Can I get a continuous glucose monitor on the NHS?

Are there different ways continuous glucose monitors are provided on the NHS?

Yes, there are two ways CGMs are provided on the NHS.

One of these ways is through what’s called procurement. It means that you access the CGM through your hospital-based clinic or Diabetes Healthcare Team. There is a choice available, including CGMs that have predictive alerts or can be used with pumps.

The other way is through a prescription from your GP which you collect from a pharmacy. There is a limited choice of this type of CGM. You can get either the Dexcom One, Libre 2 or GlucoRx aidex (although there have been very few trials for GlucoRx aidex with people with type 1 diabetes, so there is little evidence for its accuracy).

Procurement

This section covers CGM that are available through your hospital-based clinic or Diabetes Healthcare Team.

England and Wales

If you have type 1 diabetes and live in England and Wales you are entitled to glucose sensing, which includes CGM prescribed by your GP, CGM procured through your hospital or clinic, or flash glucose monitoring if you don’t have a compatible phone to use with Libre 2.

National Institute for Health and Care Excellence (NICE) guidance says that all children with type 1 should be offered CGM. Everyone over four years old into adulthood should be offered a choice of CGM or flash. NICE recommends that children should be offered CGM first, and only be offered flash if they have a strong preference for it.

However, your Diabetes Healthcare Team will still need to make a clinical judgement taking into consideration the recommendations by NICE, their professional opinion and what you need and want to use.

They’ll consider several factors, including the accuracy of the device, how it impacts your work or school life or if you have anxiety about hypoglycaemia.

If your Diabetes Healthcare Team think all options of prescribable CGM will meet your needs and you don’t have a preference, then the guidance recommends they offer the device with the lowest cost.

If your clinic won’t offer you sensing, talk to them about how you think it will help. If you can show that you can make good use of the data you should be given an opportunity to try it.

If you have type 1 diabetes and you are pregnant, you should be offered CGM.

Read our information on accessing CGM and flash on the NHS.

Scotland

In Scotland advanced CGM is not widely available on the NHS, but anyone with type 1 diabetes who uses multiple daily injections or a pump, and is actively engaged in managing their type 1, is eligible to access prescribable CGM such as Dexcom One or Libre 2 through the NHS.

The current guidance only states that all pregnant women with type 1 diabetes in Scotland should be offered a CGM. Read the full guidance. 

Northern Ireland

Although guidance states that children and adults are entitled to access CGM on the NHS in Northern Ireland, in practice access to advanced CGM is poor for children, young people and adults.

For children and young people, advanced CGM may be offered if they:

• have frequent severe hypos
• have impaired awareness and inability to recognise symptoms of a hypo
• are new-borns, infants and children of pre-school age
• take part in sports at regional level
• have comorbidities such as anorexia or are on corticosteroids

They may also be offered for short term use to reduce hyperglycaemia.

For adults, CGM may be offered if:

• you have more than 1 annual unpreventable severe hypo
• you have a complete loss of hypo awareness
• you have more than two asymptomatic hypos per week causing problems with daily activities
• you have extreme fear of hypos
• you have an HbA1c over 75mmols which persists despite carrying out 10 finger prick measurements per day

However, prescribable CGM such as Dexcom One and Libre 2 is widely available on the NHS in Northern Ireland.

Getting a CGM on prescription

It is now possible to get a CGM on prescription in all four nations in the UK. It may take some time for this to roll out across the UK, so speak to your Diabetes Healthcare Team to see if this is available in your area, and if it isn’t yet, when it will be.

What is JDRF doing to widen access to CGM on the NHS?

One of our main goals at JDRF is to make sure that everyone with type 1 diabetes who wants or needs a CGM is able to get one – for free. Read more about our treatment advocacy work and how you can support us.