Diabetic testing devices to be rolled out across the county

Diabetic patients across Lancashire and South Cumbria will have access to glucose monitoring devices - if they meet new standard criteria.
Diabetic patients across Lancashire and South Cumbria will have access to glucose monitoring devices - if they meet new standard criteria.

Diabetic patients across Lancashire and South Cumbria are to get the same access to devices which monitor their blood sugar levels – wherever they live in the region.

The Joint Committee of Clinical Commissioning Groups (JCCCG) approved a plan to standardise the criteria for prescribing the gadgets.

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Continuous glucose monitoring devices work by inserting a small sensor under the surface of the skin. They can include alarms to alert patients to abnormal blood sugar levels.

Recently-developed flash glucose monitoring kits allow patients to swipe a reader over the sensor to see the trend in their levels over time.

Criteria for being given access to an alarmed continuous monitoring device include the inability to recognise the symptoms of low blood sugar (or hypoglycaemia), more than one unexplained hypoglycaemic attack or an “extreme fear” of hypoglycaemia.

But one GP on the committee said the latter condition was an unhelpful “loophole” for doctors like him.

“How would you subjectively be able to prove [extreme fear]?” Dr. Adam Janjua, vice chair of Fylde and Wyre CCG, asked. “I think that puts clinicians in a very vulnerable state, because fear of litigation will usually make you agree to something.”

Elaine Johnston, chair of the Commissioning, Policy and Implementation Group, said it was difficult to make policy "absolutely objective", but added: “They are patients who would be eligible...because they are monitoring a number of times a day - so going through box after box of finger prick devices, because of their anxiety about their condition.”

Criteria for a flash monitoring device includes a requirement that it would reduce finger prick testing by more than 8 tests per day or where the patient is a child for whom conventional blood testing is not possible.

Patients given either type of device have to agree to undergo the necessary training in how it works and also to use it for minimum periods of time.

The committee also gave the go-ahead to a standardised policy for prescribing insulin pumps which deliver a continuous infusion.

Dr. Amanda Doyle, Integrated Care System lead for the region, said: “The more rigorous we are around policies for things which have no evidence of clinical benefit, the more we are in a position to invest in the things where there is clear evidence of medical benefit - but which have big cost implications.”

Prescribing of the devices is set to begin in mid-November.