Dr Kevin Fernando Surveys NICE’s 2022 Guidance on Continuous Glucose Monitoring, Which Experts Analysed at Guidelines Live 2022
On 31 March 2022, NICE issued updated diabetes guidelines that recommend wider access to intermittently scanned (or ‘flash’) and real-time continuous glucose monitoring (CGM) for people living with type 1 and type 2 diabetes.1–3
The updated guidelines state that clinicians should offer adults with type 1 diabetes a choice of real-time or flash CGM based on their individual preferences and needs, as well as on the characteristics and functionalities of the devices available.1
Flash CGM should also be offered to adults with type 2 diabetes if they are on multiple daily insulin injections and they have recurrent or severe hypoglycaemia, impaired hypoglycaemia awareness, or a condition or disability that precludes self-monitoring of blood glucose by traditional capillary blood glucose monitoring.2 Clinicians can also consider real-time CGM for these individuals if it is available at a similar or lower cost.2
Importantly, the guidelines state that CGM should be provided by a team with expertise in its use to support people self-managing their diabetes.1–3 This will necessitate training for many clinicians working in primary care, where familiarity with the devices and software available, as well as concepts such as ‘time in range’, may be limited.
The updated guidance represents a paradigm shift in the management of diabetes; however, NICE issues a reminder that stark inequalities persist in access to diabetes technologies,1–3 which commissioners, providers, and healthcare professionals must address in a meaningful way.
Primary care diabetes experts discussed a number of topics in the Diabetes Stream at Guidelines Live 2022, including how to implement these far-reaching guidelines and interpret CGM data in primary care. To access resources and presentations related to Guidelines Live 2022, click here. You can also view our Guidelines Live 2022 special companion editions of Guidelines and Guidelines in Practice, produced to provide further information on sessions covered in the main agenda.
Guidelines Live is a must-attend live event focussed on essential guidance-related continuing professional development (CPD). Developed by specialist GPs and GP appraisers, Guidelines Live 2023 will feature 12 clinical streams of educational sessions on the latest clinical guidance for the whole primary care team, including GPs, nurses, and pharmacists. To dedicate time to your continuing professional development, book now for Guidelines Live 2023 on 21 and 22 November at ExCeL London. Guidelines Live is an educational event made possible by sponsorship from organisations including pharmaceutical companies. Sponsors have had no input into the agenda of the meeting unless through sponsored session(s) as indicated on the main programme.
This article was originally published in June 2022 in anticipation of Guidelines Live 2022