Approval of Flash Glucose Monitor (Freestyle Libre®)

Flash Glucose Monitor (Freestyle Libre®) has now been approved by NHS Wirral Clinical Commissioning Group for patients with Type 1 diabetes in the following circumstances.

To note, Freestyle Libre® should only be used for people with type 1 diabetes, >4 years of age, attending specialist care using multiple daily injections or insulin pump therapy, who have been assessed by the specialist clinician (including specialist diabetes nurses in hospital or community specialist diabetes service) and deemed to meet one or more of the following:

1. Patients / carers who undertake intensive blood glucose monitoring ≥ 8 times daily including those on insulin pump.
2. Those who meet the current NICE criteria for insulin pump therapy (and this would be considered a viable option for them) where a successful trial of FreeStyle Libre® may avoid the need for pump therapy.
3. Those who have recently developed impaired awareness of hypoglycaemia (potentially short-term use). However, it is noted that for persistent hypoglycaemia unawareness, NICE recommend continuous glucose monitoring with alarms and Freestyle Libre® does not currently have that function.
4. Frequent hospital admissions (>2 per year) with diabetic ketoacidosis (DKA) or hypoglycaemia but only where use of Freestyle Libre® would be likely to prevent this in future.
5. Those who require third parties to carry out monitoring and where conventional blood testing is not possible.
   Patients must be initially assessed to ensure they fulfill the criteria for a trial of Freestyle Libre® and assessed after the trial period that they fulfill the continuation criteria, with both these assessments being carried out by a specialist diabetes service.