Endocrine Abstracts

Continuous glucose monitoring (CGM) allows continuous real-time blood glucose monitoring and informs users of blood glucose trend data and alarms which warn users of high or low blood glucose readings. Current evidence suggests that CGM can reduce episodes of hypoglycaemia in conditions such as congenital hyperinsulinism and metabolic disorders. Hypoglycaemia secondary to these conditions is serious with almost 50% of children demonstrating neurological impairments as a result of recurrent hypoglycaemic events. The current standard of care for these patients are frequent observations and intermittent fingerpick testing. However, this provides no details of trends with no alarm settings and carers risks missing hypoglycaemia between infrequent tests. CGM devices are currently only recommended by the National Institute of Clinical Excellence (NICE) for patients with Type 1 diabetes as most studies have targeted a reduction in HbA1C rather than hypoglycaemia episodes as a clinical end point. While there is clear guidance from NICE for patients with diabetes with regards to whom CGM should be prescribed, funding pathways for CGM are complex. Access has been reported to be highly variable determined locally by Clinical Commissioning Groups (CCGs), some require individual funding applications (IFAs) whereas others have local policies on who should access CGM devices⁴. The British Society of Paediatric Endocrinology and Diabetes (BSPED) conducted a national survey in England, Wales, Scotland and Northern Ireland between 1st January to 30th February 2021 which included all of the 22-specialist paediatric endocrine centres. The results of the national survey found that a significant proportion of teams were struggling to access funding for CGM, and funding streams were highly variable leading to health inequalities.BSPED urges for a national mandate for CGM access to be considered as a priority to address such inequalities that currently exclude patients without the diagnosis of diabetes from accessing CGM easily. BSPED request that the scope and funding for CGM be widened to include patients without diabetes who suffer from severe and recurrent hypoglycaemia.