centre at Overdale is gradually being phased out.

The first time you have a consultation with your GP after this date, they will arrange for you to obtain these supplies (at no cost) from a pharmacy of your choice.

Anyone using Glucomen glucometers, test strips and lancets should contact the Diabetes Nurses on 444547 and arrange with them to switch to a model in stock suitable for their needs.

All GPs have been informed about this new service.

This leaflet Click Here explains the new process for the collection of your diabetes supplies from your chosen pharmacy.

The criteria for support with Flash Glucose Monitoring is:

1. People with Type 1 diabetes (OR with any form of diabetes on hemodialysis and on insulin treatment) who are clinically indicated as requiring intensive glucose monitoring 8 times per day or more, as demonstrated on a meter download/ review over the past 3 months.

2. Pregnant women with Type 1 Diabetes, to be 12 months in total inclusive of post-delivery period.

3. People with diabetes associated with cystic fibrosis on insulin treatment.

4. People with Type 1 diabetes unable to routinely self-monitor blood glucose due to disability who require carers to support glucose monitoring and insulin management.

5. People with Type 1 diabetes for whom the specialist diabetes MDT determines have occupational (e.g. working in insufficiently hygienic conditions to safely facilitate finger-prick testing) or psychosocial circumstances that warrant a 6-month trial of FreeStyle Libre® with appropriate adjunct support.

6. Previous users of Flash Glucose Monitors with Type 1 diabetes (through self or other funding) where the Specialist Diabetes Team is satisfied that their clinical history suggests that they would have satisfied one or more of these criteria prior to them commencing use of Flash Glucose Monitoring had these criteria been in place earlier AND is satisfied that there has been a clear clinical benefit with the intervention.

7. For those with Type 1 diabetes and recurrent severe hypoglycaemia or impaired awareness of hypoglycaemia, NICE suggests that Continuous Glucose Monitoring with an alarm is the standard. Other evidence-based alternatives with NICE guidance or NICE TA support are pump therapy, psychological support, structured education, islet transplantation and whole pancreas transplantation. However, if the person with diabetes and their clinician consider that a Flash Glucose Monitoring system would be more appropriate for the individual’s specific situation, then this can be considered.

Necessary Requirements

1. Patients should attend for education on Flash Glucose Monitoring with the Specialist Diabetes Service.

2. For those where the indication for Flash Glucose Monitoring initiation is intensive glucose monitoring of 8 times per day or more, the patient should be in agreement to scan glucose levels no less than an average of 8 times per day (minimum 30 day average). For those with other indications for Flash Glucose Monitoring initiation, the patient should be in agreement to use the sensor >70% of the time.

3. The patient should be in agreement to regular reviews with the Specialist Diabetes Service as advised.

4. The patient should be in agreement that continuing support for long-term use of Flash Glucose Monitoring post the initial 6 months would be contingent upon evidence of agreeing with the above conditions AND that on-going use of the Flash Glucose Monitoring is demonstrably improving an individual’s diabetes self-management- for example improvement of HbA1c or Time In Range, improvement in symptoms such as Diabetic Ketoacidosis or hypoglycaemia or improvement in psycho-social wellbeing.