Low numbers prescribed “game-changing” diabetes technology - IDDT
Concerns have been raised over the low number of people with diabetes who have been prescribed new “game-changing” technology following the results of a nationwide investigation.
The FreeStyle Libre System, which spells the end of finger-pricking for people with either type 1 or type 2 diabetes needing to monitor their blood sugar levels, was made available on the NHS last November, subject to approval by local, Clinical Commissioning Groups (CCGs).
However, results from Freedom of Information requests carried out by the Charity the InDependent Diabetes Trust (IDDT) show just 30 out of the 144 CCGs who responded have prescribed the system to just 174 people.
In response to a question on which criteria decisions about prescribing the FreeStyle Libre system are made, 23 CCGs failed to provide any data.
These figures are at odds with stats provided by Diabetes UK which show 9,690 across Britain have been prescribed the technology since November, which is still a low proportion representing less than 2 per cent of the 500,000 eligible people.
In the IDDT’s investigation, just 27 CCGs adhered to either local or regional guidelines or both. A further 14 followed advice from the Regional Medicines Optimisation Committee (RMOC) and only one CCG based their decision on NICE guidelines.
The flash glucose system automatically reads glucose levels through a sensor, approximately the size of a £2 coin, worn on the back of the upper arm for up to 14 days, eliminating the need for routine finger pricks and user calibration.
It is designed to change how people with diabetes measure their glucose levels and ultimately help them achieve better health outcomes.
Two clinical trials and real-world evidence from more than 50,000 users worldwide show that people who use the FreeStyle Libre system scan their glucose levels an average of at least 15 times per day. In real-world use, higher rates of scanning to self-monitor glucose were found to be strongly associated with improved blood glucose levels and potentially reducing long-term complications.
Philip Ramsden, of Gawcott, Buckinghamshire, has Type 1 diabetes.
The 74-year-old was informed about the Freestyle Libre system by a friend whose 15-year-old granddaughter was trialing it. He continued to fund it privately after his attempts to have it prescribed by Buckinghamshire CCG failed. However, the mounting cost of using the equipment resulted in him having to give it up.
He said: “My quality of life improved, the ease of using the system was remarkable. My wife could simply scan my arm whilst driving and towing a caravan, preventing the need to carry out the difficult task of finding somewhere to pull over to prick my finger. Being able to anticipate the rise and fall of blood sugar levels at ease regularly enabled me to do something about it straight away rather than waiting until dangerous levels were reached.”
After consistently using FreeStyle Libre for four months the physiological benefits of its use were evident, with Philip noticing a reduction to his average blood glucose levels (HbA1c) and body mass index (BMI).
He added: “Initially I was spending £100 per month on sensors, which are used instead of test strips, but had to cut down to £35 per month – I don’t want to be spending all this money.
“Now I shall be increasing my use of blood testing strips from 5/6 to 10/12 per 24 hours for close control, so this will probably cost the NHS more than supplying the Abbott.
“I think the NHS are a little bit blinkered and should review individual cases, especially for those with Type 1 diabetes. The measurable cost of the complications that can arise in later life as a result of diabetes need to be considered.
“A friend of mine, who was diagnosed with Type 1 in his 20s recently had to have a leg amputated, possibly because he was not testing enough earlier in his life. If they don’t provide people, especially youngsters, with these facilities it will affect them in later life"
Martin Hirst, IDDT Chief Executive, said: “The results show a postcode lottery clearly exists in the prescribing of the FreeStyle Libre system.
“What is disappointing is the number of CCGs who fail to even recommend this pioneering technology which has the ability to fundamentally change the management of diabetes and improve the immediate and long-term healthcare of those who require its use.
“The FreeStyle Libre clearly improves management of diabetes in many areas of life. It is a substantial step forward in diabetes management but further improvements need to be made.”
The InDependent Diabetes Trust is a Northampton-based charity providing vital independent support for people with diabetes, their parents and carers.
The Charity formed in 1994 to fight for choice of treatment for all. It now provides a free, confidential helpline and has published many helpful publications. The Trust campaigns and lobbies the Government and professional organisations on behalf of its members.
There are four million people who have been diagnosed with diabetes in the UK. By 2025, it is estimated that in the UK five million people will have diabetes. In excess of 800,000 people remain undiagnosed with Type 2 diabetes.