By now, you have heard that the continuous glucose monitoring “button” (Freestyle Libre) has finally been put on the NDSS. It was in the news and current affairs a few weeks ago with an interview of some politician to get their 5 minute of fame. You may even have a few patients come in asking for details. Of course, when you delve into the announcement a bit, you realise that it was a re hatching of some old news. So, what was announced? How does that affect our patients in primary care?
We reviewed the availability of a number of CGM devices under the NDSS about 12 months ago here. The Dexcom G5 Mobile and Medtronic Guardian Connect were the only stand-alone devices that did not have to be part of an insulin pump set up. The more user friendly, Freestyle Libre, was not included in the list of devices subsidised under the NDSS. The freestyle libre button is more relevant to our patients in primary care. Of course, we discussed how wonderful that the devices were now available at least in patients with type 1 diabetes but when you read the fine print, they were free but not freely available. There were so many restrictions attached to it that only a small number of patients actually qualify. The new announcement that the Freestyle libre is now on that list but has the same onerous restrictions place on them.
- Still only for type 1 diabetes under 21 years old
- If the Type 1 is >21, they have to be on a health care or pension card
- They can be used in women who have diabetes who are pregnant or planning pregnancy
These were removed:
- They need to have significant major hypos a
- They need to have hypoglycaemia unawareness
Not a giant step forward for mankind, really. CGM is increasingly becoming an essential tool in primary care when managing patients with type 2 diabetes who are on insulin. We need to get familiar with reading the data produced by the button. See this fortnight’s article on interpreting data from CGM.